How should I prepare for my mother's return home from the hospital?
Seven weeks ago my mother (92) who has alzheimers disease and who also lives with me fell and fractured her ankle. During her week long stay at the hospital, she developed pneumonia then C-dif. She is currently in a nursing home where she will recieve therapy for her ankle until she is able to return home. After a long battle, the pneumonia and C-dif have subsided.
Before this event, she was a fairly independent person able to walk, feed and dress herself. Now she is very dependent. At one point, she was hallucinating. She is not eating well and seems so confused.
The nurses at the home all say that people with dementia can decline suddenly after any trauma. But she seems to have declined so severely. I wonder if she will improve when she returns home. Will she be able to eat herself or remember how to use the toilet? How can I prepare for her return?
Expert Answer
This may be the time to make the decision to leave your mother at the nursing home, if they have long term care. Your mother may have adjusted to living there, and the return to your home will require another transition. For people with Alzheimer's, structure is very important; their environment and the daily routine need to be consistent. Change is confusing.
Almost certainly she will not return to her pre-fall functional status. Frail elders rarely return from a long hospital stay and long illness back to the same health they had before it. Considering that your mother had a broken bone, hospitalization, illness and infections, its amazing that the physicians are even considering her return home. Good for her!
Again, familiar things are good. She may remember being in your home and it will be familiar and she will start eating again. Or, it may seem strange to her and she may continue to decline. Toileting independently may be a difficult thing to come back to, particularly if she is used to being taken to the toilet or wearing Depends. In any case, this is the time to look into a long term care placement, one where she can remain through the end of her life.
You can continue to provide quality of life such as tasty treats, friends visits, trips down memory lane, and all the loving attention that you may not have time to do while she is living with you.