My MIL has dementia along with paranoia and I want to make her move to assisted living as painless as possible. She, of course, would rather come home, but she is not safe by herself anymore. She will get very mad and mean and I am concerned she could refuse to go. Anyone have any suggestions?
Have you even talked to the facility you're interested in placing her in, and if so, does she even qualify or is she too far gone in her dementia?
Since your MIL is going to need to be placed, just make sure that she's being placed in the appropriate facility right off the bat, as moves are very difficult for those living with a broken brain.
Discuss with memory care how best to facilitate transfer. It varies greatly individual to individual.
Has she been seen by a geriatric psychiatrist to assess her for medication to help with depression, agitation and paranoia?
The doctor can phrase it in this manner...
We will see how you manage in Assisted Living with people to help you when and if you need it. They can provide more help than you can get at home.
If MIL has dementia is she able to LEGALLY make decisions for herself? If she has a POA and the POA is acting on her behalf then she really can't "refuse" to go to a facility that is able to care for her safely.
She can argue, she can b**ch and moan about it and she can say you are trying to kill her, you are putting her away and anything else. But the person that is legally able to make decisions for her is the one that has the final word.
* Yes, it is very natural / normal for elders, esp with dementia/paranoia to get angry, lash out when things change (and, as usual ... it is the person(s) closest to them in the line of fire.) No one, esp an elder, wants things to change; they want what is familiar - and w dementia, even the familiar is confusing.
* You need to reframe - learn to 'let it go,' when she emotes (gets angry; asserting herself, as she can. Remember, it is 'all' she can do - scream and try to control the situation (even though she can't).
- This is where compassion comes in. Once you realize that she is acting out of confusion and fear, you can understand her better from her perspective. You may be doing this already. Shifting into compassion, while doing what is needed / necessary helps to ease an often charged situation such as this.
My concern is you indicating she could REFUSE to go to rehab, as if she has legal authority to do what she wants (with dementia) ... ?
If no one has legal authority to make decisions for her best interest, she 'can' do what she wants although you also need to call an attorney, talk to MD, and perhaps call Adult Protective Services.
Suggestion for if / when she refuses:
* Talking logic to a person with dementia doesn't work.
* You tell them whatever will keep them as calm as possible, i.e., "Oh, yes... we are going home in a few minutes."
* You talk to the person based on what they can comprehend. With dementia, it is best to agree, change the subject, and do what needs to be done ... and learning to NOT take their behavior personally. This is very easy to say and, as a person who is quite astute, conscious, able to set boundaries, understands-studied dementia, it can still be difficult to find that boundary to not 'feel it' 'or take it personally.'
* The or one of the best ways to manage is to take breaks, even for a minute or two ... when you start to feel activated. Just leave ... a short break to 'break the cycle' you get into will help a lot. Then ...
* Try to reframe 'she is doing the best she can with a confused mind that feels very scared of the unknown, along with being in physical pain.
It is hard for everyone when these changes MUST occur. It is a way of grieving the loss of a loved one. Give yourself a lot of emotional care 'self-talk'.
You be with friends - socialize - have fun. You need to shift into your own life at times / moments ... however you can. Go out to lunch, dinner, a walk in the park. You need to renew yourself to keep going. Exercise, eat healthier than not, meditate, find joy and beauty around you (in a flower, a tree, a bird singing).
Gena / Touch Matters