When do you move a dementia patient from assisted living to a nursing home? - AgingCare.com

When do you move a dementia patient from assisted living to a nursing home?

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my aunt is 95 and she is currently in an assited living facility....she has done well up until a few months ago with little help from staff...all that she will allow that is....she gets medication reminders and two meal a day delivered but will not accept shower assistance etc....the staff at her current AL facility has told me that she can no longer reside there because of her dementia as she disturbes other residents and makes phone calls all night to staff and to us also....she imagines people are breaking in and has phoned the police twice.....she imagines staff are making sexual advances to her....I tried removing her phone and then she knocks on residents doors and if they are unlocked goes in and looks for a phone......I currently have hired aides to attend to her in the evening hours until her meds kick in and she goes to bed.......she sleeps till 2 and then it starts all over again.......I have health DPOA and a Dr. has confirmed she has advanced dementia....here is the problem....i told her she has to move into a nursing home to get the care she needs....she refuses to accept she needs any more care than she receives now, and doesn't understand what the problem is...how can I convince her that a NH with dementia care is the best place for her to go? All the paperwork is done and chest xray for admittance....once a bed opens up I will have to move her within the next two weeks.....how on earth to I do this? I told her she must move to a nursing home where she will get the care she needs and it is very close to me, right around the block...she says that is rediculous, she doesn not feel she needs more care and she isn't getting and she is good where she is.......how do i handle this....do I just drive her there and drop her off? what if she refuses to get out of the car? What if she gets in the NH and says she isn't staying? NH says they can't force her to stay!! is that right? I am so confused, guilt ridden and sad....HELP!!!!!!!!

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Gayle189, if your aunt had always said, "I don't want to have cancer -- EVER" and she got cancer, would you feel guilty?

Your poor aunt has dementia. I'm sure she did not want that, ever. And I repeat, it is Not Your Fault.

Your aunt's behavior makes her unsuitable for assisted living and she is being evicted. This is Not Your Fault.

Very few places in your area provide what your aunt needs. You found one that does. Your aunt won't like this place but that is Not Your Fault.

I wish that there were an on/off switch on guilt and you could just permanently turn this one off. But even if you cannot completely shut off that feeling, keep moving forward in spite of it. You are doing The Right Thing. You are acting in love, and you just have to stay strong!
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I feel so bad for your situation. It seems everytime I get on here there is another family going through this horror. First, stop the guilt. Caring for someone with dementia is not safe for you or them and it only worsens.Second, If you don't place her now into a facility that is willing to accept her....chances are you won't be able to place her down the road.The fact that she is already wandering is enough to have her turned away...which is beyond ridiculous , I do not understand why a facility can claim to deal with alz and dementia,and then turn them away because of behavioral issues!!!! That's what the disease is ! They wander, they get combative, they do things totally out of their character and have zero control over it. It has been so frustrating. We are currently unable to place my Father in 3 states ( I am not kidding) because of it. My advice is place them in the stages, so that when they progress they can start managing meds then before it's too late. I wish the best for you.
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guilt comes and goes....and it is soley because my aunt has always said, I do not want to go to a nursing home..EVER.....and she is not dilusional, confused at all times, she has frequent moments of clarity.....and I would bet that she will not take this transition well and will know she is being placed in a skilled nursing home as soon as she is wheeled in the door.......she is being evaluated today for NH....so we will see....if she "qualifies" they will get her there....this NH facility has no private rooms, and they said they would not tolerate her wandering.....that is confusing to me...but there is not another facility within miles that has so called dementia care AND accepts Medicaid.....very frustrating....but anyhow, I thank you for your candid and quick response to my concerns.....
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If only people who thought they needed it were in nursing homes, we could probably close about 60% of all NHs. :)

I guess I would give up trying to convince Aunt that she "needs" it. You decided to move her so she wouldn't be bothered by people trying to break in or making sexual advances to her and so she wouldn't need to call the police or to call you in the middle of the night. You found her a very nice place with good security that's close to you. (If you don't tell her it is because she needs more care, then you won't have to argue that point with her, and it is an argument you can't win.)

NHs are not prisons and no, they can't force her to stay. (Their dementia units are usually locked, though.) But where would she go, and how would she get there? Don't you think that as a practical matter it would be very difficult for her to "escape?"

I can understand your confusion. I know why you are sad -- dementia is always a sad situation. But why on earth are you guilt ridden? Your dear aunt's dementia progressed to the point the ALF can't handle her. This is sad but it is Not Your Fault. Your aunt is confused, delusional, and has no grasp of the true situation. This is sad but it is Not Your Fault. Be proud that you are doing what needs to be done in a very difficult situation. Give up the guilt.
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