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greenbasketgirl Asked June 2018

Nursing home adjustment period. Has anyone else had a similar experience?

Hello, my MIL was recently admitted to a nursing home after repeated episodes of wandering into the street and other dangerous behaviors. We had to face that we as a family, could no longer keep her safe. She has only been in the nursing facility for three weeks. Except for four days during the second week she spent in a hospital after a bad fall that occurred while she was trying to "go home to her Mother (who has long ago passed)". Visits from myself and her children only cause her to cry and beg us to take her home. We are now at a realization that she needs time to adjust without our presence. Her medications have also changed and she now gets Trazadone and Seroquel, as she is often agitated with everyone around her. Has anyone else had a similar experience? She was diagnosed with moderate stage dementia in July 2016

ASusan48 Jun 2018
Greenbasketgirl, it might help her to have the natural light and activity visible.

Mom had a *serious* aversion to being placed at the back of the building, which only overlooked a parking lot. She kept begging me not to let them put her back there. Unfortunately, because she was on Medicaid, she was only allowed to be in a shared room with a roommate, which meant being placed where ever there was space - they tried 2 different roommates at the back of the building. First one had some sort of serious bowel issue and had some sort of medical device that was supposed to catch her waste (not a colostomy bag) - but it leaked and the room reeked constantly - and she had the window bed, so Mom was stuck behind a curtain in a corner in a room that reeked of waste all the time. 2nd attempt was a roommate the staff swore was talkative and friendly - um - no. 95 years old, deaf as a post, kept the curtain between the beds closed and never uttered a word to Mom. I finally ended up shelling out $450 per month out of my own pocket to get her a private room until a room with a suitable roommate opened up, and Mom got the window bed. She was SO happy with that room.

It's worth a shot with your MIL - I truly think being able to see the outside world helps a lot.

greenbasketgirl Jun 2018
SusanA43, I love how your Mom felt better by the window! It may help my mom in law too...

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greenbasketgirl Jun 2018
So many of your responses have helped me a great deal. We have spent so much time these past two years trying to help keep her independence (which she has always valued ) and keep her safe and cared for. Although our initial visits have been difficult, I neglected to say that we have gone during recreation times, and meal times (she loves to eat!) and observed her interactions from a distance. She does well until she sees us. Learning that this transition takes time from your experiences and her staff makes all the difference. She has personal items in her room, but tomorrow we are bringing her a potted plant she can plant in the outdoor garden where she is. Prayers and fingers crossed it will be positive. As one of you kindly suggested (Sorry it has been so stressful I can't recall the name), I hope to be a kind face she is happy to see. Hugs and thankful for this forum. :)

ASusan48 Jun 2018
ShakingDustOff, knock it off. You don't need to be so cruel to someone experiencing a difficult transition. You know, some days you make some great, helpful and sympathetic posts - and then we have this. You have no right to make accusations like that against the OP when you don't know the full situation. You aren't there, you don't live with them, and you don't have the sort of information that would lead you to make those accusations.

My own mother had a horrible transition to the nursing home. She called me 10+ times per day, crying and saying "this place" would drive her crazy and wouldn't I please come and bring her home? I visited her every single evening, except for the rare occasion when I was ill or out of town - for the entire time she was in there. After a couple of weeks, she settled in and accepted that she needed to be there because her medical needs were more than I could handle at home. Once she got into a room where she could look out the window and see the cars going by (which was important to her), she settled in and was relatively happy, all things considered - she actually started participating in the activities they had.

She had congestive heart failure, stage 4 kidney failure and was starting to fall often - plus she weighed over 250 lbs. She had to be on Lasix to eliminate the fluids building up around her heart, but this had to be carefully balanced because Lasix is extremely hard on the kidneys. Could I do that at home? No. This was a case of me not being strong enough to pick her up alone, or to handle her medical needs. Not a case of me valuing my freedom or personal time over hers. I'm quite sure the OP is facing a similar situation - unable to care for their loved one and having to make the tough choice to place her in a facility - and now dealing with the "settling in" period.

Greenbasketgirl - please come back and let us know how things are going. Settling in can take time - sometimes days, sometimes weeks. I do hope your MIL settles in soon and things get easier for all of you. And disregard the post from ShakingDustOff. You are NOT being selfish or any of the other things she's accusing you of.
I believe the forum has a "block" option to avoid seeing posts by certain people. Just a suggestion.

baskethill1 Jun 2018
Give her time . Seriously ..she doesnt know the room , the people or the place. There is nothing comfortable and very little familiar . I am assuming you moved some of the things in with her. She will take a good while to adjust ..Heck id take a while and i more or less have my facilities.

ShakeoffDust . Im sorry but your approach seems to be pretty aggressive and not for the first time. This is very new to most of us and people need support. Not alot of DUhhhs . It really doesnt help the situation .Oh and dont talk about meds if you havent even bothered to google them

DeeAnna Jun 2018
greenbasketgirl, my Mom was admitted to a nursing home (after two hospitalizations in 2 weeks) for Major Depression with Delusions and Mild Dementia and sudden inability to perform ADLs by herself. It took my Mom 7 months before she calmed down and quit crying every time I called or visited--no matter how positive the phone call or visit had been.

You said that your Mom has been there less than a month. Give your Mom some more time to adjust to her new surroundings and I think that her agitation might decrease as she feels safer in the nursing home. Only time will tell. God Bless!

greenbasketgirl Jun 2018
Thanks everyone for sharing your experiences, thoughts and time responding. She has not been there a full month as of yet. We are going to see her tomorrow as a family. We are following advisement of staff at her facility, and thankful that we will never have to watch her walk in front of the police car who arrived to assist us in protecting her. So glad she's safe now in good hands. Best of luck to you and your loved ones in your own situations.

Countrymouse Jun 2018
I was sitting in a stationary line of traffic one rush hour, waiting for the lights to change, when out of the blue the car directly in front of me was hit side on, with some force, by a car that emerged at speed from one of the houses in the street.

A man and a woman dashed out from the house, ran to the rogue car, and helped out from it a little old lady whom they escorted back inside before coming to speak to the driver. I got out and gave him my details in case he wanted a witness. He didn't seem angry, just shocked and shaken. I never heard from him about an insurance claim or anything.

Looking back, I now grasp exactly what happened and why nobody was angrily blaming anyone. Thank God nobody was hurt. Thank God there weren't any pedestrians or cyclists in the way.

Advancing dementia in able-bodied persons presents challenges all of its own. There were two adults in that house with the elderly lady. For a few seconds, each thought the other was watching her. Maybe one was in the loo and the other took a phone call, who knows. But that's all it took. There comes a point where care in the family home just stops being a good idea.

Greenbasketgirl, is it the facility's recommendation that you suspend visits while your MIL adjusts? If you have confidence in their management of residents and you're happy with what you see there, then trust their judgement. But don't just stop going: this is more for MIL's actual children to do, but somebody needs to be in daily contact asking for sitreps so that MIL doesn't become a dumped elder in the eyes of the care staff.

I'd also put a deadline on the adjustment period - an improvement by [date], or we modify our approach. I would expect the facility to be right, but that doesn't mean you shouldn't press for an individualised plan.

MIL will still want to go home to mother, the only difference will be that you don't have to watch. If your presence is not helping to get her through this phase, then there's no virtue in your being distressed as well on her behalf and I agree you should suspend visits.

But if it doesn't begin to settle in a reasonable period, then she wants to go home to mother AND she has lost everybody she knows. Well, nothing you can do about mother. But you can be a loving, familiar face.

The facility knows their business. Your family knows MIL. Just make sure everyone is working together.

HolidayEnd Jun 2018
My mom’s going through a ‘I’m going home’ phase. She calls my daughter to come get her. Of course we can’t take her home, we cannot properly care for her. It’s hard on my daughter to get repeated calls.

Shaking off dust—I don’t suppose you’ve ever had an elder SUDDENLY DART OUT into parking lots or the street? Little children do that when you’re holding their hand.

Judgmental a little bit?

wally003 Jun 2018
hopefully her new rx will help.
im not an expert of course! but it may take a few weeks before they kick in. my mom has Alzheimer's, lives in AL. and she takes an anti-depressant also.

so for the most part she has a calm attitude

however she still has a mixed-up view of "everything"

obsesses about things that don't really matter, or that never happened.
she cant follow what I tell her, because its QUICKLY forgotten.
gets confused ~left and right~

but at least shes not yelling at me. or cursing. or hitting....

today I had to tell her shes not been washing her hair (oily hair)

I know she just forgot after I explained to her she doesn't look bad, but she needs to wash her hair.

ahhh, so now shes gonna have to go once a week to the beauty salon at AL :/

she doesn't know it ....wouldn't remember anyway. but I set it up with the beauty shop.

OverTheEdge17 Jun 2018
When Mom first became a permanent placement in the nursing home, she was in terrible condition and it was a rough adjustment: hallucinating, making up graphic/violent stories and being convinced it happened in her presence, having to wear an ankle bracelet to keep her from wandering off, having to sleep in a geri chair at the nurses station so they could keep a close eye on her (she would later tell me she was "forced to sleep on the loading dock" - which is absurd). Those examples were just the tip of the iceberg. She was quite unwell - but that was precisely the reason she was there!! This was the result of a futile attempt on my part to care for her at home - she only declined during this time - mainly due to her own lack of drive and diligence. Once she came out of THAT fog (probably took at least several weeks to clear the head), she still thought she was only in the "rehab" portion of the nursing home - when she HAD actually been moved (per family request) to a regular room in preparation for a Medicaid application. She always thinks she's just days away from leaving the nursing home and going to an apartment (not gonna happen). She tells the staff that her kids put all her "stuff" in storage when we sold her house (her "stuff" was (sadly) either donated or discarded). Even 9 months into her living there, the staff still considered her to be "new" to the group setting & were not surprised she hadn't adjusted yet. I hope that helps with your timeframe - even after many months, our Mom was still considered new! I was told it takes a LONG time and there have been people who after being in a facility for 20 years still think it will be just a few more days and they will be going home, going to an apartment, going to live with their kids or whatever. Mom had to sign the papers to sell her home, but still thought she could go back any time. Mom has done a little better more recently & now goes on day trips with the nursing home, she has friends, she goes to church (within the facility), she can be trusted to sleep in her room, etc. I limited my visits (without becoming detached from it) and I think it helped. It was kind of like taking a child to a new school - I had to let her adjust and do it herself. I'm there to lean on, but I can't do it for her. And I will not be an accessory to her leaving the facility. Yes, she's improved. For sure. The structure and consistency of the facility has aided her tremendously in regaining the functions she currently has. Does that mean she can leave the facility? No, it does not. I'm just mentioning that because sometimes the improvement people see is only because their loved one is in a good, accountable facility & it does not translate to the outside world due to the nature of whatever was wrong with their loved one in the first place.

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