My 84-year-old mother just entered the nursing home. How can I make the transition easier on the both of us?

I just asked the above question and pushed the send button before I was finished. Sorry.

Last Wed., after a week in the hospital, mother went into the nursing home, a small and privately owned home with a good reputation in our town. My brother built the home and grew up with the owners, so when my brother called them, they had a room for mother.

My husband and I have lived with mother in her home for nearly 4 years and she has gradually declined in her health and mental capacity, too. The past year has seen a terrible decline. She has always been rude and irritable with us since we've lived here, but in the past few months has become mean. She has dementia, diabetes and is insulin dependent and has seizures, can't see well, and can't hear well. Plus, weak in her legs and has started falling more often.

This past month, she has started getting hostile, throwing things at us, cussing, calling names, won't take insulin, eat or medicine if she's mad, which is often. She doesn't want anyone to help her, but if you don't she makes rude comments. Some of this she has done off and on, but the throwing things just started and the wanting to run away just started.

We went through a week where she wanted to run away and we started locking the doors where she can't leave the house. It was a horrible week for her and us. She wouldn't let the home health nurse come in. And, said things that were totally untrue. She has become a danger to herself as far as her health is concerned.

So, when she wouldn't get out of bed to eat breakfast and her sugar was 46, I called the ambulance and she stayed in the hospital 5 days and went into the nursing home (that was last Wed, not a week yet). So, now she is there. I go twice a day at lunch and suppertime. My brother comes up after supper and we sit around and visit. Mother doesn't visit, she is starts in about going home with me or getting my brother to spend the night, etc. Well, today, she became hostile with the aides and the nurse had to call the doctor and she is being given a sedative to calm her down. She kicked the aides during her shower and wouldn't let them give her insulin (but they did). Just don't know how long this hostility will last.

This is all new to me and of course it bothers me. So, my question is how to make things easier or better in this transistion for mother and me. What do you do to keep from worrying about it all?

Thanks for your suggestions. Many of you have experience and your advice would be helpful.

First Deep Breathe..!!! You and your family have done the right thing in seeking help and advice for your mother. I tend to think that this is not your "real" mother acting out in these violent ways, remember that. The facility has a doctor on staff that will be able to watch her and locate the proper issue and get her hopefully under control with medicine. We all hate to see our loved ones under medicine, however sometimes it is the only thing that can control such nasty outburst. Visitation daily is what I would do but that is up to what you can mentally handle, you have to take care of yourself as well.
Blessings, Bridget

You did the right thing for her health and safety to have her hospitalized and moved into a NH. As far as her health there seems to be 2 different but intertwined issues: getting her diabetes under control and having her mental state evaluated. How to handle diabetes is pretty much a set protocol - getting her to be compliant to be tested, take her meds, eat properly, etc. won't be pretty/hasn't been pretty and that aspect of her health care will be the hard part.

You say she has dementia. Has she had the standard cognitive tests done: MMSE, MoCa? If not those, has she had the mini-cog done - that's the 3 word & clock drawing one. If she did, what did it show? Has she had a brain scan = how long ago and how much shrinkage?

I'm assuming you have DPOA & MPOA, so you can request that these tests be done if they haven't been already done. If you don't have this, and she wants to fight you on being there, then it's a whole other set of legal & sticky issues.......

How does the NH handle physicians? Most NH have a medical director and all referrals come through him/her for all consults - if that's the case make an appt to meet with the medical director and social services to come up with a plan for your mom. Most NH use MD's only within their network, so if her old doc isn't one, then
he will not be her MD anymore.

For us, we were fortunate that the med director of my mom's NH was already her geriatric physician so it was pretty smooth for her medically but even then her med's were done incorrectly on admit and there were issues related to medical necessity of NH because of this. In talking with others visiting at the NH, there seems to be a real problem in getting records/medical histories from the residents past physicians or hospitalization records - part of this due to HIPPA and part to it being a not my job issue. Especially the ones dealing with mental health. My point is that if mom has a extensive medical history and her doc isn't in the NH's group, you need to get copies of those records to the medical director of the NH before you meet with them.

She isn't the first one with this behavior for them, they see this all the time. It could well be they think of her on as a 5 on a 1 - 10 scale while you see her as a 9.
Good luck.