If you have a parent in assisted living, how long did it take them to adjust?

[jerseygirl07067]

My mom just moved into assisted livng on wednesday, following a 1 month hospitalization and then 3 months in rehab, after burning her foot severely at home and not remembering. She wound up having to have her toes amputated because they would not heal due to the extensive damage.

My mom's memory has gotten progressively worse over the past 5 years to the point where she has very little short term memory. She was initially diagnosed with mild cognitive impairment but was recently diagnosed with Alzheimers by her neurologist, based on her progression. If things are repeated several times a day for several days a few pieces of information might be retained, but even then her recall can be inconsistent. Prior to this happening she was living alone by herself but "dangerously" as I'd like to call it, as she was falling, and struggling to keep up with her household bills and responsibilities. Food was rotting in the refrigerator, bills and mail were piling up, I was finding bags of mail from several months ago in various parts of her house. I had offered help, to have someone come in a few days a week to help her, and she kept refusing, saying she did not need the help. I would go to see her and try to help, but it was hard to keep on top of what she was doing. She was living about 90 minutes away from me, and with my busy kids' schedule it was getting really hard for me to keep tabs on her. She has very little insight into her issues and thinks she can still drive, cook, and return home. Live in help is out of the budget so we agreed to have her go to assisted living rather than return home. Living with us is not an option as she can't be left alone for long periods and my house is way too small. In addition, having her live with us would be very disruptive to our family. I always thought I'd care for my aging parents at home, but it is really not feasible so here we are....

So my main question is, how long did it take your parent to adjust? My mom is complaining about the new place, saying she won't be able to make friends, saying she wants to go to assisted living closer to where she lived, because she has a friend from her old community who lives there. It's is totally not feasible, there are no good hospitals nearby, and honestly it's way too far for me to keep an eye on her to make sure she is being well taken care of. So the reality is she is in a place where she knows no one. It pains me and has been giving me so much self doubt about my decision, even though I know she can't live alone safely. I feel that this is the best option. She was very social several years ago, and now doesn't engage much in conversation, so I'm worried she won't make new friends. I've been noticing how people are very friendly to her, but she doesn't always respond is a very positive manner, which tends to make her look very stand-offish. She started crying today saying she is lonely, and has no recollection of the staff and fellow residents reaching out to her and opening up to her.

This is agonizing, please tell me that it gets better. I know it's only been a few days but this is heartbreaking to watch.

[mom2binsd]

She sounds like so many of my patients, I'm a SLP and work in adult rehab. My first question, is she on any anti depressant, that may help. I'd go speak to the activity director and social worker and talk about your concerns, maybe they can find a "buddy" to help get her involved. With all of the changes she's gone through I'm not surprised she is not adjusting to the new setting. Sorry you have to go through this, it's so hard to see our parents decline and Alz is especially challenging.

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[jerseygirl07067]

She sounds like so many of my patients, I'm a SLP and work in adult rehab. My first question, is she on any anti depressant, that may help. I'd go speak to the activity director and social worker and talk about your concerns, maybe they can find a "buddy" to help get her involved. With all of the changes she's gone through I'm not surprised she is not adjusting to the new setting. Sorry you have to go through this, it's so hard to see our parents decline and Alz is especially challenging.

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Yes, she is on an anti-depressant which they started in the hospital, before she went to rehab, and it took a few weeks to kick in and we noticed a marked difference. I was thinking of having them increase her dose for a while.

[Peaches Keane]

My grandmother hated it at first, but eventually found things to enjoy. She also has Alzheimer’s and is in a place that specializes in that. They have the residents eat meals in assigned seating. That helps her form connections. They have a lot of social activities, but she won’t really do them. A lot of people hang out in the lobby (it’s like a giant living room. She won’t really do that either. At the end of the day, she is SAFE and well cared for. That is most important.

[dogmom]

No direct experience with family, but as a nurse all I can say it helps to reframe the way you think about this. Your mother is being changed by her dementia. The way she thinks, feels, lives is all changed by this. We expect a toddler to process information or make friends like an adult does, but we expect people with memory problems to. I’m not saying she’s a child, but she’s different that what she was. A know someone whose mother had a brain tumor when she was pregnant. It destroyed her shoft term memories. She said the bad news is she had to tell her mother multiple times a day that she had cancer and she was dying. The good news is she was able to say several times a day “Mom, I’m pregnant again!” and her mom got to be all happy again. All your Mother’s emotions are very real, they won’t respond to logic like telling her people are trying to be her friend, she just doesn’t remember. In general distraction and physica/cognitive engagement is one of the best ways to unpleasant experiences with someone with memory loss. I’m sure they have activities, try to schedule going to visit when one of those are happening and go with her. The hardest thing for family members to do is to accept the new reality. So if you do something with your mom and she says something or does something that is going to slap you in the face that she has this disease you need to have a script of what to do to distract her, change the subject, engage her without arguing with her or showing concern on your face. It’s tough. It’s also one of the reasons family isn’t always the best choice to deal with people with memory loss and or dementia. It’s really hard to give up what someone was and move on to meet them as they are now. Don’t regret your decision to move her. This is why it best for people to move before the memory loss progresses to ease the transition.

As an aside, don’t assume that everyone is nice to your mother. Bullying in elderly living situation is a hidden, but profound problem. Just like schools residences can take positive effects to limit it, then it will never go completely away.

Some links you might find helpful:
some stuff I’m not 100% agree with, but use what you find helpful.:
https://blog.caregiverhomes.com/50-tips-on-transitioning-a-loved-one-to-memory-dementia-or-alzheimers-careyour-blog-post-title-here

Good guide for caregivers, lots of information:
https://www.alz.org/national/documents/phase_4_home_care_recs.pdf

Great article on rethinking Memory Care:
https://www.newyorker.com/magazine/2013/05/20/the-sense-of-an-ending-2

I recommend reading Atul Gawandes book moving forward:
http://atulgawande.com/book/being-mortal/ Lots of info about caring for elderly and different approaches.

Bullying amongst seniors: https://www.chicagotribune.com/news/nationworld/ct-senior-centers-bullying-20180512-story.html

I’m also a huge believer in the power of nature and animals, I’m not sure if your mom can have any kind of pet.

[magnoliaparadise]

No direct experience with family, but as a nurse all I can say it helps to reframe the way you think about this. Your mother is being changed by her dementia. The way she thinks, feels, lives is all changed by this. We expect a toddler to process information or make friends like an adult does, but we expect people with memory problems to. I’m not saying she’s a child, but she’s different that what she was. A know someone whose mother had a brain tumor when she was pregnant. It destroyed her shoft term memories. She said the bad news is she had to tell her mother multiple times a day that she had cancer and she was dying. The good news is she was able to say several times a day “Mom, I’m pregnant again!” and her mom got to be all happy again. All your Mother’s emotions are very real, they won’t respond to logic like telling her people are trying to be her friend, she just doesn’t remember. In general distraction and physica/cognitive engagement is one of the best ways to unpleasant experiences with someone with memory loss. I’m sure they have activities, try to schedule going to visit when one of those are happening and go with her. The hardest thing for family members to do is to accept the new reality. So if you do something with your mom and she says something or does something that is going to slap you in the face that she has this disease you need to have a script of what to do to distract her, change the subject, engage her without arguing with her or showing concern on your face. It’s tough. It’s also one of the reasons family isn’t always the best choice to deal with people with memory loss and or dementia. It’s really hard to give up what someone was and move on to meet them as they are now. Don’t regret your decision to move her. This is why it best for people to move before the memory loss progresses to ease the transition.

As an aside, don’t assume that everyone is nice to your mother. Bullying in elderly living situation is a hidden, but profound problem. Just like schools residences can take positive effects to limit it, then it will never go completely away.

Some links you might find helpful:
some stuff I’m not 100% agree with, but use what you find helpful.:
https://blog.caregiverhomes.com/50-tips-on-transitioning-a-loved-one-to-memory-dementia-or-alzheimers-careyour-blog-post-title-here

Good guide for caregivers, lots of information:
https://www.alz.org/national/documents/phase_4_home_care_recs.pdf

Great article on rethinking Memory Care:
https://www.newyorker.com/magazine/2013/05/20/the-sense-of-an-ending-2

I recommend reading Atul Gawandes book moving forward:
http://atulgawande.com/book/being-mortal/ Lots of info about caring for elderly and different approaches.

Bullying amongst seniors: https://www.chicagotribune.com/news/nationworld/ct-senior-centers-bullying-20180512-story.html

I’m also a huge believer in the power of nature and animals, I’m not sure if your mom can have any kind of pet.

Wow, these links are great. Thanks for posting them.

OP, I don't have any advice, but I couldn't read without responding. I just wanted to send hugs and let you know that you are in my thoughts. Years ago, my grandmother was in a nursing home. She also had dementia and also resisted being in a nursing home and I remember how difficult it was both for her and my parents, especially my father. It did get better, but she ended up not being there very long so my experience isn't really transferable. But I still remember just how hard it was, especially the first little bit.

My friend has had her father in a facility for several years now and I know that she has a weekly visit with her kids (maybe more, but definitely once a week) and they all get together for a dinner and I think that has helped. Not sure if this would be applicable to you, but she also brings a lot of magazines or newspapers to him. Maybe get a lot of old movies that your mom could relate to and, if possible still, show her how to play them on an ipad? I'm sure you've thought of that if it's possible, but just brainstorming. This doesn't solve the social part, but it at least gives her something to do when she is feeling lonely and wants to be distracted.

[westwoodmom04]

My grandmother had dementia and was not happy to leave her home to go to the nursing home. She did however, eventually make friends and was happy there. Because of her illness, she had because very isolated, rarely leaving the house. Once she got accustomed to it, she enjoyed having people around.

[StantonHyde]

My MIL never really adjusted. She wanted to be in her home, not an apartment--and she even had a 2BR apartment. Given her memory and self care issues, home was not an option. Just focus on that part of it. Your mom may not like it, but she needs to be safe. We forced MIL to move because DH knew he would get stuck with whatever medical crisis ensued and he didn't want to manage that from a plane ride away. You can't help it if your mom didn't plan to move or want to move. She had to move and that's where you are. I am sure she is a bit depressed. It really does take a while to adjust. There were people who were really happy in the place where MIL lived. Unfortunately, by the time she moved, she couldn't remember to go to the activities nor was she really able to make new friends. But she was cared for and safe.

On the other hand, my grandmother lived by herself on a farm in the middle of nowhere until she was 95. She refused to go anywhere and didn't have any health issues. (Got breast cancer at 89, had a mastectomy, didn't like the meds so she didn't take them and still lived another 7 years) We were very frank and told her that if she fell or died and nobody knew for days that was her issue. My aunt finally made her get a med alert button. But she did fall once and was there for 2 days before my aunt and uncle came to see her. She was hospitalized for dehydration but she went right back to her house.

I will say one thing that I learned--my friend's parents moved to the same senior living place as MIL--well ahead of any memory issues or major health problems. They're 80 something so not entirely young. And it is much, much better. Move before you "have" to. Move when you are able to be social and still have your marbles intact. It makes it so much easier!!!! On EVERYONE involved.