How can I convince my mother with dementia that she cannot return to her home in Las Vegas?
My 93 year old mother is now living with me in Texas. She and my father lived in Las Vegas NV for fifteen years before my father passed away in March of this year. Mom does not have financial resourses to pay for her care. She is demonstrating symptoms of midstage demintia and is nearing the point of being imobile because of bad knee joints.Due to here mental state I cannot make her understand that she cannot return to Las Vegas. In her mind she believes that if she returns to Vegas everything will be as it once was. She makes threats of killing herself if she can't return to Vegas. How should I handle this?
Expert Answer
People with Alzheimer's or other memory-impairment tend to reflect the mood, tone and attitude of their caregivers. Because of their disorders, their impressions and perceptions are easily distorted.
It takes very little to maintain a harmonious relationship and avoid conflict when we realize that everyone needs to feel some self-determination. Everyone needs a purpose and very few people are comfortable having to live by somebody else's rules, however innocent and well intentioned.
If we caregivers set a positive tone, we'll get a positive reaction; maybe not right away, but when we stick to it, things will improve. Family caregivers have a particularly hard time, because of the history and baggage that comes with any long-term relationship. Even a demented mother may still know which "buttons" to push. Also, no matter how old we are, we're still our mothers' daughters and when they criticize us, it's particularly hurtful, especially when we're sacrificing a lot of our time and freedom to care for our mothers.
I'm going to challenge you to make a complete 180º shift in your communication and interactions with your mother. The key is for you NOT to be the "authority" over your mother, NOT to remind her or to correct her. When you find yourself on the verge of a negative reaction, take a deep breath and change the subject. When she criticizes you, ask for her suggestions and find a way to compliment her, even if you feel the compliment is completely made up.
Now to the specifics: Instead of reacting defensively when your mother criticizes you, ask for her suggestions. You see, you're in control of her life, so she'll try to assert herself whenever she can and criticizing you is a surefire weapon.
Incontinence: Take your mother shopping and have her choose among the pull-ups that look like regular underwear. Then later you can offer to help her change into the neat new designs of "underwear" that she herself chose. Add a compliment on her choice. You'll probably want to avoid using the term: "diaper" "“ rather call them "briefs" or simply "underwear."
Find ways to "remind" her without being obvious, i.e. "Hey, mom, I thought you might want to try that new cologne when you've finished changing. Can I give you a hand?" Hint-hint! If she insists that she doesn't need to change her brief, drop it for now and revisit later. The worst thing you can do is to pursue it. The more you push, the more she'll resist. It's simple human nature.
Rather than telling her that she needs to smell nice, compliment her when she does smell nice; otherwise don't say anything. You'll be amazed at the power of compliments and positive approaches.
Let us know how you do.