© Copyright 2012 by Robert Moskowitz
My favorite Aunt is suffering with Alzheimer’s. She hardly knows me anymore when I go to visit her, and it’s the same story with my cousins, her own children.
She’s still living at home, but her husband is not in very good shape to take care of her, and I’m afraid she could suffer some kind an accident in the house, or maybe cause one. She might even start wandering and get lost outside, or somehow come to harm some other way.
Her children (my cousins) aren’t sure she’s ready for a nursing home. Can you tell us how you decide when someone like my Aunt should move to a nursing home? If she’s a good candidate for this kind of a move, how should we introduce it to her?
Signed, Wavering But Worried
I’m sorry that your Aunt is suffering this way. Alzheimer’s (may I assume your Aunt has been diagnosed with this disease by a competent physician?) takes people away from their families in a very emotional and heart-wrenching way. Sometimes it can feel worse than death. And of course, there is the potential for all the problems you mentioned in your letter, and more.
Every case is different, of course, but if your Aunt can no longer be cared for at home, then she quite simply must be cared for somewhere else. But the best alternative isn’t automatically a skilled nursing facility. (For more details, see my answer to the following letter.)
Unfortunately, there is no “best” way to tell your Aunt she must leave her husband and her present home to live with strangers. The best two angles to take are generally that: 1) the family is very worried about her health and safety, and 2) those living with her – in this case, her husband – can no longer care for her adequately, even though they would like to continue doing so.
Expect a lot of resistance from your Aunt. Even if part of her understands the need for the change, the Alzheimer’s tends to make her more upset about changes in her lifestyle than she otherwise might be.
It’s vital for your cousins, and the rest of the family, to be as certain as possible about what’s best for their mother. Then it won’t feel quite such a bad thing to do to work up the ladder from discussing the idea with your Aunt to insisting, persuading, cajoling, and if necessary simply making the change against her wishes.
Once the move is complete, having the burden of caring for your Aunt lifted from his shoulders may actually help your Uncle bounce back and get healthier again.
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My father has recently suffered some broken bones due to a sudden fall on the sidewalk outside our home.
Caring for him is making my mother a nervous wreck, and draining the strength out of her. But no one thinks he’s incapacitated enough to need a nursing home.
Are there any good alternative options where he can live until he’s well enough to come home?
Needs A Temporary Place For Dad
Most people think – mistakenly – that aging parents who are ill or injured need either a hospital or a nursing home. But there are many other monitored living situations that can be suitable, depending on how much capability and awareness the person retains.
Check with the hospital Discharge Planner and any social workers you can find who are familiar with your area. They will be able to give you recommendations to the best alternatives nearby. These will probably include some or all of the following:
Seniors of varying capacities can be set up to share space in a living situation where they can be relatively independent, but can also help each other compensate for their temporary shortcomings. Paid help is usually on hand to be responsible for many of the basic cooking, cleaning, and daily maintenance tasks.
Seniors who need some help with activities of daily living can move into an assisted living center in which they can get trained help with whatever they need, but are left to “do for themselves” everything else.
Seniors who have a viable living situation but still need some help and attention can live at home, and be cared for by a “home health aid” or a (much more costly) visiting nurse, home health nurse, or private duty nurse. The paid caregiver works on a pre-arranged schedule to provide help with whatever activities of daily living the patient can’t handle alone.
It’s difficult to say from a distance which of the many good alternatives make the most sense for your dad at this time. But if you look around, you can almost certainly find knowledgeable professionals to help you find and choose between some very good living options for him.
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To help your aging parents maintain their quality of life, think in terms of becoming like flowing water, which over time can create beautiful formations out of the toughest rocks.
© Copyright 2012 by Robert Moskowitz
Robert Moskowitz is the author of “Parenting Your Aging Parents, How To Protect Their Quality of Life — And Yours!” This 300 page hardcover book has been widely acclaimed as the classic work in the field since 1991. It is available at bookstores, or directly from Key Publications. The Web site is: “http://www.KeyPubs.com/pyapbook.html“. The cost is $21.95 plus $6.95 shipping and handling. If you wish, you can ask Robert Moskowitz your own question for this column by emailing him at: KeyPubs@KeyPubs.com.