Mom's in a nursing home with dementia. My sister takes her out and causes mom to regress. What can we do?
When my sister comes she takes her out and back to her house, gets her out of her schedule. What can be done to stop her? The nursing home and we can all see that this just confuses my mother and makes her regress.
Since every patient with dementia is unique, if your mother's behaviors are worse after a visit with your sister, then whoever has her POA, stop those visits outside. Also, tell her doctor what happens and he can order her to remain inside the facility based on her diagnosis and reaction to outside stimuli.
Sounds like the sister is trying to maintain status quo as though the outings will make you mom's situation as it used to be, rather than facing the facts. If she doesn't see the aftermath, she may not realize the impact--have her stay around with you to see the results.
She may be doing this for her own benefit as though that means things aren't as bad as they are. Denial? Self-protection? My MIL's nephew claimed that my MIL's dementia was because we moved her into a nursing unit, and that he was going to visit so she would return to normal when she saw him! No amount of explanation about her neurological condition mattered: He could change that he was certain! She had been like a mother to him and was the last family member living, so I understood his desire to get her back to normal, but reality was reality. Fortunately, his physical and mental limitations made it impossible to carry out his "threat".
I agree with doing what mom enjoys doing, it is about her quality of life and if this makes her happy then so be it. She may like the feeling of getting out and experiencing some independence from the NH. NHs like to keep things quite, hence the drug dosing and under "control."
How about if the outings continue but NOT "back to her house"? A trip for an ice cream cone, a "walk" in a rose garden or nicely landscaped park, a drive that highlights the changing seasons -- lots of things could add interest to the day without the confusing aspects of seeing her old house.
A meeting with Sis and someone from the NH might be a good idea. Start from the assumption that everyone at that meeting wants what is best for mother, and together try to figure out what that would be.
If the consequences of outings is that mother is tired, so what? There is a cure for tired! If she is confused, then talk about what that means, how serious is it, how long does it last, and is her pleasure at going out worth it? Are there outings that would still give her pleasure but result in less confusion?
Instead of trying to figure out what can be done to stop Sister, concentrate on what can be done to support the best quality of life Mother can have at this point.If everyone approaches the discussion with this goal in mind, compromises or changes ought to be more easily reached.
For some people with dementia a rigid schedule is extremely important. Others do better with a baseline schedule but enough variety to be stimulating.
Dementia patients do not "regress" permanently from certain activities. They may be more confused for a while after the activities, though. Try to observe Mom after an outing, and make notes on what bothers you and how long it lasts. Enlist the help of NH staff. This will help keep the discussion "real" and leave out generalizations that may not apply to Mom.
I agree that at some point, the outings are too stimulating or confusing. We think we are helping to keep them "normal," but their awareness is reverse telescoping, so to speak. Back to the belly button. Tighter parameters. Keep it simple:) xo
Have a private mtg with sister and NH staff and get all options out on the table. Work out a compromise that's a win win for everyone, maybe shorter outing, maybe different times. Agree might be confusing but dementia makes everything confusing. If mom and sister enjoy each others company and it satisfies both their emotional needs, maybe you can work it out. If mom returns to NH and is agitated, crying jags, etc. then the outings might not be helpful and your sister may have to adjust her visits to mitigate this.
I think you have to ask yourself if the confusion is dangerous for your mom. So weigh the benefits against the confusion. My MIL loved even little trips for a hamburger. When her dementia was further along she asked if she could eat her hamburger in the car while I drove her around.
Now if the confusion is making her an even bigger fall risk, or she gets into such a state that she requires some sort of risky medicine. But just being off schedule probably isn't enough to cancel her outings with her daughter. Dementia is a progressive, recessive situation temporary setback will always occur. If its just inconveniencing the staff, not a big deal really.
My mother-in-law also has dementia, but she and I still take mini road trips etc. She is in an asst living place, but misses getting out so much since she can no longer drive. My sister-in-law told me that our mother-in-law seems more confused the day after one of our outings, but that is unfounded at this point. She doesn't call my mother-in-law the day after, she just assumes that when my mother-in-law has one of her 'melt-downs' and can't remember where she is, that it's my fault. It really upset and disturbed me when she said that I should stop taking her out, but m-i-l enjoys it so much I hate to. See, she and my father-in-law used to travel the U.S. in their motor home every year, and she did 85% of the driving when they did. So for her to lose her ability not only to drive, but also to travel anywhere just about kills her. I told my mother-in-law what her #2 son and his wife had said, and she told me she didn't care. She said she didn't want to give up our trips, and that her brain just does what it does when it wants to (her words). So I've decided, that as long as she enjoys herself and it brings her joy, I will do it. The first time she gets agitated and wants to know what we're doing and why, then I'll stop. Depending on how bad your mom is, I'd ask her what she thinks about your sister taking her out. With dementia we live in the moment knowing it's only going to get worse anyway, so what is she saving her brain for? Anyway, that's the conclusion my husband and I have come to.♥
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She may be doing this for her own benefit as though that means things aren't as bad as they are. Denial? Self-protection? My MIL's nephew claimed that my MIL's dementia was because we moved her into a nursing unit, and that he was going to visit so she would return to normal when she saw him! No amount of explanation about her neurological condition mattered: He could change that he was certain! She had been like a mother to him and was the last family member living, so I understood his desire to get her back to normal, but reality was reality. Fortunately, his physical and mental limitations made it impossible to carry out his "threat".
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A meeting with Sis and someone from the NH might be a good idea. Start from the assumption that everyone at that meeting wants what is best for mother, and together try to figure out what that would be.
If the consequences of outings is that mother is tired, so what? There is a cure for tired! If she is confused, then talk about what that means, how serious is it, how long does it last, and is her pleasure at going out worth it? Are there outings that would still give her pleasure but result in less confusion?
Instead of trying to figure out what can be done to stop Sister, concentrate on what can be done to support the best quality of life Mother can have at this point.If everyone approaches the discussion with this goal in mind, compromises or changes ought to be more easily reached.
For some people with dementia a rigid schedule is extremely important. Others do better with a baseline schedule but enough variety to be stimulating.
Dementia patients do not "regress" permanently from certain activities. They may be more confused for a while after the activities, though. Try to observe Mom after an outing, and make notes on what bothers you and how long it lasts. Enlist the help of NH staff. This will help keep the discussion "real" and leave out generalizations that may not apply to Mom.
Now if the confusion is making her an even bigger fall risk, or she gets into such a state that she requires some sort of risky medicine. But just being off schedule probably isn't enough to cancel her outings with her daughter. Dementia is a progressive, recessive situation temporary setback will always occur. If its just inconveniencing the staff, not a big deal really.