Should we persuade Mom to get care or wait until she's ready?

A fellow caregiver asked...

My mom is 75 years old and has some dementia. My older sister and I are thinking of either hiring in-home care or moving her to an assisted living facility. She doesn't seem receptive to either of those options right now. So, we're unsure what to do. Our younger sister is living with our mom temporarily. However, she works late hours (2pm - 11pm) so we're concerned about her safety while she's alone. Should we try to persuade our mother? Or wait until she's ready for a change?

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

What an insightful question and one that is heard frequently. Persuading a dementia parent to get care is rather like pushing the proverbial rock up a hill- difficult at best and fraught with obstacles along the route and Mom will be the one placing the obstacles. The dilemma lies in trying 'to persuade' a memory impaired adult when her ability to reason through the persuasive information is rapidly fading. How can we reason with someone who is losing the power to reason? We usually can't. It backfires and the person feels frustrated and often feels coerced into doing something they may not fully understand. Having to get help inside the home signals that the person can no longer care for themselves. By agreeing to this help, the memory impaired person has to face the reality of the situation. Not always easy for an independent adult. Here are a few 'helpful hints' for getting the necessary help: * Suggest to Mom that you and your sisters are going to be out-of-town together but can't possibly go unless Mom has some companionship. * Don't be fearful of creative language or 'fiblets' which are small embroideries that ultimately serve a positive end. You are NOT lying to your Mom when you use fiblets but are instead creating a scenario that will make her feel and function best. * Remember that the 'honest truth' can be overwhelming to a memory impaired adult and also very scary! * If your loved one's short term memory is not intact, try telling her about the non-family caregiver's arrival ten minutes before she arrives. Do not give her time to build apprehension. * Be sure to let Mom know that the visitor is there to give you or your sisters a break for an important errand. * Have a fun task prepared for the caregiver's time with your loved one. Perhaps a family photo album to share, or preparing a scrapbook together. * Try a 2-week stay at an Assisted Living to give her the optimum chance to have fun and most importantly to have meaningful use of spare time with her peers. *Again, tell Mom this short visit is to help you and your sisters and not because you are suggesting she can no longer care for herself.

Ultimately, relinquishing family care leads to safe and secure care with the companionship of others and offers family the chance to exhale and be Mom's daughters rather than caregivers.