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mspallone Asked April 2020

How do I answer the question "Why am I here?" from an aunt who has just entered nursing home (permanently) due to cognitive decline?

85 year old aunt has been living alone successfully for many years, but exhibiting cognitive decline in last year, and confusion in last months to such an extent she cannot live in her home any more. She has been in long term care facility for one week. She says "I have no idea why I'm here" and obviously does not like or understand the situation. I am sure "when can I go home?" will start soon. I have used the COVID-19 quarantine to dance around this topic. I do not want to either ignore her or lie to her. I would appreciate any suggestions for helping her understand what she was going through at home, why she is not in long term care, and (gently) that this is her home from now on.


Thanks so much for any suggestions.

Sunnygirl1 Apr 2020
I'd try to adjust to providing her information that she can handle in the moment. If she is not able to understand that she is not able to live alone safely, then, she's not likely able to process it and use that information.

Often, the person thinks they are fine living alone. They don't get why it's a problem that they leave the stove on, eat spoiled food, mistake their medication, don't handle hygiene very well, can't work the remote or phone, etc. No matter how much you explain that those things mean they need more care in a facility, they often don't get it. Or, if they do get it, they forget about it. And in some cases they think you are lying. So, they keep asking. I think they may repeatedly ask why, not due to insistence, but, because they have forgotten that they already asked.

I'd pick something that she can accept that's simple. Like, you're here to get better. Feel better, walk better, therapy, all things to help you get better. To me, it's not lying, because, it's actually true. When my LO got to MC, she did feel better. I think she sensed she was getting care she needed, though, she couldn't articulate it. She'd just smile and tell me, They are nice people. lol

If you want to go into other things that she can't process, won't accept and that will get her upset, you can. It'll just be nonproductive and upset you both. Lots of people argue with people who have dementia all the time. It's an argument you can't win.

Isthisrealyreal Apr 2020
I told my dad that he was in a facility to get better and build up his strength.

I would avoid the cognitive issues and tell her that the doctor said she needs to have this care to get stronger. I don't think I would say this is your home now, just you need to stay until the doctor says you are strong enough to go home, but only when she asks.

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Daughterof1930 Apr 2020
It’s asking too much of her to expect her to understand her own decline and the reasons for her to require the new level of care. You’ll see people on this site refer to the “therapeutic lie” it’s used when a person is no longer capable of understanding a situation. I’m sorry you’re in this position, but it’s far kinder to make up a plausible story that she’ll accept than to try to make her understand her decline

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