My wife had a stroke the last week in November 2022. She was entered into acute rehabilitation the first of December and completed a month's worth of physical, occupational, and speech therapy and was discharged the 29th of December. Immediately upon arrival home, she experienced severe confusion and depression. The next morning, the home health nurse sent her back to the hospital via ambulance to the emergency room. She was then sent to a nursing facility which was absolutely the worst I have ever seen. She was here for 3 weeks and I again brought her home. The same severe depression and anger occurred and this time, her daughter and I sent her back to the hospital via ambulance. She was then sent to a skilled nursing facility which is very nice as these places go.
She has been diagnosed with dementia with behavioral problems. I continue to visit her, but I am terrified of bringing her home again. I am 81 years old and the only care giver she has, She is wheelchair bound and desperately wants to come home. I have started Medicare for long term care.
We have been married close to 40 years, and I love her deeply. How do I tell her she is going to stay where she is. I am riding the guilt train and experiencing severe fatigue.
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Wish the home health nurse wouldn't have had your wife taken to the hospital. That only caused more confusion.... then being placed yet again in another facility. Then back home, again back to the hospital, now into a nursing home. That put your wife on a major dementia roller coaster.
As for your wife saying she wants to go home, please note with dementia the "going home" usually means back to one's childhood home, seeing one's parent, and any siblings they may have.
Trying to convince her to accept LTC will just create more problems, she will adjust,
IDK how many times a week you visit her, however in the beginning, less is more as she will need to acclimate to her new home.
Time to let the guilt train leave the station, you are doing what is best for her, as you cannot properly care for her. You did not cause her illness, you cannot control it and finally you cannot cure it.
Remember to take care of you as well.
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I agree to use therapeutic fibs. My 88-yr old MIL is bed-bound in LTC on Medicaid. She always asks to go home. We tell her she can as soon as she can demonstrate her ADLs for her doctor. She insists she can get out of bed. We say, "Great! Please do it now for us so we can call your doctor." When she can't do it we tell her it's ok and to continue working on it. This puts the responsibility on her and the doctor and not on you. Then we change the subject.
Her "anger" could be due to a UTI, so please have her checked for this.
Have her transitioned directly into a good care facility straight from rehab. Do not attempt to care for her at home if she is now bed-bound. Continue to appeal for continuation of PT for her, if at all possible.
So many times people are devoted to keeping a loved one at home - because it is so important to the loved one. But at what cost? They make promises that they cannot keep. To the loved one. Sometimes children make promises to parents. Spouses to each other. And people feel deeply about those promises. But at the end of the day what you are really promising is to take care of them. And taking care of a person does not necessarily mean that you do what they WANT. It means you do what they NEED.
YOU are 81 years old. She is wheelchair bound. You mention severe depression and anger. Please don't feel guilty.
As Barb mentioned -watch the videos. Use the therapeutic fibs, "We'll see what the doctor says." It's not necessary to tell her that she's never coming home. The gentler fib is better for both of you in the long run.
Get off the guilt train. What you are feeling is grief at the terrible hand that life and fate has dealt you and your beloved wife.
She can't be cared for at home, not by you and not even if you had dozens of aides. She needs to be someplace where her behavioral needs can be seen to by medical and psychiatric professionals.
You don't say "this is your home now" or "you're never coming home." Try "we have to see what the doctor says", "the nurses say you need to be stronger before we plan for that."
Have you watched any Teepa Snow videos about talking to folks with dementia? They may give you some techniques that are helpful.
(((Hugs)))