Husband has Parkinson’s and dementia. He went to snf following a hospital stay for short term rehab but I decided it was time to make this permanent as I could not manage him at home anymore. The last few days he has become totally lucid and wants to know why he can’t come home since he’s doing so well. Says he would never do this to me. He was agitated and struck out at staff when they tried to wash him insisting he could do it himself. Took him to my daughter’s for Christmas and he was perfectly fine, no falls, no delusions, no incontinence. Has he become stable enough to come home or will he revert back to previous results? He does not understand the situation. Said he has regained what he lost and doesn’t deserve to be in this “prison.” He wants to know why I left him there. I visit every day and bring him a treat. He calls me constantly when I’m not there. I am feeling guilty and overwhelmed. Should I have tried harder tocontinue the unmanageable situation at home? Assisted living is probably the best place for him with the freedom and activities offered, but that option is not affordable.
I'd encourage staying at the SNF - he might be ok for a time in assisted living but they have NO medical care and no training to deal with someone who resists care, etc.
I'd consider decreasing your daily visits - and when he starts to push about going home, accusing you of putting him in prison, etc. - tell him, "I'm sorry, dear. that is not true. You have health problems and need care that I can't provide. The answer is no." Then, when he continues the question or complaint, 'I'm sorry, dear. The answer is no." And then, "I'm sorry. Try to divert him to another topic or interest or go for a 'walk' in the hall or whatever....and if he still persists 'Well, I need to go along. I'll come see you soon, I love you". Choose your own words...ad keep your tone neutral. This strategy lets you set the boundary and explain once why he is there and needs to stay there. Then you decrease what you say. He won't like it, but you focus on the main point. And then don't argue or get emotional, just say goodbye and leave.
(Even if you need to duck into the nearest ladies room and cry, or cry in the car. That's healthy).
Maybe the staff can help reduce his frequent calls to you...and if you are able to not answer, it will allow staff to help focus his attention on something around him. They are good at 'oh, she must have gone to beauty parlor" or a host of other "little fibs" to calm him.
This is a heckuva hard road.
Stop feeling guilty you have done your best. Dementia robs us of the people we know and love. I would speak with a manager at the facility for reassurance. They are experienced and will give you an honest answer.
keep strong and know you have done your best. X
Yes, those lucid moments are the worst and yet best cause it reminds us of why we are still trying to stick it out and be there for them no matter what in whatever way we are so able.
We just put dad in an ALF before christmas. There was so much anger there on my part because it was his decisions and choices that put us in this situation. WET brain. So many holidays stolen. But now its something that is not in any of our control to fix. All I can do is try and keep him safe and as healthy as possible during this downward grade of his life. :( SUCKS!
You visit him daily and answering his constant calls is doing neither of you any good. If there's an emergency, the SNF will call you. Constant calls is a sign that he is not "totally lucid".
Thank you. Here for support in any way I can.
Your husband has Parkinson's disease and dementia. These are not conditions that improve with time. They get worse with time.
Please do this exercise for yourself and I believe it will help. Write down the reasons why you made the hard decision to put your husband into the LTC facility. Now all those reasons are true and you did the right thing. Sure, he might have short periods of time when he's doing all right. Like when you brought him to your daughter's house for the holiday. That might even last a day or more.
It's 'Showtiming'. If you were to ask the facility how he was when he went back, they'd tell you a different story.
You made the right decision and cannot move him back home.
Perhaps see if there is a middle option that might be an incentive for him to back off a little. Perhaps the nursing home would agree to him coming home for a few days, while keeping his place. They may be unhappy because it could affect their Medicaid funding while he is away, but you might be able to cover some of the loss for a short time. Or they might be able to plan to use his bed for a week or two’s respite for someone else. Talking to him about these options might help to defuse the situation – another alternative to ‘yes when the doctor recommends it’.
Excursions might help too, even as another ‘trial run’ promise. If the NH has an AL facility, he might be allowed to go with an excursion they are organising. Once again, it might cost, but a ‘trial’ is a lot easier than trying to fund AL.
If he can’t understand the problem here, he is not genuinely lucid. It must all be very difficult for him, as well as for you, but see if any of these suggestions could be worthwhile – if only as a delaying tactic. Best wishes, Margaret
This was Medicare in rehab and I only wanted to take him to look at a facility but, it definitely threw my antennas up about Medicaid and coverage for overnights and outings.
May not apply but, needs to be researched by discussing with the facility and his Medicaid social worker.
He went home and started the slow slide back downhill. He got weak again, was in pain, fell over 40 times. But was lucid enough to know he was still in control. He finally got so bad, we could take control and had him readmitted.
The difference: he did so much better in a controlled environment - regular meals, meds, bedtime, all regimented. He could also get stronger meds than he could get at home.
So keep all of that in mind too. A controlled environment is critical sometimes.
Sick elders thrive in managed care because their care is managed. Bring them home and watch them sink back down to the bad place they were in when managed care was first recommended! 😮
For today, he's lucid enough to tell you he 'doesn't deserve to be in this prison', hoping that will get him out of the care situation he's in for his own benefit and well being. Tomorrow can and probably will be an entirely new man you'll be faced with; there's no rhyme or reason to this disease and it will keep YOU totally off balance, not knowing WHAT to expect every day. Do you want to deal with such a thing?
You weren't able to manage him when he was home before rehab, why do you think you can manage him now? Because during a lucid moment, he used some manipulative techniques to pull at your heart strings?
The definition of insanity is doing the same thing over and over again and expecting different results. If you bring him home, expect him to be the SAME man you couldn't manage LAST time you had him admitted to the SNF. Maybe even worse now that his disease has progressed.
You ask, Should I have tried harder to continue the unmanageable situation at home? The answer is NO, of course not. The fact that it was 'unmanageable' to begin with gives you your answer right there!
Please do not fall into the trap that 'home is the best environment' for a man with the conditions your DH is experiencing. You are not qualified to be a substitute for the CARE TEAM that's located in the SNF where he's residing now. Remember this when you feel somehow responsible to take him home or somehow 'guilted' into bringing him home. You have nothing to feel guilty about; you're doing what's BEST for HIM by keeping him where he's at. And you're also keeping yourself safe at the same time. That's your duty to YOURSELF.
Wishing you the best of luck coming to terms with your husband's condition and taking care of YOURSELF in the process.
hug!!! :)
i'm sure there will be all sorts of replies.
i suppose, mostly in favor of keeping him in NH.
but the BEST WAY, is not a majority vote.
i mean any advice that anyone gives on this website --- it's not about whose advice is most popular.
perhaps sometimes popularity (of advice) is an indication of the right path...
but there are so many factors (regarding NH/facilities)...
...we all have different morals
...we all have different situations (some situations with LOs at home are totally impossible to keep up...sometimes an NH is SIMPLY NECESSARY).
also, even with the best of intentions from people (everyone/me) on this website, we might still direct you in the wrong direction.
YOU (and your husband) are the people who must live with whatever decision you make.
-----
i'm only giving my opinion.
YOU know all the facts. i don't.
and as said, sometimes a facility IS SIMPLY NECESSARY.
here's my opinion:
if possible, keep your husband home.
hire competent/trustworthy caregivers.
we had bad experiences with caregivers through agencies (thieves; uncaring). i found good private ones, through word of mouth.
your husband is right now:
lucid, not falling, not incontinent.
---
of course that can change again, and he can get worse.
---
it's only my opinion.
there will be many opinions.
my opinion is:
give him a chance to live at home again.
i'm sure he would rather have 10 wonderful days at home, than 10 miserable months in a facility. (in the sense, that i'm sure he would say, "put me back in NH, but give me at least 10 days, 1 month, X amount of time at home").
----
hugs!
as i said, there are many factors - you're the only one who knows the whole picture.
you know what's best to do.
pre-new-year hugs!! :)
Am I sorry I brought him home? Yes and no. I would always have questioned whether it could have/would have worked. He mostly is lucid, just seems to lazy to get up even with PT. He came home from nursing home with bedsore on his tailbone; took several months to close and heal.
What I am trying to say is that there never seems to be a definitive answer. You will exhaust yourself rationalizing either way. Good luck. You will be in my thoughts.
He may seem better, but let’s face it…he wouldn’t be referring to it as prison or saying he doesn’t understand why he can’t be at home. You didn’t go into details of what all was happening at home in your post…but if he was incontinent, aggressive, wandering, doing unsafe things (leaving stove on etc) then he must not remember what all home was like for either of you, therefore, he is not really better. He is scared and that’s totally understandable. He may come off as mad (fighting w/nurses over bath), but he’s just frightened at this new situation. He and you will adjust. You understand it’s the best thing for him. You are not alone.
meds regulated … lots of eyes on him .. nurses … support workers etc
i think part of him knew it to be true
Especially as disease progressed …
and this disease only goes one way !!! IMO you can’t rely on him to make decision.. you have to make decisions good for both of you … their brain broken . I always felt horrible when he asked go home .. deceased now … but I think it was right decision… nice group of psw’s
aides nurses .. eyes on him 24/7
activities and lots people around … much better than being isolated at home with me or caregiver … waiting for someone to visit …
best luck
So if you can no longer take care of him, then you must leave him where you know he will receive the 24/7 care he needs. And you can tell him that he has to stay there until his doctor tells you it's ok for him to return home, which you know will never happen, so that way it will be the doctors fault and not yours.
It's hard I'm sure, but you have to do what's not only best for him, but you as well. God bless you.
There is nothing to make this easier, to make it OK, to make it without grief and heartbreak. When you think on it, is it not WORTH grief? Rage?
Guilt versus grief. Prison versus human limitation to provide care. We can use and switch about the semantics all we want. The only answer here is the honest answer. "You have _______________(insert the limitations) and I can no longer safely care for you at home because of my own limitations." And when the response occurs to say "I am so very sorry; I wish it could be otherwise. But this is where we are. I will visit you. I will do what I am able to do. But this is our reality, and I understand how much it hurts."
Being sorry doesn't help anything. We on Forum say it over and over. Sometimes grief is on the doorstep and we cannot keep it at bay. Accept it. Thinking we can cure everything is indicative of an omnipotence that belongs to the Gods. Not everything can be fixed. I am so sorry and wish you the best.
"You have _______________(insert the limitations) and I can no longer safely care for you at home because of my own limitations. Tears are rolling down as I write this. I know exactly how Pamilton is feeling, the lucid moments are so confusing and painful.