Taking Mom Out

colalbert · July 20

New here - Mom has been in MC for a year (this week actually), she still asks when she is going home and her anger and agitation has increased. We did not take her out of the facility for several months following her admission but have done so more recently (breakfast, shops, etc.) but the last two visits she seems to be much more agitated upon return. Wants to know why she needs to be there, why she can't go to where my Dad is, etc. Often says on the way back that she doesn't know where she needs to go even if it's been just an hour. Afraid this means that I need to keep her in the unit and trips out are detrimental. It seems sort of obvious but is this correct that I should just visit her there? Nothing makes sense so I'm just so confused/upset.

pamu · July 20

If you haven't already maybe speak to the nurse/doctor about a medication adjustment for the increased anger and agitation. They may also have some insight about how she reacts after the outings. If it's stressful for her you may want to cut back on the outings and just visit her for the time being. My mom (88YO) has been in MC for 10 months and talks about leaving and moving out all of the time and doesn't think she needs to be there. The problem we're experiencing is that she is exit seeking. She has been exit seeking since she arrived and the psychiatrist does not think it's a good idea for outings because returning could be a nightmare. When she was first admitted, within a couple weeks she put on one of the nurse's sweaters and bag and waited at the elevator. Around 3 months ago she tried to elope and was caught in the act. She was so agitated and focused on leaving that it took 2 firemen, 2 EMT's and a physical therapist to get her onto a gurney to be brought to the ER for a psychiatric evaluation. It was horrible to witness (my sister and I were called to try to de-escalate the situation). Her medication has been adjusted and the intensity of my mom's agitation has dialed back a little. We feel horrible that we can't take her out for a drive or to get an ice cream but at this point we don't think she would enjoy it and just focus on not going back the entire time. For now I've been taking my mom to the garden/courtyard in the other section of the nursing home and she only enjoys that for a very short time. It's so difficult.

ARIL · July 20

Unfortunately I think this a part of the disease progression. When my dad was first in MC, we took him out almost weekly for a meal, a drive, a trip to our house. Then I saw increasing anxiety and also a decline in his ability to recall that we had had a trip even a few minutes after we were back at MC. He was also finding the short trips to be physically exhausting. There was also less and less positive for me, and more worry about his personal care.

We stopped with the trips out. I visit him often, and we occasionally have a meal with him in MC. He asks about “going home” a lot, but this no longer means what I would mean by that term. Sometimes it is about wanting to see his parents or other people long dead who made him feel safe. Sometimes it means he wants to know literally where he is supposed to sleep that night. Sometimes he asks if it would be OK for him to stay “in this place.” (I feel relief at that one!)

And yes—after a “good” visit I still sometimes wonder whether we should try a trip out. But I don’t think so. I feel bad, regardless. Sometimes MC caregivers—usually new ones—tell me they think my dad would enjoy a visit to my home. This is not helpful.

It is all very hard.

colalbert · July 20

https://alzconnected.org/discussion/comment/277805#Comment_277805

Thank you so much! We have asked them to reevaluate her and they are not seeing her agitation. It's SO FRUSTRATING. But this might be another opportunity for me to email them and let them know. Thank you!

colalbert · July 20

It SO HARD - agreed! Thank you - I appreciate it!

pamu · July 20

https://alzconnected.org/discussion/comment/277813#Comment_277813

It took that hospitalization (3 months ago) for my mom to be prescribed an antipsychotic (Seroquel) to help with agitation, depression and delusions. My belief if that she was prescribed it before, she wouldn't have had the meltdown that landed her in the hospital. For a while she was on Remeron and Ativan/as needed but it wasn't enough. There was no way anyone can/could redirect her or calm her down at times. I'm not saying your mom needs an antipsychotic, but maybe either some other activity/therapy or medication tweaking could help. Mom's charge nurse takes notes from myself and my sister to help build a case for the psychiatrist (mom is now refusing to meet with her). It's been an ongoing subject during our care team meetings. Apparently, mom didn't present these behaviors as extreme to the in house geri-psych so they did not want to prescribe it due to fall risk among other possible side effects. The geri-psych at the hospital warned me prior to my mom going into MC that most of the facilities (in our area) do NOT like to prescribe anti psychotics until all other avenues have been tried. It hasn't been the magic transformation we were hoping for but it does help keep her calm.

H1235 · July 20

I agree with other, it may be time to stop taking her out. You might try bringing in food for her. My mom complains often about how horrible the food is ( in her defense, it’s not great). I sometimes bring a bowl of fresh fruit for her to snack on during the visit. You might also try to think of some some kind of easy and fun task or activity you can do during a visit. Does the facility have any kind of outdoor area. Moms facility has fenced in outdoor area with a canopy. Resident can’t go out alone (if the weather is nice they occasionally have an ice cream social outside for them), but I’ve bought my mom (and her roommate) out a few times. She likes the fresh air.

Taking Mom Out

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