When I visit my Alzheimer's-suffering wife at the nursing home, she gets very upset as I leave; Is there anything I can do?

15 answers | Last updated: Sep 27, 2016
Bobcie asked...

When I visit my Alzheimer's-suffering wife at the nursing home she is delighted to see me, but she begs me to take her with me when I leave, which is not a practical request. She shouts, "Bob, come back; take me with you," as I walk away. It's miserable for both of us. Any suggestions?


Expert Answers

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.

This must be so heart-breaking for you. Even though you recognize this placement as being the most appropriate caregiving solution, I'm sure you must be devastated at each visit when you hear her plea to leave with you. The difference between your emotional pain and that of your wife is that it remains with you for a long time after your visit while it is most likely forgotten by her shortly after you are out of sight. I suggest the following possible ways to make your separating more comfortable for each of you: 1. Try to always have your departure time when a scheduled activity or meal is about to take place. Folks with Alzheimer's (AD) generally focus on one occurence at a time and if your wife is joining in a group with others or preparing for a meal, her focus is not on you leaving but rather on the new activity. 2. Speak with the staff and request an aide to assist with the transition from your visit to the new activity. 3. Do NOT let your body-language or non-verbal language transmit your dismay. Leave quickly, gently, and smilingly! Remember that AD folks are quite adept at taking cues from our non-verbal responses and read our tone of voice, facial expressions, and emotions. No matter how contrived it may be, be as positive as possible as you change companions with the staff member. If you check back with the staff shortly after you leave, you will most likely discover that she has transitioned quite well and you will find that, without the stress of a tearful departure, your visits will be more enjoyable. I hope these suggestions work well for you and do remember to take care of YOU!


Community Answers

Bobcie answered...

Dear Mrs. Coste:

This advice agrees with what I have been doing. It works well as long as I can get the cooperation of a staff member.

Thank you for your response. It assures me that I am doing the right thing.

Bob


Olderwiser answered...

I really needed some help with this issue. Thanks so much. My parents reside at the same facility but on different floors. That decision was made when my Mom with AD became too confrontational with my Dad who is in a wheelchair and unable to defend himself. They get along quite well during short visits, but we painfully decided that sharing an apartment would not be the best arrangement for them. They had been accustomed to separate bedrooms at their home and the assisted living apartments have only one bedroom units. I agree with Bobcie (above) that it is not always possible to enlist a staff member to help with the transition as they are often very busy with other residents and duties. Giving a hug and encouraging my mom to join in the next activity or group visit is my next plan of action to make that painful "Take me home" request less heartbreaking.


Helen 2010-07-17 answered...

Excellent answer and, slightly modified, makes good advice for all situations. Put yourself in the shoes of the person who feels left behind or "abandoned": Some toddlers cry irreconcilably when Mom drops them off to nursery care. I am 67 and yet partings from loved ones leave me sad and lonely. I recently married and my husband and I are not able to live together except weekends. How does he leave me? He drives me to work Monday, we kiss goodbye. He goes on to his house and I go to work. The parting that would have been a loss to me is now simply change into an activity routine, familiar and in the midst of other people.


Bob denver answered...

Hi Bob, My Dad just passed away from bone cancer 3 days short of his 63 anniversary. It was hard to see him like that every day bed confined in the hospital, but my Mom remained the pillar of the family, and she would have to face the same thing everyday at the end of our visits. He would plead with us to stay, and Mom would merely say, "we have to go, so we can get back faster tomorrow". It seemed to work well, and he understood. It's a tuff time of life but we are all going to go through it. When your feeling a bit down in the dumps, go to "www.youtube.com" and have a listen to the guy who keeps me motivated. I've been disabled for 18 yrs, but when I listen to Nick, my issues are meaningless. Here are a few of my favorite clips to help,,,,http://youtu.be/wOlTdkYXuzE, http://youtu.be/Gc4HGQHgeFE Nick's website is http://store.nickvujicic.com/ Keep your spirits up Bob, and K.O.K.O. "Keep on Keepin' on". You'll get through it. BW


Lmartin answered...

We were very lucky to have my dad in a specialized AD facility. They would distract my dad while we left. It would be kindof funny sometimes because we had one staff person distracting dad with a task and one putting the code in the doors so that they would open to let us out before he saw that we were leaving. But it was worth the effort.


Sandyy answered...

My Mom has been in the nursing home for one month and we have tried all of the ideas above. Sometimes they work and sometimes they don't. Sometimes my wily mother with vascular dementia refuses to go the activity. And...sometimes from the minute my sister and I arrive there she is insisting that she is coming home with us or "she will kill herself".

I dread visiting her and going through this constantly. I was sole caregiver and it was so out if control at home. But these visits are horrendous.

I am in my 60's and want to have a little life before I am too old to enjoy anything. But these scenes take all the joy out of my life...and my sister's too.


Geri hall answered...

These answers are all great. One thing my caregivers have taught me over the years is that it is the thought of "goodbye" that is distrtessing. My caregivers excuse themselves saying they need to use the restroom. If there are no staff around to help, this can work.

Joanne's comment on your body language is very important. If you tear up, the person with dementia will become upset too.

Some other ideas for visiting: 1. Build your visits into the person's routine...so you show up right before a meal. Plan relatively brief visits ...90 minutes (usually less) should be your target.

  1. Always bring something to do during the visit, ie combing hair, manicuring, eating, discussing a favorite magazine topic (think popular mechanics), watching a segement of a DVD, etc. When the activity is over, excuse yourself and leave.

  2. DO NOT let staff tell you not to visit for a few weeks so the patient can "adjust." What the person is doing is grieving their profound loss. It is nothing that you, the caregiver, have caused but the patient needs to work through it just as you do. The biggest feart people with dementia have is the fear of abandonment.

Because people with dementia regress developmentally, this would be similar to dropping a young child off at the hospital and expecting them to be happy. In the first two or three weeks visit as often as daily. Expect the person to be upset, and you also. Grieve together for 10 or so minutes and then say, "I'll be back tomorrow."

To expect a newly moved person to be happy about it is unrealistic, but people with dementia do adapt. If the "I hate it here" complaints last more than a month I advise families to take a hard look at the facility. Is care compassionate? Are there enough actities and do they bring your person to the activity? Is TV a major form of activity? Are the activitied beyond your person's capacity and if so do they have other activities for your person? Are you seeing staff interacting with residents even when direct care is not being provided? If these are true, maybe your loved one is in the wrong facility.

Respectfully

Geri R Hall, PhD, ARNP, GCNS, FAAN Advanced Practice Nurse Banner Alzheimer's Institute


Elviraskin answered...

If all else fails, you can simply tell that you need to go to the bathroom "right now, before you wet your pants" give her a quick peck on the cheek and exit.


Kayk answered...

I agree with many of the responses. Those with AD really have a huge fear of abandonment and just need to be reassured that they are loved...a hug and a kiss are always welcomed. During my visit with my AD mom, I leave to go to the bathroom and come back and then at a certain moment (when I am ready to leave), I just say, I will see you later....OK, Mom. She usually is reassured and gets over the moment pretty quickly even though that parting is harder on me than her. If I say...see you 'tomorrow'....it is too long for her to understand. The gift is that she still recognizes me, so I keep this close to my heart as I know the day will come when she will not know who I am. It is so important to visit even for short moments as this really helps the AD person emotionally, physically, etc. so even though the parting is always difficult, it is very worthwhile for all concerned.


Pddaughter answered...

I have no direct experience with this yet, but reading through the helpful responses already posted, I had the following idea: if no one is available to distract your wife as you are trying to end your visit, perhaps you can explain to your wife that, while you need to leave for a little while, you can still speak with one another by phone for a few more minutes. Then, in her presence, call your wife from your cell phone, chat about something cheerful as you give her a good-bye kiss/hug and continue your chat as you leave her room. This may transition your physical visit to a phone visit and, by the time you arrive at your car, you can say "good night" more gently and less traumatically. I hope this helps a little bit.


Elviraskin answered...

@ PD Daughter. Unfortunately, most folks at this late stage lose sense of time and space and do not do well on the phone and may not recognize the voice as belonging to the person who just left, but may actually get more agitated. Because they function in the "now" they are also able to switch back almost instantly. The best advice definitely is the one from Joanne. When her attention is diverted by an activity or food, you can quietly slip out without her noticing that you're gone.


A fellow caregiver answered...

It is terribly hard to leave a loved one behind when they are asking for you to stay or take them with you. Sometimes you can tell them that you are just going to get the two of you a coffee or something that your spouse likes' and tell them you will return shortly. Someone with Alzheimers/Dementia has long term memory, not short. Once you have left they will not remember that you have gone to get something that they desire. If they ask to come along tell them that only you can pick this item up. I hope this works' for you.


Dutiful deb answered...

My 88 year-old mother can still enjoy phone conversations with relatives and friends but does not have the cognitive ability to make the calls by herself. So when it is time for me to leave, I say "Mom, would you like to call Sylvia?" or someone else. It may take several tries to catch someone at home but I find it is easier for me to slip out once she is engaged in happily talking with another loved one, especially someone of her own generation. I keep her address book in her night table drawer and have several phone numbers programmed into her phone.


Twinsgran answered...

I work in varous care homes as an activity co-ordinator and although I'm not related to any of the residents, I have to be careful when leaving as some of them want to come with me. The way I deal with it is this. When they see me getting organised to leave, I usually start saying things like, "Well, I suppose I'd better pop along and pick up some milk so that we can have a nice cup of tea. Shall we have some cake or biscuits today?" often this will give them something else to focus on and we have a little chat about what cakes etc we like. Then I say, "I'm just going along to the loo before I go. I'll be back in a minute". I've found that invariably this works every time as they are quite happy for me to do this.