Should you tell an Alzheimer's patient that you are moving them into a nursing facility?

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Should you tell an Alzheimer's patient that you are moving them into a nursing facility?

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After much agony, my sisters and I have finally decided to move my mother with Alzheimers into a nursing facility. She can barely see and can't remember one minute to the next. I don't think she will even realize she is in a nursing home. I plan on telling her we are going there to visit a friend. That's all. Is that disrespectful or immoral? I have been caring for my mother 24/7 for over a year and I know that she won't understand or remember my explanation. However, if any negative feelings associated with the words, "nursing home" come up, she WILL remember those. She does remember emotions. She won't know WHY she's feeling sad or anxious. She'll just pace around all anxious. I truly believe it is more detrimental to tell her. Thoughts?

Alzheimer's & Dementia Moving Skilled Nursing Facility

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No. I agree with you, and you know how your mother will react best. You know that the ability to reason and have insight is not there now. A gentle transition will be kinder. It's really hard to let go of 'don't lie to your parents', no matter the circumstances...

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Don't tell her. This is merciful. Often on this forum the question arises of whether a caregiving adult child should tell and re-tell their parent that their spouse is no longer alive, every time they ask. No, there is no point in having the experience the emotional distress over and over. So it is perfectly moral to do what is merciful, which is tell them a "therapeutic fib". Refer to her new residence as her apartment. The staff will be happy to play along and does this all the time for others. May you receive peace in your heart.

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Maybe write a letter to your mom.

Put it in a journal, or in an envelope, but have mercy on your Mom, and don’t subject her to grief. Most nursing homes do not resemble the institutions that she may have seen in her younger years.

Your mom won’t remember if you tell her or not. This is more about you and your grief.

If you have adult children, and they can handle it, maybe share the letter with them.

I, like so many of us, have had zero training in dementia and the accompanying decisions, until I was forced to by crisis circumstances.

I am sharing portions of my caregiving journey with my adult children. I don’t ever want them to have to go in blind, like I did.

Best wishes.

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Given the circumstances, I don't think you should tell her. If you're comfortable with the facility you've chosen, then allow them to care for her and follow their suggestions. They may ask you to stay away for a week, while she adjusts to her new surroundings. When I brought my mother home to live with me, she kept asking, "Why am I here? " I told her it was so that she would be safe and well cared for. If your mother wants to know why she's there - tell her something similar and make sure she knows that you love her. This is so hard - sending you hugs and prayers that this will be an easy transition for both of you. 🤍

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You are doing the right thing. Why or how could that possibly be disrespectful or immoral?

Don’t talk about her leaving where she lives presently until you’re in the car headed there.

When you arrive ask if someone can come out to meet you. When you get to her room, hugs and “I love you” from everyone, then “Goodbye, I’ll see you soon”.

Then leave. Hopefully someone will have briefed you about how long you should stay away before your first visit.

My mother’s life was lonely after my dad died, and upon entering the SNF where she lived after a badly broken hip, she bloomed to enjoy 5 1/2 delightful years before her death at 95.

May your sweet mother’s new life be the same.

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Honestly, I wouldn’t.

I had a conversation with my mother-in-law the other day about when she was going to see my sister-in-law. Saturday. How she was going to get there? What day was it today? What day is tomorrow? And then the days got all mixed up, and the conversation went in circles for an hour as she tried to get in straight in her head. Only for her to forget the next day. I didn’t bring it up again. I had learnt my lesson.

With this (like me) it would just be punishing yourself. And I’m sure the hard (albeit necessary) decision you’ve already made is punishment enough.

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Thank you all for your thoughtful and caring responses. I am so grateful for this forum. Caring for my mother has been the hardest thing I've ever done and YOU helped me through it. She is leaving my house but not my life. God bless all you incredible souls who give so much of yourselves.
-Burnoutgirl

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No.

Your plan is great, and is the kindest way to handle the situation.

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My Mom was pretty much into her Dementia by the time I placed her. I told her nothing until the day of. Got her moved in and then took her to the AL. Told her she was going to a new apartment. She would meet new people. Got her settled. Think we may have left her in the Common area where the dining area was and the staff. That way when we left, she was not alone.

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Maybe consider telling her she is going for an extended visit since you need doctor-ordered rest for your health. She won't remember, but you may feel better that this is closer to the truth,

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Perhaps - a white lie along the lines of going to visit for a few days whilst you have to be away, and you have found a hotel for her? Whatever will help her to accept it more comfortably. With her current level of Alzheimers being as you have described it, she is unlikely to know the difference between a hotel and a NH. So avoid any possible negative words, and as staff are generally welcoming she should not feel anxious. This is purely a personal view, but I would not be telling her or trying to explain anything, there is no point causing stress or anxiety to someone who doesn't understand or who would think they would not like the solution you and your sisters have arrived at as being necessary. I agree with you that sometimes more information is more harmful than less. It is very sad to see people we love suffer with any form of dementia and cease to be the person we would like to remember, you and your sisters sound to be very caring and Mum will be in good hands, with good care which is the best you can do for her.

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I am moving my husband who suffers with dementia, into a Memory Care facility next week. He has been going to an adult daycare facility for the past few months - when I talk about that, I call it Senior Care. I have told him that I will be moving him to a new Senior Care place that is bigger and brighter and has more activities and he will be having physical therapy for his balance issues. I told him that he will have his own room with his own bathroom and I will visit him every day at 4:00. Don't use the words "nursing home". Yesterday, I told him it was a Senior Care/Rehab/Resort.

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Very smart!

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You don’t have to tell her that she’s going to a nursing home but explain that she going somewhere to get stronger or better or whatever. If she becomes agitated or questions where she is, it helps to use diversion by asking her a question or changing the subject. My mom is in a memory unit with dementia. She wants to go home and will never be able to. At this point, I tell her whatever will pacify her. Her peace of mind is worth more than her knowing all the details that might upset her.

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The 'best' communication would be 'anyone or anything' that brings this woman joy. Helping a person with dementia isn't a lie, fib, or anything negative. It is a way to support a person where they are to get their needs met - while maintaining as calm an environment as possible. Reduce fears and anxiety any way one can - during transitions.
Gena / Touch Matters

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In my opinion, it is not disrespectful or immoral to tell a loved one with dementia or Alzheimer’s “white lies” that help them handle situations. As her illness progresses, you will find yourself using that tool more often. Now whether it is best not to inform your mother about the move, you are the expert on her.

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This is an easy-to-read book with great advice on a seamless move into a facility: "Moving and More" ISBN-13 ‏ : ‎ 978-0971039056

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Therapeutic fibs are definitely a common practice.

My mom with ALZ and borderline personality disorder didn't take the therapeutic fib so well ("you need more room and therapy after your recent falls - the doctor wants you to be here to get therapy").

Use therapeutic fibs, but know your loved one and be prepared for reactions.

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It needs to be called: "therapeutic support"

(3)

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Is she there yet?

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Fill her room with her favorite chair and cover her bed and pillows with familiar covers (permanently laundry marked). Family photos and sentimental items at her bedside and sink. A treasured framed piece of art.

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tell her the truth, thats what we did. Yes she always insisted she was going home, she walked again etc Total denial , we decorated her room with lloved items and finally after 5 days she "got it" and said sooo this is where i live now, yes Mom there was no other way as we were all needing rest too! She thought I lived there too ! And I insisted on the truth. I'm glad I did rip Mom we luv you and miss you. Prayers for your Mom and all who love her, tc

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No. No reason to tell a person with Alz the 'truth' - as is stated, she can't remember one minute to the next --- WHY cause this woman more stress when she won't remember / know anyway?

While this is what you did - it was your mother. There is absolutely no reason (logical reasoning) to create more fear and stress than there already is. I would not recommend (your) this advice to anyone.

There is a broader 'picture' than just what 'you did' with your mom.

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i read the opposing viewpoints here and i agree, whatever works. Its funny NOT that at home she thought she was in a Hotel cause her bed was gone and Hospice bed was there. In Nursing she thought she was in the Hospital, it will work out, hang in there! ****update000btwHospice Nurses did not fib and told her everything- that shes on Hospice, Chaplain came too and didnt fib, Social Worker too and we all talked about the move and why, does your Mom have a Social Worker?

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Absolutely DO NOT tell her.
She won't remember.
Momentarily, the 'truth' will cause her more confusion, fear, anxiety.
There is no reason to tell her she is moving.
--- NEVER EVER USE EMOTIONALLY TRIGGERING WORDS ---
* Your question to us tells me that your needs and concerns are based on how you feel and your emotional needs, not your mom's. This is understandable - it is a shift in the relationship, her care.
* I commend you on taking this step. It is not easy emotionally.
* You ARE doing what is in her best interest.
* Keep the conversation 'happy' and refocus as you need to (or re-direct as it is called in).
Gena / Touch Matters

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if the facility will allow it perhaps you could do what was often suggested here pre COVID for moving your elder. Since her short term memory is often fleeting maybe you or your sister. Outdoor take her out to lunch while the other one moved some of her special “things” and or furniture and set up her space to look as much like the one she’s leaving as possible. “Remind” her at lunch that the house or her room is being worked on for a few days so things will be slightly different during that time. Don’t make a big deal of it, it was expected after all but give it a shop prepping her for why going home is different. You aren’t lying when you tell her she’s “home” this is her home now and you have a response for why it looks like a different (or is) place. When you arrive at her room there her things will be along with your sister. Again I would act as if it’s all normal, not a special adjustment or sad and if both of you are doing that along with her things being around (family photos are often helpful) she may not notice the difference as much and adapt more quickly. I do think that like young children who depend on us or elders who often feel as dependent (wether they admit it or not) take emotional cues from us so when we are nervous or anxious about wether or not they will accept something or trying to make everything good, acting differently, they instinctively feel anxious and fearful of whatever is causing us to feel that way. I know I didn’t explain that well but hope it’s making enough sense to get the picture. Only things I can think of to offer. It’s a tough decision I know but it’s the right one, you and your sister have made it together and committed, Mom will be safe and cared for, you are doing what is best for her rite now.

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I liked your ideas until I got to the end. The person and her sister committed to something. How can you say that YOU KNOW their decision was the RIGHT ONE? Presumptuous and arrogant. 99% of the time, there are other options on any given subject. You did not indicate that you know these people nor the intricacies of every aspect of their lives with their mother. Old saying: "Those of you who think you know everything are annoying to those of do.".
King Solomon asked for wisdom to know everything. Read Ecclesiastes. I call him my favorite schizophrenic king. He went mad.

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Tell her the truth. My cousin was dropperd off at a nursing home and told by her daughter she will be right back. She waited and no return for about two weeks. Cousin at the nursing home was so upset and daughter decided to end the relationship until when she was on her death bed. Very sad story. She was a good mother and deserved better. I tell my mother the truth about everything. She might remember for a short time but I reinfore it as needed.

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earlybird,

It depends on how far gone they are from dementia. If a person doesn't remember being told something from one minute to the next, why upset them?
Telling them they're going to a nursing home over and over for them will be like hearing it for the first time. It's not worth upsetting someone like that.

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Don't tell her. Just stay with your original explanation of going to stay with a friend.
If she won't remember what you're saying anyway, why upset her?
Just be very careful not to use the words 'nursing home' or 'facility' around her.
I had a client who was totally invalid from dementia who had to go into temporary respite care while her house got renovated.
She was told that she was going to a hotel. She didn't know the difference.

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My mother believes she lives in 'a motel'. She even thinks the CGs 'take me to a different motel across the street that looks exactly like my regular motel room but how can that BE?' every now & then. She also believes they take her out to eat to different restaurants every day for lunch & dinner. It's better that way; why rock the boat? :)

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We moved my mother to memory care when she developed shingles that we couldn't manage at home. I told her it was like a cross between a hotel and a hospital. She seemed to like that description. No mention of the intention for it to be a permanent move. She has adjusted well, and is quite content now.

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Good thought!

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If you tell her, she’s not going to remember in 5 minutes. But when it’s time to go..the day of…say you’re taking her to doctor appointment & then out to lunch! Which in a way, true because she will get checked by dr when arriving & then give her lunch..,& you can help her eat. Hugs 🤗

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Burnt and Care. You are right. I was thinking about my own mother. I guess I always told her the truth about things and she understands most days.

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Burnoutgirl: Imho, since (sadly) your mother has a broken brain, there is no real need to tell her. However, if you feel a moral obligation to tell her, then do so.

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You think this is funny? A moral obligation? Don't tell her? Seems as though you lost your moral compass, if you ever had one. If I have misunderstood your answer, I apologize. At first glance, I found it disgusting.

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I would not even make up a story about visiting a friend. Get her dressed and ready and just explain things as they are happening. "You're sweater is in the closet, mom " while she watches you hang it up. "Miss Eleanor (nurse or aide on duty) will help you turn on the tv.". "I love you. I'll see you soon. "

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I would tell her the truth - not for her, but for you.

She may forget, and you may be experiencing “Groundhog Day” — but you will feel better because you won’t be hiding anything.

i understand how you feel- a part of you is torn up because you don’t want to feel like you are deceiving her — so tell her and try to feel peace.

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Should you tell an Alzheimer's patient that you are moving them into a nursing facility?

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