Is moving with an Alzheimer's dementia patient to take a temp job in another state detrimental to her prognosis? -

Is moving with an Alzheimer's dementia patient to take a temp job in another state detrimental to her prognosis?


I landed a temp job (with the expectation of extension) in another state. I had planned to find an apartment there and another adult daycare center there for my wife, the AD patient. Our kids think it is a terrible idea, and my daughter-in-law, who is a social worker, believes it will precipitate an accelerated downward spiral in my wife. But if I give up the job, it is likely that I will never get my engineering career restarted, and will have to resort to minimum-wage labor work (I am unemployed now). What is known about such a situation which will aid my decision?

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Additional Details Requested:
Thanks for all your answers. To answer your questions about our situation: My wife has early onset AD, diagnosed 5 years ago, she just turned 65, I will turn 65 next month. She attends adult daycare every weekday and is still walking. She speaks, but her sentences are mainly collections of words and things she sees around her, strung together to simulate conversation. She is on a Medicare Advantage plan via Social Security Disability. I dress and bathe her. I thought we could move and continue this arrangement for a few more years before she had to go to a NH. Now I do see her health failing more: hiatal hernia with acid reflux, difficulty standing up and needing assistance to go to the bathroom, pain in her lower back from earlier occurrence of osteoporosis. But the recent changes have been subtle: I cannot tell if the mobility issues and back pain might have been caused by recently-initiated physical therapy (which seemed to be helping initially, and we have temporarily paused), and might end up going away. As for discovering the acid re-flux, I initially thought this was a positive development, because it gave us an explanation for her loss of appetite, and something to treat, but the medication has not conquered the nausea enough to return her appetite reliably, and some of her inability to eat may be caused by constipation from all her medications (the original cause of her loss of appetite), which I treat with Miralax, but it is difficult to anticipate the correct dosage to keep her regular. So the point is: I cannot tell if she has begun a new unstable decline, or just individual problems which need to be wrestled with. If the final decline to NH living has begun, then I feel I should not move her, because I think I can manage her at home for some time longer (I don't know for how long). But if she is in a general stable decline, then I might be able to move with her, without driving her into a downward spiral, shortening her life considerably. None of the kids are capable of attending to her hygiene (they are all boys, and my daughter-in-law just feels that type of care should be provided in a NH). Just finding adult daycare, an HMO, and an apartment in the new state location would be challenge enough. I should have asked for more time initially, but the recruiter wanted to close the deal with the client, and was not receptive to deferring the start date of the job any further. Sorry to be so long-winded, but these AD situations are complicated.
Helpful Answer (1)

davero, the way I look at it, if you move your wife out-of-State her dementia might accelerate. But then again, if you move without her, she would miss her primary caregiver and that could accelerate her condition. So it is darn if you do, and darn if you don't.

Having a job to go to is so very important for one's mind and well being. And since your wife is able to go to adult day care, that tells me she still is social, so that is good. Are you able to talk to your wife about this move? Is your wife good with new faces? Would she miss her doctors/dentist... and even hairdresser?
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My mother had dementia. My husband had dementia. I've attended caregiver support groups for years, listening to others who care for people with dementia. I have attended seminars and lectures. Here is what is known about such situations as the one you describe as far as I can see: Pretty much nothing. And unless she has had specific training, I think my observations trump most social workers' theories.

Some people with dementia are upset if the color of the rug in the porch changes. Some delight in the seasonal changes in the NH decor. Some don't want to leave their houses and some don't recognize the house they've lived in for 30 years. There is no formula for "how people with dementia will react" to just about anything.

My mother had a rocky adjustment period when she moved into the NH. And then she absolutely thrived there. It was clearly the best situation for the last couple of years of her life. Once she had to be moved temporarily while they painted her room. That increased her confusion considerably. She was fine when she got back to her room.

My husband loved traveling, and we did it throughout his dementia -- by train, by car, by plane, to visit relatives, to national parks, even to Tahiti. Waking up in strange room never seemed to increase his confusion. I think the key was he was waking up with me there.

Many people in my support group did travel with their loved ones, and there were no disasters reported. Some couples downsized to a more manageable resident. There were some adjustment problems but in the long run the person's dementia baseline did not change.

The truth is, dementia gets worse. Always. We'd like to prevent that, but at this time there is no known way to do that. Keeping someone in the same environment might be comforting. Some well-managed changes might be stimulating. And what either of these do to the disease process in the brain is simply not known. We have stories and examples, but which ones will apply to our loved one? We have no way of knowing.

I know this: it is better for the loved one if the caregiver is happy.

Personally, and this is just guesswork, I would not do the move in stages. Staying in the same house while you go ahead and set things set up MIGHT be a good transition, but staying in the same town without you and not in her own house just adds another move to her life. I suspect that the most important thing in your wife's life that keeps her grounded is you. Try to minimize your separation while all this other change is going on.

When I traveled with my husband I always made a big deal of it beforehand. Got travel brochures, printed stuff from the internet, discussed what the climate would be like, etc. This extended his pleasure in the trip. I didn't do this months ahead, but for a couple of weeks he could tell people "We're going on AmTrak!" For some people this talk about the future might invoke anxiety. Go slow and see how it works for you.

You are becoming the expert on what works for your wife. Trust your observations and instinct.
Helpful Answer (2)

I think you should take the job, not taking it effects your future SS. I think it will be hard for u to go to a new city, new job and her, new things. Maybe one of ur children can take Mom in. This let's you get settled and see how things work out before u uproot her. Maybe u can get her in a NH on Medicaid. Making sure ur children check up on her. Ur wife will only get worse.
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Could you provide more about your situation, like you and your wife's age, how advanced is her dementia, etc.?

 Moving may not be ideal for people who have dementia, but, sometimes, it can't be avoided. I think it depends on a number of factors. Regardless of where you are living, how long will it be feasible for you to work at a job during the day and care for your wife all other hours?(I had to move my LO when she had dementia and it was actually no problem for her.  She had a smooth transition, but, that may not be the case with everyone.)

 I might explore how it's going to be worked out. Does your wife have a long term plan for her care?

 Is it feasible for your wife to stay in the same town with another family member so you can pursue this career opportunity, before moving her to be with you?
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