She has advanced dementia and is VERY needy. She has lot of anxiety, some hallucinations, and is very confused. She cries a lot of the day. “I miss my mother but she’s passed away.” “There’s people that are going to hurt me. Let’s go.” "I’m having some real problems.” These are all things she says. I know they’re pretty typical. So far she’s been clingy with staff and other residents.

I wanted to see what other people thought of being advised to not visit for two months. The head nurse said it might be sooner but that they would continue to update me and let me know when they thought it would be good time to start regular visits. They obviously said I could do whatever I want, but this is what they recommend. I understand there’s a need for Mom to adjust, but it seems really long. Thoughts?

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I am the Director of Nursing for an Assisted Living community, what I tell our family members is 2 WEEKS not months. This is a settling in period and the new residents are always going to have periods where they are not happy, I tell our families that when they call them and report things they say we are not doing to call me and let me look into it.  My reasoning for this is that it allows my face to be the one they will come to when they are upset or need something and family members can go back to being just family and not have to be caregivers. 2 months is way too long, to some residents that could make them feel abandoned and I would never want that. I want our families involved with every aspect of care, that is the only way we can all make sure we are doing what we can for our residents.
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No way. 3 weeks is too long. At most I'd wait a few days only then begin going regularly. You should visit as frequently as you want or can. Now, you can stay out of sight for a few weeks so she doesn't spot you, but I would still go and check on things. There's no reason why you couldn't do this and stay 20 minutes or so at a time to make sure things look right with the facility and interactions with staff. I'd also make myself known to the staff, telling them you and your sister will be dropping in on alternative shifts for example and so they'll get to know you. Be communicative and polite with staff, but not overly friendly. If you see anything wrong, or neglectful don't hesitate to address it with head admin. If you see something good and she's getting good care when they don't know they are actually being observed, compliment them.
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My thoughts on this is do what you think is best. As much as they are experienced with this, they don't know your mother better than you do. Use your gut and your own discretion when it comes to this.

My mom did not have advanced dementia and I was still advised to leave her there for a bit before I came to visit. I knew my mom would feel like she had been dumped there if I had agreed to that. So I visited immediately and regularly. Your mom may feel differently but only you can know that. They can't.

That's my opinion for what it's worth. Take it or leave it.
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Is your mother's anxiety and agitation being treated? We found that early on, getting mom seen by a geriatric psychiatrist made everything else easier to deal with. Not because she was "drugged". Because she was calmer and not jumping out of her skin with anxiety about EVERYTHING.

I know that the recommendation is often not to visit at first. We wouldn't have been able to do that.

If you feel you need to go, go and accompany her to activities. Go for a set amount of time. Listen to her complaints and say "I'll take care of that, mom". Don't feed into her delusions; listen, but don't share her awfulizing or drama.

Talk to senior staff about her/your concerns. Asking the aides or med techs won't get you action or solutions. Find the DON and make her an ally.
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Hex6837 Jun 2019
Yes the anxiety and agitation are being treated. She was in a behavioral hospital under observation for a month while they tried and adjusted meds. They have her on four doses of klonopin each day, but she still has anxiety. I’m guessing they’ll have to continue to tweak and maybe up the anti-depressant. They have a visiting Geri psych that comes once a week.

Thank you for the answer :)
My Mother was in a nursing facility for 4 years and just passed away this past December. There is no way I would go that long without checking on her. It may be considered a “great” facility, but that doesn’t mean a thing until you spot check yourself to be sure she is being taken care of properly. I strongly advise against that nurse’ Suggestion. I even had to go to the Administrator several times within the first 4 months my Mom was there. They weren’t feeding her properly and she needed speech therapy. Then her meds were just not working properly and they took away one and added another. Be sure CNA’s are taking proper care of your Mom too. You get good ones and then you can get bad ones. Just check on her.
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If you can refrain from providing direct care or trying to direct the staff's direct care, then I would say visit. From what I have heard, most of the persistent problems are not with the patient but with the family getting accustomed to LTC.

Personally I would never leave my LO for weeks anywhere without at least a "monitoring" visit. I did monitor my father where I didn't interact with him but came by the facility and watched him for a few minutes on a monitor. Dad was very angry with me for gaining guardianship and forcing him into MC so my visits were usually somewhat upsetting at that time. I did an in person visit at least once a week.

I believe that even in a good facility, patients get better treatment when the staff knows someone is going to be showing up. Years ago when my grandfather's aunt was in a NH, he got a call from the nurse letting us know his aunt was complaining of eye pain and the NH didn't have the staff to get her to the eye doctor before the weekend. Grandpa and I picked her up an hour later and took her to the doctor.
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Zdarov Jun 2019
Lots of good thoughts here! We can look in without it being a visit, and that’s just what I’m going to do too.
I don’t think there is any set period for this issue. I had to put both parents in assisted living within days of each other. It was the week from hell. The staff was great, told me to pull back but no set period.

So what worked for me was to pull back gradually, I had to be around the place moving stuff and fixing up the room which I’d do while they were eating. Then I’d stop by the dining room, mom would always yell JUST WHERE HAVE YOU BEEN!? I’d tell her I was fixing a leak/furnace/light whatever at the house.

After a couple of days I would watch them in the dining room from the lobby where they couldn’t see me. I had to fight the impulse to run in and cut up moms food for her and help out. But they had to figure this out on their own.

They sorta settled in eventually, never really happy but accepted their fate. My presence just reminded them of all things HOME and stirred them up. Mom was so mad at me I had to even quit calling for a couple of weeks.

Use your own judgement on this. Few elders are ever happy when they go to care but they usually adjust. Good luck.
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I can understand the rationale behind this but think that 2 months is way way too long. With all of the concerns about things happening in NH that are not on the up and up, and I have personally seen some of these things, I would have to be there to observe how my hubby was doing even if I was out of his sight for a couple of weeks at the most. And I could do that. The thing is too, to not show up at he same time every day, but to stop in unannounced at different times. It tells alot. There are alot of good facilities out there, but the ones we hear and know about that are not up to par are the ones we worry about. If hubby ever needs to go to one, they will know that I am aware and visible.
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My experience with my brother was - When I had to place him in a Nursing Home he was terrified. I stayed with him for about a week, going home around 10pm. During that week I slowly lessened my time there, or left for a few hours here and there. It also gave me a chance to help him meet other residence (he has gotten very shy). I am not sure if the NH wanted me there, but I could not leave him crying with fear. It all worked out great. He is now active and participating with activities and eating in the dining room. I do try and go every other day to make sure he is being taken care of properly. I have had many issues with this. I have tried to move him into another facility, but I realize it isn't going to happen any time soon. When I visited other NH's and fill out the applications, they always seem positive they can help him. After they have contacted the NH he is in, I never hear again. I call 4 places weekly for about 6 months. Now I am trying to make the best of where he is and be informed of everything medically and psychologically being done to him and for what reason. They don't likeit because I want blood reports, culture results, kidney numbers, hygiene, etc. Finally they are also accepting me and my advocating for my brother and have the information ready. It has been a long journey.
I can not stress enough about following up daily with her care. You don't have to let her see you going there if that is their rule, but I would make sure of how her care is being administrated and that you are very visiable.
I am not trying to bash Nursing Homes, but it is what it is. Our loved ones need care and we want it done. I found out that my brother wasn't getting showered or shaved because they came in the afternoon to do it. He is no good after 2... so he refused for WEEKS. Even being in advanced stage of dementia they let him make that decision not to shave, shower or brush his teeth. The solution was simple - I asked them to do his hygiene in the early morning. It worked, but had I not advocated he would probably have fleas!!!
If you have questions about this maybe seek advice from a senior therapist or her neurologist. Good luck. You have tons of support.
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I agree with techie, I think its just as much for you as for her. We all tend to "hover" a little. I would ask my RN daughter "what do u think" and she would tell me to complain or not.

I feel thought 3 weeks to two months is long. I feel they are like children. You were their everything and now they may feel abandoned.

I never visited in the morning. Too hectic, with getting the residents up and dressed for breakfast, med passes and before u know it, its time for lunch. Mom never napped so I would go in the afternoon sometime. She was not able to carry on a conversation so I didn't stay long. Just so I knew she was OK. Never in the evenings because again, they r getting residents ready for the evening.

I may give them a week. Then call and see how Mom is adjusting. I may go 2 weeks but not longer than that. I would learn the routine. You really need to adjust to the facilities way of doing things. When I started visiting, I would not make it more than an hour. And let the aids do their jobs. If Mom needs changing, have them do it. Change of clothes, let them do it. Show Mom that these people care for her, not you. You just visit. This is now Moms home. She is a resident not a patient.

Maybe make a list of Moms likes and dislikes. My Mom was allergic to deodorant. At the NH I found an aide had used their brand of deodorant on Mom. Made me mad since her box of toiletries was right there next to her bed with the deodorant we found she could use. With a note on it. Took the tube out to the head nurse and told her it was on the list I gave them what Mom was allergic too. The aides needed to use the items I provided. If she had broke out, it would have taken a while to clear up.
So, you do need to be present and 2 months is a long time to let a facility have complete control. Thats my opinion.
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