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My uncle fell and suffered fractured vertebrae that required surgery March 1, 20124. After multiple trips from rehab to hospital to clear an infection he has exhausted 100 days of Medicare capped rehab. He is unable to walk or stand due to multiple heath issues. He will be transferred over to long-term care today. He was also diagnosed with mild early dementia.



The care team and I had a meeting yesterday to explain that he will remain in the facility because of his high level of care. He is a two person lift and wheelchair bound. He said he was aware that he can't go home until he can walk and why can't he do still do PT. It's not financially feasible to continue because he has depleted all savings and will transition to Medicaid in September. He seemed to understand everything even repeated what had been told to him.



I returned later in the evening to visit and he was so excited because his PT ended and he was upgraded to range of motion exercises and would be walking soon. I didn't know how to proceed. I just reiterated that yes he is no longer getting PT but he would be there for a long time. He replied yes but by next week the new exercise will work and I'll be running. I replied that would be great but if it doesn't happen don't be discouraged and keep doing your exercises.


It is mentally taxing to say the least. All visits revolve around this topic even when we divert the conversation he always goes back to when can I go home by next week I will be walking. Do I lie and skirt around him going home? Any advice on how to proceed with him to understand it may never happen or should I just go with it?

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You may believe (know) that he will never go home. He will need that hope to help him acclimate.
Look at it as he has to live with his condition 24/7, especially when his mind is having a clear day. You only have to reassure him for a few minutes that he needs to just focus on healing and then change the subject.
Do consider antidepressants, watch his diet/weight for signs he is unhappy (and who wouldn’t be). Encourage that he take part in any activities available.
Don’t try to convince him of anything. Defer to his doctors etc. Just be his loving niece there for a few minutes to bring him a treat and a hug. Let him tell you how he is doing. Don’t be the expert but do let him know you are checking in on his progress. In other words, offer reassurance that all is well.

He may never understand long term. He might understand in the moment. You are learning a foreign language. You might notice that his foreign language is different from your moms.
Dementia and how it affects different people is not the same depending on many mostly unknown factors.

We don’t call it a lie. It’s a therapeutic fib. Meant to leave him feeling as well as possible. But he will know on more cognizant days and not so much on other days. Set your intention before going in to bring him cheer. Don’t stay too long. Especially if he repeats.
I’m sorry this has happened to him and to you.
Helpful Answer (3)
Reply to 97yroldmom
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My MIL is in LTC. She hasn't walked in a few years, is completely bedbound. Has mild-ish dementia/memory impairment. Whenever she asks to "get out of this place" I tell her she needs to show her doctor that she can do all her ADLs first so she can approve her for discharge. She then says, "But I *can* do them!" and then I say, "Great! Make sure to tell her next time." And then I move on to another totally unrelated topic.

The point is to make the doctor the "bad guy" and you're Switzerland.
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Reply to Geaton777
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Just keep agreeing with him that when he's walking again, on his own, you'll speak to the doctor about him returning home. With dementia at play, they get a thought stuck in their head and it cannot be chopped out of there with an axe. Just come up with a line to keep repeating over and over again to your uncle each time he brings up the subject. It's really all you can do.

Its an unfortunate situation for elders who've lost their mobility and get stuck in a situation they don't want to be in. Then add dementia in, and it's just a big mess for everyone. I dealt with my mother and her dementia in Memory Care Assisted Living for nearly 3 years. And a few years before that, too. It's like we jump down the rabbit hole WITH them.

Best of luck with a difficult situation.
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Reply to lealonnie1
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