Adjustment to Nursing Home-Advice

Dawn MB

Hi everyone.  Been absent for awhile dealing with a major decline for my mother with Alzheimers.   We ended up having to take her to a senior behavioral unit at a hospital in order to get her back on medication schedule and begin the transition to a nursing home.   She seemed to be constantly sunsetting and wanting my father to take her "home" and packing the car over and over again.  She wandered away a few times only to have the police bring her home.  She has been back on meds for almost 2 weeks now; Zoloft, Resperedol and Klonopan (sp?).  Yesterday, she was transported to a nursing home. She is one step below memory care because she still knows us and has some sense of reality, but she will be evaluated because she does wander and may still have to go to the locked down memory care unit soon.  My father and I did not visit while she was at the hospital as the Dr. said we are triggers and they needed to get her properly medicated in order to have any chance of a calm visit.  She was an angel for them; Took her meds, showered when it was time and even ate a few hearty meals.  She has been fighting these things for a few months now.  

Yesterday, I went early to the new nursing home and set up her room with pictures, her pillows and blanket.  I came back to visit her once I knew she was all checked in. The conversation was fine for a very short while.  She then began to ask me to take her home.  I held  her had and explained that she needs to stay because she needed to get her meds regulated. and do some therapy on her legs to get them stronger.  I explained softly that it was not safe for her at home.  She went from screaming angry and disowning me (holding up her cane like she would  hit me) to sobbing and then to begging.  She kept saying that she would never do this to her mother and couldn't believe I would leave her like this.  She promised to be good and take her medicine ect... It was probably the worst day of my life.  

I just called the nurses station to see how she was overnight and to see if anyone had been in to evaluate her yet.   The desk nurse said she have someone call me, but in the meantime, mom was right there looking to call me anyway.   So I told her to put mom on and, as suspected, she asked when I was coming to take her home.  I softly explained that I could not because she needed to stay and get her medicines straightened out.   She told me not never talk to her again and that she has no F'ing daughter.  

I know this is the disease and I do not hold any anger over it.  My questions, after all this, to you is should I continue to try and visit her and deal with constant argument?  Or should I stay away and allow her to make the adjustment, if making the adjustment is even possible?  I feel like I should stay away, and tell everyone else too, because it's too painful for everyone.  Maybe when she has progressed deeper into the disease visits will be more positive.   What do you all think?

Thank you in advance,

Dawn

Rick4407

Hello Dawn,  One of the hardest lessons for many of us is to recognize that logic and reasonable explanations are not going to work.  For easily 3-4 years I told my DW several times a day when asked the same "When are we going home?".  It always satisfied her for sometimes a day or two or sometimes just 15 minutes.  Then she would ask again.  She did not know she had asked before or that I had already answered her.  My response was always sympathetic and enthusiastic. 

"Oh yes I am eager to go home too, we are hoping to get things set up for tomorrow" 

You can add whatever variation seems to fit.  They are repairing the plumbing, fumigating, painting, working on the heater, etc.  I always agree and I always say this weekend or tomorrow or whatever you like that is not far away.  

Show sympathy for her feelings and understanding of her concerns but delay until later in the day or whenever!  Good luck,  Rick

Ed1937

Dawn, Rick gave you some good pointers. We never know how long it will take for someone to adjust to the new surroundings. We have one member who cannot visit by himself because his partner goes off the deep end. He has to visit when someone else accompanies him, or his visits are very short for good reason. She has been in a facility for nearly a year now. Most people adjust much quicker, with some adjusting almost immediately. Some facilities might ask for no visitation for a month or more, to give them time to settle in. I'm sorry it's so hard, and I wish someone could tell you what would work, but nobody really knows.

Emily 123

Hi Dawn,

 I don't think you could go wrong with discussing it with the team at the facility & holding off on visits for at least a little bit. If she's been calm and compliant in the hospital she'll hopefully be the same there, which might help her settle in.  As others have posted,  adjustment times vary from person to person, and if needed, finding a fiblet that makes sense to her will help. 

 I think too that you'll have to tailor visits to where she is in her disease-if she's reached the 'out of sight, out of mind' stage it might be easier than if she's able to retain some memory.  If that's the case you can start with very quick visits, or even better, perhaps drop in when she's in a group activity.  That lets you pop out quickly by excusing yourself or when she's distracted. Good luck. 

harshedbuzz

Dawn-

I am so sorry you are going through this.

Many MCFs strongly encourage families to put off their first visit for at least 2 weeks. We went to see dad immediately and had the same exact experience you are not enjoying.

It did get better. It almost always does. Dad settled in within a month which surprised us; he was more challenging than most PWD in most aspects. Things that helped-

Leaning in to the fiblet about dad being there until he was strong enough to come home safely. We didn't discuss his very necessary psychoactive medication management, only physical well-being. Early on, I didn't let my mom visit alone as he had enough with-itness to behave around others. I went with her or my DH did as he was less likely to carry on. I also kept visits in a more public space-- bringing him lunch to have in the dining room, stopping by during an activity or talking in an alcove off the busy atrium. 

If this isn't enough or you feel it's best to take a break, you can still often arrange to observe her during an activity or meal without being seen to confirm that she's OK. For this reason, I wouldn't call of all family visits if there are perhaps people around whom she would still showtime-- they could be your eyes and ears for now. I would be cautious about others (often friends and her siblings) who will take her side and fuel her upset.

HB

Dawn MB

Thank you, everyone. I appreciate all the advice.

Dawn MB

Again, thank you everyone for your advice.  I did go to see my mother after work yesterday.  I took her a bag of her favorite popcorn and a container of watermelon.  She was in a common area with others watching TV when I arrived and proceeded to introduce me to everyone and admitted she didn't remember their names.  She held my hand tight and when when sat off in a corner along, she did tell me how badly she wanted to go home.  I  opened the watermelon and as she tasted it I explained that she needed to stay until she got stronger.  I did talk to her about how everyone was doing and how my dad and her sister missed her.  She kept eating the watermelon and did again tell me she wanted to go home. She was not crazy mad insistent, or sobbing like before.  I just kept saying the same thing about getting stronger.  I talked about a wedding I went to over the weekend and while she was looking at those pictures, I open the popcorn for her.  She started sharing it with everyone in the room and reintroducing me.  We walked the hallway down to her room and looked through the wedding pictures again.   She then said she didn't want me to drive in the dark, and I didn't want to get into how much daylight is left these days.  We walked back to elevator where she hugged me tight and told me to come visit soon.  I was stunned and beyond grateful to have had a calm visit.   It lasted only about 30 minutes, but I will take it!   I think I'll go with my dad this weekend to see her.   Since he's a BIG trigger for her, I think the advice about having someone go with him will be valuable.  Thank you everyone again!