My mother had a stroke and has since been diagnosed with mild dementia (she's on Aricept and a depression med amongst other things). She has some trouble swallowing (soft foods only), can't walk on her own, etc. She is in complete denial of her situation. Right after the stroke (before her dementia diagnosis) I got POA for her (she agreed at the time). She has since consistently been asking for me to 'get her out' of the nursing home and now she has switched to demanding me bring all 'the paperwork' so she can review and figure out how to revoke the POA and sign herself out since I'm not helping her. The nurses/staff know that her stay is permanent and don't mislead her. Besides my normal tactic of deflecting, changing the subject, and just listening to her... anything else I can do? Her dementia appears mild (to me) and mostly appears to be mild word-finding issues and some minor mis-speaking (referring to her ex-husband as my son's father instead of his grandfather for example). She has already told the nurses (once that I know of) that she doesn't need her meds, but ended up taking them anyway. She is a fall risk (has had multiple falls, but none in months) but can transfer from her wheelchair to the toilet by herself (the surfaces are stable enough). She cannot get out of bed or her recliner without help (too soft). Since she can do little things, she thinks she can live independently. In the skilled nursing facility she is at their level 4 (highest) of required care and I know that she can't take care of herself. Any advice on how to handle?
Bring her the POA papers, what's the difference? She's not going to be able to DO anything with them anyway, nor can she make any changes to her POA since she has dementia; she's incompetent to do so. But allowing her to 'look things over' may calm her down, and that is the goal for you: to calm mother down. Taking her out of the SNF is not warranted, and a bad idea to boot. She can certainly 'breathe' quite well there, believe it or not, and she also has freedoms! SNFs are not prisons, and the residents do have rights. Those who start shooting their mouths off about "killing themselves before being put in a nursing home" really have no business commenting on a post that's asking for help with a mother who LIVES in one! My own mother lived in a Memory Care ALF (but was headed off to a SNF in short order) for nearly 3 years before she passed rather unexpectedly last month from heart failure. She was treated beautifully by a loving & attentive staff & had no horror stories (nor do I) to share with anyone about the ALF. Neither one of us tried to commit suicide over her necessity to live there, either, I'm happy to report.
Learn all you can about dementia, and how to interact with your mother in the least confrontational manner possible. I suggest you read this 33 page booklet (which is a free download) which has THE best information ever:
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Here is a list of useful tips from her e-book I found to be excellent:
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
When mom wants to be let out of there, or go home, simply tell her "when the doctor says you can leave, then we will discuss it." Then change the subject/use diversion/offer her a snack/take her outside into the sunshine. I was used to being The Bad Guy with my mother after 10.5 yrs of being her POA & advocate. I did everything in my power for her, but dementia destroys their brains, so they can't see the reality of that fact. It's tough, what we go through, but it's all for THEIR benefit. You are not doing 'anything wrong', either; it's the DEMENTIA that's causing your mom to BELIEVE you're in the wrong & she's in the right. #Truth.
Wishing you the best of luck with a tough situation.
I'm sure you can imagine what's going through her mind. She may not even have mild dementia. Every senior gets diagnosed with dementia when they are in a nursing home. Being in one certainly will affect a person's mind and cognitive abilities.
Don't lie to her. Stop trying to deflect and change the subject. Don't do this to someone who is still mentally with it enough to know you're doing it.
If she wants take you off POA, explain to her that what will happen if you give it up is the nursing home will petition for conservatorship over her and they will win. They will get whatever doctor they use for their facility and probably a dozen others to sign off on her having dementia. This is what will happen. Try being honest with her because she might do better with the truth.
hug!!
Tell her you'll bring the paperwork once her doctor ok's her to leave on her own unassisted. Don't let it bother you...she may not relent so just keep your story the same. That's as much as you can do.
Your Mom is fighting hard to keep her independence - her brain doesn't see the stroke robbed her of it.
She is blaming you. Often our nearest & dearest cop the fallout of our real emotions.
If possible, change the 'Headline' to Blame the Stroke. I think that has worked somewhat with my Mother.
I think Vascular Dementia is very hard. Long & short term memory can be quite intact so strategies like distraction just don't work. Pills for anxiety/depression can work to reduce some of the depth of emotional pain.
I like what 97yroldmom said
"Could she see a mental therapist or someone from her church? She has a lot to deal with". I see you already have someone she can talk to.
I think a few chats with a Psychologist did help my Mother, to set some achievable goals. I see you already have that too! Work at PT to get stronger etc
I think you are doing everything that can be done. A safe place, PT, meds, psych.
So as Counytrymouse said so simply & beautifully "sympathsize & wait". Wait this stage out.
Friends with parents further along have found the blame slowly slid away, along with other skills. One has a whole new Mother now. From angry at family all the time to quite mellow. It's a mixed blessing. The anger has gone, but so have many more parts of her personality. They can grieve now though.
This small saying helps many: This too shall pass.
A BIG (((hug))) to you
It was the key tool for us. Holding POA AND a formal psychiatric evaluation over rode any concerns about how well my LO could do and confirmed her need for supervision and support, even though she “seemed” fine.
“I feel so sorry” for people who make blanket statements about providing care when all other alternatives have been exhausted, without acknowledging that some caregivers CANNOT sustain a level of care that meets the needs of their LOs without becoming permanently damaged themselves.
My mother also asks me most days to go home. She doesn't have a home anymore as my father died when she was in the NH for respite (she stayed after his death). She is well cared for and is in better physical and mental shape than she was before she went in.
The only way she could leave the NH is if I bought her a house and a full-time carer as I don't have space in my home and I don't want to care for her. That will not happen as I currently don't have the financial means to make that happen. I have young teen kids and a full-time job so there is no way I could provide her with any level of care.
Sometimes you have to make hard decisions for both your own sanity and the safety of your mother. Based on what you say above, I think she is in the best possible place. When my mother asks to go home, I deflect or say that we need to discuss with the doctors.
I think the anger/sadness/depression most elderly feel is for the loss of their independence, which they will never regain. I know if my mother was at home she would feel she doesn't need help, even though she is incapable of doing anything on her own. It is hard, makes me feel guilty, but for me (and sounds like you), the only option is an NH.
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