The Challenges of Placing a Loved One With Alzheimer's in a Nursing Home
I remember moving Mom into the nursing home. It was one of the worst days of my life – and I didn’t handle it well at all. Mom had been in a geriatric psychiatric clinic in a hospital in another city being evaluated for dementia. The social worker recommended that Mom be placed in a skilled nursing home with an Alzheimer’s unit because of her chronic obstructive pulmonary disease (COPD) and her dementia. Because she was considered a flight risk, the social worker also recommended that Mom be placed in a locked unit.
I ended up driving Mom from the hospital to the nursing home and had arranged to drop her off without spending time with her and trying to ease her into her new surroundings. I think this decision was based on a conversation I had with my mother when she was in her 60s when she demanded that I promise her that I would never place her in a nursing home. I felt stuck as I drove the car up and didn’t want to face her when she realized where she was. She did figure out and ended up having a temper tantrum and I had to return to the nursing home to try to calm her down (as well as the staff, who weren’t ready for Mom’s wrath).
So what lessons can you learn from my mistake? Here goes:
- Involve the whole family in helping the loved one who has dementia acclimate to a nursing home. We had a number of issues going on at the time – my parents had gotten into angry arguments regularly, my brother was dealing with the death of his wife a month before – so I ended up shouldering the load of being the person who dealt with Mom’s transition. In a perfect world, I would have had my brother come to help. Therefore, I’d encourage you to have a plan that includes family members and friends who can regularly visit and can help comfort the loved one in his or her new residence.
- Be prepared with a response if the loved one asks why they are in a nursing home and if they demand – like my mother did – that they want out NOW! I had to come up with one on the fly. I told Mom that the doctor had recommended that she be placed in a nursing home. She demanded that I call and tell him that she wanted out. At this point, I had to go with the white lie of pretending like I did make that call and then telling her that I had left a message and expected him to return the call. That sounds like an awful thing to do, but I felt like this was a time where one needs to go with this type of response since Mom’s sense of reality was impaired and she didn’t understand what her health needs – and mental capacity – really were. If I had been fully truthful, she probably would have had a traumatic reaction. That would have been OK, but she would have forgotten it and then asked the same question the next day and the next. By taking this tact, I felt I could help her adjust to her new situation while lowering her overall stress level.
- Make the loved one’s room feel like home. I actually did this a bit. I took a brightly colored quilt that Mom really liked to the nursing home and put it on her bed. I also made copies of pictures of family members – her parents, my brother, me and others – and placed them in her room.
- Plan trips with your loved one, if possible. I didn’t feel comfortable doing this for two reasons. First of all, Mom was on oxygen 24/7 and it was difficulty to corral that big oxygen canister by myself and also manuever with Mom. But more importantly, I was afraid that once Mom had a “field trip” with me, she’d refuse to go back and would cause another scene. We did, however, arrange for Mom to come over to my home at Thanksgiving. I assigned my brother and his daughter to chauffer Mom that evening and that seemed to work because she didn’t have an outburst upon returning to the nursing home.
Moving a loved one with Alzheimer’s disease to a nursing home or other type of care facility can be extremely difficult, especially since their ability to reason may be impaired. Therefore, I’d encourage you to come up with a plan ahead of the move to try to make this transition as positive and stress-free as possible both for you and for your loved one.