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My mom has dementia and has been in a NH since summer and has good and bad days in adjusting to this change. Sometimes she is very confused and wants to go home. She was starting to say this last spring when she was in her home, so I know it's really that she's looking for a better place when she wasn't so confused (I also learned that from reading so many helpful posts about a similar topic here). She feels she gets lost in the NH and gets worried she won't find her way "home." Except for word finding issues she is conversational but not assertive. So she'll express these worries to me but not to staff, therefore probably being worried for long periods of time w/o reassuranceo She'll just wheel quietly around and be confused and worried in her mind. She is from England originally (though hasn't been there in about 60 years) and often says she wants to go to her childhood home. When we talk about practical reasons why she can't get there, she understands. But overall in these moments she just looks so sad and confused. When I had to leave her yesterday to go to work I know she was still very confused and I just felt awful. I guess I'm looking for advice in how to respond to help her feel better. I have tried distracting the conversation or activity, asking her to reminisce about what it was like in her old home, but often her mind gets locked on this worry and confusion to the point where she can't enjoy the visits from her family. I appreciate any advice.

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If someone is in pain, you give them a pain killer. If someone is in anxiety, you give them an anxiolytic. In both cases you relieve suffering and allow them to be comfortable.
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Hi, it's more b/c I have found that without my advocating the NH resorts to meds very quickly rather than trying other things first. They had mom on Haldol (many potential deadly effects for someone with dementia) until I advocated against it and offered to help with environmental modifications. So though I know an antidepressant may be needed, I don't want them to think it's okay to throw a drug at something rather than trying other things first. I just want to tread cautiously, trying other things first.
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I would rely on your relationship to your mom to reassure her.

"Mom, I've got this. I'm not going to let you get lost in the shuffle here. I PROMISE you that. I've got both my arms wrapped around your little self even when I'm not here. I'm talking to the nursing home staff, checking on you all thru the day. You NEVER have to worry about your safety here. I've loved you all of your life, and I'm never letting you go."

Give her a little Beanie Baby or something. And tell her that's her "direct line to you."

Let her know specifically exactly when you'll be back. Let the staff know. Ask them to remind her a few times a day when you're coming next. Tell her when she gets worried, to remember. You've got her just like SHE'S got that Beanie Baby.

As mom was dying, the most comforting words to her were from me: "Don't worry, mom. I've gotcha'."
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I m curious why you want to avoid antidepressents?
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Thanks for that I was thinking to talk with social worker, who has been a wonderful resource. No meds and no eval for depression/anxiety but a very anxious person her entire life. I'd like to stay away from meds if it can be handled otherwise but if things continue I will look into that. I do have a photo book and will try taking it out to see if it helps with the gear shift.
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First of all, I would talk to the social worker on staff. Second, what meds is she on? Has she been evaluated for depression and/or anxiety? Third, do have pictures of her childhood? Can you make her a photo book of her childhood home, siblings, friends, but also pictures of her long life...happy occasions like birthday and weddings.
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