We were advised to tell my MIL that was moved into AL during an intense medical crisis, involving hallucinations, that the drs. said she needed to be there for now. She does not believe she needs help. Her Primary Care Dr- who has not seen her in person for almost 2 years- told her over a video appointment that she should go home for a week to see how it goes. We live 40 minutes from her, she lives alone, she has fallen, and the police have “recommended” that she not live alone anymore. She is now focused on this. She is doing very well in AL, with proper nutrition, medication control, and exercise. Has anyone tried this or had this recommendation made to their family member?
The rational part of the mother's mind is telling her-- you don't need to be in this Assisted Living situation! Get out! You're still able to be independent! I can't admit to this! No! These people are trying to control me! Ack!
Honestly that seems so irresponsible of the GP to tell her to go home and try it. What havoc will that wreak, and in how many peoples lives?
The fact is that she is thriving in her current situation because there is enough help there for her. To send her back to her house, alone, where she needs to try to start managing all aspects of her life again? That is not a good idea.
Rather, is there a way to improve her life at the AL? Are there activities that she can participate in? Can you visit regularly or take her out to lunch or dinner? What are some things that you can provide, within this framework, which will add value and meaning?
Who's your MIL's doctor? Dr. Vinnie Boombotz? SMH...This doctor who hasn't seen her in two years tells her over a video call that she should go home for a week and see how it goes. OMG. I guess it's possible for doctors to get fooled by a bit of showtiming from their patients.
If the cops said she shouldn't be living alone anymore, listen to them. They've seen her more than her doctor has. If she's being well looked after and is thriving in AL, leave her there. Let her fixate and focus on it until she tires herself out, but don't let her go back to her house. She's in AL for a reason and cannot manage living on her own anymore. Do not take her out of AL where she's already acclimated and doing well and send her home to God knows what could happen.
Any Primary Care doc who says yeah go try it... Is negligent, based on what Information and assessment...none? So I doubt he she actually said it. Think lawyers lurking ..
You should call him to ask if this was really said. My 90 parents would have fabricated this in order to try to go home...
Get the facts.
Dementia patients are still manipulative and can and will confabulate..
Prayers for you..
If no one is there to check her every move, there will be trouble. Keep her where she is. Please.
This isn't an exercise in vain as this should be done anyway to be prepared for eventualities. The home should be kept up.
When you point it all out to her tell her that there is no point in being in residence as repairs or renovations are done and take her back to AL. Reinforce this by saying "take you back home" when you refer to the AL.
GP: So Mrs H, what can I do for you today?
Mother: You were going to give me a letter for my travel insurers confirming that I'm in good health and fit to fly.
[GP gives impersonation of someone who's just accidentally swallowed a whole grapefruit.]
Now on this occasion, GP did help with mother's travel insurance, but he did so by stating the facts of her complex co-morbidities correctly and she still got her policy and she did get to go on her trip to Alaska and the Canadian Rockies, I think that one was.
No one is out to imprison older people or restrict their preferred lifestyles unduly. But if the PCP said in so many words "fine, sure, go home, give it a whirl for a week, what could possibly go wrong" then I am a Dutchman. My bet would be that he said something more like "where there's a will there's a way, let's see how we might be able to get you home for a trial period."
Is there any way that you can talk directly to the PCP and find out what his actual view is?
She's actually safer, happier and won't be subjected to things that happen in Nursing Homes to be in her own Home. Nursing Homes are understaffed and they put too many on pills for so called anxiety and depression when in actuality it's mostly done to keep the patients drugged to make them not be as much trouble for the Nurses and Aides.
Hplease will be the Best Place.
You can always put cameras in her home so you can check on her anytime 24 7 from your cell phone or computer.
one is focused on the ‘home trial’ and that they need to walk that recommendation back for the reasons you mentioned. The PCP started this conversation and they are the one to fix it.
When I had to tell my brother he was going into his own apartment in assisted living, the meds were a big issue. And at the time he had enough awareness to see that. I also pointed out how much happier he seemed while he was in the hospital because people were checking in on him and he was getting attention, as opposed to holing up in his apartment.
Reality check questions can help. Who will do her laundry? Lead her in exercise? Grocery shopping and cooking? Bringing her attention to the improvements she’s made because of assisted living may help.
Nobody steps in to help in any way, shape or form. She will either get home and work it out or she will continually use what the idiot told her (I would file a complaint against his license for this crap by the way.) to try and guilt everyone to take her home and prop her up.
I told my dad, you can do whatever you can do. That doesn't mean ordering me to find a place, pack you up, move you, make phone calls or anything else. Whatever YOU CAN DO. Boy was he hot. In his head getting others to do it was him doing it.
I will say though, it took him a year of hard work, lots of sorting things out, mostly alone, his caregivers helped him on the computer but, he did actually pull off moving out on his own. He would have rather been dead then in a facility and he did get his final wishes. He lived alone, was able to shop, take care of 3 dogs, get his laundry to the shop and prepare his own meals. Was it perfect, not close but, he made the decision that he wanted quality over quantity and I honored that desire. He was as happy as anyone could be in the situation, he had some dear people that loved him and he wasn't endangering anyone but himself in the end. Would he have lived a little healthier in a facility? I don't know but, I do know that he would have been miserable and that wasn't a good option.
As hard as it is to watch and know that the train wreck is coming, we have to step aside and let them fail on their own. If that means an earlier death, which I personally believe that our days are numbered and that we go when it is our time, then at least they got to do it their way.
Obviously there are exceptions to intervention but, I think people are pulling the trigger to soon in many cases because they have no boundaries and their parents are using them as personal slaves to prop them up, when changes could mitigate alot of the load placed on us by our senior loved ones. Making them make changes to keep their independence is a conversation that we should all have, making it abundantly clear that we are not going to step in so they don't have to make changes.
Best of luck with this difficult situation.
An elder with dementia cannot be left to fend for themselves. The same way a child cannot be. Home alone quickly becomes a dangerous place for the senior with dementia.
No elder wants to be in a care facility and no adult children should ever have to become nanny-slaves to their parents because they're stubborn and demanding.
We have to do what's right for them though. What's right might not be what they want or what we do. It may not make them or us happy. Sometimes what a person needs is not what they want.
It's a trial. In order to give the person every chance to live the way they want to. If successful - great.
If not, back around the merry-go-round of fall-hospital-rehab... then the choice again of home or into care (AL/NH/MC). Sadly, sometimes the injuries decide the course.
Some Doctors don't mince words & will tell their patients straight up "it's time, make the move". Other Doctors will not, preferring either the patient to 'get it' or family to make it happen.
You cannot force people to move who are deemed competent. Guardianship applications may even require such trials be undertaken (& have failed) before deciding on a person's competency to decide their living arrangements.
My advice would be to get home help visits set up, call her for welfare checks & be ready for the next round.
((Hugs)) & strength to you.
I am curious, because in her later years, mom heard what she thought the doc was saying, not what he was actually saying.
You might give him/her a call, describe mom's CURRENT level of functioning and see what s/he thinks.
Returning to her home alone sounds like a bad idea. If it was determined that she needed AL supervision, she still does. If she expects to live alone at home and that you are going to help her as needed, that's not living alone at home and it's a "No."
A person with dementia isn't going to know how it goes. When it goes badly (and it will), she gets the trauma of being placed in AL all over again. That's utterly absurd.
I do hope someone in your family has power of attorney and all MIL's other paperwork (will, trust, advance medical directive) is in order, because it's time for someone to take the wheel here.
A person with dementia should not live alone.
If she has adjusted to AL then I would leave her there.
Ask if her doctor is willing to move in with her for a week so she is not alone and the doctor can "see how it goes".
1. She falls, breaks a bone and ends up in rehab, or
2. She manages to stay upright but you get calls everyday about something she needs, groceries she needs, the TV channel isn't working, she things there is someone lurking in the yard, etc...... You make multiple (daily trips) to check on things, or
3. She is at home but you realize that she isn't really eating or taking her meds because there is no cuing or supervision. She thinks she doing fine but you realize that she's not doing fine at all and you can't convince her to return to AL, or
4. She is at home and she the neighbors and police finally contact you to report that she needs more help than she has or
5. Any combination of the above scenarios.
Do you actually see any scenario here where she returns home, her dementia disappears and she manages to not fall, shop for groceries, cook meals, take her meds, and live alone without any daily assistance or supervision?
And she will NEVER agree that things aren't working out living at home, no matter how bad you realize that they are. That's part of her magical thinking that she really CAN do all the things she used to do and everything is just fine. Make up some vague excuses until she finally stops fixating on this because this is the worst idea I can imagine.
Were you part of this video call, are you certain that is what was said? Because I can't imagine a doctor being so absolutely clueless (or maybe I can but I don't want to believe it)
Denial is not just a river in Egypt. It is something many, many, many elders suffer from, unfortunately (for the family).
Your mother's PCP has a lot of nerve 'recommending' that she 'go home for a week to see how it goes.' Why doesn't he recommend she climb a fourteener in Colorado while he's at it, if he's going to make unrealistic & ridiculous suggestions, after not even having the decency to see her in person for over 2 years?
Your mother is doing very well in AL precisely BECAUSE she is getting proper nutrition, medication control, and exercise. Move her out of that controlled environment, and all hell will likely break loose again, as it did before she was wisely moved to AL in the first place.
If this were my mother with 'mild dementia', which doctors ALWAYS seem to call it when it's really more like Moderate dementia, I'd tell her that it's time to retire her former PCP b/c video doctoring is not real doctoring at all, and that going home for a week isn't an option because there's nobody to stay with her for that time to insure her wellbeing. So she stays put; the family is all in agreement that she's in very good hands at the AL and well cared for there. Since you have the POAs intact for her, you need to act in her best interest which is what you are doing by keeping her where she's at. "Going home" to see what happens is a recipe for disaster. Even if things go well for that week, they will NOT go well long term. Dementia does not lend itself well to living alone, under any circumstances. It progresses and worsens with time, which means your mother will wind up in AL anyway, now or later. So don't fix what isn't broken, that's my suggestion.
Good luck!