Alzheimer`s Disease/Dementia / "escapism"
My father-in-law is 84 and was diagnosed with dementia two years ago. He has other medical issues including having a stint emplaced and diabetes, and is taking medications for them.
Around six months ago, his overall condition deteriorated and he had several visits to emergency rooms (for dehydration, etc.). His wife was unable to care for him properly and home care didn’t work out. In July, we placed him in the memory care unit of a local assisted living facility.
Generally, he’s doing well there. The care is good, he receives medications 3x a day, eats regularly and has even stopped taking insulin (better diet). We visit twice at night during the week (just after dinner) and bring him over to our home on Sundays; one son also brings him to his house on Wednesdays (or out to a local restaurant). We also scheduled twice weekly PT, just for some exercise during the weekdays.
But one issue that keeps coming up is his need to escape. Go somewhere else. He started with this in the weeks leading up to his departure from home, taking each sibling aside (when his wife couldn’t hear) and saying, “You have to get me out of here. Anywhere, but here. I don’t belong here.” After being placed in the home, this lessened a bit until recently. Now, his anxiety has increased and he remains convinced that he has to leave. Although his wife is still alive, he insists on getting married and needing to move.
The consistency of his pleas is surprising. Last night, he begged to be taken out of the home and only calmed down when the head nurse (who is wonderful) discussed it with him, agreeing to talk about it today. We checked in and she said he’s asked several times when they’ll meet to discuss his departure. We’ve found that he often packs a bag with photos in preparation for leaving.
Can you explain why this is happening? I know it’s a complex disease – ex-wife’s mother endured Alzheimer’s for several years so I’m not new to the condition – but need some help/counseling in how to help him, help my wife. Can you offer some strategies for coping with it? Diversions only go so far, and not sure how effective Xanax is when he’s so upset.
Thank you for your time,
Sorry about the delay; I just returned from vacation.
If you have read about AD, I'm sure that you realize that your father-in-laws symptoms are not unusual. He is probably in the middle stages of the disease where he still has a relatively high cognition level, but he is often confused. It is great that the facility he is in seems to have staff who are able to work with him on some of these issues.
While it is possible that a medication change might help minimize these symptoms, they probably will not ease up or go away until your father-in-law's dementia worsens in that his cognition level drops. In the meantime all members of the family should recognize that these behaviors are simply symptoms of the disease and it is often best to try to change the subject or in some cases, go along with what he is saying.
AD has been called "the long goodbye" for good reasons.