Moving Part III: The Importance of Stability and Structure
It's interesting to hear about the reactions by the residents who were with Mom in the secure unit when they were relocated into the main portion of the retirement community. In talking to the nurses and the aides who had worked in the secure unit and who knew what to expect, I found out that many of the residents had become very confused. They couldn't find their own rooms (albeit all the hallways are painted the same color, which doesn't help with differentiation). They also were going into other residents' rooms to find their beds - which was disconcerting for the residents who did not have dementia.
In Mom's case, she was fine for about a week. She asked me shortly after the move if Dad and Dr. Deaton would know where to find her. (She thought she had moved to another city or facility instead of to another wing of the same building she had been in since September). She was a little paranoid during the early part of the move, but staff members who she knew from the secure unit would stop by and visit her. Still, Mom stayed close to her room and didn't participate in activities such as her beloved bingo.
Then a week later, Mom had a reaction. She was very "out of it" mentally - she did not respond to conversations, did not recognize people, did not eat at dinner, and did not answer when the nurse asked her if she had swallowed her pill. Plus, Mom seemed to be tired all the time, and continually had a glazed look.
My father was visiting at the time and saw Mom's reaction. We both got worried about her lack of engagement, and began quizzing the nursing staff about what was going on. Luckily, the nurse who worked for the majority of the time was one I knew by sight from walking down the other wing to the secure unit. She was patient and explained that Mom's vital signs were good, and that her behaviors might be a reaction to the move.
From Thursday until Saturday, Mom remained in the same state. At that point, I considered cancelling a business trip because of Mom's refusal to eat. But Dad and I decided to have another visit on Sunday morning, before I left that afternoon. Sure enough, Mom was much better. She was interested in reading the birthday cards that she had received recently. She talked about what she had for breakfast. She was relatively alert, but still complained about being tired.
It was good for my dad to see Mom's response - and the lack of a logical sequence to this disease. We were thinking that Mom was on a downward slide during the three days of her reaction, but come Sunday, she was much better and Dad better understood that Mom's mental state varies from day to day.
Perhaps one of the hardest thing to realize is that Alzheimer's Disease does not have a linear progression; instead - at least in Mom's case - it's a slow and painful dance to determine where her memory stands on a daily basis. But her move to the new room in a new wing has illustrated how important stability and structure are to helping people with Alzheimer's remain comfortable and engaged in the events of their life.