My mum has vascular dementia, how do we persuade her to move?

[Dragon Daughter]

My mum is relatively young (71) and currently lives in alone is a big house in a rural location. She was diagnosed 18 months ago with vascular dementia but does not remember. She suffers from memory loss of anything short term and believes she has burglars who not only take things but bring things too (clothes, chocolates).

She agrees that she needs to move but trying to get her to commit to anywhere is almost impossible. My brother and I have Power of Attorney. How do we persuade her to trust us and does there come a point when we just have to act?

I can see her distress and anxiety but it's having a negative impact on my own family life and my brother's too.

I'm sure there are other people going through this too, it's just so hard to know what to do.

TIA

 

[Amy in the US]

Hello and welcome

Hello, Dragon Daughter, and welcome to TP. I hope you find some help, advice, and support here. Remember that it's always open.

I am sorry to hear about the situation with your mother and please let me assure you that you are not alone. I know it doesn't do any practical good, but it can be very comforting to learn that others are, and have been, in your situation. Caring for someone with dementia is very challenging and sometimes, you just need to talk to others who have also dealt with dementia and understand what you're experiencing. There is plenty of that here on TP.

If your mum needs more care than she can get in her current location, and/or she is no longer safe to be left alone, and/or she is too distressed to be alone, and/or she is some distance from you, those are all very good reasons to consider a move. Are you looking at a move to a care home, sheltered housing, one of your homes, or some other type of situation?

I am sorry to be blunt, but the answer to "how do we persuade her?" is, you don't. Not if what you mean is, how do we have a reasoned, logical conversation where she understands fully and agrees to do what is best for her? because with dementia, that is not going to happen. There may well be days or moments when someone is more lucid but, especially combined with the memory loss, the ability to reason is just not functional.

This is not to say that you cannot move your mum, just that you may not be able to accomplish it in the way you would like. And if she is not safe where she is currently living, then you will have to make other arrangements.

Do you have support from her GP? What sort of care package do you have in place, and can that be increased until you figure out what is next for your mother?

Again, I'm sorry to be so direct but you can tear yourself apart trying to reason with dementia. The memory loss makes things much more difficult, as I know only too well (my mother, age 73, has Alzheimer's type dementia and severe short-term memory loss). There is some good information from the Alzheimer's Society about communication which may be helpful: https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=84 (lots of good info on their website; have a look)

This might also help: http://www.ocagingservicescollabora...te-Communication-with-the-Memory-Impaired.pdf

You also mention that your mother is having delusions (the thieves coming and taking or leaving things from her house). A delusion is a false, fixed belief and is commonly seen with different types of dementia. You cannot argue or reason with a delusion, and doing so can cause agitation, so don't even try. If the delusion isn't distressing, you might not discuss it at all, just say, "I see," and move on conversationally. If it is upsetting, or brought up again, you might try:

1) acknowledge what they are saying and especially how they feel
2) reassurance
3) distraction

So, if your mother is upset and says, the thieves were here again in the night and took my clothes, you might say, Goodness, Mum, I'm sorry to hear that about your clothes. That's terrible. I'm sorry you are upset. Let me look into that for you and I will let you know what I find out. Do you know, I'm thirsty, how about a cup of tea?

I'm not saying this works every time, but sometimes. It's also not a bad idea to ask the GP for a review of medications to make sure there isn't something that could be contributing to the delusions, especially if they are upsetting or preventing your mum from sleeping, et cetera. Some of this might be helpful: https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=159

The Alzheimer's Society and Age UK are good resources and you shouldn't hesitate to call.

I also want to say that if and when the time comes to consider a care home, whether for respite care or permanently, please try to remember that it could work out. The move to the care home was the best thing that could have happened to my mother, who was unsafe and unhappy living alone in her home (small home in an urban area but miserable nonetheless). I had to wait for the crisis (she was found wandering in the cold, no coat, injured, disoriented, and hallucinating and was then sectioned). It's great that you already have the PoA sorted and perhaps you will be able to take the time to make the best possible arrangements, and prevent a crisis from happening.

I'm sorry as my response is all over the place. I am sure others will be along to offer advice. Apologies for any distress or upset I may have caused you.

Best wishes to you and your family.

 

[fizzie]

Hi Dragon
That's right - you will just have to act - there are ways of being kind and considerate and still just acting in your Mum's best interests and just getting through it

The world of the person with memory loss can be very scary and your Mum is probably feeling this hence the burglars.

Can you look at some kind of sheltered extra care housing for her - there are some really wonderful private schemes and Local Authority schemes around - usually called Flexi care housing or Extra care housing. You would need to talk to them in some detail as some are very good at accommodating people with memory loss and others not so good in the longer term but if she is not ready for a care home yet then this could be a good option.

Age UK have a great practical helpline for the Attendance Allowance and benefit checks and will send someone round to help fill in the tricky forms

Adult social care will do an assessment or you can privately employ a carer to check mum is ok. A really good option for a lot of people is a day care centre (often accessed through adult care social services duty desk) where she can have lunch and be with people during the day.

The leaflet link that Amy gave you is great too
but it would be a good idea to start to get some practical help for mum - I was given some very good advice when we first realised that my Ma had memory loss - get help in early because the later it is, the more resistant the person is to accepting help/care.

Good luck and keep posting

 

[CJinUSA]

Moving is so overwhelming. I can see how your mother might easily want to put off any changes in her life.

With my own mother, she had a seizure right in front of us, and then the Alz diagnosis came. I appealed to my mother's sense of justice: "suppose you were driving and this happened to you? you'd lose control of the car, and you might get hurt or you might hurt someone else." Because my mother lived in a rural area and didn't even have mail delivery but had to go to a post office to get her mail and to shop and do all else, it was clear to her she shouldn't drive any more. I asked if she would give me her keys, and she did.

This is how we got the ball rolling on the permanent move to my home. It took about an hour of soft talking, trying to think of alternative ways she could remain in her home without a car, etc., but she finally gave me her keys and said she was ready to move.

If an approach like this is not feasible, then I have another suggestion.

Sometimes it is just so hard to sort our clothes and all the *stuff* we have accumulated. Your mother will need help with this. Suppose you and your brother could help your mother tackle a room at a time, beginning in a bedroom, and just start cleaning out "what you don't need, mum." You could pack things away for her, throw out other things, clean and tidy up, and work, room by room, paring down her things. This process of gleaning her goods would help her see how much she has that she no longer uses or needs. It will be very trying - she will want to hold onto everything - but it would be a way to help her clear out her things and to think about her life and a possible new life. I know I sure will need help cleaning out my stuff - we all accumulate so much stuff - and this will surely be part of a reason I would not want to think about moving. It's hard work. She is probably not emotionally or physically up to it.

Would either of these approaches, or both, be a way to get this started?

 

[AnneED]

Hi DD,

There are some very good ideas from the others, above and I probably can't add much to those but I would emphasise the communication thing: communication with dementia involved is a whole new ball game and means that consent and agreement can often not be obtained by telling the full truth; sometimes not until you don't tell the truth at all. This relies on those of us trying to get the consent to be acting in the parent's best interest, and from what I've read on TP, the vast majority of us are.

Consent does not involve your mum agreeing to what you are doing; it involves her going along with it often by not being told what is really going on.

So, given you're working in your mum's best interest; given that you can't tell the full truth as it doesn't work for her any more;

What and where is the next best thing for your mum? You have P of A so can organise it.

How is the most comfortable sympathetic way of presenting this to your mum? (often, what is the best lie?) With a move of home it's often the emphasis on this being temporary (just until you're feeling better; just until the boiler's fixed; when your holiday here ends...) When you've decided on it you all need to adjust to your acting roles to present this.

Go ahead and do it - it won't be easy and you may have to change the plans both practically and in the story you present your mum with. If she gets upset use the communication suggestions to move to more comfortable places for her - the diverting cup of tea, the on the spot lie, whatever.

I make it all sound easy - I know it's not. It took me a long time to grasp what we needed to make progress for mum, and although I can 'talk the talk' I can't always do it; it always feels wrong inside, and I always feel as if she's going to 'find me out' and hate me for it. But she doesn't and it works largely.

Good luck, and do come back to Talking Point. It is a really supportive place.

 

[Aisling]

My mum is relatively young (71) and currently lives in alone is a big house in a rural location. She was diagnosed 18 months ago with vascular dementia but does not remember. She suffers from memory loss of anything short term and believes she has burglars who not only take things but bring things too (clothes, chocolates).

She agrees that she needs to move but trying to get her to commit to anywhere is almost impossible. My brother and I have Power of Attorney. How do we persuade her to trust us and does there come a point when we just have to act?

I can see her distress and anxiety but it's having a negative impact on my own family life and my brother's too.

I'm sure there are other people going through this too, it's just so hard to know what to do.

TIA

Are you able to get a carer for her? Do people in her area know that she is not well. People calling in are a great help but sadly this does not always happen. If you talk to her about options, is she able to understand? It is an awful time for you.

Aisling (Ireland)

 

[Missy]

My sister and I had to recently "persuade" our Aunt who has dementia that she needed to be cared for 24/7 as she was having lots of falls etc too.

We told her she was going into the care home to get her strength up - she needed a holiday, etc and if she got stronger she might be able to go home. Of course she will never be stronger but she doesn't remember this. It has taken her a couple of months and she still will ask when am I going home, and our answer is always the same! But she has settled in. Not easy any of this.