Asking for opinions

Ed1937

As most of you know, my wife has been in MC for a little over 2 weeks. One of our daughters visits just about every day, and she tells me her mother cries for a while when she visits because she wants to come home. She doesn't know she's there for the long haul.

Another daughter thinks it might be a good idea to tell her she won't be coming home, so she can focus on settling in. When I first heard that, I told her I didn't think that was a good idea because that would just upset her, and she would probably forget about it in a day or so. The problem is that although she does forget, she also remembers things that I wouldn't think she would. As an example, a few days ago I talked to someone we were very close friends with, but had not had contact for a number of years, She told me she would love to hear my wife's voice again, and maybe if someone were visiting, they could call her so they could visit again. One of our daughters was visiting, and asked her mother if she would like to talk to "Wanda". She said she wasn't feeling well, and she didn't want to talk to anybody. The next day, another daughter visited, and her mother told her that Wanda wanted to talk to her. So clearly she didn't forget about that. I just don't know what she will remember. If this were your spouse, would you tell them that they would be living where she is? My thoughts on this keep changing. Of course my thoughts on keeping her there keep changing too, but I expected that. Should we tell her that is her new home? It would be nice if she focused on settling in.

sandwichone123

Ed, I understand the reasoning behind saying it's just for a while or whatnot, but I think in your wife's case what do you have to lose? She is already upset and not coping well, and if she learns that this is her new home it seems unlikely she will cope less well. Of course, you know her better than I do, but that's my view from here.

As an aside, I love reading your posts because you remind me a lot of my dad, who is of a similar age and often counts himself fortunate. His life has brought good and bad, as all of our lives do, but he sees himself as a lucky man. I was reminded of this reading your post on the cost of memory care.

M1

Ed, for the last two weeks of her hospitalization my partner was told daily that she was going to memory care, but it didn't stick.  Still doesn't stick after two months there, settling in to a new home is just not a concept for her.  Texas is home now, and she alternately thinks she's there and is staying packed up ready to go.  It makes ME so uncomfortable that she won't settle into her room, but there's nothing I can do about it.  So I'm doubtful whether it would make a big difference....but hard to judge from the outside.

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toolbeltexpert

Ed this never gets easy, I might try it once and watch the  response.  And I know what you mean about remembering some odd thing,my dw is the same.

GothicGremlin

I'm not in the same situation - it's my sister who I had to place in memory care, not my spouse, but I had/have similar thought processes.

Peggy did not want to go to memory care at all. She viewed it as punishment, and she promised she'd be good if I didn't send her there. Really, she was petrified, and I felt like the biggest monster on the planet.

The way I got her to accept it was I told her to try it out for awhile. If it was horrible, we'd come up with something else. I told her I'd call or see her everyday until she felt comfortable (and I did).  Thankfully, that worked for us. It took her awhile to settle in - at least a month, probably a little longer than that. Now, she tells me how nice everyone is there. One time she told me she should have moved there sooner (!!!).

The other day we were talking, and she was miffed about something that had happened earlier in the day. She was quite indignant, and said "but I've lived here for years and years!" Ummm, well, no, that's not actually true. She's been there since late-October, but I wasn't going to contradict her.

When Peggy asks if she can leave, or when she states that she wants to live on her own again, I always say words to the effect that she needs a lot of care right now, but if there's a cure or an effective treatment, we'll spring her. Sort of the "yes, but not right now" approach.  

Recently, she's been focused on having cats with her, which is a "no". That's been a lot harder to deal with.

dayn2nite2

I think she's getting daily visits and it is impeding her "settling" into the rhythm of daily life at the facility.

Can the daughters lessen the visits, maybe every OTHER day for 2 weeks and then a couple of times a week?

I do not agree with telling her flatly she's never coming home.  Very superficial, the doctor says....when the doctor releases you....not the sledgehammer of "you aren't going home again."

Please stop second-guessing yourself.  She DOES need placement and her placement is appropriate.

Jo C.

This is a tough place to be.  I do not know your dear wife, so I am only giving input based on a general sort of basis and what I learned with my own LOs.  You will know what best to do; trust your gut Ed, you have  very good instincts.

NOTE:  You are in very early days yet, it has only been two weeks. The adaptation period can take six to eight weeks give or take a bit more.  Do you think enough time has passed to make such concrete statements as yet?  Possibly not yet.

Basically, for me, I would take into consideration that causing the least amount of pain and hurt would be paramount; especially at the early two week mark.  I would also take into consideration that her ability to not only grasp concepts and clarity of processing her thoughts and memory may well be variable as they have been.  That she remembered "Wanda," does not mean she will retain other thoughts and concepts or especially process them adequately. She also does not have the old triggers for her behaviors as she did at home where she was once in control and felt no longer having said control.

Sometimes the abilities of processing and some memory retention is better than others. She has, in all probablility, been in better stead in her present setting due to facility structure and routine as well as her increased socialization, her eating well and also getting more exercise walking with her walker which she had  not been able to do at home. She also does not have any of the environmental triggers for her behaviors that she had at home.  She appears to have improved with the change in her setting even though her at-home care was good.

Therefore, it gets to be a toss up. If this were my LO, I would probably, at this point in time, after only two weeks transition let it continue to be a "temporary, until you are better, the doctor says," sort of thing. Give it more time for the adaptation period to progess and be certain that all of the family stays on the same page regarding the approach; that includes no very subtly telling mother anything different which may engender causing issues to not resolve. (They may benefit from some coaching at re-focusing and changing subjects when things go a bit sideways.)

As for thinking of taking her home again; that will be a call only you can make.  However, the improvements may be variable and you may find that they will not stay improved.  All the old triggers she had at home that fueled her behaviors would still be there.  That being said, there is no way to know with certainty what will be the outcome going in either direction. 

Use your best instincts, but personally, not being there, it seems that it is too early to make any profound statements of that being her permanent home.

So hope all will go well; let us know.

J.

harshedbuzz

Your daughter is wrong. Terribly wrong.

Aside from the cruelty of dropping this information in the lap of someone who does have the bandwidth to understand why she's there (anosognosia) or follow a reasoned argument (because her reasoner is broken), it'll only serve to upset her and, by extension, you. Taking away her hope is cruel and unlikely to be effective.

She will settle in time. It is still very early days. 

ladyzetta

Dear Mayor Ed.

I agree it is not a good idea to tell her that this is her new home. Maybe when she understands why she's there would be a better time to tell her that. When I placed my DH we told him that his doctor wanted him there so they could run more test. Then we told him his doctor wanted him there and when he gets his strength back he would be able to go home. 

After a few months he stopped asking these questions. A few times I asked him when he lived and he always gave me an address of a house he lived in when he was a kid. Your wife will settle in, its still new to her. Believe me this is harder on you then it is on her. Please take care of yourself and get some rest. Hugs Zetta 

ElaineD

Can you discuss this with the caretakers in Memory Care, or the Nurse Director?

I think advice from experienced professionals might be useful.

ElaineD

Stuck in the middle

Ed, I don't think I would tell her the placement is permanent.  I think, if someone told me that, I would feel they didn't want me back and had already rented my room.  I would say she's staying until you are able to properly care for her at home.  (It could happen.)

Paris20

Ed, the fact that your wife is in MC means it is highly unlikely that she will remember what your daughter wants to tell her. All it will do is upset her for the moment. I’ve written about my DH’s AD and subsequent stroke. I visit every day but will be cutting down because he cannot recall whether I have been there or not but I remember every detail and it is very stressful. When I leave, I tell him I’ll be back soon or back later. Otherwise he becomes upset. As soon as I’m out the door, he's incapable of remembering anything I said. When my daughter insisted on saying good-bye to Dad before she left for her long trip home, she stopped by for 40 minutes. I arrived less an hour after she left and asked my husband how his visit with our daughter went. He answered, «Oh, was she here?»

Ed1937

Once again, I appreciate the time everyone took to reply. Reading through the posts is making it easier to figure out what would be best in our situation. Thank you. Thank you.

DJnAZ

Ed, you and I placed our wives at the same time and it is interesting seeing the question you presented. I wondered the same thing...should I tell her this is her new home?

I spoke to the head nurse and her advice was not to bring it up. She said it will take time for my wife to accept her new environment. Telling her now this is her permanent home will likely add stress and frustration and definitely not speed up her acceptance.

 I visited her Sunday after not seeing her for two weeks and she keeps her things packed and ready to go. So for now I don't plan to tell her anything.

Davegrant

Ed, 

I read that your first thought was not to tell her that this was her new home and I would agree with that. I would give her more time to adjust. I am always uncomfortable giving advice since I am not in your position at this time. But not telling her seems to make the most sense. My first thoughts are often the best for me unless there is compelling new information for consideration. This is all so hard.

Dave

Joydean

Ed I believe you know the answer and you will do what is right for your dw.

Gig Harbor

My husband has been in for 5 days. The staff say he is settling in well and taking part in activities. I haven’t seen him yet and the plan is that I will call him every afternoon and tell him that I am still in the hospital. I will wait one more week to actually go in and see him. In the evenings he talks about packing to go home but he talked about that too while he was with me. The staff said he is easily directable and they can find other things for him to focus on. I have a feeling that once he sees me he will want to leave. Him being away probably saved our dog. She has been getting sicker and sicker and the vet called and said she could fit her in if we could be There in 30 minutes. We would never have made it if my husband were home. Diagnosis of Addisons Disease and a dose of prednisone and she is so much better.

Ed1937

Gig, it sounds as though you have some positives there. I'm happy about that. 

Sorry about the Addison's disease, but glad the prednisone is working well. Hope she continues to improve.

Sligo177

Ed,

If I were being put into a new setting, I would prefer to think of it as "just trying it out" or "until the doctor says you can be at home safely".  Comforting phrases.  And, I know these must be such tough weeks for you.  You are doing the best for your LO.  I feel my time to do this is coming soon, I dread it but I read your posts and those of others, and feel a bit stronger.  Take care of yourself.