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Angels19 Asked October 2014

At what point did you decide a nursing home was necessary for a parent with dementia?

Did an event occur that decided this for you? I feel like I might be so close to the situation that I may try and bury my head in the sand and become locked into denial. I was wondering what I should watch for, or what your own experiences have been. Thanks

notrydoyoda Jan 2015
I wonder what Angels ever decided to do? From a thread that she started in December, things did not sound too good at all. I hope things have improved for her.

Rosebush Jan 2015
I was able to keep my mom at home and have a suggestion about your mom not knowing you. I would say " hi mom its Patrice your favorite daughter. " Had my whole family do this. Once we told her who we were you could see that glaze look go away. I can honestly say my mom did not forget who I was. Best wishes to all

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jeffrey20832 Jan 2015
I am running into this same problem. My 84 year old mother with Alzheimer's seems to have had a real cognitive decline in the past 2-3 months. No UTI (we keep checking). For about 2 months, she has been losing the ability to dress herself. She basically is unable to dress herself now, so my wife has to help her. She also started incontinence. Now we have had to start diapers on her. Every morning I go in and I am cleaning the bathroom floor. I just don't know how much longer we can care for her safely at home, but we do have someone to help us shower her three times a week. In the past several days, it seems like the incontinence is under better control. I am not sure how far I can take her in the car now, which used to be an escape to help keep her settled. And it is winter. She still remembers me most of the time, though she doesn't always remember I am her son. I have been thinking, are we getting over our head? Then I see Sujean's posting and I wonder what the right thing is to do. Anyone else had to struggle with this situation with Alzheimer's parent?

Sujean Oct 2014
I cared for my mom in my home. I always said, when she is incontinent and doesn't know me any more, then I would place her in a nursing home. When she couldn't ride in the car, because she was scared.Didn't want to shower, and having a difficult time doing that She was pacing around and wouldn't sit still. Started ripping magazines for reasons I don't know. Starting to get confused on this being her house and starting to not recognize my son. I was so afraid that she would forget me and freak out saying, who are you, I want to go home. This is not my home. Well, I placed her in the nursing home memory care unit April 22, thinking she would have activities and friends. She just paced all day. At least she had a safe place to pace. She only lasted 10 weeks in the nursing home. She stopped eating and drinking which ended her life. I started the grieving process when she went to the nursing home. I do believe that it helped me to start to let go. Kind of like baby steps to the end. It is such a painful process to watch someone you love in the end stages of the disease. You will know, what you can handle and know when the end is getting near. Hugs to you!

jeannegibbs Oct 2014
It depends not only on the level of care that the loved one needs but also the level of care that the family plus in-home professionals can provide.

Mother with dementia moved in with my sister and brother-in-law. They did a wonderful job of caring for her. After about a year Mom had a series of acute illnesses that made her care much more demanding, and she began having issues during thenight. Sis decided she could not continue in the primary caregiver role. The rest of us got busy finding a care center. We found something sooner than we expected (a nursing home). There are now three shifts of staff to respond to Mother's needs. And oddly enough, she seems more content there. I think she always felt a little bad "imposing" on her children and she is more comfortable with people who get paid to help her.

Angels, just keep in mind that the caregiver's needs have to be taken into account.

blannie Oct 2014
Boni don't even THINK that! It's your family's problem, not yours! You can finally set some good boundaries and let your family step up and DEAL WITH IT. Stay strong in your resolve to take care of yourself!!

Angels, my dad didn't have dementia, but the final straw that sent him to skilled nursing was when he couldn't get himself up off of the toilet, his legs were too weak. At that point, he went to the skilled nursing part of the facility where he and my mom live and he passed away three months later from his lung cancer.

BarbBrooklyn Oct 2014
I should add, I took her to a geriatric neurologist/psychologist at the behest of her ger pscy in the spring of 2012. They did a complete workup and dxed "Mild Cognitive Decline", which was apparently the source of her increasing anxiety. Got her on the right meds. Took her back in the spring of 2013; there had been little progression, so at that point, NOT officially dementia, but the start of her not being able to reason. Important distinction between loss of memory and loss of cogntive capacity,i.e, reasoning, ability.

BarbBrooklyn Oct 2014
Okay; the whole story. Mom started having spkikes of BP back in 2010. Taken to hosp. no findings other than out of whack electolytes, sometimes UTI, etc. At that point (she was 87, we SHOULD have gotten a geriatric doc involved, but we didn't know from that). After third hospitalization in three weeks, I realized that anxiety was PART of this and the hosp. doc put her on a low dose of Xanax. Okay for a while. About 9 months down the road, after numerous doc appts (GP, Cardio. Opth) each with terrible urgency on her part (SOMETHING is WRONG) and a three day period in which she had an EMERGENCY every day, we sat down with her and said MOM this isn't working out. We had tried caregivers coming in (what do I say to them????, what do I tell them to do?, she said), we moved her to a nice AL that other relatives were in. Bad move. Not enough research. What we/I didn't know was that at that point, her PRIMARY problem was fecal incontience (She wasn't telling the doc, and certainly NOT me). After a complete meltdown which involved great amounts of sh?t and her becoming unresponsive, she was taken to hospital, where she became paraoid and delusional. Being held against her will in a basement, etc. Got a geriatric psych involved at that point who suggested that she might benefit from independent living (she was still quite competent, when prop medicated), benefited from the socilization, good meals, ability to get herself across the parking lot to the geri doc. Fast forward. She had a stroke in July 2013. After 8 weeks of rehab, dxed with Vascular Dementia. Rehab told us that she would be okay in an AL that knew how to handle progressive demential. We found an absolutely lovely place and moved her in. The fact that she tried to grab the steering wheel from my husband on the way there should have been a clue. She wouldn't go into the bathroom, said it wasn't hers. the facility checked on her every ten minutes or so; she fell within 20 minutes of being there; didn't press the "button". Checked out in hospital, no breaks, etc. Clearly, she needed a higher level of care than was afforded by AL. There was a bed available in Memory Care, so we moved her there. She was disoriented and increasingly "not there". Got her a 24/7 aide. Second night in that until, she fell (two aides in the room), xrays. no breaks. A few days later, as she became increasinly non responsive, PT insisted that she have another xray of hips, etc. She had broken her right hip at some point (we've looked at the previous xrays, no fracture was evident) Hip surgery, moved her to NH for rehab Oct 2013. Where she thrived! Gained weight! learned to use a walker, got around, talked, participated. Got pneumonia in Jan 2014. It's been a downward spiral ever since. BUT, NH gave her back her mobility, sense of self, etc.

BoniChak Oct 2014
Do what I did. Have a massive heart attack and live. In the 2 weeks since my MI the family is totally losing it. I wonder if it would have worked out better if I had just died. I bet she would have been placed in one of those fancy homes that was acceptable to the ones with the money.

Shebba Oct 2014
Needing same advice!

Sunnygirl1 Oct 2014
Great information baBalou. Could you elaborate on why the Memory Care didn't work. I'm looking into that now.

BarbBrooklyn Oct 2014
There are levels of care that need to be determined: Independent Living, Assited Living, Memory Care or Nursing Home in that order of need. Listen to what her doc says she needs, if s/he is a geriatric doc. otherwise, get her to one. These levels of care are VERY differnt, espcially wide variety place to place. We took mom, with the beginning s of dementia, very anxious, to assisted living; it was at once both too much and too little care, based on HER NEEDS. We eventually settled her in Independent Living for a year or so, she had control of her care and day to day activities; doc across the street, geriatric psychiatrist who came in once a week to see her , three meals a day and activiteis up the wazoo. This all worked great until she had a stroke and then broken hip. The, she needed NH, although we tired AL and Memory Care; they didnt work.

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