How do I reason with my Mom, who has dementia, but thinks that she can live by herself? - AgingCare.com

How do I reason with my Mom, who has dementia, but thinks that she can live by herself?

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In assisted living for 3 weeks and wants out. Mom is not great at making friends but responds to friendly people. She doesn't think that she needs the help that Assisted Living provides - she doesn't "need all that stuff" and needs to get out. I don't know how to make her understand that she has dementia and that it's not safe for her to live by herself. My brother and I have talked to her about her memory and that we want her to be safe. She disagrees. The assisted living community that we chose is nice but I don't think that they have done enough to make her feel comfortable with living there. She doesn't think that there are many other residents there that she can be friends with. It is a relatively small community and new - in business 1 1/2 years, capacity is 92 which they are about at half that. I thought smaller community would be better for her, but now I am worried that this is part of the problem. Not enough capable more vibrant people to become friends with.

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You don't reason with her. She has dementia. That means that her brain is dying and large sections are already dead. Would you reason with a 2-yr-old child? Would you reason with a dog or a cat? No.

Maybe she needs some meds to allay her anxiety. Sorry that you're having to go through this. Don't feewl guilty if you've done your best - that's ALL that YOU can do.

Here's a great book that's helped us" Being Mortal" by Atul Gawande, MD.
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I see your concern. It's difficult to find a facility where all things fit perfectly. My cousin is in a Memory Care unit, but there aren't many there who are at her level of dementia, however, they do have many other things that are excellent.

I decided to weigh the pros and cons to see if the place was right for my loved on My loved one's Memory Care unit is VERY clean, small number of residents, above minimum staff/patient ratio, majority of staff have been there 7 years or longer, staff and director available by phone anytime, all staff and director knows my loved one and engage with her daily, they are eager to do anything I ask and genuinely seem to care about the residents.

I would weigh the pros and cons of the place your mom is at at to see if it's worth trying a different place. Keep in mind that her level is going to change, so that even if she moved somewhere new, when her condition progresses, she could once again end up somewhere with other residents who do not match her level. There is no way to now how she will progress. For that reason, I would be reluctant to move just for that reason.

I also agree that 3 weeks is too soon. I would give it months. And keep in mind that you mom is likely not capable of being happy at any place, regardless of the environment. Reasoning with dementia is not possible. I would read a lot about how to redirect the conversation. Such as when she says, I'm not happy, why can't I move back home. Don't go into details. Just say, "You are safe here and we are doing what is best for you. Don't you look lovely in that shade of blue. I think I gave you that sweater for your birthday. Let;s go walk to the sitting room. Shoe me where your dining room is. And so forth. Keep redirecting about other things. Don't spend more than a few seconds on her wanting to leave. I can tell you that often they will stop saying this and may forget they have a home anywhere else.

AND I would discuss meds for anxiety with her doctor. Often that can really help reduce the anxiety and the patient is able to settle down and actually have some peace so they can relate to the staff and other patients more. IMO that makes a HUGE improvement. Before my loved on went on Cymbalta, she was scared, nervous and anxious and could not be relaxed enough to enjoy the activities. With medication, she became much more social and loves most everyone in her unit.
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We had a very similar experience with my mom in 2 different ALF's. The first one my mom seemed to be making friends but wasn't getting the care she needed at all! I think she was there about a month before the aides finally gave her a shower! Every day I came she had the same outfit on for days! Her hair was a mess, and one day her bra was hanging out of her shirt because she couldn't fasten it! I finally went to the administrator about it. Although she did finally get a shower or two, she ended up getting a UTI, getting more confused, and having to go to the ER. After a brief stay in rehab, we moved her to another nicer ALF that I thought would take care of her better. They did, but then she became dehydrated because she wasn't drinking and eating enough and ended up extremely confused to the point where she couldn't be left alone in her apartment even overnight! So after another trip to the ER and then another stay in rehab we were told that she needed care 24/7. Either she was going to have to stay in the nursing home long term or come live with us. After having a family meeting we decided it would be better to bring her home to live with us. I ended up quitting my job to take care of her. That was almost a year ago, For the first 6 months everything was going pretty well except for the fact that she was having TIA's and now she doesn't know who we are anymore. So in essence, we moved her here because she wanted to be with family. However, now we are just strangers to her. Our biggest problem now is that she often tells us she wants to go home to her mom and dads. When we try to reason with her and tell her that they have been long gone, she doesn't believe us because she thinks she saw her dad the other day. When I try to tell her that I'm her daughter, Lori, she becomes upset and tells me I am not her daughter, Lori! A couple of times she has even tried to leave! There is no reasoning with her! So now I try my best not to argue with her although at times it's tough, especially when she is sitting there talking about her daughter Lori as if I'm not there. I have to be content with just being some nice lady that takes care of her! I'm not lying, it is extremely tough, and there are days that I become so frustrated and I just want to throw in the towel! In fact, if this keeps up and she continues to want to leave and go home I will probably just have to place her in a nursing home because it's just getting too hard to deal with. Now I realize that she won't like that either. In fact, she probably won't last too long in the nursing home, but that is the only thing left to do.

The other dilemma we have with her is when the home health aide comes to give us respite care. My mom gets mad and tries to leave because "she doesn't need a babysitter!" Again, there is no reasoning with her. So we just have to accept that she is going to throw a fit every time the aide comes. This is another huge source of stress. However, as her one and only caregiver I'm also not about to quit having the home health aide come just to please my mom! We only get 15 hours a week of respite care, and without it I would go absolutely crazy! So now when my mom says she doesn't need a babysitter or 24 hour care, and that she can be by herself I just tell her that the aide is here just in case she falls. She does seem to be content with that at least for a little while as she has fallen a few times. And the fact that we have her on medication at night to relieve some of the agitation has helped some.

Anyway, I have learned some very important lessons through this all. First, there is no reasoning with her. Don't even try unless you want to get in an argument! Secondly, she is not going to be happy anywhere she goes at this point! She is not going to be happy in a nursing home, and she is not going to be happy here. So in other words, she is not going to be happy anywhere! You might as well learn to just accept it.

However, I agree that 3 weeks is a little soon to know if your mom is going to settle into the ALF and make some friends. My mom would probably still be in an ALF if she was able to take care of herself enough, but she just needs a higher level of care now. You have some great suggestions here such as showing up at mealtime and encouraging your mom to socialize with others at the table. I also did that and it seemed to help ease the transition until my mom made some connections with the other residents at the first ALF she was at.

I don't really like to resort to lying, but a little fibbing may be necessary at times. Perhaps all that is needed is just to acknowledge and validate the feelings behind it, like saying, "I know it must be tough to have to give up driving." And possibly redirect as able. Sometimes I'll tell my mom, "It's too late to drive you home. We'll talk about it tomorrow." Anyways, you get the idea. You just have to get creative sometimes and find something that works in your situation with your mom.

Best of luck!
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When you say "the assisted living community that we chose" - does that "we" include your mother?
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I would say that 3 weeks is too soon to know if you mom will settle in to her new environment. I took my dad about 3 months to start going to activities and looking forward to them after he moved to a fairly new AL facility. He would tell me he did not know anyone, etc. but I would learn from other residents that that was not true. I would try to attend one of the weekly social events with your mom to be able to judge for yourself.
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Glenna, as the others said you cannot reason with dementia, don't try, it will only be frustrating for you and agitating for mom because nothing you say will make any sense to her. Talk to staff about your concerns. One of the problems with new facilities is they tend to be understaffed. I have a friend that had his wife in a brand new, beautiful facility very close to home. But, all beds were not occupied, so staffing ratios are lower than if they were full. Then those that work as caregivers get frustrated because they have a heavier than normal work load. Then families complain to the director, director tells caregiver they have to try to do better. Caregiver becomes stressed and decides to leave this new facility, reducing the number of caregivers to residents again. What is the ratio of caregivers to residents?

You see it is an endless circle with new places? And ao many of them are opening. Where do they find all of the trained caregivers? Is there a Caregiver U that none of us know about?

And the friend that had huis wife in this new facility was paying for the top level of care in the area of $9,000.00 a month. The facility wanted him to pay another $700.00 a month promising his wife would get the level of care she needed. He refused moved his wife to an established facility, not as beautiful az the other one but his wife received much better care at the level she needed. Fancy, beautiful, new does not mean adequate care. But, perhaps it makes families feel better if folks have the newest, prettiest, most modern amenities. Personally I think the reputation for excellent care is the most important consideration before making a move like this.
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You cannot reason with her. Just forget it! Do not bring her home. You will only get caught in the revolving door of care, home, ER, back to care. Don't do that to yourself and Mom. She will adjust eventually.

My Dad has dementia, doesn't know what day it is or if he ate breakfast but he thinks he is just fine. He will not agree to even the most obvious issues that require help. I can't reason or convince him of anything. I have to wheedle, fib, lie and trick him to do anything that makes any sense. If I ever get him in care, there ain't no way I'll reverse the process.
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Truth is, you CAN'T reason with her...anymore than she could reason with you when you were three years old. She wants what she wants.

I suggest you talk with staff and see what they suggest...especially admissions. In two places we were involved with, the Admissions Coordinator ended up being our go-to.

Tell her/him that mom doesn't seem to be fitting in, and you wonder if there's anything you should be doing differently. She may have a suggestion or two. You've also put her on notice that she just might end up losing a resident without you saying as much...which you should NOT do.

Just an idea or two. I would often come at lunch time and encourage mom to sit with others...putting on my best social smile and manners trying to be engaging to other residents. Sometimes I'd show up mid-afternoon with cookies or donuts or some other group treat. I went out of my way to treat staff with respect, find reasons to compliment them, and maybe once a month bring in a big box of candy or a couple dozen donuts.

I also treated mom a few times a week with a pretty of some kind...a pair of earrings from Walgreen's, some dusting powder, small bottle of cologne, her favorite snack...

Give her time. Plenty of it. We can't expect everything. Sometimes we just have to be happy that they're safe and comfortable. We simply cannot do it all.
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At the point that we realized mom couldn't be alone anymore, we got her into what we thought was a nice AL, other relatives were living there. It was a disaster.

Mom did not yet need the services they provided and there was not the kind of socialization she needed. After a hospitalization and talking to a geriatric psychiatrist , who pointed out that mom's biggest problem was anxiety , and that she needed a very friendly facility with super concerned staff, we transferred her to an independent living facility. This did mean that I had to show up once a week to set up her pill boxes, but mom was still able to self administer accurately. Just some food for thought. At that point, we didn't know that IL existed.
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