As you can imagine, I’m often asked how to convince a loved one who has dementia to move out of a home when she or he has refused. The issue is further complicated when someone is ambulatory, somewhat functional, but safety is a concern. If your loved one refuses to move, it is unlikely that you’ll be able to talk him or her into moving anywhere. It isn’t worth bringing up the subject. The person may become upset and dig his/her heels in deeper. The disease prevents the individual from rationally understanding the situation. While each case is different, here are some basic ideas I have seen work for my clients.
- Once a community has been selected on behalf of your loved one’s best interests, have his/her physician write orders saying that the person should be admitted for general care and management of a medical condition. The move should be presented as a temporary situation that has nothing to do with your loved one’s mental capacity. Remind your loved one that life for all of us is best lived One Day at a Time, and that nothing is ever written in stone. The move is a step, taken with his/her safety in mind. It is not an “end.” Hopefully once the person is settled, s/he will adjust well and forget prior objections.
- Convince the person that the home or apartment is unfit for habitation due to physical problems and have them “temporarily” relocate to the chosen community.
Do either of these suggestions work? Read the following real-life story to find out.
My clients were a daughter and her 86-year-old mom. The mom had a diagnosis of Alzheimer’s disease and is a hoarder.
The daughter (who lives out of state) informed me that three years ago her mom took a drive to take care of some errands in a neighboring suburb, got lost, and ended up in Wisconsin. She had also taken some walks along a busy highway, became confused, and flagged down local drivers to take her home. In three instances, a Good Samaritan had picked her up, was admitted to her house, found the daughter’s number on the refrigerator, and called her.
In order to rectify the mom’s companionship needs and mounting hoarder issues, the daughter flew to Chicago and hired a non-medical home care agency. After a last ditch effort to convince her mom to move out of state with her, the daughter went back home hoping the problem was solved. When the home care agency employee came to the house, however, her mom refused to let her in.
After a “last straw” episode where her mother lived in the house for close to a week without heat, the daughter decided it was time for her to move.
The daughter gave me the opportunity to assess her mom and her current living situation. Her mom greeted me thinking I was an old friend of her daughter’s from high school. The situation was typical of a hoarder with 2 full screen TVs in the living room, 24 pairs of shoes under a table, junk food (still packaged) three feet high on the table, a refrigerator and freezer filled to the top with old food. She was still able to feed and dress herself. Bathing was an activity of daily living that was being skipped. She told me that the junk food was her main staple for meals and that it took a trip across a very busy intersection to obtain. I asked her some questions. She knew that Obama was the president but didn’t know the season or her birthday. After another episode of losing her keys, the daughter asked me to come up with some options and said she would return the following week for tours.
I narrowed the options to three communities. The best option was a 29-unit apartment building that included the appropriate staffing and activities for people who were at my client’s stage of dementia. Their activity program had recently been re-designed through the Alzheimer’s Association. The building had security and alarms for residents at risk for wandering, as well as a lovely enclosed outdoor area. This was an important feature, because I was very concerned that my client would try and leave to obtain her snacks. Now was the time for the daughter to be creative with moving her.
The original plan was to have the doctor write orders for a temporary stay in the selected community. My client needed to have a TB test done for admission. When my client asked me why they were going to the doctor, the daughter replied “for a test.” Her mom’s response was, “If you both think I’m going to the hospital or anywhere else, you’re both nuts.” The daughter then realized her plan wasn’t going to work and she had to devise another plan.
The daughter’s husband works for an agency that deals with air quality. A letter was addressed to her mother stating that the air in the neighborhood was laden with carbon monoxide. The excess of carbon monoxide would cause dangerous breathing issues along with skin outbreaks. The need for evacuation of the property was immediate. The letter was taped to her mom’s door. The mom found and read the letter. She was taken to the community and shown her new apartment. After she moved in, my client removed her mom’s keys from her purse. She boarded her plane home the next day.
It was reported that her mom did try to escape via the stairs one time. However, she set off the alarms and was seen via a resident tracking system. She was headed off at the pass. An escape attempt didn’t occur again. When her daughter called her, she happily reported, “This place is great. We play games and do activities and I love it!”
While I never condone telling a lie to a family member, this was a life or death situation (recall the mom wandering along a highway) that required the daughter to devise a loving ruse–a fib to protect her mother and other innocent people (recall the automobile driving despite dementia). There will be times when nothing but a fib will work. A loving stratagem and the right choice of a community solved my client’s problem. Let me solve yours.