Discussion (or not) and getting my uncle to the memory care center

physics911

Hi, everyone. Thank you in advance for your feedback. First time poster.

My question is, and advice being sought, how best should my sister and I go through the discussion and process of getting my uncle moved into the memory care center next week?

We are getting him into the local memory care center this coming week; the contacts are all signed just waiting for the room to be prepped, The major concern is, my sister and I absolutely expect he is going to bow-up and not want to go. So, how best to go about it? Do we sit him down and talk about it? Do we just get him in the car with the pretext of going to the store? Do we tell him we are taking him to the hospital where he will be cared for? And then once we are at the facility, how do we handle it if he bows-up and doesn't want to go in? (We have reached out to the memory center on this as I am sure they know how to deal with it.) There have been no discussions with him yet on this topic.

Background: My uncle is 85, living on his own, but with family support next door. He still knows everyone, but has gotten to the belligerent, and even somewhat aggressive stage, and is have hallucinations pretty frequently. Additionally, he is often forgetting his basic needs, i.e., not drinking and ending up dehydrated. He was never married, and no kids. My sister and I (remote) are his POA's. He has lived his entire life in the same tiny little rural mountain town. He never learned to read or write, and while he is not intellectually disabled he does fall on the low end of the IQ spectrum (probably around 85 or so). I give you that last bit of info just for context, i.e., before the dementia most people would never know he had any kind of issues, but you did need to take extra care when explaining complex topics or getting him introduced to new situations.

My sister and I appreciate your feedback.

H1235

Welcome. Many people with dementia have anosognosia. This is an inability to recognize their symptoms or limitations. Because of this understanding the need for additional care is almost impossible for many. Trying to convince them will just get ugly. Some people have tried telling a loved one they need physical therapy and it’s just temporary. This stage is so difficult. Up front they can almost appear that nothing is wrong, but anyone who spends time with them and knows the situation understands that’s not true. You might also want to talk with his doctor about something to help with his anger and anxiety. You don’t want to wait til he has physically lashed out at someone and they are talking about kicking him out to start thinking about meds. I hope it goes well.

Anosognosia and Dementia - AgingCare.com.pdf

physics911

https://alzconnected.org/discussion/comment/284417#Comment_284417

Hi.

So does that just translate down to, we tell him we are taking him to the hospital? He goes to the doctor a fair amount at this age, so that probably wouldn't be too much of an issue; at least to get him to the facility.

Phoenix1966

You could tell him once you got him inside that this is a rehab facility his doctor has recommended (or even required for him to keep his health insurance) to treat whatever ailment you think might fly(to help him walk/balance better, deal with arthritis related mobility issues, etc.).

Some people choose to have lunch with their LO and let the staff step in to distract them while they are eating so that you can slip away. Oftentimes, it is recommended to not visit for the first week or two so the LO can somewhat acclimate to their new surroundings.

Be aware that some PWD never fully settle in. They will always ask to leave or go “home” (sometimes home can be a time in their past as opposed to where they last lived). But a facility can be the best place to make sure they are cared for and their needs are met.

@H1235 makes a good point that if you feel his anger might escalate, discussing anxiety meds with his primary care physician would be a good idea before you try to move him. Again, use whatever therapeutic fiblet will work(Dr. wants you to take meds for brain health, etc.).

Just remind yourselves that you are doing this for him and not to him. It’s the disease that is chipping away at his life.

Emily 123

Hello,

I think you have to use your experience about what will work for him, as you know him best--people's experiences can vary widely when taking a person to a memory care because each person with dementia is different. If going in to the 'hospital' for testing seems like it will work, then go for it. The goal is to get him through the door. If one reason isn't resonating with him drop the subject and try to come at it from a different angle or try it again in a little bit - if he has poor memory you should be able to do this. Just keep things as calm and day-to-day as possible.

You might want to discuss your concerns about his possible reaction with the director at the memory care and come up with a plan for the drop off-a lot of times they can have you come at a meal time or when there are activities so your person can be distracted and you can slide out. As H123 said, If there's a concern that he might become belligerent then you should discuss this with both the facility director and his physician to see if some anti-anxiety med might help him with the adjustment.

This helped me tremendously:

understanding-the-dementia-experience.pdf

J.A.

I wish you luck with your uncle. I'm also having trouble with my brother. He should take a memory test bc he is showing signs of memory and cognitive decline. And I think he has anosognosia. I spoke with the Alzheimer ppl on the phone and I need help getting him tested. And to make matters more complicated we live in diff states . I am his DPOA, but not sure what weight that holds in getting him testing. Do I just wait until it get worse?

sandwichone123

I told my spouse we were going to see the doctor (true, because we were going to be seen by the facility doc), but many families say they're going to lunch (also true, because lunch will be served). I agree with Emily, above, that you should choose a story that you think will fly, somewhere that he will willingly go, and make sure everyone involved is in on the story. It doesn't have to work for long.

Don't announce it days in advance, just at the time you need him to get his shoes on or come out to the car.

H1235

https://alzconnected.org/discussion/comment/284427#Comment_284427

It translates to, it just depends on your specific situation. I don’t think my mom would have never bought into the rehab story. We included mom in the packing and everything at y brothers insistence). I can’t imagine any situation where this would be a good idea with a person with dementia. Moms actual move was an absolute nightmare. If you think he might accept a fib, then I would go with that. Go easy on yourself if it doesn’t go well. There is no way to know in advance how he might respond. You make your best guess, that’s all you can do.

physics911

I appreciate everyones feedback. My sister and I have a plan. But as the great philosopher Mike Tyson said, "Everyone has a plan, until they get punched in the face." We recognize it will be a tough day but we have both been caregivers for much of our lives, so we can roll with the punches.

And FYI, he does have anxiety meds, and Haldol for episodes. The center is aware and hopefully when he has 24x7 care and gets his meds on time, his episodes will be more manageble.