Expert: Paula Damgaard - 2/2/2010

Question
QUESTION: HiPaula,

My mom entered an alzheimer's unit of a nursing home 5 days ago.  She hates it and is not adjusting well.  My father feels extremely guilty and regrets the decision to put her there.  We were told not to visit her or call to help her adjust for 1-2 weeks.  This seems so cruel to me.  How can't she feel completely abandoned? We are all so heartbroken over this...  Maureen

ANSWER: Dear Maureen,

yup it does seem cruel.  Is it necessary, yup.  Thankfully because of her disease the separation is MUCH worse on YOU then it is on her!!  Similar to when we bring our children to the first day of kindergarten, the kids cry and scream and hold on to our legs begging us to take them back home.  The teacher peels them away, tells you the mom to go home.  You are anxious and nervous and feeling like the worst mother this side of the Mississippi all day.  You rush to the school as soon as it is appropriate to be there waiting anxiously for the dismissal bell.  The bell goes off and you frantically search for your child to appear.  Out comes your child happy as a clam, talking non stop about what a great time they had!  Sometimes some kids don't do it exactly like that but they do over time get used to it.  

Patients with AD are similar.  Some adapt really easy and as long as they have something to do they are happy.  They may tell you when you come to see them that they want to go home, but as soon as you are gone they will forget that.  Out of sight out of mind.  

This is very hard.  But if you can look at it as, if she had a broken arm, you wouldn't hesitate to put a cast on her. Alzheimer's units are the "cast" for these patients.  Another thing to think about is: 75% of the caregivers get major illnesses or die before the AD patient due to the stress of having to take care of them.  You do not need to lose both parents.  

I hope this helps.  Please feel free to write again if you need! Take care.  Paula

---------- FOLLOW-UP ----------

QUESTION: Paula,  I do need you again. Do all patients eventually adjust to a nursing home?  It is almost 2 weeks and my mom hates it and cries constantly. She can verbalize this.  She seems more lucid and focused since entering than she has for months at home. She doesn't like the activities and seems to be spending a lot of time in her room. We are questioning the decision to put her in.  The people there all seem so much worse that my mom.

Thank you Paula for any advice that you have for us!

Maureen Nee

Answer
Maureen, My suggestion would be to ask the nurses to see how your mom is when you aren't around.  Many times when they see you they tell you they are miserable but then when you are out of sight they are fine.  IF that is the case then tell your mom that you are in the process of fixing things so that she can.  You don't have to be specific just saying something so that she thinks you are preparing for her.  

You may have to get the doctor to give her something for anxiety to help ease the transition.  Remember you really didn't see those other people when their family members brought them in so you can't really judge that.  And tho your mom may not be as bad as them now, unfortunately that is her future and it is better to get her acclimated now to the surroundings then to try to do it later.  

This is the best treatment for your mom.  I know this is hard, but like I said before you can't afford to lose both of them.