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My mom, age 98 and with increasing dementia, always begs me to stay when I'm ready to leave her ALF, whether it's been 30 min or 5 hrs. She's more & more like a toddler who doesn't want "mommy" to leave. And her conversations are a jumbled mix of lifetime of memories & people. Not sure how to handle this without leaving her feeling sad and guilty. Both my sisters have died in last couple years; my brothers live far away & are no help at all. Her ALF is wonderful place w/loving & caring staff.

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My 85 year old mother does the same thing! It's SO hard and frustrating. I have to just turn around and walk out hearing her screaming and crying. She does the same thing when my brother is leaving.
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Just be honest with her in a gentle way. Tell her you have some errands you have to run and will be back as soon as you can get back. It will make her feel better to know that you coming back as soon as possible, even though she doesn't know how long that will be. It isn't a lie. It is the truth with hidden time information. I don't think lying to them is right even if they will forget it in 2 seconds, God won't and neither will you. Just be gentle as leaving your child at school for their first day. I will see again just as soon as I get done with the things I have to do.
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Whatever you do, your mother is going to be upset at the point when you leave: as you said, it's the same whether you've been there all afternoon or just a short time. It is sad: she's clinging to you, she's distressed. What kind of person wouldn't be sad to see that?

But you can't stay longer than you do, you're not upsetting her through choice. I expect you do wish your mother could understand her circumstances, could know that you'll be back when you say you will, wasn't afraid to be left; but wishing doesn't change anything. What I'm getting at is that I think what you feel is sympathetic sadness, more than guilt, and your feeling is appropriate: the situation is heart-breaking.

I agree with many people above that reassurance, distraction, handing over to another person may all help your mother, which will help you a little. But it won't change the reality of what you're dealing with, and I'm sorry for it, it's a terrible thing. Don't feel guilty, though; because whatever you'd give to be able to do it, you can't cure her. Her suffering is not your fault.
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Charles1921 - guilt is a prison. And what does it change? Nothing. You got to be there at the critical moment, and so many of us have been robbed of that. You could not have stopped a heart attack. You would not have even been allowed in the room while they worked on him. Please give yourself permission to let go of the guilt. Channel that energy into giving back or paying forward somehow. Maybe volunteer at a senior place nearby as a companion visitor for their shut ins. Or meals on wheels. Etc. Do something positive.
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We should remember that each situation is different so you have to take the advice you see here and adapt it to your situation. If your mom doesn't remember things after a few minutes, then telling her a fiblet is actually better for her than being firm. Being firm implies that she still has the ability to reason. If she does remember things from day to day, then fibs are not good. Also, I personally think the word “manipulative” makes it sound like this behavior is intentional when in fact it is not. I too believe much like a toddler, they are fearful of being left alone by anyone. Having someone with them makes them feel safe. I’ve seen this with residents that have never met me. They latch on to my hand within seconds and just won’t let go. They beg me not to leave them but you have to. Some of them have so much fear radiating from them, I wish we could figure out how to reduce this anxiety without medication. I know sometimes a stuffed animal helps them feel comfort.
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I have been there with my dad before he passed. It tore me apart everytime I had to leave. I stayed 8-10 hours everyday. THe last time eig whe he was admitted to the hospital for dehydration and I said I'd be back in the morning to bring him home. His eyes started to tear up ad my heart broke. I the morning they called to say he had a heart attack and to get there quickly. He died shortly after I got there. The guilt eats at me daily.
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Bless your mom, great age, 98 wow. I do like lulabear suggested, she does not do it as much as she used to do it, but when she does, distraction and she understands when I tell her I want to go before it gets dark and I'll be back soon. She then wants me to go and get back safely. They say the rosary where my mother is around 4:00 pm, so she usually is content to do that. Distraction is the best way with my mother.
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Telling your mom that you'll be right back and then leaving seems cruel to me. We don't know what goes on in the brain of someone with dementia.

My dad did this when I visited him at the nursing home. He wasn't being manipulative and we had reversed our roles, he was the child and I was the mom. And small children whose mom's are their entire world hate to see their mom leaving. That's how it was with my dad. He told me he wanted me to quit my job so I could spend more time with him (he had hepatic encephalopathy which is swelling of the brain due to advanced liver disease).

It was very difficult to extricate myself from him once I had been there and spent a good amount of time with him. He'd get a hangdog expression on his face and tell me in a pitiful voice that he didn't want me to go. I didn't feel guilty leaving but I hated that it upset him so. But every night I would call the desk and ask how he had been since I left and I was told that he had been fine, social, and out of his room.

I don't think the behavior is always manipulative in nature. If I had to live in a nursing home or ALF and my daughter came to visit with me I'd be sad to see her go too. I like to think I'd have a stiff upper lip about it but if I had dementia or Alzheimer's there's not much likelihood of that.
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I don't think its a good idea to tell them you are going out to do something then leave. That could make them even more mistrustful and they could be asking everyone where you are. I just tell the truth, give a return time, be firm and loving. No, they don't like it when you have to leave, but that's where you can't let them control and manipulate; altho most are not doing it intentionally. They just love you and want to be with you. You have to go do things, and in their childish mind they don't understand. You have to do them, anyway, My mom has advancing dementia.
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My mother, 82 yo with dementia, does the same thing. It's very sad because she is genuinely scared and upset, not just being manipulative. What I do is bring her out to the common area and ask on of the staff to distract her with an activity or conversation, then I slip out. One minute later, she's ok.
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Try telling her you are just going out to talk to the staff and will be back in a few minutes. Most dementia patients have no concept of time and once you have left the room she will forget you were even there. Little white lies are a necessary evil when dealing with people with short-term memory loss. Forget the guilt - you are just being kind.
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Like a toddler, she is attempting to manipulate you into getting her way. Assure her you will be back and tell her when. Kiss her cheek and go. Lingering only encourages a tantrum.
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