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Mother has been living with me for almost 5 years, but her needs have increased & the arrangement isn't working as well for either of us any more. So at my mother's request I researched continuing care communities, got info, read the Medicare ratings, checked staffing levels & turnover, etc. After some visits, she really liked one of the places & asked me to submit her application. Everything is all approved, we did a second visit last week & she says "I could really enjoy living here; this is a good choice." It's a mellow, quiet community. She likes the people she's met, the rooms, the gardens. Then today, on a third visit to talk details, it's "I don't want to live here. It's too confusing." The AL manager was calm, helpful, low-key. Mom says she needs to go home and think.


Meanwhile, I'm thinking "Really?!?" Do I have to back up and start over? Look at in-home care (actually not a good solution for either of us)? Time is running out before I have to return to work FT, the holidays are coming, I'm getting burned out . . . .


Sometimes she knows that her needs are changing & is an active participant in thinking about how to adapt; at other times she is totally passive. I know that these major transitions can be tricky. I want to facilitate good decision-making, but don't want her to feel pressured. Others must have faced this kind of indecision in a loved one. Any do's and don'ts for getting through it?

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Anything new is frightening. Think about when you started a new job, moved to a new location, a new grade in school or went to a party where there may be people you did not know.
Yes it will be frightening, confusing and she will get used to new friends, new routine, new surroundings. She will develop friendships and learn to enjoy herself.
Tell her you understand the fear and apprehension she is having but give it a chance. Try on the community and see how it fits her and if after a few months she is not adjusting then ask if there is someone that might be able to take her under their wing and be a "buddy" for a while until she makes friends of her own. Get her involved in a group or two doing projects that she has enjoyed in the past. The key is to keep busy! I know when I am busy my day goes fast and I don't have tome to dwell on things.
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Change is hard for an elder to accept. I think you should pray to God and HE will give you the answer.
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Just moved my 96 year old father into assisted living from independent (should have been done a year ago with falls and rehabs). He loved the place I picked out. a mile from me (better than the 45 min. I was driving every time he called). It's been 6 weeks and he has settled in really well. The first couple of weeks was hard, couldn't find things in the new apartment and his memory seemed to be off (more so than usual although pretty darn good for 96!) but now, he's back to normal (sort of) and really glad he did it. Now, I don't have to worry about doing his medications, incontinence (that is getting worse) or him falling. Yes, it is an adjustment for them as it is for us (and will be when I get to that stage) but hopefully after all I've gone through with family I can make that decision easy on our son and he won't have to. I think just keep taking her back a few more times to have lunch or let her do some activities with some of the ladies. I had lunch and dinner with my dad a few times the first week or 2 just so he wouldn't feel so alone. Good Luck and God Bless....
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Your situation is similar to mine. I too had been taking care of my mother for the past five years, and it was time. We had a medical emergency with my son, and while taking care of the both of them, she saw that it was too draining on me and elected to move to Assisted Living Facility. One beneficial aspect of our situation was she had stayed there the year before during a two week respite while I was away.  If it is available, I would suggest she go for a "respite" and then once the period is over, hold your ground. We decorated Mom's room with all her special belongings and filled it with memories.  It wasn't a perfect transition, but we are five months into it and she is making friends and going to the social gatherings. We have since had to move her to Skilled Nursing, so I feel like our timing was perfect.  They are not going to get any better than they are today, so you and she need to plan for her future.
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I would tell her that it is all right to feel overwhelmed and confused with the new environment because it was a big decision to make the transition. Big decisions always have those reactions and it is normal to feel the way she does, but it does not mean she made the wrong decision. Much better to make the move now and not regret the missed opportunities that AL can provide.
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KiriG65 Oct 2018
Absolutely - we have talked about the fact that major transitions are challenging because they are IMPORTANT.  If a change like this were trivial, it would be easy.  So thinking it through and making a thoughtful decision is exactly the right way to do it.
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jasmina, great points! Yes, ask for a buddy thing, I’m sure they have it. kiri, also, I don’t know how you’d slant this but when she’s feeling independent/confident with you can you say ‘Then you’re ready to live on your own vs. my home.’ Don’t have time to make that sound any better than mean, hope it conveys. :) I think you could reasonable say that this is more independent than her being under your care.

I keep, keep looking for a way to say to my mom (and hope I remember it when I’m older) - actual independence is knowing where you need help and accepting it.
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Reassure her you are a phone call away and that you arent abandoning her there. Program her phone so she can push 1 button for you.

Go with her to activities, brunch, lunch etc. Visit often until she gets accustomed to it. Make a standing brunch or whatever appt with her, so she knows its just a few days away, I wont be alone.
I think she is afraid of change and the unknown. That she will be "put there" and abandoned.

Tell her the plans have been set. No backing out now. You will help her make new friends and get interested in activities. Show her some info about people who are happy with the change moving to an AL, so it is not so scary for her.

Ask the AL what do they have in place for new residents? A welcome wagon on her first day there? Someone to be a buddy to show her around? Have breakfast with her the first morning? Anything like that? Good luck.
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KiriG65 Oct 2018
Great suggestions; I'm going over to the AL on Monday & will be sure to ask.  Thanks!
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You may have already heard this but get her things moved there and the rooms looking like how they were in her room at your home. Everything is hung on the walls, put away, etc.
stay and have lunch or dinner with her to meet others and then let her spend her first night there. Stay away for a few days but you can call her. Be aware it can usually take 3-6 months before they totally adapt. My dad went through several phases of wanting to move out. Don’t capitulate and stay strong, knowing it will pass. After a while my dad said how much he loved it there. As someone else said change is so very hard for them and especially for dementia. Can be unsettling to them.
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Yes, it is very hard to know when they are no longer there in the conversation.

Kiri you are doing great, you are very much concerned with her well being so any decisions you make, will be made from that position and will be right.

Hugs to you!🤗
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& I forgot to add...don’t take mom along on 3rd trip to discuss details...which is probably $$$$$....too confusing & scary for her...that’s for you & office to discuss privately....Good luck
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KiriG65 Oct 2018
All the business end of things has already been discussed, so the plans are all made, they just need to be carried out.  Finding it challenging to shift from supportive helper to ultimate decision-maker, especially when she's an engaged participant one minute but not the next.  I've got a little case of mental whiplash going.  :-)
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Tell her it’s a vacation/spa retreat trip & you’ll join her after a couple of days ...you just need more time to pack
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Sounds like mom is acceptable to the move. Remember this when she says she doesn't want to go.

That's the hardest thing, daily trying to figure out who you are dealing with-mom or dementia?

You are doing a great job, keep it up and take care of you 😎
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Weeroo - No UTI, but a fall in May and noticeable decline in the last 3 months.  

JoAnne29 & Golden 23 - Characterizing the initial move as a "trial run" actually fits right in with her comment today:  "I could always come back if I don't like it."  And we've talked about coming "home" for a few days once in a while, e.g., when my son comes to visit over the holidays.  She likes that idea, but I wouldn't be surprised if she's more than ready to go back to the peace & quiet of AL after having experienced it for a couple months!  She already finds home, with its lively (sometimes barking) dog & normal activity a little too much at times.  Add some holiday visits and activity and who knows?  :-)

Isthisrealyreal -  Thank you for your kind words.  This is a challenge, and I find it hard to follow the advice that we all give others:  take care of yourself, your life also matters! 

This change in executive function (& I do think that's what it is going on) is so new.  My mother has always been so sharp & on top of things, such a great person to problem-solve with even just 6 or 8 months ago.  I think sometimes that my struggle to recognize that change & to take a more active, directive role, has just made it harder for her.  It's like using an old computer - there's still the memory, but the processing speed . . . She started to do something tonight and got sort of stuck half-way there, and all I could think of was how frustrating it is when the video doesn't load, or the page sticks: buffering . . . , hanging . . . , spinning . . . !  Hah!
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JoAnn29 Oct 2018
I like that analogy:

It's like using an old computer - there's still the memory, but the processing speed... the video doesn't load, or the page sticks: buffering . . . , hanging . . . , spinning . . . !
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She needs to go there but her brain is not working right though sometimes it seems to be. I agree that you are the decision maker now. Have you talked with the AL manager for ideas how to deal with this? You might tell her the move-in is a trial period and see how she adjusts, but with the agenda that she stay there. "You aren't ready to come home, Mum." or some therapeutic fib that would prevent her returning - could be house repairs, your health or whatever,

In some cases the elder has to be taken there unawares that they are staying. Maybe go there for lunch and set up their room up ahead of time. In one case I know one daughter took the elder out for shopping while other family set the room up. Then the family brought their mum to the AL and left them with the staff to deal with. The elder was not happy for a while but adjusted pretty quickly. Family continued to visit and take mum for outings. This may sound cruel but if they need that level of care the move must be made. Eventually they adapt. Switching from being the child of a parent to being in a parent role to your parent isn't easy.
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AT1234 Oct 2018
In my opinion, This doesn’t work very well when a mom is “in and out” cognition. She will resent, but I do like the get the room ready first which isn’t easy either.
My mom left after 1 month, went home a pretty quickly fell broke her hip. Now she’s going back where there is help. Period. The end. No more. It’s really hard but I want her safe.
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If she has any dementia her executive function is reduced, decision making, planning, follow through, etc.

Unfortunately, at this point you are now the reasoning adult in the relationship.

She agreed, just because she is hedging now doesn't change anything. Mom moves to the AL she picked and agreed to. You go back to being her son/daughter and not her 24/7/365 caregiver.

She will most likely have an adjustment period that will involve a whole host of emotions from tears to rage, you will be the bad guy, it's all your fault, you don't love her, etc. Be strong and know that this is the best solution for both of you and she will settle down.

Do encourage her to engage others, participate in activities and to be as physically active as she can be.

Don't buy into her guilt trips, or your own. Don't stick around and get beat up when she is ranting about how terrible it all is, including you. Walk away, hang up and live to fight another day.

Do be kind and forgiving to yourself, it is okay that you can't take care of your mom in her old age. You are making sure that she has a nice place with ample care, that really is one of the greatest gifts any child can give their parents.

Stay strong! You can do this!
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Levans2008 Oct 2018
Very good advice!
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Its scary for her. She has been living with you for 5 years. Change is hard for the elderly. Maybe tell her to try it and if she doesn't like it after a few months you will figure out something else. But for now this is what you both need.
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Just reading about UTI in another post and how it can produce drastic changes. Perhaps?
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