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?
It sounds like your mom in far enough along in the disease not to need a "real" explanation. A month ago I had to move mom from her assisted living apartment into memory care which was just another section of the same facility only it's locked down. I told mom that her apartment needed some repairs so we were going to a nicer one that was in better shape. I took the day off from work to help her "decorate" it. I told her that her room was nicer than the others and she was fine with it. Some nights I take popcorn to her and we sit on her bed and watch a movie together. So I guess my answer to your question is that you can't really help her understand, but you can tell her something that she will go along with or accept. You know your mom better than anyone else...what will appeal to her? If you say that she is moving to this new room because they have better care, will that make her feel better? Something along those lines might work.
With dementia, no matter where they are, they will be confused. You can explain until doomsday but nothing will sink in. Just reassure her she is in a safe place, you are with her, you love her, etc. They are used to handling these issues much better than you. You cannot fix a broken mind. Be in peace - it is not you.
We have a little trick we’ve learned through the years that helps my mom accept most things. It was my sister’s idea. We tell Mom that our brother, whom she idolized, said she needs to do it. She will shake her head up and down and say ok.
I also am confused about a request to go to memory care because the NH cannot handle the anxiety. Like others, it is my understanding the order is ALF, MC, then NH. My mom recently had a delirium episode in ALF. She went to the hospital which after a week wanted to discharge her back to ALF (in the midst of hallucinations) with hospice. Doc was a total jerk. Anyway, at that time I assumed memory care was the best choice but learned no, they do not have the medical resources to deal with that kind of issue. She recovered from the hallucinations in a couple days, went to rehab and is doing great! Returned to ALF 3 days ago but truthfully, I don’t expect it to work. I think she needs the extra attention of NH. All this is to say—get an explanation for why this NH thinks your mom should be moved to MC and be sure you agree. You know your mom. My mom’s hospital doc was way off base. You push for what you think best serves her. Best of luck.
My experience agrees with the person who answered a simple "no," there is no way to get a person with dementia to understand, and the best thing to do is just to do it and remain as calm and reassuring as you can while you do it. You can say that you are moving her to a place where they can take better care of her. My mother is also able to live in a memory care unit with advanced dementia. She is petite and they are able to move her from her bed to the wheel chair without using equipment. My mother needs help with everything, including being fed. All the best to you both!
The simple answer is No, there is no way to help a dementia person understand. That's the truth about dementia, and a sad truth it is. 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.
More important than if your Mom understands (she won't) is the care she receives. Visit the Memory Care unit and be sure you like it before you move her. From your Mom's standpoint, it won't be any different. However, if you feel the the quality of care will be better, than this is a no-brainer.
Unless she asks, why bother telling her anything. IF she asks, tell her you are all taking a small vacation and that to enjoy the time now. They won't understand even if you tell them now, because in 10 minutes they won't remember, their brain is like a sieve........some of the holes are closed to retain some of the information they have lived thru, other areas are open and stuff flows right thru and has to be repeated. i wish you luck.
Is there a reason to have them understand? Isn't it conceivable that it does not matter? Believe me, it is very difficult for us to understand that our beloved family member understands little to nothing. Just hope s/he is content and oblivious. Yes, a damned shame.
No, there is no way to make them understand. Once someone reaches that point, it is up to their family to accept that this is how they are. This is their current reality and that's that.
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.
You mom regrettably will never understand. When mom seems agitated or frustrated, do what you would do for a child and be reassuring. Be patient as that will be your best defense
Unfortunately there is no way to make you mother understand where she is living especially if she thinks she is now living in a hospital or lost in the mountains.
Just keep reassuring her that she is ok and that she is safe. MC is more likely to be able to reduce your mother's agitation. Your only assurance you have is that the facility will work with your mother and keep her safe.
This very thing happened to us as well. She was in assisted living and within less than 90 days they told us Assisted Living wasn't the right place for her and wanted to move her to memory care. We were not happy; she hadn't even had time to adjust to Assisted Living and they wanted to move her again. BUT, after talking with a friend who's mother was in the same facility, she said, it's harder for you than it is for her, they will get her room all ready and take her from one building to another. She will see some of the same caregivers and within a few days it won't be any different. So, that's what happened and she didn't appear to have any issues with the move. If she did, she never said anything to any of us.
Your generously honest comments about your mother’s care and the loving decision you made is possibly even more helpful than you can realize.
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.
No, there's no way to make her understand. She may be able to comprehend an explanation for a moment but will soon forget what you told her. She thinks she's in the hospital now because nursing homes look like a hospital. Facilities that are exclusively for dementia patients don't. Many of them look like a nice hotel. Your mom will be happier in a place that she doesn't think is a hospital. Have her moved and don't try to explain.
Is MIL paying privately for the NH because MC is private pay.
I really don't understand why a NH can't handle this. In my area its AL then MC and then a NH when MC cannot handle the care needed. A NH usually has a number of Dementia patients and should know how to deal with them. Why haven't they suggested giving Mom something to calm her when she gets like this? What your MIL is experiencing is not uncommon in Dementia patients. And no, she will never understand what is going on.
With my Mom, we just told her she was going to go to a nice apartment where she will meet new people. My Mom never asked to go home.
I've yet to meet an elderly nursing home resident who doesn't have some form of dementia. Most large nursing homes have a special floor or wing which is what is now called 'Memory Care'. Back in the day it was called the Dementia Unit and really the only difference from skilled nursing care was a locked door. Today they want everyone with dementia off the skilled nursing facilities and into memory care because they don't have the staffing levels they need to look after the dementia patients (many of whom are still mobile) and the ones who need medical care.
Moving my dad from skilled nursing to memory care was the best thing for him. The only reason he was at skilled nursing was for some medical issues that had stabilized but he was not getting the socialization he needed. We chose a small facility that is run by an RN. She manages dads medical needs and works with the medical providers and home health. He is integrated into daily activities and gets socialization he needs. His anxiety is almost gone (with the help of Seroquel), as they seem better equipped to deal with his dementia behaviors.
Since her thought process is clearly already disordered, do you have a specific reason for not wanting her moved to an MCF?
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.
No, there isn't any way to help a person with dementia grasp reality in the ordinary meaning of the word. Some types of dementia destroy a person's ability to orient herself in time and place.
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.
Actually the facility is giving you good advice. A person with dementia needs MC for their safety. 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.
All this is to say—get an explanation for why this NH thinks your mom should be moved to MC and be sure you agree. You know your mom. My mom’s hospital doc was way off base. You push for what you think best serves her.
Best of luck.
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.
They live wherever the mind tells them they live.
So sad for people with dementia.
Changes are very hard on them.
Prayers
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.
When mom seems agitated or frustrated, do what you would do for a child and be reassuring. Be patient as that will be your best defense
Just keep reassuring her that she is ok and that she is safe. MC is more likely to be able to reduce your mother's agitation. Your only assurance you have is that the facility will work with your mother and keep her safe.
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.
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.
She thinks she's in the hospital now because nursing homes look like a hospital. Facilities that are exclusively for dementia patients don't. Many of them look like a nice hotel. Your mom will be happier in a place that she doesn't think is a hospital. Have her moved and don't try to explain.
I really don't understand why a NH can't handle this. In my area its AL then MC and then a NH when MC cannot handle the care needed. A NH usually has a number of Dementia patients and should know how to deal with them. Why haven't they suggested giving Mom something to calm her when she gets like this? What your MIL is experiencing is not uncommon in Dementia patients. And no, she will never understand what is going on.
With my Mom, we just told her she was going to go to a nice apartment where she will meet new people. My Mom never asked to go home.
I've yet to meet an elderly nursing home resident who doesn't have some form of dementia. Most large nursing homes have a special floor or wing which is what is now called 'Memory Care'. Back in the day it was called the Dementia Unit and really the only difference from skilled nursing care was a locked door.
Today they want everyone with dementia off the skilled nursing facilities and into memory care because they don't have the staffing levels they need to look after the dementia patients (many of whom are still mobile) and the ones who need medical care.
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.
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.
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.