Dear Carol: My mom is 86 years old and lives on her own, but it鈥檚 obvious that this can鈥檛 continue. She doesn鈥檛 eat well. She forgets her medications or may even take the wrong doses. She leaves the stove on. We鈥檝e tried in-home care, but she won鈥檛 let them in. Mom refuses to believe that her mind isn鈥檛 healthy. Her doctor has suggested memory care in the past, but she鈥檚 refused that, of course. I know that moving people with dementia can make them worse, but she can鈥檛 stay where she is. The question is how do we get her there? 鈥� SN.
Dear SN: In general, we try to honor the natural wishes of older adults which often means helping them live safely in their homes. However, dementia changes that picture. There are times when forcing the issue is the only option, and it sounds as if this is where you are.
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How you approach this depends on the stage of your mom鈥檚 dementia. If she can still remember conversations, be compassionate but direct. Tell her that her doctor has made it official that for her own health and safety she needs to move to an apartment in a care facility. You don鈥檛 need to stress that this is memory care. If possible, take her to the facility for lunch several times before she moves so that the place becomes familiar.
The more the family can act as one cohesive group, the better this experience will be for everyone involved. Ideally, once a room can be secured, if some of her personal belongings can be moved in early, she鈥檒l feel more at home once she鈥檚 there.
If her dementia is further along, you might need to be sneaky. Doing so won't feel good to you, but remind yourself that this is for her health and safety and it's a last resort. To get her there, try taking her out to lunch and perhaps for a drive. Afterward, instead of going to her home, take her to her memory care room. You could explain the new environment by saying that her kitchen sink flooded so she needs to stay here temporarily. I repeat: This won't feel good, but this kind of subterfuge is often the only choice left when someone is cognitively impaired.
If the rest of the family could move her personal belongings while you take her out on this adventure, that could help. Having her own bedspread, pillow, robe, nightgown and some pictures can be especially comforting.
You鈥檙e right that a move could cause your mom to become even more confused for a time. She鈥檒l also likely be angry. However, most people find that eventually, their parent or spouse living with dementia gets used to the new living arrangement and many learn to love having people around and activities to do.
I鈥檓 sending you my sympathy because I know that this is painful, yet something needs to change for your mom鈥檚 sake. Huge hug to you as you tackle this move.
Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of 鈥淢inding Our Elders: Caregivers Share Their Personal Stories.鈥� Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached through the contact form on her website.
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