Expert: Michalene Peticca - 8/29/2008

Question
My mom suffered a broken hip Oct. 2007.  She has been diagnosed with some form of dementia and her short term memory is not good.  I have been caregiver for her since she got out of rehab since December 26, 2007.  We are going to move her to a nursing facility but not sure how and when to tell her.  We are hoping to do this in September.  We told her in Feb., March, April and May that she can't live by herself and would have to find a place for her.  Her initial reaction was that she wasn't going and could find someone to stay with her.  Of course, she hasn't said anymore to us about this. I know she doesn't comprehend that I am away from my home in OK and away from my husband etc. since December and that my brother and sister both work and she needs to be in a place for safety etc.  She is also diabetic and I have to give her meds and insulin shots.  I am just wondering how much time we should give her before we tell her we are going to do this.  I know we should be positive and tell her we have obligations etc. but not sure when to tell her.  She has always been one to want to know what was going on etc.  She has been a widow for 42 years and has been strong etc. but she isn't the same mom now.  Please advise.

Thank you
Linda

Answer
Hello Linda,
Thank you for writing.

It is wonderful that you and your family were able to take care of your mother for as long as you have.   

You have done very well at already "laying the foundation" for the move.

While even mild Dementia can change personalities and create different reactions to life changes....which you have already experienced....the biggest challenge is that a Dementia individual lacks the initial "filing" process of when they are told a new fact or idea.   That is, you may introduce something new into their life and they do not have the capability to "file" that new information, so each time you bring up a topic, it usually seems "new" to them.  

HOWEVER, i am a firm believer in a Dementia individuals ability to remember "emotions".   Therefore, here is what i suggest:  You continue bringing up the idea little by little that she is going to be "transferring" (not moving! that is too "permanent" of a word) to a rehab (not nursing..scary word) facility where others can help her 24 hrs. a day and that you and your family will have such a great time decorating her apartment (not "room"....bad connotation) and being able to enjoy visiting her in her new apt. and taking her out at times (if she is able), etc. etc.   Play it up as a Really Positive move.   When she starts to complain, get scared, etc.   just be patient, kind and speak very softly "i know, it will be a change, but i think you will really enjoy it".   Does she know anyone else already at the home?  You might point out other friends that may be there already...maybe she knows where it is located, etc.   Point out the familiarities of it.

I'm not saying this info. will stick w/ her...but she is going to associate the emotions YOU and your family express at times you bring up the topic.   I would NOT bring it up everyday...but every so often until so that when you do move her....she will have some positive foundation to reflect one.

PS...on the day you move her...if she starts w/ "i had no idea", etc. etc.    DO NOT say "but mom, remember i told you, etc. etc."  IGNORE it....bring anything along that makes her happy....pictures, perfume, special blanket, pillows, etc.

I wish you the best of luck....i know how hard it is to make that transition.

Best Regards,

Michalene Peticca, MA