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We were advised to tell my MIL that was moved into AL during an intense medical crisis, involving hallucinations, that the drs. said she needed to be there for now. She does not believe she needs help. Her Primary Care Dr- who has not seen her in person for almost 2 years- told her over a video appointment that she should go home for a week to see how it goes. We live 40 minutes from her, she lives alone, she has fallen, and the police have “recommended” that she not live alone anymore. She is now focused on this. She is doing very well in AL, with proper nutrition, medication control, and exercise. Has anyone tried this or had this recommendation made to their family member?

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So, let's walk through the scenarios of how this could go..... She returns to her home to live alone and
1. She falls, breaks a bone and ends up in rehab, or
2. She manages to stay upright but you get calls everyday about something she needs, groceries she needs, the TV channel isn't working, she things there is someone lurking in the yard, etc...... You make multiple (daily trips) to check on things, or
3. She is at home but you realize that she isn't really eating or taking her meds because there is no cuing or supervision. She thinks she doing fine but you realize that she's not doing fine at all and you can't convince her to return to AL, or
4. She is at home and she the neighbors and police finally contact you to report that she needs more help than she has or
5. Any combination of the above scenarios.

Do you actually see any scenario here where she returns home, her dementia disappears and she manages to not fall, shop for groceries, cook meals, take her meds, and live alone without any daily assistance or supervision?

And she will NEVER agree that things aren't working out living at home, no matter how bad you realize that they are. That's part of her magical thinking that she really CAN do all the things she used to do and everything is just fine. Make up some vague excuses until she finally stops fixating on this because this is the worst idea I can imagine.
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Bighouse Sep 29, 2021
Jkm999- It’s crazy how spot on your response is!!!! Everything you list, except for broken bones has already happened!!! I actually used the TV remote example as something that I could not do for her every other day if she was home alone. Thank you, and everyone else for reminding me that we really are trying to do what’s best for her. She does so well in a monitored environment, that I start to question my decisions! And… yes, we are switching her doctor.
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Living with and caring for my wife who is stricken with hideous AD, I can tell you that she would be at risk at home. Every day, every hour, is different. One minute she will do everything right. Minutes later nothing makes sense. Water left running, doesn't know how to go to the bathroom, can't dress, puts ice cream in the frig or a million other things.

If no one is there to check her every move, there will be trouble. Keep her where she is. Please.
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Let me tell you this: my mother is almost 95 years old, with advanced dementia & living in Memory Care Assisted Living since June of 2019. She will tell you vehemently there's NOTHING wrong with her and she does "not belong" in Memory Care at ALL. Period.

Denial is not just a river in Egypt. It is something many, many, many elders suffer from, unfortunately (for the family).

Your mother's PCP has a lot of nerve 'recommending' that she 'go home for a week to see how it goes.' Why doesn't he recommend she climb a fourteener in Colorado while he's at it, if he's going to make unrealistic & ridiculous suggestions, after not even having the decency to see her in person for over 2 years?

Your mother is doing very well in AL precisely BECAUSE she is getting proper nutrition, medication control, and exercise. Move her out of that controlled environment, and all hell will likely break loose again, as it did before she was wisely moved to AL in the first place.

If this were my mother with 'mild dementia', which doctors ALWAYS seem to call it when it's really more like Moderate dementia, I'd tell her that it's time to retire her former PCP b/c video doctoring is not real doctoring at all, and that going home for a week isn't an option because there's nobody to stay with her for that time to insure her wellbeing. So she stays put; the family is all in agreement that she's in very good hands at the AL and well cared for there. Since you have the POAs intact for her, you need to act in her best interest which is what you are doing by keeping her where she's at. "Going home" to see what happens is a recipe for disaster. Even if things go well for that week, they will NOT go well long term. Dementia does not lend itself well to living alone, under any circumstances. It progresses and worsens with time, which means your mother will wind up in AL anyway, now or later. So don't fix what isn't broken, that's my suggestion.

Good luck!
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MJ1929 Sep 29, 2021
Not sure everyone would understand the "climb a fourteener" reference, but I do. I lived in CO for 13 years. 😉
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If she is absolutely insistent that she goes home, then make her do it. All by herself, nobody does one thing to assist her.

Nobody steps in to help in any way, shape or form. She will either get home and work it out or she will continually use what the idiot told her (I would file a complaint against his license for this crap by the way.) to try and guilt everyone to take her home and prop her up.

I told my dad, you can do whatever you can do. That doesn't mean ordering me to find a place, pack you up, move you, make phone calls or anything else. Whatever YOU CAN DO. Boy was he hot. In his head getting others to do it was him doing it.

I will say though, it took him a year of hard work, lots of sorting things out, mostly alone, his caregivers helped him on the computer but, he did actually pull off moving out on his own. He would have rather been dead then in a facility and he did get his final wishes. He lived alone, was able to shop, take care of 3 dogs, get his laundry to the shop and prepare his own meals. Was it perfect, not close but, he made the decision that he wanted quality over quantity and I honored that desire. He was as happy as anyone could be in the situation, he had some dear people that loved him and he wasn't endangering anyone but himself in the end. Would he have lived a little healthier in a facility? I don't know but, I do know that he would have been miserable and that wasn't a good option.

As hard as it is to watch and know that the train wreck is coming, we have to step aside and let them fail on their own. If that means an earlier death, which I personally believe that our days are numbered and that we go when it is our time, then at least they got to do it their way.

Obviously there are exceptions to intervention but, I think people are pulling the trigger to soon in many cases because they have no boundaries and their parents are using them as personal slaves to prop them up, when changes could mitigate alot of the load placed on us by our senior loved ones. Making them make changes to keep their independence is a conversation that we should all have, making it abundantly clear that we are not going to step in so they don't have to make changes.

Best of luck with this difficult situation.
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BurntCaregiver Oct 3, 2021
Isthisrealreal,

An elder with dementia cannot be left to fend for themselves. The same way a child cannot be. Home alone quickly becomes a dangerous place for the senior with dementia.
No elder wants to be in a care facility and no adult children should ever have to become nanny-slaves to their parents because they're stubborn and demanding.
We have to do what's right for them though. What's right might not be what they want or what we do. It may not make them or us happy. Sometimes what a person needs is not what they want.
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Wow…tough BUT my counselor told me my responsibility is to keep my mom safe, a roof over her head and food in her life. PERIOD. I am not responsible to make her happy! My mom , in Al, due to Lewy Body dementia always questions her placement now that the extreme hallucinations and dementia has subsided. I tell her…no going home…Lewy could trigger again when you are living alone and that is unsafe. I schedule 3 very active visits with mom weekly…spaced out and on the same day time…that satisfies her..hope this helps…Good Luck! P.S. I am her POA and my decisions are the bottom line…she set that up a few years ago and always said do what I need done not what I say if I am mentally not correct..
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Reply to Sadinroanokeva
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Dear Bighouse.
Any Primary Care doc who says yeah go try it... Is negligent, based on what Information and assessment...none? So I doubt he she actually said it. Think lawyers lurking ..
You should call him to ask if this was really said. My 90 parents would have fabricated this in order to try to go home...
Get the facts.
Dementia patients are still manipulative and can and will confabulate..
Prayers for you..
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I have two ladies right now who I am assisting: One is in a NH and the other is in a rehab setting due to a fall. Both ladies have previous rehab "experience". Both ladies seemed to do fine in the facility when they were in the controlled setting with people checking on them, meals, meds, bathing assist, and all of the other things a facility brings. Both ladies did well and it actually looked promising to bring them each to their respective homes, but neither did well at home. One lady did last a few years at home, but had multiple falls where she laid on the floor for hours because she didn't have her life alert on and she lives alone. This led to multiple trips to the hospital and she was admitted many times. The other lady only lasted a few months after "graduating" from rehab and she was back in the hospital and then to NH due to severe confusion, multiple falls, and general physical problems partly due to her refusal to do her prescribed therapy. Trust me, both ladies were A-OK in the protected environment with all of the help that comes with it. Both ladies insisted that not much was actually being done for them in the facility and why wouldn't home be better? Well... please don't attempt this. One of my ladies had returned to her home of 45+years and seemed confused/overwhelmed by being there. Sad as that was, being home did not help her feel better or do better. It brought on a decline. Since being back in the facility, she's had long periods of stability and seems OK again. Are we moving her out - even temporarily? No.
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Vickimatthews Oct 2, 2021
Agree! My mom would take her life alert necklace and bracelet off all the time while living alone. Not good!
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Jeez -- get her a new doctor. What a ridiculous suggestion!

A person with dementia isn't going to know how it goes. When it goes badly (and it will), she gets the trauma of being placed in AL all over again. That's utterly absurd.

I do hope someone in your family has power of attorney and all MIL's other paperwork (will, trust, advance medical directive) is in order, because it's time for someone to take the wheel here.
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Bighouse, were you at the televisit when mom was told this?

I am curious, because in her later years, mom heard what she thought the doc was saying, not what he was actually saying.

You might give him/her a call, describe mom's CURRENT level of functioning and see what s/he thinks.
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RedVanAnnie Oct 2, 2021
I was also wondering if Bighouse had been in on that PCP convetsation. I do not think the PCP would suggest going home out of the blue. MIL may habe asked PCP if she COULD go home and the doctor might have answered that she could "try it out."

Returning to her home alone sounds like a bad idea. If it was determined that she needed AL supervision, she still does. If she expects to live alone at home and that you are going to help her as needed, that's not living alone at home and it's a "No."
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Bighouse,

Who's your MIL's doctor? Dr. Vinnie Boombotz? SMH...This doctor who hasn't seen her in two years tells her over a video call that she should go home for a week and see how it goes. OMG. I guess it's possible for doctors to get fooled by a bit of showtiming from their patients.
If the cops said she shouldn't be living alone anymore, listen to them. They've seen her more than her doctor has. If she's being well looked after and is thriving in AL, leave her there. Let her fixate and focus on it until she tires herself out, but don't let her go back to her house. She's in AL for a reason and cannot manage living on her own anymore. Do not take her out of AL where she's already acclimated and doing well and send her home to God knows what could happen.
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