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Need Guidance on how to best transition a very resistant parent to full time at-home companion care or Memory Care
I can't say how BEST to transition your mother because I don't know what will work for her, but it helps to let them take small steps and then take more small steps until you get your mother in the situation that keeps her safest. For now how about saying you have a friend who needs a job and could the lady do things for your mother like fix meals, drive her to the store and clean the bathrooms, etc. In actuality the lady could be keeping an eye on your mother during her most difficult times-like mid afternoon or whenever she is most likely to wander.
Another tactic that works sometimes is to bring the parent to your home "for a short visit" which then lengthens as needed. "Oh, lets go back next week." "Oh, I can't take you home today, let's go back next week."
Once I got my mother to come stay with me, she forgot about her own home. In fact, we sold it to her grandson and when we went to visit him and her old house-she did not recognize it and was ready to go back "home" after a few hours there. Her "home" was where her cat was, and he was at my house.
I made the decision, and I moved him there. I did tell him about it two days prior to moving him. I explained to him that it was the best way I knew how to care for him. = Really, there wasn't any other choice. He could not stay in the house by himself. 24/7 caregivers would have put him in the poorhouse in a few years. He was not going to live with me in my house, that simply wasn't an option, and I'm not living with him in his. I don't have a patient, caregiving personality, it wouldn't have been good for either of us.
I did the research, and I found a beautiful facility near my home. Was he happy there? No. Was he happy at home? No. But he was as well-cared for in the facility as I could have hoped for. It is so hard to reach these people once they get that far along in their dementia.
Welcome to our world KM. I'm so glad you fud our site.
Google ansognosia. This means a person with cognitive impairment isn't in denial, their brain is just compromised to the point it can't recognize it's deficits. It's very common with dementia.
Keep in mind even living with you or with help that comes in, she needs 24/7/356 supervision now. No running out to run an errand. You will need to coordinate shifts for 24 hours a day. My mom used to get up during the night and wander around the house and my dad didn't always hear her. So someone needs to be prepared to on guard, ready to wake during the night. If she moves in with you, prepare for not sleeping as much and needing to arrange a caregiver for every moment you aren't there. Too much can go wrong, it just takes a second. At the point where she is wandering there may be other safety issues that are on the horizon or even here and you don't realize it, such as in the kitchen. Things that often cause someone to need to move a PWD to a facility is wandering, night waking, and incontinence all of which are likely coming for your LO.
As far as tactics, you can't reason with her or lay out logical facts to convince her. That ship is saild, her brain can no longer process this. You will likely need to use fibs and finesse the situation.
If you bring help in, say it's just a cleaning lady "as a gift so you don't have to worry about that" or your friend who has found hard times and you are paying her to help the family to get her on her feet. If you move her, either to your house or a facility, go there from an outing and say there is something wrong with her house. A pipe broke and it will take some time to fix so you have a room set up at this great "senior hotel." They will take great care of you and they have lots to do. The furnace went out but you can stay with me and I get to spend more time with you this week, won't that be fun? We can pamper ourselves. Whatever will fly. Redirect the conversation. Never say it's permanent, just that you validate her feelings about wanting to go home and maybe she can soon. Maybe next week. And repeat. And repeat.
Many PWD in the middle or later stages refuse to move or have help and we have to just find a way to force it on them with as little anxiety and discomfort for them as possible. it can be very unpleasant and difficult but we do what we have to in order to keep them safe. For my mom, we got her room at the memory care facility mostly set up ahead of time. Then my dad took her for an outing, I got the last of the things she needed out of the house, and finished her room. He brought her there and spent some time with her and said the doctor wanted her to be here for a little while, then at some point excused himself and left. He left notes saying the doctor wanted her to stay there for observation for a few days and he would see her soon and those notes really helped. It feels so awful and wrong but there were few options for someone resistant to it. You plan ahead with the staff, they should be able to help and give extra TLC the first day and week. When we got her adjusted to an adult daycare years before that it was a similar strategy and challenge. You go with the flow, try not to freak out, and do your best.
Trying to reason is 99% unsuccessful. Trying to convince someone that they can no longer take care of themselves is futile. Taking away independence leads to anger and taking away dignity leads to depression.
In my case having someone come in part time because they had been laid off worked well. It made my husband the helper.
I'm 58. Last kid is a freshmen in college. I'm an only child. My mom passed almost a year ago. Dad has ALZ. I'm also self-employed.
I kept Dad at home for 7 months after Momma died. I lived with him 16 of 24 hours a day for 7 months (he was never happy and would not come live with me). CNAs $25 per hour during the day (Some challenging times with their work schedules). Dad started falling frequently, so I had no choice but to place him. Memory Care $5500 per month (he's still not happy, but he's basically content and I can sleep at night). 24/7 care at his home $15,000/month (he would not be happy and would gripe about the caregivers during all of his waking hours). It was not an easy decision/move, but he's where he needs to be and I'm only 15 minutes away.
Add/Edit: Love my Dad. I miss my Dad. I can be a better advocate now. When I was working to keep him at home, he was agitated and I was exhausted. I feel blessed that he is in a place where he's a bit happy (most days) and I know he's getting adequate care.
Sending you a lot of sympatico, KM. This is a very stressful transitional period, in my experience it was the hardest - their reasoning is gone, but they are still actively up and about, able to argue their case as it were, and to put themselves seriously in harm's way. In-home options have worked for other people, but my thoughts...
You are not alone! Went through this with my father over a year ago and it was the hardest thing I’ve ever done. He was becoming really paranoid and was constantly agitated. He’s a retired military officer and had worked in the prison system and he had guns in the house. He was also the victim of financial abuse and leaving him at home meant the return of his “ companion”. Eventually adult protective services opened a case. Because he absolutely refused to give me PoA, I wasn’t able to do anything on his behalf initially. Even if I’d convinced him to move to a care facility, he was within his rights to leave it at any time. I ultimately had to file for guardianship. My father refused to let caretakers into his home, or pay for that service, so that was just not an option. There was no other choice but to have a judge sign a court order to have him picked up and evaluated by the state. I was then able to get him placed in a memory care facility. I felt so guilty and terrible at the way in which I had to go about it all as it was literally with him kicking and screaming, I’m not sure if you mentioned having a PoA, but if not that would be my first step before you do anything else. As uour mother’s condition deteriorates it will be more and more difficult to find someone to notarize the document. You will be unable to do anything for her without it.
I agree with others that keeping her in her home may not be the best option, even with the help of an agency, especially since she’s resistant. It will still require a lot of oversight by you and is really expensive. The one I tried to enlist charged for a visit even if my dad refused to let them in. Hopefully the gentler tactics mentioned work in your situation. It’s hard no matter what and, as previously mentioned, every scenario is. different. My dad came in at an earlier stage of the illness and absolutely hated the facility he eventually was placed in. He’s still not happy and I struggle with the guilt. I just have to remind myself that I’m not in control of this illness and I can only do what I can do. At least I know he’s safe and getting the medication he needs. With the guardianship I was able to move my father into a facility close to my home and I visit him nearly every day. It’s not perfect but I’m able to step away from it a little bit and be a better caretaker as a result. I really hope you have a better experience and that the transition goes smoothly for you whatever you do!
Thank you all so much! Mom saw a geriatric psychiatrist who has prescribed Lexapro and Donepezel.