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While I can change the subject with my mom, other patients there tell the truth.
When my 94 year old mother says she's going home, I can change the subject or just tell her I don't know yet but some of the patients at the nursing home will tell her that they are going to die there, they are not getting out ever. What do you do? I am not there all the time so I can't keep her from talking to people. She has dementia and does not remember a lot of things but sometimes when I go to visit she is sure she is going home that day and maybe it is coming from other residents since I heard one telling her that she would die there and told an other patient that she wasn't going home either.

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Well, they are telling the truth: She IS going to die there. Bottom line with all of these elder people their kids put them in there to die. You can't gag other people. I would just tell her that the nursing home IS her home, where she is going to live for the rest of her life. What else can you do.
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Sorry to tell you this, but i didn't put my mom in a nursing home to die. We placed her there on medical advice because she needs nursing care. I'm a psychologist andy brothers are botb engineers. Not sure what part of "we are not nurses" aome people don't get.

Often, when dementia patients seek to go home, they are seeking a time and place before they were ill. Because of their cognitive limitations, they often don't understand that it's not safe for them to be unsupervised.

If your mom is sad, upset or agitated frequently, that is a symptom that should be discusaed with a doctor.
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We had this occur also, my DDMIL had vascular dementia which had turned her personality positive. She had always been a negative sort before dementia. When we moved her into a nursing home she was delighted with everything. The food, the people, her room. The regular residents who befriended her sort of clued her in that all was not wonderful. She became part of their community and I think, in the end, that was more important. While those residents tended to complain, so she complained, she became close with them quickly. I think the residents that do better are those able to make friends quickly, it's a situation that calls for quick, sometimes sadly short, friendships.
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Babalou made ME feel better! It makes sense to me (not a nurse or doctor) that those desirous of 'home', want something more than a building at a particular address. It sounds like you are taking kind and loving care of your mother. I wish I had a brilliant idea to keep her from hearing upsetting statements.
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When I used to visit the nursing home it struck me how much the dynamics between the residents resembled the schoolyard, cliques, bullies and all. I guess dementia and proximity combine to toss social filters out the window. You can't protect your elders or your kids from hurtful comments when you aren't there, but you can reassure them they are loved and cared for. And I agree that "home" is often symbolic of the sense of control and normalcy that they have lost, not necessarily a physical place.
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I think honesty is important. I believe patients can have unpredictable moments of lucidity, and treating them with respect as adults under supervisory care is needed. They have a right to understand WHY they are in a facility to the bed of their ability. Your counter conversation to this is about safety, needed care or therapy, and this placement is for her benefit. It is not a dumping ground. It is not necessarily forever. Hospice provisions may include a return to the family home at some point when this placement is no longer effective. The important thing foe a senior to understand is that they are valued, they are not being abandoned, and their needs are not being ignored. Your care decisions are first and foremost about proper supervision and quality of life.
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misery loves company, so I'd say there isn't much you can do. I wouldn't lie to her, but I sure would steer the conversation away from dying, be it there or where ever.
The situation really doesn't matter, they all are looking for "home" but like Tom Hanks said in Sleepless In Seattle " It was like coming home... only to no home I'd ever known..." Mine is still in her home with a caregiver and myself and she still asks to go home! I try to tell her she IS home, but I think she means the one she grew up in.
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Assuming you and your mom come from a religious/spiritual tradition, one could argue that heaven (or the afterlife) IS home. So technically, she is not home yet. She is getting ready to go home. Some say that death is the ultimate healing, because what follows is so much better. Thus, you would not be lying to say she is there to get well and go home.
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You can speak to the social worker at the facility. Since your mom has dementia and forgets easily, any grief she feels from others telling her things you don't like is brief, and even then people with dementia don't process things the same way they used to. It may not be a big deal to her. You can continue to tell her, you don't know or we need to see the doctor, there's no harm in that. Dementia robs us of the person we love, they slowly fade and that's unfortunate. Love her while you can, spend as much quality time with her as you can, for all to soon she will either pass away or the dementia will become worse and she won't be able to communicate.
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My mother started telling her friends before we moved her into assisted living that we were going to put her in a "home". At that point we had no reasons to from all that we knew about her daily living. When the time came a few years later and mom could not take care of herself we found an assisted living arrangement in a private 4 patient home. It is considered an "age in place" home so mom will be staying their until her death. The cost is far less than what a nursing home would be ($3000 right now for level 3 care) it will go up if and when mom's level of care needed changes. Mom still asks to go home but she knows that her Dr. said that she can not go home. They keep her occupied with excerise, games, puzzles, reading, crocheting, TV if she wants, nap time, sitting outdoors, visiting pets, hair dresser comes in also. They prepare all meals and snacks from fresh good, I have have been there numerous times and have seen what the care giver cooks. Mom can't tell me what she has had to eat during the day but I have seen what she eats. I would advise everyone to look into private assisted living if it is available in their area that has "age in place". If mom lives long enough and all of her money is gone we will apply for a medicare waiver and if approved medicare would pay the bill. Others have the waivers and that is what keeps them in the assisted living home. This is in Maryland.
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I can only share what I saw Tuesday. I got mom (with dementia) dressed and went to my husbands business as they were having a special meal that day of corned beef and cabbage. We all love that and I thought it would be a change to take mom out. She loved the meal and ate almost all of it, when she notices the visitor tags we had on. She started to cry and said this is an institution and you are going to leave me here. I smiled and said we were not, we had just came for lunch. We went to the bathroom afterwards and the hall is kinda sterile and she got to the bathroom and was shaking, she said she was scared. She begged, please don't leave me, I want to live with you. I kept assuring her we weren't leaving her. As we walked outside and she saw the car, she was so happy. She was very quiet in the car and took a long nap when we got home . I have been taking care of her for six years. Life isn't always good as the hallucinations and wanting to go back to her childhood home and her parents are on her mind a lot. But even though she doesn't always know who I am, her daughter, I do love her and just could never leave her as she is so vulnerable and frail at 95. I do have a wonderful friend who is a caregiver and stays with her when my husband and I spend a few days away. Glad I haven't had to use a facility and hope I never do.
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Hm.

Rimrock, if your mother is being upset by particular residents, you can discuss that with the staff and ask how they manage inter-resident relationships. It could be that there is some wriggle room in terms of who she shares communal areas with, for example. But the actual topics of conversation aren't really something that anybody can control - the only certain answer would be to prevent her from socialising at all, which I assume you wouldn't want. The rest of it, I'm afraid, is just part of dementia territory: from time to time your mother will hear upsetting nonsense from other people, but then again she may also dish it out. Not much you can do except offer continuity and reassurance in her life, as you are doing. I'm sorry for it.
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PS - don't speak critically about other residents to your mother. It really won't help her if she starts seeing any of them as hostile or as liars when in reality… they have dementia, just like her.
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My mom is 97 years old and is in the hospital recovery from a gi bleed and contracting mrsa in the hospital. she has 4 more weeks of iv antibiotics so we have at least that long to rehab her before we have to make a decision of where to go from there. she has slight dementia so occasionally she drifts off into her own world but for the most part she is very lucid. she is very weak right now but is doing very well. She is very strong willed most days but some days she says she is just tired of fighting. I don't know if she would be better off going into nursing care or going home with me, which is where she was before.
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I know when we placed my father in a NH; at that moment I did not think "he is being put here to die".........never crossed my mind. He needed care that my mother could no longer give nor could we quit our jobs to do the 24/7 care. Yes there are some at my fathers NH that say' you are never going home" this is where you will be. but you know, i just explain that for now this is where he has to stay cause their home is not equipped for a wheelchair. Like someone else said, this is a temporary home until the Lord calls for them (or whatever your belief is).... but I, nor my mother/brother ever thought "lets put him there so he can die".............
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What is the one thing you want her to know that would erase all fears..... maybe something like "Here is home, until Dr. says time to go!". If it's something like that, whatever works best for your mom's personality.... type it large on beautiful paper, frame it, and put it up in her room. She will constantly be reminded of the positive thing.... or maybe a quote from someone like Helen Keller, who knew how to make the best of everything... or Mrs. Roosevelt.... or someone your mom admires! She needs to hear something that contradicts the negative. My thoughts!
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Maybe when she brings it up you could say something reassuring like "I/we will always be here for you Mom" "That will never change" It's sort of skirting the real issue but giving her something to hold on to.
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Yes, Tryingmybest.... that is the idea. Even posting a picture of herself saying those very words... any visible and tangible reminders of her daughter and her love for her mom.
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My mother is thriving in a NH and has been there 2 years. In fact, the floor that she is on, everyone is healthy - just really old.

That said, I could tell the other patients were telling her about the high cost of being there. She would call me up and say not to pay her POA and do not put any money on her account. Hmmm. Money was not and is not a problem.
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No One Knows the Day or Hour - “But of that day and hour no one knows, not even the angels of heaven, but My Father only."-Matthew 24:36.
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Amen!!
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tlhanger I just read your response and felt so heart warmed by what your wrote. Your mom is so blessed to have you. I would have done the same for my grandmother, who was more like a mother to me than my own mother ever was. She loved me and I loved her. My mother on the other hand is a person who I would be hard pressed to even visit once I found her a place that was warm and safe. I would do what is 'right' but she has been so abusive to me all my life, that now, when she is 80, I have no contact at all with her and practically sad to say, feel about nothing when it comes to her. We reap what we sow. I also have to comment that much as my husband and I loved his mother, who passed away two years ago at 93, there would have been no way we could have had her live with us either. She was very hardheaded, stubborn and her temperament was such that making sure she would be safe and also clean (she was incontinent and wore diapers and it was a struggle to get her washed even at the nursing home where they had the right bathing facilities and several if necessary, people to lift and move her). We took her on a cruise once and the smell in the room we shared with her was overwhelming. Although we were very attentive to her needs when she visited with us for several weeks at a time and took her on this particular trip, we both knew there would have been no possible way to have her in our home. It was so sad to see her in the nursing home that she 'chose' in her small town (not near us, but where she lived all her life and close to my husband's brother who was dutiful but not empathetic). Her mind was fairly sharp unless she got one of her very frequent UTI's but she was wheelchair bound (after not holding on to things or sitting down to dress alone, having broken her hip several times). The nursing home was awful but BIL insisted she go there. He had not 'saved for my retirement' as he put it and considered her money his as well. So sad. She refused to eat at the 'hall' and took her meals in her room. She needed 'socialization' but most of the residents had Alzheimers or another form of dementia and besides the fact that the food was terrible, being with people who were mentally gone was depressing. Every situation is so unique and temperament, physical condition, money, location, all of it predicates each outcome. I am making myself a list of the things I want to proactively be, possess, embrace, let go of and do in preparation for having happiness and peace when and if I reach a very old age. Control is something I guess each of us wants to maintain and the very thing none of us can.
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Thanks for the answers. I'm not sure what is wrong with the woman I heard saying this but apparently she is there for the long haul. My mom is blind in one eye, has mobility issues and gets very confused. Mostly I tell her I don't know when she can go "home" because it is up to the doctors.
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I think there are a lot of variations on how much of "the truth" you share with someone, and of course the other resident is a bit out of line. Some people will need the dignity of the truth and can accept it and make the best of it; others may be happier to engage in a little adaptive denial, still others won't remember from telling to telling of anything at all...

My mom never really stopped hoping she would go live on her own again, though towards the end she told me she realized she could not live in her old home by herself; she thought maybe an apartment near us would be the ticket. I never told her I had actually sold it, just that I had arranged to have a nice couple live there and take care of it and pay bills so she could come and be here with me and my hubby and the grandkids more while she was still in rehab (which she was, on and off...) Once when she asked me if she could die from her heart disease I even admitted she could, though we certainly wanted to give her good medications and care to help her heart problems and hoped it would keep working. I'll admit to fudging again when she actually moved to inpatient hospice - our skilled nursing facilities actually DON'T want even a DNR patient to die on premises if it can be helped, apparently! I told her it was a different kind of hospital that was nicer and would not do so many tests, but would give her medications mainly to help her feel better...she was more often distressed and upset and having angina by then, and probably had even more progression of her vascular dementia.

I had to do what my heart told me to, and tried to make the best decisions and say things in ways that would make Mom happier. And I was blessed that my son, who thought we ought to be more blunt, absolutely respected that and did what he could to spend time with her, which I think really made her feel as loved and happy as possible.
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I have never understood why an 80+-year-old Nursing Home resident frequently wants to go back to a home they cannot manage, a home where everything is booby-trapped, a home where they can slip in the shower, etc. I am not talking about those with Alzheimer's who don't remember clearly. I am referring to elderly persons who are in assisted living or a nursing home.

I do not believe that most adult children put their elders 'there to die." Most place them in a Nursing Home because it became unsafe for them to stay in their own living quarters - be it house or apartment. They put them in a safe place because they love them and are concerned about their well-being.

We all live in denial, believing that we will be able to manage in our own homes indefinitely. But reality is that old age or infirmity will change the equation for us - and we will need round-the-clock supervision. We would never expect a two-year-old child to manage on their own. So, why would we expect it of an 85-year-old?

I know a woman of sound mind who is now age 100. She told me that she just had to move into a nursing home because she could not "get enough help to enable her to stay in her own apartment." What exactly was she thinking? A 100-year-old body is quite frail. Why would anyone at 100 (or even 90) believe that they can still do what they did at 60 or even 70?

The nursing home is her home now. Becoming elderly is all about "downsizing."
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I like the term "adaptive lying" that somebody above used. When dealing with a person with dementia, it's often very upsetting to tell them the "blunt truth." So, sometimes it's better to "let them down gently" by a little adaptive lying.

Let me give you an example. I know of a woman in a NH who did not remember that her daughter had died of cancer 10 years earlier. One day, she asked my nurse friend, "Where in my daughter? She is usually here by now." The nurse did not have the heart to remind her that she had died of cancer. So, instead, she said, "well it's Saturday, and it's likely that she is out shopping. Perhaps she will be by later." The elderly woman said, "Oh, yes, my daughter is quite the Saturday shopper. She'll stop by after dinner tonight, then."

Ten minutes later, the woman had totally forgotten about the shopping and the daughter. No harm was done by the "adaptive lying" and it avoided upsetting the woman with dementia had the brutal truth been told.
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If the money runs out, you would need to apply for Medicaid, not a "Medicare waiver." The Medicare Waiver program in Maryland is related to hospital care, allowing the State to set its own Medicare reimbursement rates that are different from the federally-mandated Medicare rates. Medicare does not pay for an "assisted living" facility as it does not cover "custodial care." It will pay for up to 100 days in a skilled nursing facility if a person was admitted there from a hospital due to something like a stroke, broken hip, etc.
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This has to be hard. My mother was on top of her game until last year. A series of UTI infections and TIAs have left her really mentally challenged. I intend to keep her at home until she dies. She is anxious to sell her own home of 50+ years to take some of the burden off me. Shs still gets it that she wants to put in her "fair share". I hope she never has to go into a home. 2 of my aunts died in a home. They begged to go back home all the time. I pray that I die before I get to this point. Please keep your parents in a private home environment and not send them to a nursing home as long as possible if they don't want it.
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Sherry1anne, I have had my Mom here over 7 years now and she will never go into a nursing home. They do not ever have to, its just us that needs a break. Even thou Mom cannot walk or talk and I need to puree her foods because of swallowing issues, she still loves to tap her hand to music and can laugh. A lot of times she just sits and cat naps for 2 minutes or so, then looks at the ceiling all smiles and gabbering entertaining herself. She was a great Mom, I just dont have the heart to ever place her. I do however feel as though my life is on hold and wonder who will outlive who. My cna just offered to work 4 hours eachweek day morning for $60 a day, wish I had a better deal but its a wonderful break. I remember you saying you got someone fulltime correct? I wrote you once about it but you must not have gotten it, oh how I wish, but ss and va only covers part time with diapers, supplies, meds etc. We did sell moms home for her care, its gone now, but she will be here forever regardless. Thanks for your post.
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Right on Dragonflower, its called theraputic lying at daycares. It was so extremely hard for me to start it years ago but we all because pro's at it and it made mom happy. They live in the moment only so why not keep them happy. If you tell them something bad, they might get upset, or get in a sad mood but FORGET why they are in a sad mood, just that something made them sad. Good info.
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