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She and my dad are both residents in a nursing home. He'll never leave; would not even try to do the therapy after breaking a leg (after a stroke, after covid, after pneumonia). He's bedridden and will stay there and is in mid-stage dementia. She's in mid-stage dementia, has had a stroke, has fallen and broken a hip. He needs constant nursing attention, requires 2 just to change his diaper.



My mom is convinced she can care for him at home by herself. She can't. Can't care for herself. Will not leave their room long enough to even get her hair done (on-site) as he misses her too much. Yet she believes she can go home during the day (a home 6 miles out of nearest anything, in the woods) and drive back and spend nights with him. Two doctors have said under no circumstances allow her to drive.



She can't stay alone. Can't remember her med's - how much/if/when/anything. If she fell and she's very unstable, she'd be there until somebody found her.



None of this sinks in. I assume there is nothing to do but ignore it? Logic and reason do not work. She has no grasp of her situation and will not give this line of thought up.



Honestly, I have several times thought of just getting them both back to the house and saying "fine, here you are. good luck", then driving the 600 miles back home and leaving her with it. But, that would be way cruel.



Roger

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How frustrating. But I guess it's time to get used to it cuz it's not likely to improve. If none of your explanations have made sense to her so far, it's just not going to happen. Stop trying to be logical. Realize she CAN'T understand the situation.

Time to shift to making vague responses and changing the subject. "We'll have to see what the doctor says." or "Hmm, I don't know about that. I'll look into it."

I understand your desire to sometimes just do what they THINK they want. My mom complains about caregivers coming to the house. OK, I'll cancel them and leave you home alone, confused and lonely? Nope. Complains about having to do PT - oh OK let's not do PT and just sit around and end up in a wheelchair. And on and on and on. They can't understand the ramifications of their short term thinking.

Good luck. At least they are both placed somewhere, being taken care of and safe.
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Roger, your mother has dementia and that is the reason why she cannot comprehend the reality of the situation. The situation being that she's unable to go back home during the day and drive back to the SNF and spend the night with dad. No matter what you tell her, it will not 'sink in' because her brain is damaged now, due to dementia, so you need to distract her away from her line of thinking rather than try to correct her. Your frustration in saying you've thought of driving them both back to the house and dropping them off is evident. And yes, it would be cruel and it would be abandonment to do such a thing to two elders with dementia who are unable TO care for themselves alone at home!

Do you understand the mechanisms of dementia? It's important for you to understand how the disease process works so you can learn tricks to help your parents and to cut down on your own frustration with them. Not that it's 'easy', it isn't. I wound up dealing with my own mother for 6 years who had dementia (which became advanced) and she lived in a Memory Care ALF for the last 3 years of her life. I too had to listen to her begging to 'go home' and deal with her delusions on a daily basis. Toward the end of her life, she thought she was living in a 'hotel' and that the caregivers were moving her to a new & better 'hotel' every night, as well as taking her to fancy restaurants with entertainment, so her delusions were favorable, thank God.

I suggest you read this 33 page booklet (a free download)which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it. There are lists of Do's and Don'ts in this article than can be very useful to you in dealing with your parents:

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Here's a few tips from the article

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time
· Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Of course, you do the best you can and you keep your visits brief. If/when they get too agitated, you leave rather than argue. Ativan helped my mom a LOT when the agitation and Sundowning set in; .25 mgs to start, then increased to .50 as needed.

Wishing you the best of luck with a difficult situation. I feel your pain, as an only child myself.
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Redsister Dec 2022
Would be oh so nice if everyone was the same. Sounds so simple. I refuse to ‘agree’ and go along when she thinks people are there and she is not safe.
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Roger, who is the POA?
Your Mom is diagnosed with dementia. She won't be allowed by her facility to leave. But more important is who the POA is to override any decisions she may attempt to make in her current disabled condition.
Your Doctor needs to supply you with letters attesting Mom is no longer responsible for her choices and cannot safely function on her own. The Social Worker at the facility where Mom and Dad reside may be able to get you emergency guardianship if push comes to shove.
Under no circumstances should you do something you acknowledge here that you understand to be unsafe.
Mom has dementia. You cannot reason with Mom or with this disease. She will likely go on in this manner forever. Side step it as best you can, saying "Let me talk to doc for you and see what he thinks" and etc. Just anything you can make up to get out of there that day.
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"None of this sinks in. I assume there is nothing to do but ignore it? Logic and reason do not work". 

You got it.

When logic & reasoning do not work - you & others use your logic & reasoning instead. To get the folks somewhere safe - as you have done.

Next step would be for Mother to adapt & connect to her surroundings.

Maybe sell Mother on the idea that a little help is ok? Let the staff 'help her' to look after Father. Why do it all herself - these people WANT to help. It gives them a job. People need a job don't they?

Why not get her hair done? A little pampering.. (hey you don't get that at home 😉)

Maybe discuss with the AL Activies Co-ordinator how to coax her along to socialise & join in.

Losing one's home IS a big deal. But my (very wise) Aunt explained while she grieved that loss, she also lost having to juggle bills, arrange workpeople for garden maintenance, cleaning windows, home repairs - what a relief! Plus gained new friends, hot meals available, sing-a-longs, social groups. Happy hour! (It may well be watered down wine in a plastic cup but what an optimist, eh?)
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Stop trying to make someone who is unable to comprehend something comprehend something. That's absurd.

She WILL stop this obsession eventually, and until then you tell her they can go home once Doctor "Welby" says they can. (Now there's an ancient reference!)

It'll never happen, so you have no worries. Just keep repeating that response, because it's short and sweet and just enough to register with her, plus it puts the blame on an imaginary person and takes it off you.
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Yes, ignore, tell them when the doctor sends you a letter approving that they can go home you will let them know.

No sense in trying to explain anything to them, their minds no longer function properly.
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