Advice on visiting 'exit-seeking' parent in MC after transitioning from AL (it's complicated)

Sea Jay

As I write it is November 20 and my mother with AD has been, first in a hospital and now currently in acute rehab, since November 10, when she fled the building where she was in AL and took a significant fall in the parking lot. My brother and I have been taking turns staying with her at these facilities so as to provide comfort and ease confusion. She will be discharged on the 22nd and will return to her community but move directly into secured memory care. With the injuries she sustained and so much transition (hospitals and had only moved to this place at the end of September), the increase in her confusion and sundowning is dramatic right now. I'm so concerned about the cold-turkey withdrawal we'll be piling on top by not staying with her (not really an option), and while the facility is supportive of us spending time with her, they recommend keeping our visits to a minimum in frequency and time, until she gets settled, however long that may be. I understand. And they are trained for this. But I feel like this is going to be REALLY hard (for me at least). I want to do what's best for her and have found other people's feedback and experiences very helpful, so if anyone has gone through similar transitions and has any sage advice, do tell. Thank you very much.

M1

Sea jay I'm glad she's going to be in a more secure environment. i think you have to realize that this transition may be harder on you psychologically than on her. It's too bad it's happening the day before Thanksgiving, though not surprising-most facilities want to minimize their censuses during the holidays.

You probably need to just let the staff handle it and communicate with them by telephone the first few days until they think she is ready for a visit. Let the holiday go this year, as far as she's concerned. Keep us posted how it goes.

psg712

Hi Sea Jay, I don't have experience in this transition but am in a similar situation right now ... my mom in AL had to be hospitalized with COVID and another infection. We were already waiting for a memory care room at her facility. Now we are hoping to take her directly from the hospital to memory care. As you have experienced with your mother, there was a huge increase in confusion and some uncharacteristically agitated behavior during the hospital stay. Just hoping that there will be room in memory care quickly, because otherwise we will be forced to send her to a skilled care nursing home first ... doc says she is medically ready for discharge but her strength and cognitive abilities have taken s big step backwards since admission.

Sea Jay

Oh my gosh that IS so similar to what we've experienced and I'm sorry, I hate that anyone has to go through all this. I hope by now a space opened in memory care and that your mom is safely in it. My mom has forgotten all about her fall and hospital stay, thinks she's at college and desperately wants to go home. It's daily heartbreak. I send your mother and you wishes of calm, comfort and ease.

psg712

College! Oh my. Has she gone into memory care yet ? How is it going?

My mom's AL/MC facility health director came to assess her at the hospital and recommended a short term rehab stay for more PT to get her stronger. Then (if that works) she could go to the MC at her old facility. So today it was a scramble to check out the available nearby skilled facilities, agreed on one but then realized that the hospital has not yet resolved the issue of her constipation...it's a long story but the main issue is she has had only one tiny bowel movement in her 16 day hospital stay. I called the case manager and left a voice mail that I will not let them transfer her out until she poops! As a longtime nurse, I am kicking myself for not being more vigilant AND more assertive than just bringing up the subject every few days ... when there are different caregivers every shift, there's little continuity of care and follow through, unless the obnoxious nurse daughter makes a big deal of it (sigh). I'm tired of doing that, but if I don't advocate for her, who will?

Sorry for long story! Thanks for listening.

Lisa Anhaiser

It is a difficult transition, more for us than for them I believe. My mom was in MC for a year before I brought her home but only because my circumstances changes more than hers.
She was not a runner but it didn’t matter if I visited or not, she constantly packed her room and wanted to go to the bus station.
Now that we live together she thinks she’s in the barracks, never married, no kids. She wants to know if she can leave and go home to see her mom… since she’s 83 I don’t think they’ll be there to great her. Sorry I know it’s not a funny thing but you can’t wallow.
I always felt guilty but she never remembered the last time I was there even if it was an hour before. It almost feels like they’re gaslighting you. How is it possible to not know I was just here? It happens.
I laminated notes that were personal but not sensitive info. One side has photos and the other had answers to the most often asked questions.
It’s hard for you but ask questions to figure out where and more importantly when she is living.
Answer the questions that would matter to her at that time in her life and use pictures from that era.
If mom sees pictures of herself or her life beyond her memory she thinks it’s fake. It hurts but it gets easier to manage but doesn’t hurt any less.
Hope this helps a tiny bit.

BonnJeanV

> @"Sea Jay" said:
> As I write it is November 20 and my mother with AD has been, first in a hospital and now currently in acute rehab, since November 10, when she fled the building where she was in AL and took a significant fall in the parking lot. My brother and I have been taking turns staying with her at these facilities so as to provide comfort and ease confusion. She will be discharged on the 22nd and will return to her community but move directly into secured memory care. With the injuries she sustained and so much transition (hospitals and had only moved to this place at the end of September), the increase in her confusion and sundowning is dramatic right now. I'm so concerned about the cold-turkey withdrawal we'll be piling on top by not staying with her (not really an option), and while the facility is supportive of us spending time with her, they recommend keeping our visits to a minimum in frequency and time, until she gets settled, however long that may be. I understand. And they are trained for this. But I feel like this is going to be REALLY hard (for me at least). I want to do what's best for her and have found other people's feedback and experiences very helpful, so if anyone has gone through similar transitions and has any sage advice, do tell. Thank you very much.

I had an experience with my Mom when she was in early stages. She was hospitalized and turned into someone I didn't recognize at all. Hospital induced psychosis and encephalopathy was the medical term. She was hitting and biting and kicking. She had to be restrained. I lost it between being so angry and sobbing. The physician explained things to me and then suggested that I take the time for some respite and remember to just be her daughter and not her caregiver for that period. It was helpful to let the professionals take care of her problems and just visit for short periods. I just reassured her and loved her but let her keep the routine there. Let her settle in. It was so HARD to let that go but better for both of us. I am now thinking about finding memory care because it is getting really hard for me to take care of here physical needs. I am really scared to make the wrong decision or make her feel unsafe. Logically I know it just has to be done but...
I wish you peace and love and luck with your journey with you Mom and be her child and take good care of yourself.