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Mom will be going into a nursing home for respite care for 5 days. I have to go out of town, so I cannot care for her then (I am the main caregiver). I am so worried about how she will react, though. I am expecting the rest of my family to go visit her, hoping to ease some of her anxiety (that I expect she will have). I don't know what to tell her about going, other than to tell her it will be a vacation for her. She is 94 and is showing some signs of dementia. Will sending her for respite care make things worse? I won't know if there is a bed available until a few days ahead of time. So, if there isn't one available, I will have to hire more in-home care to cover the time I am usually there. It seems she has an issue when new people come to the house. I feel like I am between a rock and a hard place.... Any suggestions? What can I expect when she gets home?

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I put my dad in respite care a while back for about a week and a half. I think he probably had more advanced dementia than your mom does currently, though so it is hard to say. To be honest, I think every time a change of setting occurs (hospital visit, respite care, etc.) it does put a dent in their mental status. For dad, I just explained to him that I had to go away for the week, and that I wanted him to stay in a place where they could make sure he'd be ok, I didn't want him to have to worry about cooking for himself and remembering the take his medicines etc. (although at that point he was unable to do those things on his own, I voiced it as if "I know you can do these things on your own, but i dont want you to have to worry about it) He seemed OK with that explaination. Do I think the visit seriously progressed the disease? No, not especially. But I do think it may have worsened things a bit. Sorry to say that,but it is a risk. That said, everyone needs a break sometimes and if you don't have family who can step up for that time, you have to do what you have to do! At the end of the day, anything COULD affect the dementia (a fall, a cold, etc.) and its difficult to pinpoint exactly what it was, so you really just have to accept that you are doing your best.
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I did this with my dad a few years ago. It was disturbing to me that I thought everything was all set, as I'd gone in person to make the arrangements and see the facility, but nothing was ready for him when we arrived. I probably didn't help the situation, because I became so upset and didn't want to leave him. I did, tho, and I had arranged for visitors for every day while I was gone, and he actually did just fine, even made a friend in his room-mate.
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I had my mom in NH for respite twice. The first time I checked in often and it was disaster! The second time I was out of the country so I couldn't check how things were going but I had to leave and I just had to trust that she was cared for. Now mom lives at the same NH and I've had time to better understand the whole institutional dynamic, it may not be home but the people there are safe and their basic needs are taken care of. Of course there may be some fall out after she gets home but you will all get through it, honest!
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I placed my Husband in the Memory Care facility where he had been going for "Day Care" I figured he "knew" the staff and the surroundings.
I would be gone for 3 weeks. (My first vacation in 5 years.)
In my heart and mind I was afraid that being in the facility for that length of time I might not be able to bring him home. I though maybe he would be so set there that it might be more of an upset to bring him home.
I had nothing to fear! The day I dropped him off they suggested I stay a while to get him into bed as was our usual routine. He would not settle down and wanted to leave. I left him. I figured he would get into bed when he got tired or he would fall asleep watching TV. Picking him up I waited until lunch, while he was eating I arrived and packed up all his clothes. When he was done eating I asked if he wanted to go home, he got into the car and when we got home and got him into the house he settled right down into his recliner to watch TV.
At this point his dementia was pretty advanced and he, for the most part was non verbal. But there seemed to be no stress on his part. He settled right back into the routine we had had previously. When I brought him back for "Day Care" he seemed not to be afraid I would leave him there again.

Your Mom may be upset. But depending on how severe her dementia is if you can explain that you both are going on vacation. She may take it a bit better. If you have a bit of time before she stays can you bring her in 1 or 2 days to see the grounds, maybe have lunch. This way she may be more comfortable when she stays there.
The important thing is ...time away is vital for you.  You need to take a break.  This is important physically, mentally and emotionally. 
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I recently put my mom in an Assisted Living Home for respite care. I checked out several facilities in my area that was suggested to me by A Place for Mom. Once I selected one I took mom for a visit. The facility was a great help in making her feel welcomed and excited about her coming for a vacation. I always referenced it as a vacation for her. Each caregiver at facility had 7 individuals to assist. Plus nursing staff 24/7. I had family members check on her while I was gone. She loved being with people her age. AL had a lot of engagement activities planned each day. It turned out to be great for mom. I plan on sending her again.
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Not personally, but my friend had to do this with her mother when she bought a new home. She (Mom) had been on HomeHospice and they took care of placing her for the time-frame my friend needed to get moved into a new house.

The flip-side is my friend never brought her mother home again, and she is still in the Nursing Home today.

Another friend had to put her DH into respite/nursing home care because she needed knee surgery. Her DH didn't do well.

You do what you have to do and just keep praying. Unless you are absolutely sure about hiring home-health-care, Mom would probably be safer in the NH, just my humble opinion.
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My mom still has her mind. (She tells me everything to do.) She gets upset any time she has to go anywhere. Has been that way for years. I went on respite and sent her to the top notch NH around and she came home with stories of terrible care. The next time she went, my sister went too, and spent the entire time with her...ate there, slept there, stayed there. They both were treated with utmost care and respect. She observed everything, helped explain to the staff and to Mom every issue that came up. Mom came home bright eyed and happy and glad to go back. We decided that in order for it to be a good experience, someone will need to go with her. We learned that the tales she told were not accurate and that our perception of the state of her mind was not so accurate either. We found a way to make it work for us. I am so thankful for hospice and for a sister willing to fill in so respite can work. God is our provider and He has a plan for our deliverance. I am so in the middle of the problem, I did not come up with the answer. Someone outside came up with the idea. I think we who are in the problem need others to give ideas and this site is just that. Thanks to
all of you who share your ideas with us. Blessings to you all as you give.
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If it's a nice nursing home with nice people staffing it, your mother will be fine. She may be a bit muddled, during and perhaps for a little while after, but she sounds less resistant to the whole idea than my mother was; and even so my mother did nothing worse than sulk in her room with her arms folded, and thus missed out on what could otherwise have been an interesting, companionable few days.

Depending on how advanced your mother's dementia is, and how well (or not) she retains information, you may decide it's better not to try to "prepare" her for her respite break. Put it on the calendar by all means, be open about it if the subject comes up, but don't try to make her look forward to it because just trying to remember and plan her stay will be stressful for her. Have her suitcase packed ready, and a box of familiar items, and then if/when you get the go ahead you can just treat the whole thing as a matter of routine. If you take it in your stride, she's more likely to, too.
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I have my caregiver take my Mom to a memory Care NH occasionally for day activities. And they offer individual day stays. I would absolutely use that option. In fact, I'm redoing mom's shower and will use some days visits for hygiene. I have just been reinforcing the in AND out parameters.
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In our state, Medicare pays for 5 days respite for Hospice patients, I think it's every 3 months.
My brother was fine with it, and I think his wife took advantage of it as much as possible to get some time to rejuvenate.
My father-in-law's experience: Hospice arranged for his 5 days in local NH and suggested that family not visit. NH welcomed him warmly; he thought it was a special facility owned by his doctor rather than a NH. He was unable to understand the call-button concept, not too coherent, and unable to feed himself. The family set the heat at a level his roommate agreed would be comfortable. His son and wife came in the next day around noon to check on him. His bed was lowered to the floor. He was naked. The heat had been turned off, and he was shivering. Wife and son cared for and dressed him, and it was over an hour before anyone on staff even came in. His roommate commented that it had been cold all night. The curtain was pulled between them, so he didn't know Dad was naked and freezing. When staff finally did wander in, all they knew was that he didn't eat his breakfast.
MIL called Hospice and told them to get him out of there PDQ.
After 6 months, MIL had to have cancer surgery, so she agreed to 5 respite days at a different NH. Thank God, the new facility was great. We did, however, wander in and out at all hours just to be sure. She didn't recover as quickly as she thought, so she agreed to another week or two at self-pay.
And, his condition actually improved from what it was at home, since he was getting professional care that they just couldn't do at home. He's still there 10 months later, and everyone is better off.

My advice, then: Take the respite time. Ask friends and acquaintances to visit and check on her. You've already investigated the facilities, so you feel comfortable with them (a step we didnt know we should do the first time).
She may actually be better there!
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