Should we move my mother to a nursing home in France...???

Discussion in 'I care for a person with dementia' started by Angela T, Mar 20, 2015.

  1. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Hi everyone,

    I am wondering whether we should think about moving my mother to a nursing home in France to be nearer her family...???

    I don't know if any others have had to face this dilemma (moving an Alzheimer's patient to a country with a different language...?).

    If not, I would still be interested in your opinions on the importance of language (speaking and understanding) as the illness progresses.

    My mother is 89, with mild to moderate Alzheimer's. She was living alone in North London before going into a NH in January. She has no close family nearby, except one of my daughters, who visits occasionally (she lives about 2 hours away, is very busy and travels a lot for work). She has some friends, but I think as the illness progresses, visits from friends will taper off. Also her friends are increasingly ill, or immobile, themselves.

    Her only other close family is me and my 3 other daughters and 2 grandchildren - we all live in France (southern).

    There is a lovely nursing home 30 mins from where I live (and there are others which are closer) - so I could visit frequently, and be in touch with the doctors etc... visit if she goes into hospital... One granddaughter, and 2 small great-grandchildren (whom she never sees at the moment) live in the same town, and she would see the other granddaughters much more frequently than if she stayed in London.

    The downside though, is that she would be in a French-speaking environment !!! Some of the staff would speak and understand English, there is an English-speaking resident, they told me - BUT it is a huge upheaval... My mother spoke French before, but I assume she has probably already lost that ability.

    When my mother had a fall and went into hospital in February, my daughter and I rushed over (an 8-hour journey door-to-door), and I realised then the importance for my mother of familiar faces (us!) and also the importance for us of being able to talk to doctors etc... and make informed decisions about her care...

    I won't always be able to rush over from France at short notice - and I think a dementia patient in hospital needs family around to look out for their interests. I am feeling it would be so much easier if my mother were local...

    When we spoke to my mother about this in February, she loved the idea - but I know that she is not able to make decisions like this now.

    But is it a realistic possibility, given the Alzheimer's...?

    I think that, as the illness progresses, her surroundings will matter less and less. Is that also true for the language...?

    Thanks for reading !

    Angela
     
  2. MeganCat

    MeganCat Registered User

    Jan 29, 2013
    356
    South Wales
    My mum moved from hospital in Scotland to a care home in Wales and didn't seem to notice the change in accents. She used to talk at that point as if she was still there - asking me when I'd arrived and for how long. I had wondered if she'd cope with such a drastic change in accent but it wasn't an issue. Also she never questions the carers who have foreign accents.

    She has advanced over the year and can't form sentences herself now and I don't know if she can follow anything I say - her responses wouldn't indicate that she can. She can chat away but you can't follow what she's saying and some words are made up.

    I think she responds to a smile and gentle voice and tone is probably more important now than content. Mums quite advanced now but I guess the less advanced you are the more important language is. I also think recognising someone is important. Mum doesn't remember who I am now but she usually smiles when she sees me as she knows I'm important to her.
    Trying to care from a distance is really difficult, mum was recently in hospital for 6 weeks and so I visited every day so she had a familiar face and I could keep in touch with what was happening, get some extra food into her etc (same staff were never on 3 days in a row) - that would have been a nightmare if she had still been the other end of the country.
    As she progresses I'm increasingly glad she's close by
     
  3. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    #3 Angela T, Mar 20, 2015
    Last edited: Mar 20, 2015
    Thank you MeganCat.

    Yes, everything you say echoes what I'm feeling.

    It is true that almost all the carers in the NH where my mother is, from the Manager down, have strong accents - so I don't know how much she really understands... I have difficulty understanding at times!

    I also realise that language will become less of an issue as the illness progresses - both for speaking and understand, I suppose.

    And I agree totally that what will matter increasingly is not the words spoken, but the intention - a gentle voice, a smile.

    Yes, I noticed the importance of recognising someone when my mother was confused in hospital - every time my daughter and I came, her face lit up!

    You are right that trying to care from a distance is difficult. At best I will be able to travel over to London every few weeks - which I don't feel is enough. And if there are further emergencies and hospital stays, it will be a nightmare. I cannot drop everything and go over for weeks on end, so sooner or later, my mother will be neglected...

    As you say, as our mums progress, it makes more and more sense to have them close by.

    Often what we think is an issue, is not necessarily for them, in their dementia world. We need to see what works for them, and for us.
     
  4. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Thank you Piph,

    That is a good idea !

    We could bring her over to France for a summer (?) break - and see whether the language really is an issue... and weigh that up against the benefits she was getting from increased visits from her family...

    I will visit 2 or 3 homes in my area, and see what they say about the language.

    English is so widely spoken, that most staff in a French NH would probably have basic English...

    Also, very surprisingly, the cost of NHs in France is much lower than in the UK, so as my daughter pointed out, we could easily pay an English-speaking companion, for example, to spend time with my mother, if we felt that was helpful...
     
  5. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Yes, this is constantly on my mind at the moment, so I know I have to find a solution.

    At the moment, she needs extra nursing care, but when she regains some mobility we can look at bringing her over.

    As my daughter said, she would be able to be part of family gatherings etc... in a way she never will if she stays in London.

    But she does have visits from a few friends - that would all stop, if we bring her to France. I feel it is a huge responsibility, taking her away from where she has lived all her life !
     
  6. MerryWive

    MerryWive Registered User

    Mar 20, 2015
    55
    Is French her first language? If so, she might regress to it.

    My MIL's first language is Italian, she came to the UK aged 13. As her dementia progressed she 'lost' her English and spoke mostly in her own dialect. Her carers learnt her key phrases (I'm hungry, I'm cold etc) - I wrote them a list to refer to. Now she mostly garbles so it is not clear whether she understands anything. To be fair, I would say she enjoys the sound of her own language, I think it is reminiscent of her youth, but she mostly responds to smiles and hand gestures and language per se is pretty much irrelevant. Having said that, I would not want to leave her in the care of someone who could not understand her if she did say something sensical as I don't think that is helpful to the experience of dementia. But that is just our preferences and I don't think it would impact on the actual quality of care she received.

    Being surrounded by friendly faces and feeling safe and loved is the most important thing. I think it sounds like a wonderful idea to be honest (presumably you can speak the French needed?). The weather would be warmer, you could take her outside in a wheelchair to enjoy the flowers. And I daresay the food would be nicer in France than in an English care home!!
     
  7. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Yes, thank you Piph, I did read that thread - maybe that's why I decided to post my thread, since it is a difficult question.

    Yes I am aware that friends will visit less and less - and that my mother will eventually just need the comfort of close family visiting regularly.

    Also, friends can't keep a close eye on things, like family does.

    If there was no language barrier, I wouldn't hesitate... that's for sure !
     
  8. Bod

    Bod Registered User

    Aug 30, 2013
    1,180
    I agree if mother has had the language in earlier life, then it may not be a major problem.
    Remember Alzheimer's affects the short term memory most, much older memories, are often untouched.
    On the whole I say go for it, but sooner rather than later.

    Bod
     
  9. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Thank you - I love the end of your post... it made me laugh ! Yes, it does sound lovely doesn't it ?

    True though, it would be a lovely environment.

    No my mother's first language is not French, it is English, but she has always enjoyed speaking French. I have lived here since I was 22, so she visited regularly and spoke French when she came.

    Your experience with your MIL is interesting - enjoying the sound of her own language... Good idea to give her carers a list of her key phrases ! And yes, she responds to the smiles and gestures, not to the words...

    I'm beginning to think that this is not such a crazy idea - that there are ways round the language problem - the staff would learn how to communicate with her, and she does/did understand French.

    Thank you !
     
  10. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Thanks ! My mother spoke French when she was younger, and kept it up with regular classes, reading and visits to my daughters and me in France over the years.

    Yes, she may well remember her French from before. I am going to visit next week, I will get my husband to speak to her in French, and see what she remembers !
     
  11. BR_ANA

    BR_ANA Registered User

    Jun 27, 2012
    1,082
    Brazil
    My mom first language was German. (Pre war). She used little Portuguese until ww2 ( German was forbidden-> communities had to learn Portuguese on war)

    Now she is on stage 7 and she still says odd words in Portuguese.

    If you are moving your mother do it sooner than later, so she can enjoy it.
     
  12. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Thank you - that is good advice, moving her sooner than later so she can enjoy it.

    Bod said the same thing "sooner rather than later" - interesting because I was thinking the opposite : "maybe later, when she has lost the use of the language" but your advice makes sense.

    I've called to make an appointment to visit and talk to the director of the very nice NH that just opened 30 minutes away from where I live - to see what they think about an "English patient" !!
     
  13. sistermillicent

    sistermillicent Registered User

    Jan 30, 2009
    2,949
    My grandmother's first language was French. My husband's grandmother's first language was German. Both had AD and both reverted to speaking their first language....BUT they both still UNDERSTOOD English, though they would answer in their native tongue.
    So I think there is a good chance that your mother will understand the French even if she can't speak it in later years. I would live in the moment, which is often good advice dished out for dementia sufferers, and if it feels like the right thing to do now, just do it.
     
  14. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Thank you Sistermillicent, yes it does feel like the right thing to do.

    I do not like the fact my mother is so far away, that I cannot see the health professionals regularly to talk about her situation, that we cannot reassure her and that I cannot be available whenever there is an emergency.

    I know I should not move her to nearer where I live just to reassure myself - the priority is how she feels, and how she would adapt. But I think she will like the idea of being near her daughter and granddaughter - I think it will reassure her.

    Thank you !
     
  15. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    16,138
    Toronto, Canada
    I think it will also reassure you, which is equally important. Go with your heart.
     
  16. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    #16 Angela T, Mar 20, 2015
    Last edited: Mar 20, 2015
    Yes I agree about going with my heart... I have these images in my head.

    One of them is when my daughter and I turned up at the hospital where my mother was taken after her fall. She had been agitated, confused etc, desperate to leave... and once we arrived, she calmed down and she was less agitated after that.

    We then moved her to a nursing home and I had to come back to France the same day - and she has been agitated since, trying to leave...

    It may not make that much difference if she sees her family regularly, but I can't help feeling that it must calm her down to see familiar faces. It must be such an upheaval - hospital, care home... all those new faces...

    One thing made me laugh in the hospital : she suddenly looked at my husband and said to me "He is reassuring isn't he ? We did well choosing him, didn't we ?" "WE" ???
     
  17. Tin

    Tin Registered User

    May 18, 2014
    4,815
    UK
    It would make a huge difference to you and if your mother is agitated or stressed you 'll be close by to visit and help. sounds like your mother is reasonably ok to move care homes and can still communicate with French staff and able to build up relationships with them. Like someone else has said, you should do this sooner rather than later. Good luck.
     
  18. MerryWive

    MerryWive Registered User

    Mar 20, 2015
    55
    Sooner rather than later

    Just want to echo the 'sooner rather than later' comments - time to settle in, time for you both to create memories, learn what works, time for your children and grandchildren to build up some kind of relationship with her.

    Afraid to say but with dementia you never know what is round the corner, and sometimes there is no later, one thing after another happens and you never quite reach where you wanted to.... Just would try and make sure that the home you choose is capable of meeting her changing needs over time.

    Hope things work out xxx
     
  19. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Thank you, yes I agree, things change over time, and it is all very unpredictable.

    I am going to at least explore this option - looking at NHs in my area who could accept my mother, and see where it leads us.

    if it doeesn't work out, for whatever reason, we will at least have tried !
     
  20. MeganCat

    MeganCat Registered User

    Jan 29, 2013
    356
    South Wales
    Sooner rather than later

    My mum isn't able to walk now, but I'm glad we spent the last year making good memories whilst she could and wanted to get out: eating ice cream whilst walking in the nature reserve park, shopping for clothes in an out of town m&s, wandering around garden centres looking at the flowers, coffee and cake in cafes.
    The care home she is in has a garden so I will be able to take her out in a wheelchair in the summer - still a little nippy now!
     

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