When we visit our mother at a long term care facility, she is angry and asks us why we "put her in a home." How do you handle the bad days?

I agree with reducing the number of visits and cutting visits short when she is having a bad day. Yes, she is ill, and to some probably large degree degree can't help it. However, that does not obligate you to stay around for the abuse, any more than if it was physical abuse due to her condition. In time, as the disease progresses, she may get better or she may get worse. Discussing her moods with her doctor with the aim to finding meds that help is good.

You did the right thing by placing her in a home. Your first obligation is to keep her as safe and well cared for as possible. You have done that. Hopefully she will adjust in time. Meanwhile look after yourself. The stress of being responsible for another person is not small. Give yourself some breaks from the care-giving role. You need that.

When a person has dementia, 90% of the time they obsess about things. Bowel movements, food, and most often just wanting to go home. In the early stages, they might remember their current home, and their obsession to return there can be all-consuming. However, we, with all of our mental and social capacities intact, understand what they don’t—that they are no longer safe in their home and we don’t want them hurt...or worse, if something happens. My mother was the same way. But, she was sarcastic and bitter. She was a “snarky sniper”. She would make short, disparaging comments to me. “I hope your kids never do this to you!” Or, if I didn’t visit for a few days, she would “introduce” herself to me when I walked into her room.

You may want to stop visiting every day. She’s waiting for you to come and when you walk in the door, she lets loose the barrage of insults. If she hits her mark and makes you feel guilty, she’s accomplished her goal and in her mind, she may have guilted you into getting her out. Do not defend your decision, make excuses or try to reason with her. That’s not possible. If her insults and nastiness are off the chain when you visit, tell her you see she’s having a bad day and you’ll come back “in a few days”. Do t let her lay this guilt trip on you all. She doesn’t understand that you did this out of love.

If your mother were angry and unreasonable and inconsolable because she had bad 'flu, you would roll your eyes when she wasn't looking and carry on regardless, yes? She feels dreadful, we must make allowances.

You wouldn't think "we're doing something wrong" and feel guilty about it. You'd pity her for how she's feeling, and sympathise.

Well, your mother has vascular dementia. It will have affected her mood and behaviour in various ways - one of which, by the way, is severe depression; and another is loss of inhibition - and made her ill. Ill being the key word.

Assuming you've drawn her doctors' attention to any marked changes, and asked if anything can be done to help her if the doctors agree that she may be depressed; then all you can do is stand by her. But she is not intentionally doing anything to make you feel anything. She is expressing herself, not trying to hurt you.

That does not mean that it does not hurt, of course. Seeing your mother in the depths of misery, lashing out at the nearest target, being venomous, making wild accusations - this is very painful. Who is "we"? - do you have other people around for mutual support and consolation?

I was in this same position with my father with vascular dementia, or maybe even worse. I obtained guardianship of my father and then moved him into MC and sold his home to pay for it. I also had an estranged older brother who believed he should be in charge and reminded Dad of my "sins" during his near daily visits.

First, I think you have to get right in your own mind that you did the right thing. Your parent needed 24/7 care that you and the family could not provide. The parent has better care in LTC. Second, since a person with dementia is unable to make reasonable decisions and sometimes not able to remember if he/she did, I would not have long repeated discussions about why you placed her in LTC. Come up with a short sentence or two - "Your doctor said you needed more care than you could get at home and needed to be in LTC. You are safe and well cared for here."