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donero Asked May 2018

Looking for advice - Bring her home or let her stay?

My wife is in a nursing home. She has been there for 10 weeks. She has dementia and periodically she has sundowners. I would say 70 to 80% she is fine. Although she can't remember recent events. Other than that we have a good life together. (except for the periodically sundowning. I'm 86 years old. Very mobile and active. I could walk a 6 mile day. My wife is 80 years old. She can shower, dress, put on make-up and etc. We have been married for 63 years. We're very attached to each other. We have a few years of life left. I'd like to spend those few years together. We both miss each other very much. I think about her spending the rest of her life in a secured area and I to feel lock in when I'm in an empty home surrounded by 4 walls. I would like to bring her home and enjoy 70% of our remaining lives together. I know that her condition will get worse. But when that time comes a descion will be made. But in the meantime we'll both have somewhat of our lives back. She is very difficult when she is sundowning which is about 30% of our time together. And it is very rough. But I'm looking at a trade off. 70% versus 30%. What do you folks think and perhaps your advise..

GardenArtist May 2018
I'll probably be in the minority but I say bring her home, IF you think she can adjust to the change, and that could be the critical factor.

You've already scoped out the future and know what probably will have to take place eventually, but you can plan for that and address it when it happens.

I'm wondering though what has prompted this reconsideration now, after she's been there 10 weeks? Is that you're re-evaluating, and think that you could have a better life with her home than when she's at a nursing facility?

I give you a lot of credit for considering that, as well as evaluating the future of both of you and recognizing that changes eventually will take place.

May you both have as pleasant, peaceful and enjoyable life as you can!

OverTheEdge17 May 2018
Do you have the option of bringing her home for 24 hours or so before making your decision? Her behavior may or may not be the same outside of the nursing home as it is within the nursing home and that's a very real possibility. With that in mind, if it's the two of you in your home alone for that trial run, I think you should have someone else there with you (or able to be reached quickly) for that 30% of the time when your wife is having trouble.

One other question is does she wander at night? Frequent waking? If she does, you will never get any rest for yourself. Please consider that.

My loved one did somewhat well in a rehab setting, but her condition took a nosedive once we brought her home. Now that she's in long term care in a nursing home, she's doing much better. Will I bring her home again now that she's somewhat better? No. She needs the controlled setting the facility provides in order for her to be "better." In the facility, she has consistency, predictability, and structure that she did not have at home. I did my best as a caregiver, but I could not give her what the nursing home provides each and every day. Of course, Mom is so used to it by now that she fails to see *everything* (even the little things..) which the staff does for her. She takes it for granted. We tried home health at one point, but she needs 24 hour care due to needing help with *everything* and 24 hour in-home care is not available in my area unless one is wealthy and can self-pay.

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Daughterof1930 May 2018
What prompted the move to the nursing home? And what help would be available to you in the home during the rough times? I commend you for being a loving husband to your wife and wanting a life with her, she’s blessed to have you in her corner

freqflyer May 2018
donero, I can understand that you would prefer that your wife be home with you. One has to remember that a nursing home evaluates a person to see if they do, in fact, need to be in a nursing home.

If your wife is living in a private room, may I suggest that you spend a couple full days with her to see what is her normal day, if the facility will allow that. It could be when you are visiting your wife, she will go into "show timing" where she is acting very normal. And when you leave, or when she is exhausted trying to keep it together, she will go back to what now is her new normal with dementia.

You could bring your wife home if you have hired professional caregivers who are very familiar with dementia. Such caregivers know exactly what to do and what to say when a patient goes off rails.

ed812day2 May 2018
Very interesting and diverse comments. I have a story too. My wife is in a memory unit of a senior living center. She has Alzheimer. She has been there 3 months. I too question whether I should bring her home. She ask me to bring her home each time I visit her [4 to 5 times a week].
As I ponder the question of her returning home, I think about how and why she is there. It has been about 4 years since she was told by the doctor that she has Alsheimers. I have noticed the increase in memory loss, confusion and agitation resulting in out burst of anger, name calling, threats of bodily harm to me. I have seen in her restlessness, anxiety, wandering-especially in the late afternoon and at night, sometimes in early morning.
Three months ago, she started calling the police, saying I was a threat to her. She would wake up in the am [2,3,4,5] get up and turn all the lights on in the house, and then started accusing me of stealing her money, abusing her and she decided she could not stay in the house with me any longer. Later that same day, she could not remember her actions.

Although there were keyed dead-bolt locks on the doors, she went out of the window, to escape from me [she believed I was trying to hurt her]. To shorten the story, the APS [Adult Protected Services] got involved and I received a court order from a judge to provide a secure environment for my wife outside of our home for at least 20 days. It was somehow expected that things may improve during that time at the facility.

When, I visit her at the facility, she is pleasant . She does not appear to be angry with me or fearful. I am not a threat to her now. but, I tell myself, she has Alzheimer, and thing will get worse over time and not better. The environment at the facility may be a sort of "safety net". That could change if I bring her back home, going back to the way things were before entering the center. I would not get any rest, Sleep deprivation is bad for your health. I have been told that I need to stay healthy so that I can care for her, even from afar.
So, while I missed her [been married 52 years], retunring home to just me and her in the house may not be a good idea [two adult sons out of state]. While the facility is not perfect, I believe it can care for her better than I can by myself. Of course I do a lot of second-guessing. I think that is normal.

Before she entered the facility, I had arranged for expereinced people to set with her. She resented it. So, for now, she is stiil in the memory care unit. It breaks my heart everytime I visit and leave her there.
This a an awful condition that requres hard decisions to be made.

Well this is my story, and it continues.

maggiebea May 2018
If you can afford it, you might consider a setting where the two of you could live together with plenty of staff support.

I worked in an Assisted Living with a locked dementia ward that was set up with private rooms for patients, common living rooms for 8-10 patients, a kitchen where patients could cook with supervision, a larger activities room with scheduled events.

We had two couples there where one had dementia and the other was cognitively intact and physically 'healthy elderly'. They lived together, sharing a private room, spending time together there alone, and also walking the corridors together, sitting in the courtyard on nice days, attending activities together, etc. The healthy partner had a car and was able to leave the facility to see friends, go shopping, etc as desired. The partner with dementia had good support and supervision and was readily distracted by staff when the healthy partner was leaving.

It seemed a good solution for them. Might be for you.

If someone can keep the puppy for you and bring it for visits, that could be ideal.

TNtechie May 2018
Donero, my mother cared for my father with vascular dementia for over a decade until three things happened: (1) my father became physically aggressive with my mother, (2) Dad developed a serious heart condition and needed careful monitoring of his condition and medications, and (3) Mom's health was impacted and her doctor recommended she discontinue being a full time care giver. There was also a family problem where one child tried to take over decision making from my mother. My parents had been married over 60 years when my father entered MC and Mom came to live with me. It was very difficult for Mom even though at that point she didn't get to "see" the man my father really was even once a day.

Since your wife has shown physical aggression, there is a real risk she could push or hit you and cause a serious injury during that 30% of the time she is not herself. My father's wondering was limited to inside the house but it was during the night, so Mom didn't get a good night's sleep for a number of years. Sleep deprivation can become dangerous too as you're more likely to fall, leave the stove on, or have a heart attack or stroke.

If you choose to bring her home, you will need some help. We installed a security system in my parent's home so Mom would know if Dad ever did go outside during the night. The system's monitored smoke detectors and panic button helped us kids worry a little less and Mom actually used the panic button to summon help a couple of times. Can you afford someone to stay overnight at least a few nights a week so you can sleep without interruption? Someone on-call to help when your wife has a bad spell?

A better solution might be a better nursing home. There are a couple of facilities in our area that have apartments for couples when one or both needs nursing care but are still mobile and able to complete most daily living tasks. One couple I know took both beds in a nursing home room after the wife (who had been the care giver for her husband with mild vascular dementia) had a stroke. Another family friend spent the day (everyday) with her husband with Alzheimer's, arriving just before breakfast was served and staying until a couple of hours after dinner.

The transition out of the home and into skilled care is a difficult one for everyone involved. Given your wife's diagnosis, even if you bring her home now she will likely eventually need to return to nursing care. If you were my father I would fully support your desire to spend more time with mom but I would worry about you both if you brought her home without some good support available.

God bless you and comfort you. Know that people on this forum will be here to listen and offer support whatever your decision.

Susanonlyone May 2018
You state that the facility doesn’t want you to take your wife out, and that they only want you to visit once a week. So, it sounds like you spend very little time together. Hence the reason you want to bring her home? If you aren’t permitted to visit daily, I would question the reason. I would consider moving her to a nursing home that doesn’t have these rules. If you are able to visit every day and take her out for visits, you might be less lonely and the arrangement would be better for both of you. At this point, if you only see her once a week you aren’t in a position to evaluate her behavior.

JoAnn29 May 2018
I think you need a sit down with the son and the Social Worker at the facility. I have a feeling that they have asked you to come once a week is because your wife gets agitated when you leave. Its been over 2 months now that she has had time to adjust. If she has shown some violent tendencies then she is further a long than you think.

Call your son and tell him what you have told us. That you miss her and you need to see her more often. I think the once a week is a suggestion. At Moms facility a woman visited her husband everyday. She came after breakfast and stayed till dinner. She was there for activities and even joined in. I feel your wife is where she needs to be at this point of her Dementia. Its pretty much all down hill from here. It was exhausting for me at 65 to care for Mom I can't imagine doing it at 86.

Countrymouse May 2018
I agree with Maggiebea: the ideal would be a facility that offers continuing care and supports couples living together. This would mean that you and your wife could stay together, but at those times when she or you needed extra support it would be there.

There aren't as many facilities like this as one might wish, but it's worth looking. I hope you will be able to find a way to stay close to your wife and take the best care of yourself, too. You need to stay well to look after her, no?

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