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To go or not to go........
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An_190731 posted:
Hi: I am new to this so please, I hope you don't mind me asking. My mother who is 83 has Alzheimer's, moderate, so we have been told. She is currently in a lovely assisted living facility who specializes in memory loss and Atzheimer's. For the past two days she has been "sharp as a tack" (she has been on Namendia for about 2 months). Since she has been in the assisted living facility she has not mentioned her home in which she was moved from. Now, for the past two days, she wants to return. I have told her that I would need to get the okay at her facility, that I can just not "take her there" (it is about a 2-3 hour drive away). She said she has no real "attachment" to the home but wants to go back to "look at her things" and to "pick out some clothes."
After discussing this with the caregivers and nurses (I will also run this by her MD and PA before doing so), they felt it would be okay to take her there, that this is maybe what she needs for "closure" of the home. I'm just not sure. I lost sleep over this last night. On one hand I think it would be good, that maybe this is what she needs to put that part of her life behind her and on the other hand, well, I think what if this sets her back? She has come so far with how she is doing at the facility where she is that I would just hate for this to set her back. BUT, if she is now remembering her home, maybe it would be good to take her there, one last time...just to gather some clothes and look around. I just don't know. I only want the best for her. She has been told she would not spend the night there, that that is out of the question. She is a "fall" risk and could get very disoriented. Because of this she would not stay over night there, it would only be for an hour or so. My only fear is that she will now want to start going back there periodically, yet I hate to deny her the chance to take a last look at her home....Please help, any advice would be helpful. Again, I'm new to this site, have never posted anything before and would value any feedback I may get from this.
Thanks,
Karen.
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Helene Bergman, LMSW responded:
Karen,
Relocation is a process (vs. an event) for older adults with or without dementia. There is a honeymoon period where they are getting used to the new setting and people. Once they settle in, they begin to mourn the loss of their original 'home' and the adjustment period begins. This could take any length of time depending upon the facility and staff and the coping skills of the older adult. Dementia, of course, complicates matters.

The word "home" has different meanings at different stages of dementia. At the early stages it usually denotes the place the person is living at or for someone who just relocated, it would signify where they just came from. At more moderate stages, it could represent an earlier setting- perhaps where they grew up- rather than the immediate setting they came from. I would suggest you begin by trying to understand this before acting on her request. Reality perception of a moderate stage dementia is usually quite impaired so perhaps your mother's dementia is more early than moderate? Namenda might have some effect but will not usually result in a moderate dementia patient becoming 'sharp as a tack'.

You could try an alternative before taking the risk of bringing your mother back 'home'. One suggestion is to present her with a scrapbook of large pictures of her last 'home' and see how she responds to them. These may help her with 'closure' if this is the home she is referring to. She could point out the belongings she wants and keep her 'home' close to her. If this is not successful, you could risk the 'homecoming' as long as you have a plan for her return to the facility....and special 'party' or 'welcoming event'. After that, you will need to see what happens. It sounds like she needs to feel the 'comfort' and 'familiarity' of home so as she continues to experience these feelings in her 'new home', her longing for the past will progressively dissipate.


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