My mother is 81, and has been extremely lonely and depressed for many years. It eventually pushed her into mild dementia. After a bad fall with a brain injury in March, she graduated to moderate dementia. Her short term memory took the biggest hit. After a hospital and rehab stay, my brother and I selected an ALF to see if she could adjust to assisted living. It's been 2 very loooooong months.
She is miserable in the assisted living, and her most frequent complaint is due to having such a small living space, and constantly begs to go "home", even though she only has a vague idea of what home is. My husband and I work full-time, so living with us is not an option. I feel guilty in not helping her to get back to her patio home, even though I know she would lose the small bit of social interaction she has at the ALF. It feels like there is no really good option, and am being drained by the amount of attention she needs. We've hired a companion to spend afternoons with her and assist her in learning to socialize, and I have spent almost every evening with her trying to help her adjust. Her misery is really wearing on me. I'm thinking that going back to her patio home with some paid assistance is going to be the least of the miserable options. Even though she will quickly be crying about "staring at the four walls, alone".
Does anyone have any wisdom to share?
Care giving can last as long as 20 years with today's medical advancements. Caregivers are giving up jobs, homes, relationships and their own physical and mental health to provide care for their loved one.
There must be balance in life. There will be life after care giving. The quality of that post care giving life will depend on what you do as an individual in the present.
The statistics are dismal for care givers- did you know that 50% of the primary care givers of individuals with dementia actually die or seriously ill ,before the person with dementia passes.
Care givers need to realize that assistance is needed. They cannot and should not attempt to provide care alone. Care giver stress kills.
I have worked as an agency nurse over the past 20 years while I did a full time job. I have worked in the worst and best assisted livings and nursing homes.
I have also done home care.
It is important to know that home care is a wonderful solution. It is not utopia. A family must learn to protect themselves from strangers that come into their lives. The hardest part about home care is that even the most seasoned family member with professional management experience is not prepared for what lies ahead.
Home care and the level of intimate and personal care that is provided promotes comfort and letting our guard. It is sad to admit, but there are people that take advantage of that.
There is no perfect solution to what we are going through. There is only the course that is right for you and your family member.
If you choose placement in a facility, that is not a sign of weakness. Your role will change to one of advocate. That is just as hard and even more so sometimes. Your role of care giver is a long and hard road. It does not have to totally consume you.
Love, tonio999
I think that one of the hardest things to understand is that consistency and a routine are so important to a person with dementia. Even more so when they get to the level your mom is.
The small home is most likely your best choice-even though you may not feel that it offers enough right now. You will find that most AL's do not offer consistent activities on week ends.
There is always different staff - maybe even less staff. The routines are weekends change.
This is not good for the dementia patient- but, even when a facility says they offer "dementia Care"- it is NOT really dementia care at all.
The staff most likely is not trained on behaviors or even cognitive approaches to care.
If a facility really did have ":dementia care" they would have staff trained in behavioral approaches, offer consistency and keep a schedule, even on weekends.
I know I sound harsh, but the fact of the matter is, the facilities offer custodial care- with a locked unit - to keep people safe. May offer an environment where a person can wander and not get lost. But, it is just high level custodial care.
Getting a person to work with your mom is great. If you have old pictures and are able to bring them- I have a suggestion for you.
These pics may spark some sort of long term memory. You have to work with what your mom has- and not focus on what she has lost.
Get the old photos out, and create an album. IF the person working with your mom can discuss photos and old times with her. That is a strength of your mother's right now. Focus on her long term memory.
Bring in a cd player and play her favorite music. If she did not have a favorite kind of music- get music from her time and play it. You will be surprised at the results and responses.
If she is an animal lover, make sure you have a visit from a pet therapy group.
It is sad to say, but, families have to guide and teach the facilities how to care for a family member. You are the expert.
A person with dementia is truly living in the here and now. They do what we are all trying to accomplish- not focus on the past, and not worry about the future.
It is a hard concept for us to grasp. The important thing is that she is feeling safe and basically happy.
Catwoman, you can only do so much n hopefully she will be able to settle in n be comfortable. All ALF r not the same so u may want to be checking other places that can give your mom the best care they can if the place she is already staying is not able to give her that care. Eventhough, she has memory loss, she is a human being. I would think she will remember some stuff n a place that does activities would help your mom even if she don't remember it later she enjoyed it at the time. That what I think about my mnl when we take her once a wk to an activirty respite care for four hrs. I know she is smiling when I drop n pick her off n even though she don't remember what they all done that day, I can see it on her face that she enjoyed her self. Now, next Wed will have to start all over again to explain she will be visiting her friends at the church n that she will have a good time. of course next Wed there not open due to holiday. U get what I mean. All u can do is the best u can n live your life too.
Mom was already socially isolated at home before the accident, which is what we hoped the ALF would alleviate. And it has, just a little, even though she doesn't realize it.
I discussed my mom's poor adjustment w/management. (threatened "make her less miserable or lose our $ forever!) It is a smaller ALF, so they don't have a social worker on staff. They have made some extra small effort to settle her in, but with her short term memory loss, the small and constantly changing staff aren't able to keep up the repetition as often as required. She's been there two months and rarely even remembers that they have a dining room.
That is why I hired the companion who just started this week. Hopefully in the next 2-3 weeks we will see if more repetition has any effect.
We chose the ALF as it was smaller and hoped mom wouldn't be totally lost in it, and might with time actually make a friend. She has a shared living room and currently one of her neighbors does spend a little time with her. She hasn't taken mom under her wing...but we encourage any help we get. Have to say the activities are pretty poor, there is almost nothing to do on weekends. We can consider a larger ALF nearby with more amenities, but I think with the short-term memory loss, it would take a miracle for her to get to know anyone. I will spend some time really thinking about your responses and let you know how we progress. Thank you all so much! Really appreciate the feedback!
As my FIL's dementia increases so will the demands on the family and care givers that is a given. He may have to be put into an ALF one day as his mobility is extremely compromised and he is not a small man. We take it one day at a time and count our blessings.
Prior to my in-laws health decline, they were the care giver "organizers" for 4 different people helping them with their end of life journey. I think this is why my in-laws are so prepared. There are 5- 6 different care givers taking care of my in-laws so that helps with socialization; they have friends who also drop in and, on occasion, they are able to go over to someone's house for a meal.
Wishing everyone dealing with aging parents God's loving guidance in making choices on behalf of your loved ones.
I am a strong advocate that a person should remain in their home as long as possible, if the person is safe and has a support system in place.
I do not think that a person should remain in their home at the expense of other family members - meaning many family care givers give up jobs, outside relationships and are financially affected.
Care givers do not realize what they are agreeing to do when they say they want to support someone in the home. It may be 10 years or longer of care giving.
My suggestion to you, is to sit and discuss what your family member wants and expects as far as living arrangements.
Now, here is a step that many care givers do not take- SET LIMITS AND BOUNDARIES as to what you are willing and able to do.
Sit and discuss- I cannot take care of you when you are no longer able to walk, become incontinent, become a behavior problem, socially isolated etc.
Put all this in writing. Then, everyone knows what to expect.
Discuss options- nursing home and assisted living. Include those in the conversation. This is a way to make informed decisions comfortably.
Diane C.RN