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Mom with dementia won’t accept help at home and fights going to memory care

"Minding Our Elders" columnist Carol Bradley Bursack says there are times when a decision has to be made on behalf of a family member.

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Carol Bradley Bursack, "Minding Our Elders" columnist.
Contributed / Carol Bradley Bursack
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Dear Carol: My mom is 86 years old and lives on her own, but it’s obvious that this can’t continue. She doesn’t eat well. She forgets her medications or may even take the wrong doses. She leaves the stove on. We’ve tried in-home care, but she won’t let them in. Mom refuses to believe that her mind isn’t healthy. Her doctor has suggested memory care in the past, but she’s refused that, of course. I know that moving people with dementia can make them worse, but she can’t stay where she is. The question is how do we get her there? — SN.

Dear SN: In general, we try to honor the natural wishes of older adults which often means helping them live safely in their homes. However, dementia changes that picture. There are times when forcing the issue is the only option, and it sounds as if this is where you are.

How you approach this depends on the stage of your mom’s dementia. If she can still remember conversations, be compassionate but direct. Tell her that her doctor has made it official that for her own health and safety she needs to move to an apartment in a care facility. You don’t need to stress that this is memory care. If possible, take her to the facility for lunch several times before she moves so that the place becomes familiar.

The more the family can act as one cohesive group, the better this experience will be for everyone involved. Ideally, once a room can be secured, if some of her personal belongings can be moved in early, she’ll feel more at home once she’s there.

If her dementia is further along, you might need to be sneaky. Doing so won't feel good to you, but remind yourself that this is for her health and safety and it's a last resort. To get her there, try taking her out to lunch and perhaps for a drive. Afterward, instead of going to her home, take her to her memory care room. You could explain the new environment by saying that her kitchen sink flooded so she needs to stay here temporarily. I repeat: This won't feel good, but this kind of subterfuge is often the only choice left when someone is cognitively impaired.

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If the rest of the family could move her personal belongings while you take her out on this adventure, that could help. Having her own bedspread, pillow, robe, nightgown and some pictures can be especially comforting.

You’re right that a move could cause your mom to become even more confused for a time. She’ll also likely be angry. However, most people find that eventually, their parent or spouse living with dementia gets used to the new living arrangement and many learn to love having people around and activities to do.

I’m sending you my sympathy because I know that this is painful, yet something needs to change for your mom’s sake. Huge hug to you as you tackle this move.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached through the contact form on her website.

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