She has fallen four different times in the last six weeks, broken a different bone each time, hospitalized twice and has gone to a rehab facility twice. She always agrees to follow the restrictions set up by her doctors to keep her safe, but fails to follow through, or doesn't remember why the falls happen, or simply lies about it (I don't know which). She is endangering herself and is resenting me more and more. My husband and I have reasoned with her, explained what is going on, but nothing sticks. My husband and I have tried everything possible to help her get back to AL, but now it is apparent that she simply is not a good candidate anymore, even though she thinks she is. Any words of wisdom to help her (and us) to get her through this. Right now she is in rehab facility again for a foot infection and broken toe, along with a broken wrist from a previous fall. She must be in a wheelchair, but will walk with a walker if assisted, too. Any help would be greatly appreciated.
They are not at all like a big facility that your loved ones are left alone way to long.
You cannot 'reason' with her as you've mentioned here.
She doesn't have the cognitive ability to 'understand' with dementia.
Refer to TEEPA SNOW - her books, website, You Tubes, Webinars as she teaches how to communicate with people / LO inflicted with dementia.
Teepa is one of the country's leading experts on dementia.
You accept and EXPECT that she will resent you - she is trying / wanting to protect herself in the only way she can. From her point of view, you are the 'bad guy' for upsetting her world / what is familiar and feels safe to her.
You do not take this personally as you know you are doing what is in her best interest, even though it is a very sad and difficult situation - allow yourself to grieve these transitions.
* The goal is to keep her calm.
- You do this by focusing on being present - and aware of your tone/voice, facial expression(s) - smile, make eye contact.
- You let her know you are listening, even if you do not understand her or she doesn't understand you. You support her where she is:
"I know how you feel."
"This is temporary"
"I love you."
* Do not go into 'long stories' as she won't understand and/or it will continue to cause her distress. You NEVER ever set up a 'tug of war' trying to win or convince. It cannot happen and causes more frustration, fear, discord.
You change the subject:
"Look at these beautiful flowers I bought you today"
"Your blouse looks lovely on you."
"Let's go for a walk, okay?
"I'm working on getting you home" (she may not know she is already home or know where she is.)
* You bring her furnishings to the facility to make her room like like her home.
* As needed, during the transition, consider medication needs and enlist volunteers (caregivers) to help w socialization / company.
Once you understand that logic doesn't / won't work, you will be able to use other sensory resources (touch, sound, visual). You won't be banging your head against the wall 'trying' to make her more accepting / comfortable.
You find other ways as outlined above, namely "agreeing, showing compassion, changing the subject."
Gena / Touch Matters
You can try telling her it's temporary, or that she agreed to this a few weeks ago, or that when she gets better (6 months with no injuries) she can start doing more herself. It doesn't really matter what you say, as long as it helps you to deal with it. Anything you do now is really about your comfort level because what she wants and what she needs no longer aligns. She can't understand this and will protest even if she could.
Whatever her complaints, just empathize. "I know Mom. But we'll get through this." Look for little things that will make her happy on a day to day basis. Favorite snacks? Favorite music? Favorite movie? Audio books? Video calls? Do your best, give yourself credit for the love and effort you put in, and make sure she is safe and healthy. That is all anyone of us can do for our frail, older loved ones.
The second time (that place went downhill and no cameras which was their way of getting away with shoddy care), I told mom they were going to paint her room and I packed everything up so it would not get paint on it. I also, in the new place, had her caregiver and her in a model room for the time it took to move her belongings. Mom and her caregiver had a comforting day and 2 meals. This time I helped my husband with the move and got it set up-texted her caregiver and brought her to the new place. Mom was very tired and was grateful to see her bed. It has been the best place so far and MC and I get to have a camera in there that is live 24/7 so I can just look at her anytime I want. She does have a part time caregiver because all places are scary and lonely with very few staff and mom does best with one/one cuing as well as a dedicated person to do her showers and wash her hair. She loves this place and we do too.
As others have said, there is no explaining or convincing that will work. This sounds terrible, but much like a two-year old cannot understand why they cannot have candy for dinner; your mom cannot and will not understand this. It is too much for you and your husband to expect of her at this point. Sad, awful, and as terrifying as it is; logic and rational explanations are beyond her capacity now.
This is so hard to process and work through. She is not the mom, parent, adult you once knew and now you have to make decisions in her best interest irrespective of if she understands, agrees, accepts or likes it. Much like telling your two-year old (if you had kids) that they cannot have candy for dinner.
Best to research high quality long term nursing home (SNF) facilities w/memory care units that are Medicare and Medicaid qualified (those entities have to comply with US Federal laws/regs; not just states). Memory care is a nice term for locked unit so they do not wander. Do the research now while she is in Rehab and make one move next to a high quality SNF w/memory care there. Best to not have to make another move.
Have the social workers there work with her on adjusting. Some never adjust, my mom never did. Often, giving your LO time and space to adjust can help. That means perhaps not calling or visiting every day for the first two weeks or so.
This is all heart breaking for any family on this journey. I hope you might consider therapy to work through and process your feeling about this. Therapy helped me (still is helping) when my mom was placed. It still helps 6 months after she passed.
Prayers to you and your family.
And she can't follow through with any instructions because she can't remember them, and she's not lying about how or why the falls are happening, she just honestly doesn't remember. That's what dementia is all about.
Perhaps your husband and you need to educate yourselves a bit more about the horrible disease of dementia, so you can better understand why your mother does what she does and so you'll learn that you CAN'T reason with someone with a broken brain, as logic doesn't live there anymore.
But in the meantime, just pick out the skilled nursing facility that you want for your mom and get her room there all set up with her things so that when she gets out of rehab they can just have her transferred to her new home.
And when you get her there you just tell her that this is her new home now.
I needed to use therapeutic fibs for my own Mom who was in her late 90's. She was living in a nursing home as it was now taking a village to care for her. I was a village of one. Anyway, Mom thought she was staying at a hotel, so she would ask if she could visit her parents. I told her her parents were visiting the old country, to which she smiled, and said "that's nice".
Every once in awhile she would ask to visit her sisters (all of whom passed) so I had to quickly come up with a "fib" that Mom would believe for each sister (couldn't use the same for each). Whew, Mom accepted each excuse. Her smile told me I was doing the right thing. If I had to say everyone has passed, she would be reliving that grief over and over.