We were also instructed not to visit my mother when she was first placed in assisted living but we all sent cards, flowers and gifts every day telling her to be strong and that we loved her.  It did help her a great deal. 

#1 daughter, I am so sorry you are in this situation.  While I only have a paragraph to go on, if this were my parent, no matter what I was told, I'd be there every day and especially at meal time.  

While I know that many care facilities have their way of doing things, can we please have a discussion on this?  Can we challenge the current line of thinking that it is best for the daughter, son or spouse to leave and not come back for a period of time?  Sorry guys, but I can't help but feel that your mom is scared, lonesome and feels abandoned.  She needs your support, your face and touch, to reassure her that all is well.  She needs you, the one person she remembers, to grab her hand and say, "Hey Mom, let's go enjoy a nice breakfast together."  

I personally believe that we mishandle the "transition" period in this country.  And it is up to US to change the standard in every care facility in this nation.  Who knows, maybe in ten years, care facilities will recognize that there can be a more loving, less anxiety ridden, transition period for all.  And it includes "loved ones". 

Dear #1Daughter, I am truly so sorry for what is happening and my heart aches for both you and for your mother.  It is evident you want to do what is best and I can understand how concerned you must be.

I am an RN whose mother had FrontoTemporal Dementia and whose step-dad was diagnosed with Alzheimer's Disease.

It is not unusual for facilities to ask families not to visit for the first few weeks following placement, BUT; that being said, it is not a hard and fast rule.  You may visit whenever you wish.  The facility cannot fault you for that or keep you from visiting your mother.

I do understand why some facilities request this of us; the facility wants the person to begin to bond with the staff and begin to rely upon the staff and not see the visiting relative being felt as a, "way out," by their patient/resident which may cause them to take longer to adapt to their new circumstances.  I do get this.

HOWEVER, I also can also truly understand the deep-seated fear the placed person can have of being totally, abandoned.  This of course, is not so, but our Loved Ones (LOs) do not reason as we do and their ability to process is badly damaged.  Their personal reality is absolute truth to them and in a case such as this, the fear can be overwhelming and the stress monumental and this can lead to traumatic insecurity.

In such a situation as your mothers, where in nine days, almost a week and a half, in which she has literally not eaten much at all and is not taking fluids, this is a horse of a different color and she may be at high risk for developing a physical downturn with negative outcome.  Dehydration is a very real specter and can happen quickly and really affect an elderly person's health.

To give her a tranquilizer to "lessen" her anxiety is one approach the facility staff wishes to take.  There are different outcomes in such an approach.  It may work very well and help turn things around.  But perhaps this approach may possibly have it's own risks in causing sedation, increased risk for falls and further confuse her and cause her cognition to be further compromised.  I wonder if the medication will lead to her wanting to eat and in being willing to take in fluids.

At this point, her intake for both food and fluid and ability to void sufficient amounts needs to be monitored very carefully and documented in her record, and a licensed nurse needs to assess her carefully for signs of dehydration on each shift and document the assessment findings in the record.

What you now do will be up to you.  If you feel things have evolved to a deep concern for your mother's condition and you have become worried about her stability, you may want to make a visit to see her.  Will she be upset and act out and beg to be taken away?  There is no way to know this and it may happen to a degree or it may not happen at all. 

It is really rather "scary" to face such behaviors in our Loved Ones; and if we are feeling a bit of guilt regarding placement, this can make us feel even worse and more stressed about facing our LO.  However, upset will not kill us and we are strong and can deal with it. 

Then again, you may not feel it is necessary to see her as yet, and of course that is your decision and choice; you know your mother and the facility far better than we do.

Does she have any familiar objects with her?  Does she have a comfortable quilt or afghan or even stuffed animal or doll she enjoyed having at home?  Does she have any familiar pictures or favorite robe or other thing that would be comforting to her?  Is there some special thing she always enjoyed eating or drinking that may trigger her wanting to eat or drink?

Personally, when my mother had to be placed as there was no longer any alternative, it was immensely difficult and stressful and yes; I did have a reasonable amount of guilt.  I was asked to stay away for a few weeks and it was explained to me why.  Well; I complied, but it drove me to distraction.  I found myself calling the dayshift and the evening shift to check on her each day.  I also visited a couple of times and stayed in a room with glass windows that the residents could not see into, but I could see my mother and how she was faring during the day.

Frankly, I think that being far more experienced, knowing what I know now; I would not have honored the facilities request not to visit.  I would have visited anyway.  I don't know if I would have done this daily, but I do know I would have limited the amount of time spent at the facility and would not have stayed a full day as that would have been counterproductive to adaptation for sure.

 If I put myself into my mother's position, I could see how upset I would be, how I might feel abandoned, how frightened, threatened and dreadfully insecure that could make me feel.

However, many other caregiving family members may feel quite differently; each person is going to be different and one approach does not fit all.

In this instance, the lack of nutrition and especially of hydration is complicating matters and if her health is becoming compromised, turning that around will trump the facilities request for family not to visit for two weeks.  Rather than initiating a new medication, perhaps using a different approach may be useful.

AND:  Please do contact the Alzheimer's Assn. Helpline at (800) 272-3900.  If you call, ask to speak to a Care Consultant.  Consultant's are highly educated Social Workers that specialize in dementia and they are wonderful sources for all sorts of assistance.  A Consultant may well be able to help you problem solve and work through this.  There is no fee for this service.

If your mother is capable of understanding and processing it, the idea of sending flowers, or little gifts or cards in your name may be of assistance as time moves forward in her adaptation. 

I send you my very warmest wishes and do understand how this must be affecting you.  You are a caring and loving person and are in the process of becoming a very fine advocate for your mother.  I can really understand how difficult this must be for you.

Please do let us know how you and she are doing, we will absolutely be thinking of you and we truly do care.

With a soft hug from one daughter to another,

Johanna

If she isn't eating and drinking after nine days-it mean she isn't bonding with the staff. And if it's anything like the MC I put my mother in for respite care-it might be because they can't give her enough time to bond with them. In fact-I asked about how much face to face, hands on care and time my mother will get from staff and was told they give hands on care for daily living functions, but after that it is not one on one care. Activities and eating are group function.I was told if I wanted more one to one care-to hire someone! I did-someone came during lunch. I wanted to be sure she ate and drank well during their big meal.

 I also rarely saw the same group of aides on the floor so unless your MC have a system that is special for the first 2 weeks a  new resident's entry-your mom could be seeing a different person every day!

IF it was me, I would want to know -what are you exactly doing for my mother when she is crying for me? What are you doing to get her to eat and drink?

THIS. Exactly.

And I second what His Daughter and Jo C. had to say about visiting. If after nine days she is still crying and not wanting to eat or drink, IMHO staying away is NOT working. Going to visit her, perhaps at mealtime, and reassuring her that she hasn't been abandoned there may help... and I can't imagine how it could make things worse.

My heart aches for both you and your mother after reading this. I am sorry that this transition is SO hard for both of you.