Mom has dementia - how do we move her to a nursing home?

25 answers | Last updated: Apr 23, 2014
64px-hh6b80fd52d1
Q
An anonymous caregiver asked...
My Mom has dementia and is 87 years old. It is time for us to look for a nursing home for her and I have no idea how to talk to her about this. Her short term memory is severely impaired and she has been showing signs of aggression and has been belligerent. Please help me if you have any suggestions as to how to handle talking to her before moving her into the nursing home. Many thanks.
For this question:
 

Answers
Caring.com User - Jytte Lokvig
Caring.com Expert
Send a Hug or Prayer
Send a Hug or Prayer
A
Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops...
68% helpful
answered...

Moving a family member into a nursing hone is traumatic for most of us. The good news is that most people with advanced Alzheimer's do really well in the company See also:
9 Common Alzheimer's Myths

See all 856 questions about Alzheimer's and Other Dementias
of others with the same condition. Your mother's spirit and behavior are likely to improve.

Thankfully, times have changed and most nursing homes these days are quite decent, with good nutrition and activity programs, but most of us still have the image of the horrors of old, so even if you could reason with your mother, it would be very difficult to convince her. Because of her advanced dementia, talking to her about that definite a move will really aggravate her.

I suggest that you look on your own at homes in your vicinity. After you've taken the tour of a facility you think will work for her, spend a couple of hours just observing. This will give you a better feeling for daily life.

When you find one that feels suitable for her, there are two options for you:

  1. If you think you can do a gradual transition, make arrangements for the two of you to have lunch and ask the staff to pair you with one or two other residents who are outgoing and social. Don't mention to her that you're planning for her to live there. Instead introduce her to your table mates with something complimentary about her. An example: "This is my mother, Sarah. She is a wonderful cook." After a few more visits, you can suggest that she might want to spend more time with her new friends. You can give her the "good news" that they have a really nice room where she can stay for a few days.

  2. However, if this may not be feasible for you and instead you'll have to move her straight in. In that case, talk to the staff about their transition program. She'll need some time to adjust without your presence. Ask staff to let you know when she's ready for you to visit. When you first get there, you may have to tell her a "loving lie," i.e. that you're going on a trip "“ or you need to do major renovation on your house - and you've found a nice "hotel" where she can stay until you return. Keep your tone joyful, as hard as that sounds and bury whatever guilt feelings you may have. It may be hard for you to use "loving lies," but keep in mind that her telling her the truth would be unnecessarily hurtful.

Once you get the go-ahead from the staff, make your first visit short and sweet. Keep the conversation really positive. She'll likely ask you repeatedly when she's going home. Avoid telling her that she's now living there, rather divert her by talking about her new friends, activities, and food (if it's good.) If it gets to the point when you get frustrated and find it too hard to be upbeat, tell her you need to run an errand and will see her later. This first visit can be as short as you need. The fact is she'll most likely have forgotten about your visit a few minutes after you leave. However, if the staff reports that she's agitated after your visit, you might want to give her more time to adjust. She'll settle in and you'll be able to resume regular visits.

Good luck.

 

More Answers
73% helpful
Mj#010553 answered...

Went through this just about 2 years ago, my dad was a saint and insisted on keeping mom home however the stress caught up with him and he had a heart attack and died. So we had a home care person until we could find just the right place for mom and then it was a very easy transistion. We found a place called the Sterling House, they offered assisted living then moved them in to the memory care unit which was also still assisted living, we were able to take her funriture in and decorated it as if it were her home, the people were extreamly nice and caring, food was wonderful and she was well taken care of yet still had her independence, her room was like a one room apartment. I would recommend a Sterling House facaility to anyone in this situation. Mother was very happy there and when she passed it was peacefully in her own room private and all her family was with her. Check into it in your area and if you need any help please let me know I would be happy to assist as I've been there and can say I know what you are going through.

 

64px-hh6b80fd52d1
84% helpful
An anonymous caregiver answered...

Moving a parent with dementia to a assisted living/nursing facility is a long hard process. Finding the right facility and timing your visits is a must. Talk to the staff and find out what she/he does during the day. Get them to involve them in the programs available. Yes, they will ask when are they going home. My mother at 84 could no longer stay alone and was very hard to handle. She was agresssive, stubborn and verbally abusive. All patients are different and you will need to find out how to handle your situation. I had to avoid visiting during meal times. She would refuse to eat and want to do home. She was never very social so that was a problem as she wanted to stay in her room all day with no stimulatiion. Good caregivers are a must. They are the ones who eventualy get their patients to cooperate and do all that they can for themselves. We tried moving her to a residential home with fewer patients but that did not work out as she would not cooperate and had numerous falls because she would not use or just forgot to use her walker and eventually had to return to a skilled nursing facility. Communicate with the caregivers and drop in at different times. This is a must if you are able. Most of all, take care of yourself so you can be all that you need to be for your loved one. Stay positive and do not let their abusive words stay with you.They do not know what they are saying and will not remember 10 minutes from now what they said.

 

56% helpful
PJSPT answered...

Nursing homes and Memory Care centers are very expensive. I placed my mother in a Board and Care home, when she started to wander from an assisted living facilty. This placement saved me over $4,000 per month and I truly feel she has much more personal care there. There are 6 residents and 3 full-time caregivers during the day, 2 care-givers at night. This home is in Los Altos, CA.

 

75% helpful
Redbeard answered...

My father moved from an assisted living facility to a skilled nursing home when he had a mild stroke, and he reamined there as his dimentia got worse. Then he started trying to get out of the facility and they said we had to move him to a locked facility. We found an Assisted Living facility that specialized in Alzheimers and Memory Care and found the care to be better suited to his needs and the rooms less "sterilized" looking, as well as being less costly than skilled nursing. I wished we had found this place sooner.

I'd suggest looking at several facilities and looking for ones that specialize in memory care.

 

67% helpful
Redbeard answered...

I agree with the advice to take your mother for a visit and have someone at the home spend time directly with her. When we decided that my mother, who had Alzheimers, needed to move to a care facility, we took her for a visit and tour. She didn't like the facility at all - but then we realized that the person giving us the tour was talking mainly to my father and I and neglected my mother. We took her back and asked the facility person to pay attention entirely to my mother and give her another more personal tour. After that visit she decided that it wasn't such a bad place!

 

67% helpful
Lainers answered...

My 102 yr. old uncle has dementia and is getting worse. Hise wife, who is 86 and not in good health herself, has beenunable to grasp that the things he says,(cursing screaming at her, telling her he's going to leave and get a divorce)takes everything personally, and is caving under the stress. She has had a heart attack 2 years ago, and I fear for her. Last week, M. was in the shower, and his knees buckled, and he couldn't stand up.( he has neuropathy, his only physical problem)and E. couldn't get him up, so she called 911. They got him out and took him to the hospital. He remained for 3 days, and they sent him to a "Rehab" where they are giving him a little P. T.. Every day, he sundowns and becomes violent. This is in Florida, where they don't use restraints of any kind, not even bed rails. He has fallen at least once attempting to get out of bed, and his arm is bright purple from shoulder to elbow. In the meantime, the social worker tells my aunt that he can only stay under Medicare so many days, and then he will be private pay.They have very little money, and my aunt has contacted a lawyer to help her apply for Medicaid and direct her to have him admitted to a nursing home facility, hopefully with a Dementia Unit. She cries every day, and isn't eating because she is so nervous. Anyway,she has been hiring nurses aides to sit with him from 6PM till 11, so he won't be alone when he's at his worst. Otherwise, the facility calls her and says he is carrying on . What can she do? She can't afford to keep hiring aides, and if she runs out of MC days, and doesn't get Medicaid, then what? I am so worried about them. Im in Pa. and they are in Fla. Can anyone offer any info that might help?

 

29% helpful
slenhardt answered...

when looking for a placement in memory care its helpful to find one that offers respit care. If they spend some time in the community befor they need that much care it make the transision much easer. Not to mention giving the caregiver a much needed break. Do look early befor its needed that way you have more options as a family. It sometimes sneeks up on you.

 

50% helpful
englishlove answered...

Well, hmm. None of you have evidently dealt with Kaiser. Here's what I've got so far. First, they try the path of least resistance. My mom was admitted with severe agitation, as in running up and down the street pounding on doors and stopping cars for help. Kaiser kept her overnight, gave her a powerful injection to subdue her, didn't include a psychiatric evaluation, and discharged her the next day to another unsuspecting residential care facility. Never mind that I was under the impression that Kaiser was arranging a lock=down, high intensity care facility. Apparently, the discharge planner did her own thing in simply assigning my mother to the same type of residential care that she had just come from. There is a great deal of hand-washing of responsibility in that institution, and it leaves patients and their families to fall through the cracks. Naturally, my mother tore the new place apart because she wasn't on the right drugs, but how would we know since there was no order for a psychiatrist to review the situation in the first place. If he/she had reviewed the situation, it would have been ascertained immediately that the rinky dink drugs that her careless primary care physician had her on were not even in the right ball park for treating her psychosis. It wasn't until the second day that I had to return her to emergency that a psychiatrist was summoned to evaluate her and to put her on the right meds. Right now, I'm furious. I'm thinking very seriously about filing a grievance through my "powerful" California Teachers Union. Whatever you do, get the proper education on all the insane protocol that is Kaiser before you try to navigate their system.

 

85% helpful
StayingMe answered...

Every parent is different of course. What works for one person may not work for another. The truth is that the best person to decide on how to move your parent into care is actually you. Suggesting that you widen their social experience of, and ease of entry into, a facility may work for some but will likely cause considerable resentment in others. Despite the assumption that those with dementia are easily hoodwinked, most will realize what you are trying to do and react aggressively. Expect lines such as 'you are not going to put me in a home'.

You need to consider your parent - their lifelong attitudes and beliefs, their loyalties and their expectations; you need to consider where they are on the dementia time-line - understanding what they understand, feeling what they feel; you will need to be honest, tell lies, re-assure, perhaps even blame the great un-named 'them' for the ultimate decision. For some people there will be no easy way, the decision and the process will be difficult and thankless. Yet there may come this time when you still have to do it.

It is very important to retain as much of the supportive relationship that you enjoy now once they have been moved into care. This is critical. For this reason - depending on your parents and your relationship with them - you may need to bend the truth, or ease them in as suggested above, or even to put the blame on an unfeeling government (the 'them') who have taken the decision from you all. Whatever works to protect your parent (and yourself) to enable them to get as much out of life as possible - that's what you'll need to do.

And as I've said - the best news is that no-one can do it as well as you, no matter what you think.

 

83% helpful
Gamafan answered...

We recently had to admit my mother to alzheimer's unit at the nursing home I work at. The ploys the expert suggested have worked for her although she repeatedly removes and packs the personal photos that my sister and I hung because she has to " get ready to go home". I sat down with her one day and told her she was staying and it was horrible for me and her. The next day she had totally forgotten the conversation. That made me realize that a "loving lie" is sometimes the best answer. I can say that the staff have been wonderful with her and that I have seen her happier and more engaged in the past 2 months than in anytime time in last several years.

 

100% helpful
blueyes123 answered...

Lainers, In Florida she will have to apply for Nursing Home Waver Medicaid if he is in a nursing home. The social worker in the nursing home should be able to help her if she needs help. You can also contact Elder Care in the region of Florida that she is in and they will also help her apply for the services that she needs for her and for him. Their main number is 800-963-5337. Their internet site is http://eleraffairs.state.fl.us/. I hope this helps you. I went through the same thing with my husband and I am in Florida.

 

94% helpful
nickddd222 answered...

I just dropped off my wifes grandmother after taking her to dinner and telling her we were visiting her new place... What new place she said? she was so pissed off and swears she is never going to forgive us for lying to her. She even told me she hates white crackers, me being the white person in the group, i actually found it funny to be honest since my mom has had similar things to say about my girlfriend.. its sad no matter how you spin it, it really sucks to leave someone at a place no matter how nice when they dont know anyone and think they are in better shape then they are. My suggestion is dont debate, bicker, point out why your doing ti. it isfuel to the fire, they dont remember anything in an hour and you just end up burnt out and angry.. this dementia issue is gong t be worse then cancer x 200000 in thirty years. cancer sucks but at least it typically has a course, get it , live xxx, die. Dementia, get it, get worse, drag your family into it in every emotional way possible, load them up with guilt, take them to the poor house, hate them for doing what they have to do to care for you and keep you from burning down your house, wrecking you car, giving all you money away and do this for 4, 5, s@#% 10 years at times ........ i would rather die in a car wreck then have to go though this s@#%. if you have not experienced it (I have twice) dont think I am being too harsh or uncaring. I watched my dad die of colin cancer and that hurt bad. Watching my mom go through dementia makes cancer seem like a root canal. I feel like s@#% for being so impatient with the person I have loved more then anyone ever in my life and carry that guilt with me every day of my life. If that aint a bi#%@ i dont know what is. Am i the selfish? If I am I sure am not asking for forgivness. I would PRAY someone puts me out of my misery if i get to this stage. I am healthy,weathlty and still find life challanging.. Give me 7o years of health and i will gladly punch the clock and move onto whatever comes next, anything beats the life i see my mom living,seriously, anything.

 

67% helpful
nextinline answered...

@nick222: I am going thru the same thing with my mom. Every woman on my mom's side of the family has had alzheimers. I looked into Hemlock Society. I will not put my husband, family, or friends thru this. I'll end it before it gets bad. :)

 

Caring.com User - Jytte Lokvig
Caring.com Expert
Send a Hug or Prayer
Send a Hug or Prayer
67% helpful
answered...

Specifically for "nextinline" A dear friend of mine had likewise pledged to herself and her family that she would spare them the burden and grief of the Alzheimer's that had taken her mother. When she reached 75 and started experiencing MCI, she gave each of her children a copy of "Final Exit." She was still functioning relatively well in spite of her progressing dementia. By the time her memory loss was so bad that she had to move into a facility, she had completely forgotten about her pledge. She was lucky enough to be living in a great assisted living and ended up truly enjoying herself until she took her last breath at age 95 1/2.

Alzheimer's can be a wonderful experience, in the right setting, supported by people who are trained to work with the abilities still in place. Several folks of my acquaintance had the best time of their lives once the disease had obliterated their baggage and bad memories.

Because this disease seems to run in your family, i suggest that you get involved as a volunteer with an Alzheimer's facility in your area. If it's possible, volunteer to do a sing-along or help people have conversations. You'll see how little it takes to bring true joy into their lives.

You might want to visit my website and those of the other Caring.com Alzheimer's specialists for tips and ideas. I trust you'll be reassured.

 

100% helpful
Caring Community answered...

Thank you, Dr. Lokvig, for the wonderful expert advice! Thank you to everyone for also adding your caregiving advice and experiences on this topic.

If you are searching for a nursing home, Alzheimer's care facility, assisted living or other types of care providers for your loved one, you can start your search in Caring.com's Senior Care Directory by entering the city, state or zip code of the location which you are searching for care.

If you have had first hand experience with a care provider, feel free to leave a business review of the provider in our Senior Care Directory here: write a review You can learn more about the Ratings and Reviews program and guidelines here: Review Guidlines

 

50% helpful
bexterz8 answered...

@anonymous posted 10/30/12. I recently moved my 85 yr old mother with dementia into a home & care facility. I have been caring for her over a year & 1/2 on my own and had recently hired a caregiver to come to the house & help on a weekly basis. This helped for a while until I planned a weekend away. Unfortunately, since I'm the only child, she only wants me to be with her and doesn't want me to leave her with anyone else. She became overly agitated with me to the point I had to admit her to hospital because I couldn't calm her. She was diagnosed with dementia as well as stroke & memory loss she suffered a year & 1/2 ago. Thanks to a good friend who did legwork finding a place suitable for my mom, we moved her into a duplex home with 10 patients, 5 women & 5 men, on each side of house, who also have dementia. They have a personal cook & caring staff who are attentive to their specific needs. After 1 week, I feel I made the right decision with this facility. I no longer fear leaving her to run to the store, etc. and feel she is getting interaction & proper food & exercise to keep her going. I purchased a bed alarm for her from med supply co. so that if she tries to get out of bed, staff is alerted and can help her. Even though I know I made right decision, I still feel guilt but I have to remind myself that it's not going to get any better with her illness & I can no longer let it affect my health by going into a deep depression. I would definitely look into Home & Care facilities in your area that have good ratings. We worked with a social worker who gave us name of facilitator who suggested high rated home facilitators in Santa Monica, CA.

 

bexterz8 answered...

@anonymous Last line correction: We worked with facilitator who suggested high rated home & care facilities in Santa Monica, CA. area. The have been in business since 1995 with good ratings. So thankful!

 

jednastka answered...

Responding to nickddd222; We just placed my 87 year old mother in what I guess is the Canadian equivalent of a "Skilled Care Nursing Home" a week ago. She has been diagnosed with vascullar dementia, is legally blind, has a heart condition, and is on numerous meds. My brother cared for her in her home for the past 2.5 years, but he has now graduated, and is moving on with his life. In preparation, we started talking to her about needing 24/7 help over a year ago, and then about moving to a"studio apartment" near the rest of her family with full care some three months ago. None of it sunk in, until the day she came to the facility. Now, all she talks about is getting back home (some 900 miles away), sueing all of us, etc. She tempers her comments when dealing with my wife, or her grand-children. The facility is fantastic, and the caregivers are first rate. I have visited her almost daily, taking my lumps.

My questions:

  1. Should I reduce my visit frequency, to say, once a week or less? My wife and her grandchildren would continue to visit regularly.

  2. How long before things settle down?

Thanks for your help;

 

clarasgirl answered...

My Mother had dementia and bi polar disorder. She was very difficult to agree to respite care. Finally I found a place who deals with elders and their medications. PLEASE be sure your loved one is on the correct medication. I was so very blessed to bring her back home with a private duty nurse while I worked. She did so much better in her home around her familiar surroundings. It is a terrible disease and no matter what it is still our parent and we want the best for them. I spent nights with my Mom at the nursing home and knew she needed to be back at home. Dementia is so rough on everyone but I looked in my Mom's eyes and saw the woman she always had been. I was blessed to be able to deal with the hitting, anger and hearing the alarm when she left. After 3 years of her passing I lost my job and my health.

 

CA-Claire answered...

Jednastka - reduce the frequency of your visits, and when she starts talking about things that you are unable to change, change the subject. It took my parents nearly a year to recognize their Independent Living apartment as home, then a year later, we moved them to Assisted Living. A year later, Mom died. Dad knows it is home and is OK with it. Every case is different and depends on the type of dementia. Best wishes to you.

 

LTCO 10a answered...

I would offer the option to call your local long term care ombudsman program. We advocate for the least restrictive environment and can offer you options in home and community care before you have to move towards nursing homes. Ombudsman will also assist you with navigating through web sites such as Medicare.gov. This web site provides information on quality measures, staffing and recent health department surveys that allows families to make informed decisions.

 

CA-Claire answered...

My family's plan for Dad, currently 92, to remain in Assisted Living for as long as possible. Luckily, he has the financial ability to do this, and we will hire additional private caregivers as needed to keep him in the 'home-like' environment, rather than a SNF. His parents each died about 3 weeks after being moved into a SNF, so he has a very large fear of them. His parents were 91 when they died.

 

iWilliams311 answered...

Sorry to know about your predicament... I think what's important is that you consult with your mom's physician/doctor about her healthcare needs and condition. The information you get will surely help you find the appropriate nursing care facility that can take care of your mom's needs. Also, consult with an elder care expert who works in your area. He/she might be able to recommend a good nursing home that is also affordable.

 

 
Ask a question Ask a question | Add an answer Add an answer