How do I explain to a loved one with dementia I'm placing them in a nursing home?

"I'm placing my loved one with dementia in a nursing home how do I explain to them what's going to happen? Should I tell them in advance? What if they resist?

Answer

Telling a loved one in advance about placement is a very individual decision--sometimes the PWD (person with dementia) has made it clear earlier that they wished to not burden family and would like to be placed--that's the best scenario for families, but often doesn't happen.  But even if that LO has given those directives earlier, they won't remember that and their world is in the NOW and HERE.

Usually they won't want to go anywhere their family is not present. Check out the facilities in advance; when you've decided, possibly take your LO with you for a meal there and stay with them. If the facility has day care, start using it and gradually increase time spent there. It's not necessary to "explain" to your LO since they will forget and will argue they don't want to go.  It's "just a lovely place to wait for me until I pick you up in an hour or so..."  Always give them hope that you are returning to take them "home."

On the move-in day, again accompany them. Have belongings packed when your LO cannot see that happening, and have them delivered to their room while you are enjoying a meal at the facility.  Get them involved in an activity and slip away when they are occupied. The staff, if properly trained, will know how to redirect them when they realize you are gone.  They will discover a way to help calm them down (without meds).

When you visit, and your LO says they want to leave with you--"I would love to be able to take you with me right now, but the doctor said he needs to get all your test results back before you can come home--probably tomorrow." Again, always give them hope they will get what they want.

Your goal is to help them be calm, happy, safe and comfortable and that won't be achieved if you're constantly re-orienting them to the fact that this is where they must now live and they become upset--and then forget all about it again later. That becomes slow torture not only for them but for you. We call these "therapeutic fibs".

AgedCarer Contributor: Cindy Keith
Dementia Practioner and Author