Mom is stage 6-7, start of advanced Alzheimer’s. Keeps falling and injuring herself. She needs to be re-homed to skilled nursing permanently. She will fight family/doctor decision and make life unbearable for her spouse. Is it ok to tell her she needs to go to recuperate and once there for a bit tell her she’s not coming home? Or, should we just tell her she has to go and will not return home at all? Thoughts please. Many thanks.

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I've been in a similar situation & it's not pretty. We brought our loved one home after a stroke and attempted to care for her in her home. She'd done well in a carefully controlled rehab setting, but declined rapidly once home & it became increasingly obvious she could not stay at home. However, she refused to leave her house. Period. She had multiple falls in a short time and a zillion other things which indicated she could not stay home. I have to think that deep down she herself knew it.... but she fought us tooth and nail. Informed us she would be "dead in two years" if moved from her home. She guilt tripped us all over and was generally difficult to be around. She even started hiding money, but we never did figure out what that was supposed to accomplish. It was odd and it bothered me that she was suddenly so suspicious of me - her primary caregiver. Meanwhile, when you'd think she would be trying to PROVE she could stay home, she became increasingly noncompliant with the care plan and her condition declined. After a fall (with likely loss of consciousness) that landed her in the hospital and then to a nursing home rehab setting, we decided not to bring her home. When her insurance company cut off her rehab stay, we were asked by the rehab people what our plans are for her. I told them "She has nowhere to go and we would like her to stay here." I listed all the reasons for that and the staff agreed. I'm making it sound easier than it was, but having her already there for rehab and then basically just switching her to a nursing home room is much better for everyone than trying to move someone from their own home to a facility. Fortunately, the place she's at has rehab beds and nursing home beds under the same roof. At first, we just told her she would "be in a different room for a while" and we didn't tell her it was her permanent nursing home room. Eventually, we told her. She still claims she's getting out one day soon and I do continue to sense her resentment of me, but she's doing very, very well in the facility.
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Dear Ones,
Many thanks for your quick, and insightful answers. They are important to our decisions. Hugs to all.
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My Mom had to go to NH for rehab. She was falling a lot. She was convinced during a hospital stay by staff.

She did great in rehab but unfortunately her memory was so bad at that point she could not remember to use a walker while in her room and the falls continued.

After the 100 days of rehab she remained in the nursing Home as a resident. She did ask to go back to her house often. And I lied...I told her she needed to stay until she got better and could function in her home.

Sometime after the first year she thought she was in a hospital. So my story was she needed to stay to get better.

I have learned from this site my lies were therapeutic fibs. Not that I was uncomfortable with my lies at the time, really, I had no other explanation her broken brain could understand.

I am so sorry you and your Mom are in this situation, it’s so hard.

When your Mom is re-homed expect and adjustment period. Take staff recommendations as to how to best get your Mom settled in. It will take some time.

Best of luck to both you and your Mom.
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I would do it the first way. Then once she’s there, use what we call the “theraputic fib” and tell her she can come home when the doctor says.
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It is a good idea to tell her that she needs to go to the Nursing Home for convalescent care. There may not be any need ever to tell her that she cannot go back to her own home again; and unless there is, and I can't imagine why there would be, why would you tell her that? It's just rubbing it in.
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