My question is, she thinks she is in the hospital, or she is lost in the mountains, she didn't recognize her own house when she lived there. Is there anyway to help a dementia person understand where they are now living?
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Everything you said was exactly how I felt- LO had been living by herself in a large 2 story house, driving to Church and her local supermarket daily in heavy urban traffic, and in general, managing her own affairs.
A week after entering Assisted Living, we got the call that she was being moved to the AL’s onsite Memory Care facility.
We grudgingly acquiesced to the move, and very soon afterward, realized it was the right decision for all of us.
More happily, there are ways to reassure her which may also help her connect with the people who are looking after and/or living with her. It takes all day, and it takes training and aptitude and very special communication skills. If the memory care facility the NH is recommending can offer that kind of support as well as a living environment you'd be happy with for your mother, you'd be well advised to take their advice. At least look into it.
Has anything happened recently that might have exacerbated your mother's dementia and made her more frightened and disoriented recently? If so, could it be something she might recover from, e.g. anaesthesia, trauma, surgery? She won't recover from the dementia, of course, but that doesn't necessarily mean there's no hope of *any* improvement. You should still consider Memory Care, but if this is an acute situation it might not have to be forever.
She doesn’t know where she is now, and whether you decide to move her or not, she will not know where she is wherever she is placed.
Prior to the tragedy of Covid, good MCs provided structure and appropriate types of stimulation. My LO could get her hair done, watch a movie, play Bingo, do puzzles, cook and enjoy snacks in part of a social group, go to church services…..
Nothing made her cognitive status any different, but everything contributed to a pleasant quality of life.
Fortunately she is still in a beautiful environment, and the people who care for her are cheerful and attentive.
Your MIL’s physician may want to consider trying a small dose of calming medication if she is terribly uncomfortable when agitated, but there is no reason that you as her caregivers may not wish to place her in new surroundings as long as you are comfortable that the suggested placement will work better for her and those of you who visit and oversee her life in her residential placement see that she is more peaceful while there.
I'm afraid that is not in your power.
What you can do is make it homely with some familiar/favorites items, act positive & reinforce it is a safe place.
Does she need a Skilled Nursing facility?
Many MC will not take a resident if they do need more skilled nursing and they typically will not take any one with "tubes" so IV's. Feeding Tubes, Ports, and the like as people with dementia tend to try pulling them out.
Have them help you find a facility that will accommodate her needs then tour it and a few others. The facility where she currently is can help arrange transport if that is a problem.
You might think about it as a child is in the stage before they can memorize their address. Sometimes I think about dementia as aging in reverse, back to childhood.
The staff at Memory Care is trained to deal with these issues. The agitation is something that they may be able to help with.
But there are ways to make the transition less traumatic.
There is no need to have explanatory conversations about the move. Just do it. Talking about it, planning it as a future event, can cause apprehension.
Change is confusing, so try to arrange her room in the memory care as close to the arrangement in the nursing home. Especially try to get the bathroom on the same side of the bed. Keep the same bedspread and the same items on the nightstand. You get the idea.
In my experience people tend to move from memory care into a nursing home. It sounds like your MIL may be in better physical condition and doesn't need the extra care of a nursing home. She'll have more interaction with people in memory care. It could be a good move for her! So just make it happen, and accept the fact that she may not understand.
Best of luck to you.
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