Does MC delay death?

rockfarmerswife

After several of his hospitalizations, by LO was placed in nursing facilities for "rehab".  The last one had him so doped up that he was just breathing, and not much else.  I guess it was good while he was there, because there was a resident who yelled all day and night, and you could hear her as soon as you entered the building (and this was one of the nicer facilities). Once he got home, I weaned him off most of them.  My concern is that if he is not willing to participate in life, would he become sicker and just be "cleaned and fed"?  I used to work in nursing homes and know that there are good staff, but they are often overwhelmed by all that is expected of them.

Ed1937

rockfarmerswife wrote:

 The last one had him so doped up that he was just breathing, and not much else. 

If a nursing home or other facility keeps someone drugged up, they'd better have a good reason for doing so. There are strict laws against that now.

We just don't know how anyone will adapt to a nursing home. Most do fairly well with time. But you have to be concerned with your own health first.

Stuck in the middle

You said elsewhere that he just stares at the TV when he's home.  I don't see how he could be worse off in MC.  If he can't or won't participate in live, we can't make him.

Cynbar

I don't think placement either hastens or delays death, every person is so different. Some PWD do very well in MC, they are early enough in the disease process to participate in and benefit from the socialization and activities. Other PWD are placed late in the process, quite near the end of their journey. I haven't attempted placement, but from the many posts her, it seems that most people do settle in. If anyone is overmedicated, it's time to consult with the staff and question the medication plan. Placement is a difficult decision that sometimes has to be made, either for the caregiver's health and sanity or because the person's needs aren't being met in the community.

Quilting brings calm

You’ve stated in a post from a couple days ago that your husband is physically abusive to  you and that you worry for EMSs safety if they are called.  I think the appropriate question is will NOT putting him in an MC hasten YOUR death, or your sons death. 

You’ve also stated you are a nurse practitioner. I asked in the other post what you would counsel your patients to do if they were being abused.  What would you tell them if they described their situation as you have?  I hope you would tell them to place their spouse. 

rockfarmerswife

Cynbar, my biggest frustration with this whole journey has been getting to talk to the professionals in charge of my husband's care.  While in the nursing homes, only the unlicensed staff ever shared anything, forget the physicians answering questions. While he was hospitalized the last time, the only information I got from a physician was from the GI doctor after an upper endoscopy - I left several messages from the hospitalist asking for updates, but never got a call (and this was during the height of COVID and couldn't go in the hospital to ask questions, plus as a working CG, I couldn't sit at the hospital all day waiting for rounds even if I could have been at DH's bedside).  

Quilting brings calm - DH has only been physically abusive twice (I know, 2 times too many). I wish he would agree to being seen by a physician, but I understand that his lack of insight for any health problems is part of the disease (his teeth are rotting in his head, and his response is "they don't hurt".

Thank you everyone for your support - I'm working on my end of things to be better able to handle this burden, and you help me so very much!

Cynbar

Rock, I agree that it is very difficult to communicate with doctors and nurse practitioners in the hospital or facilities. Interestingly, I have had the opposite problem to yours. My DH has been in a local nursing home for short term rehab. They are totally opposed to giving him his anti-psychotic and sleeping pill. He has been on Zyprexa and now Risperidone for a couple years with generally good effect on his delusions and agitation, but this facility wants no part of it, gave me a long lecture on how anti-psychotics are bad for the elderly. Other facilities have hadn't no problem with it (he has physical issues also which have been cropping up.) I know he's been agitated at times because the staff will sometimes tell me he was up all night. He comes home Tuesday and I have a feeling this will be a nightmare to straighten out. But this goes back to your original post: if placement does become necessary, discuss relevant points like how they use medications before admission. Hopefully they will be upfront re their policies, not all facilities do things the same way.

ElaineD

Dear Rock,

There are both Assisted Living and Memory Care facilities where I live.  I'm in Independent Living.

I don't get to observe the Memory Care, but I have watched several residents move from Independent Living to Assisted Living.  And I have visited AL many times.  MANY of the AL residents are in some stage of Dementia, but not ready for MC.

In all cases the people I have known fairly well, do MUCH BETTER in Assisted Living.  There are many more staff, the population is smaller, and there are many activities all day long.

All my friends are happier in Assisted Living, and I have seen that several who were with me in Independent Living are now physically stronger and healthier looking.  I think my friends were stressed by taking care of their apartment, and became depressed and isolated.

The staff pay close attention to each resident, encourage them out of their rooms, and there are 3 meals a day in the dining room, so each resident has socialization at the meals.

I have only observed the Memory Care residents when some of them come to our wonderful pool (88 degrees and only 4 ft deep).  Each resident had a staff member with them, and the interaction was loving and supportive.  The smiles on their faces when they enter the water is amazing!

Do they live longer in Memory Care?  There is NO research on that topic.  I think there are too many health variables, age variables, and varieties of MC,  etc. that confound any effort to tease out life expectancy.

elained

Stuck in the middle

I suspect that a memory care placement delays the death of the PWDs spouse.  I have no research to prove it.

Gig Harbor

Alzheimer’s causes damage to the brain until it is so significant that the brain is unable to sustain life. From what I have read there is nothing that slows down this process or speeds it up. I don’t think it matters where the person lives.

Marta

In the sense that an exhausted lone caregiver is less able to be proactive and prevent issues that may hasten death, a move to MC might buy some time.

rockfarmerswife

Cynbar - I pray that your journey becomes smoother, and that the medications resume their intended action. I know that many facilities have done the pendulum swing from overmedicating residents to make it easier to "handle" them, but now it has swung too far the other way to "antipsychotics lead to an earlier death".  In the case of the LO and their caregivers, I'm not certain that a peaceful end (even if earlier) is worse than a miserable end.  I truly believe some of DH's acting out is in response to his knowing of his lack of control, loss of memory, etc.  I am working now to try to get him to go see a doctor (his long-time physician retired, and we moved, and it has just been hard to go see someone new), and hopefully this provider will see the big picture and at least give him a mood stabilizer.  I have seen several LO's have a satisfying life when the demon of their emotions can be calmed somewhat.

GA-Mom

My sympathies are with you about your spouse. It's like walking on eggshells when the person becomes violent, even when it's not physical. Just the anger is scary. It's  not knowing what will happen next that keeps you stressed.

I won't go into all the details, but 2 weeks ago I placed my husband in a facility that is memory care only. He is so much happier there. I truly think he had reached a point where he suddenly didn't know who I was and where he was. He has made friends there.

At home, I had a very hard time keeping him entertained. He was wandering half the night in the house, keeping me awake even tho I gave him melatonin. He was rummaging all the time. He was getting into the refrigerator at night. I think in the memory-only facility they are the sole concentration for the staff.  There is no assisted living section. There are activities most of the day. Last week they went out for ice cream. He is joining in the activities where before I could not get him to do anything like that. 

And it's a tremendous relief for me. There is peace in the house. I am cleaning out all the drawers and closets that he made a mess of. I don't have to cater to his needs. Do I miss that person? No. I don't miss the person he became. I do very much  miss the wonderful family man I married so many years ago. But I'm trying to stay busy and even do a little volunteer work. I am fortunate to have support from family and friends.

I hope you are able to make a decision that will bring you peace.