The Nursing Home Decision - Memory and Alzheimer's Disease

family members often ask what's the

trigger for placing someone in a nursing

home in fact there is no one it varies a

great deal from person to person and

family to family my experience is that

usually families wait too long to put

someone in a nursing home that is that

as often and would have been better for

the person to go in sooner but that too

varies a great deal my children came

home at Christmas time and see they

weren't with him they saw him but they

did not live with him anymore Judy said

mother you you've got to put him in a

nursing home she said we've lost daddy

and we don't want to lose

nursing home placement is often the

result of an accumulation of a number of

different things to happen but the

development of a physical impairment of

physical needs that the caregiver can no

longer meet becomes a common trigger for

the family to finally decide that it

really is best for the person to be in

long-term care physically it would it

took two people to handle him and I

wasn't strong enough to do being be the

one person I mean if I kept him home it

would have been somebody around the

clock and me and that wouldn't just

wouldn't make sense because we wouldn't

give him the care that he could get in a

good nursing home yeah so for both of

you that was the right decision yes the

family shouldn't feel that they have to

make this decision on their own they can

talk with their physician their priest

minister with the social worker there

are a lot of agencies that can help

people think through this issue feeling

that you're facing it all alone puts

more of a burden on you as a caregiver

and more of a burden on the family then

really there needs to be I was relying

on people at daycare also to keep me I

thought I was too close to this

situation to be able to make that

decision and I was in touch with her

caregivers at the daycare center to try

to to to keep me informed about when

they thought our current situation

living situation with her going to

daycare wasn't working out anymore

I was getting to a breaking point there

and but also relying on other people to

to tell me that

that I'd done

one of the surprises that many families

find is that the ill person often does a

little bit better when they go into a

nursing home or other long-term care

facility I think one of the reasons that

happens is because the person is able to

get the physical care that they need

from the staff but the family members

are then able to provide the loving care

the interaction that they've not been

able to do because of the overwhelming

physical nature of the care that they

were providing at home I didn't have to

cut fingernails I didn't have to shave I

didn't have to brush teeth I didn't have

to get dressed get him dressed so things

got better after yes he entered the home

he's still the most important person in

my life and I see him every day and I

know that he misses me when I'm not

there this is the dearest man who ever

lived I love him so much

daycare is one of the resources that can

help families delay long term care

placement I often recommend daycare

earlier in the course of the disease and

many families might think that they need

it but it gives families a break from

the day-to-day 24-hour care

that the person needs and that they

become overwhelmed by daycare was also a

tremendous help and that took a lot of

convincing my father thought she'd hate

it and he didn't want to put her in

daycare and really really resist it and

the group kept saying the support group

kept suggesting you know you ought to

try it go to try and he said no no no no

and finally after about a year of real

prodding he decided reluctantly he'd

allow her to go two days a week

and within two or three weeks he had her

signed up for five days a week

most families and most people would

rather never go into a nursing home and

I see my job as a professional for

helping people stay home as long as

possible on the other hand when the care

becomes overwhelming for the family or

the caregivers it's often in the ill

person's best interest to move into a

long-term care facility and I see it as

part of my job and I think it's the job

of the professional to help families see

that sometimes it really is the right

thing to do for the ill person it's not

a failure on the family's part it's the

disease that's necessitated somebody

moving to a higher level of care I hope

that we're able to keep my mother at

home for the duration of the illness

that's something I would like to do

whether or not that's going to be

possible only time will tell

you could be a failure if it came to

that no no I mean I I'm realistic where

if I see my father's health declining

and my own health declining at that

point then we would have to make that

decision but when it comes to a physical

need that's not being met for either my

father or my mother then you know I know

that it's time to step in it a majority

of people who advance an Alzheimer's

disease to later stage condition require

nursing home placement that's

disappointing to many families in too

many patients but often the positive is

that it allows the loved the caring the

relationship actually to blossom more

because the physical care that the

family was providing is no longer the

focus of care I mean this was my best

friend my lover my husband the man who

could solve any problems who knew

everything I didn't need an encyclopedia

if John was around this man was so much

and he still is