dementia + COVID-19

The Son in Law

My mother-in-law has struggled with worsening dementia for a few years.  She moved to our area to be closer to her daughter about three years ago.  She recently had COVID.  She did recover, but was left with worsened dementia symptoms.  She has been in AL, but they insist that she move to MC now.  She will be insulted, deeply sad, angry and frustrated with this change.  Her daughter is consumed with guilt and I don't know how to help.  I am the caregiver for the caregiver in a way.  Does anyone have any suggestions for how I can support my wife during this incredibly tragic time?

Stuck in the middle

Brain fog is a frequently seen effect of Covid, so your MILs decline is not surprising considering the dual diagnoses.  Unless your wife is somehow at fault for the covid infection, I don't see that she has anything to feel guilty about.  

Moving your MIL isn't an insult to her, it is about keeping her safe and getting her the help she needs.  I don't like hiring people to do some things I used to do, but I'm older now and need the help. It happens to all of us if we live long enough.  

In your place, I would reassure my wife that she was doing the best she can for her mother.

MN Chickadee

Any infection can cause a decline. It's hard to know how all these parts of the body work together, but somehow it is all connected. My mother has a big dip in cognition and function from a basic UTI. I can see how something as big as covid would really cause issues. And yes, even in people without dementia lasting brain fog can be a symptom. As for your MIL, time for therapeutic fibs. Don't tell her it's memory care, don't talk about dementia, don't call the change permanent. Her brain is beyond logical reason and it's time to only give her information and responses that bring comfort. Maybe it's a "rehab facility" the doctor ordered for her to get stronger and then she can return to wherever home is. Maybe there is a problem with the other apartment like no heat or water and she can stay here until it's fixed. When she asks to leave deflect. When the doctor says you are ready or the water is fixed, distract to a treat or activity, rinse and repeat. Eventually she will settle in.

As for your partner who is filled with grief over this - it's a difficult place to be. Moving my mother from her long time home to MC was by far the hardest thing I have ever done. Feeling grief, sadness, and guilt are pretty normal for this point in the journey. I truly felt like my heart was breaking; I was wracked with emotions to the point I had physical symptoms, like my own brain fog, always being cold etc. The stress was immense. So to some degree just let her grieve and work through the emotions. You might gently remind her that she is doing this FOR her mother, not TO her. This disease is what has put her and her mother in this position and none of it is her fault, she is just doing what needs to be done and doing the best to overcome this rotten hand mom was dealt. Giving mom the level of care she needs is a kind and loving thing, and she is just doing her job as a child and legal POA. In the end MC will meet her mom's needs better. In hindsight moving my mom to MC was the best thing we could have done for her, and she has done very well with the higher level of structure and support. But that's hard to see in the moment when you are just starting out. I keenly remember how awful and depressing the notion of MC seemed as we were taking the leap. If it's any help I don't feel that way anymore. She has wonderful staff who care for her and is getting the care she needs. Taking other things off her plate around the house in the mean time may help. Encourage her to do some self care and take time for herself.  One day at a time. 

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harshedbuzz

Guilt is pointless and misplaced here. But I totally understand the pain of the milestone of needing to move into MC.

Best practices in dementia is that care needs dictate placement. Providing less care than is required by the progression of the disease would be negligent and unsafe. I am sure that is not who your wife is.

Having survived COVID with dementia, I am not surprised there has been marked progression of the disease process and loss relative to her previous baseline. This can happen with bone breaks, surgery and other infections.

It's best to create a fiblet, as Victoria suggested, creating a compelling need to move. There is no need to point out that she is going into a higher level of care or that this is a permanent move. You could pull the "redecoration/problem with the HVAC in her unit so you need to stay here while it's taken care of" ploy. My dad sensed he was less steady on his feet, so we sold MC as a temporary rehab ordered by his doctor. 

HB