T:<institution> or <institution>?	Q:My mom was diagnosed with vascular dementia <time_period> ago. She currently suffers from hallucinations,  total incontinence,  and is very confused. She was hospitalized for a UTI,  and from there moved to a <institution> for physical therapy. She has had <num> bouts with cancer (the last time it was lesions on the spine) and it has left her weak in her arms/hands and back. Her <professional_practitioner> advised that she should not return home and requires full-time care. I have been taking care of her for the last <time_period>. She hates the <institution> and is not very cooperative with the medical staff. I recently found out that she has some insurance that pays <num> of an <institution>,  but does not contribute to <institution> care. I found an <institution> that houses all stages of alzheimer's/dementia patient from beginning to end. However,  they told me yesterday that if the patient ever gets to the point that she is no longer able to feed herself,  I will have to hire a <professional_caregiver> or a family member will have to be there <num> times a day for meals. I'm the only child. I know that she will be happier in her own little suite,  but am I sacrificing her care by placing her there? They do have a 24 <professional_practitioner> and 24 hr <professional_practitioner>. I don't know what to do.  	A:Are you able to care for her full time? Does she do better being at home? Do you work? Can you hire a <professional_caregiver> to be with her during the day (or night) if you do work or when you need to go out?


A:<name>, She would be happy at home and I could hire <professional_caregiver>,  but the problem is she is very uncooperative. She argues about everything from taking a bath to changing her depends. That is how she ended up with the UTI and a bedsore. And this was even with home health coming <num> times a week. On their off days,  she sat in a chair with the same depends on for <time_period> in a row. When I tried to get her to change,  she refused. And she smoked at home. She burned holes in everything and we're lucky she didn't burn the house down. I had retired to stay with her,  but she just won't cooperate at all. That's why the <professional_practitioner> want her in full time care. When she was in the <institution>,  she refused to keep her IV in. She pulled <num> of them out and told the <professional_practitioner> that she was going to keep doing it if they put it back in. She's acting the same way at the <institution>. It took <num> aides to hold her down to take a <diagnostic_test>. She's just too much to handle. But I do want to make sure she gets the best care she can get.  


A:Ah ok. that makes things a bit clearer. Unfortunately,  I hate to say this,  and I rarely do because I HATE <institution>. she might be better off at one. <institution> are more or less for people that can still somewhat care for themselves. Granted there are AL <institution> for advanced AD patients,  if you can get her into one of those,  that would be even better but many of those AL <institution> don't want to deal with advanced dementia patients even if they say they take them. You can look around and see if you can find an AL <institution> that can care for your mother but more than likely they won't. <institution> are designed to handle and deal with advanced patients such as your mother.  It's a sad situation all around and I feel for you,  truly I do. My heart just breaks for the elderly that are in this situation as well as for the family members.  If you decide to put her in <institution>,  look that <institution> up online,  with the BBB (if your in the states) or other reviews and make sure they have a high rating. Never ever under any circumstance should a person be put in <institution> that has complaints filed against them,  especially for abuse or neglect.  


A:I'm going to investigate more about the <institution>. They say from beginning to end Alz. support,  but if they don't feed those who can't feed themselves,  I don't think that's right. That IS one of the last stages and you can't wait until they get that bad and then not give them the support that they need. I'll probably leave her where she is. It is a very clean place,  no complaints filed and they have a lot of activities for the patients. I hate <institution> too,  and right now my Mom is hating me for putting her in there. Sad places,  but I know they have their purpose. At least she is clean and safe.  Thanks for your support.  


A:I'm glad to hear she is in a place that is clean and has no complaints. She may hate you now,  but just keep in mind that she still loves you if that makes sense? It's a really hard situation to be in,  but you have to do what is right not only for you,  but for them as well.  


A:Here's a few ideas. My gma (RIP,  she passed away earlier this <month>) had dementia. Her <professional_practitioner> said she needed round the clock care,  so I moved in. SHe had me 24/7. And it seems like things are esculating to where like <name> told me before,  It sounds like mom needs a med adjustment. As a soul caretaker,  you can qualify for in home care,  with the Adult And Family Services. You can respite,  nursing,  cleaning,  shopping help. In fact I even did meals on wheels just to give me a little of a break. Sounds strange,  but baby proof your house,  including the doors and windows. You can get motion door dectors at Walmart,  we rigged it to every time the door opened the alarm went off. If I was going out,  I would flip off the alarm and enable it again. If that won't work,  then it is time for <institution> or <institution>.  


A:No,  you are not compromising her care,  <name>,  by placing your mom in a <institution>. Your mother is not the same person she was <time_period> ago,  and it's a condition that grows steadily worse. You also must guard your health as well as that of your mother. Placing her in <institution> enables you to have some peace in your life. You may always visit each day to make sure she is getting the proper care there,  and still return home for rest and calmness. You need that very much.  I worried myself sick over the same situation,  except that I was not the only child; I was the one who had the situation that permitted me to be a caretaker until Mother had to be placed in a <institution>. I had the support of my brother and sister,  but Mom's care was in my hands. Alone,  it is much more difficult for you personally,  so provide ample time for you to recover from the stress and feelings of helplessness that occur when a parent's life is ending.  Visiting her daily if possible provides her with assurance that she is not alone and that she is still loved,  despite how angry she may be with you. (Anger is a frustration of the drive for love.  )You will have some comfort in knowing that you are doing the best thing possible under the circumstances. (And you still keep your eye on how she is cared for.  ) Have you thought about having a <professional_practitioner> talk to her for a little while to determine if an antidepressant might work for her anger issues? Or a tranquillizer? Strangely enough,  Mother's strokes removed all anger from her. Seeing her each day,  even bringing in things like a wallpaper design that you may be planning on doing at home help keep her interested in what's happening in life outside the <institution>. Bringing a fresh plant or flowers occasionally is appreciated,  as well as a treat at times. I remember how much Mother enjoyed being wheeled out to the garden at the <institution> just to sit and look at flowers and the world outside.  Take care.  Good wishes, <name>Post Edited (<name>) : <date><time> (GMT-6)


A:<name>,  I think I'm getting a little more used to her being there,  but it is still hard. The N/H <professional_practitioner> had upped her anti-psychotic meds and the <professional_practitioner> had to reduce it again because that was when the anger got out of control. I think it's leveling out now. She's a small woman,  and it was just too much for her. She also has a new roommate and she thinks it is her sister,  so that also has eased the stay just a little. I'll just keep praying it gets easier for her to accept. I sure don't want her hating me for the rest of her life. It's just a tough thing to do to someone who has taken care of you when you needed it. Thanks for your support.  


A:Yes,  I know it's hard,  <name>,  and you must understand that she really doesn't hate you. Her world is totally different now from the world you knew as a child.  And I know what it's like to take care of a child. It's all part of love,  <name>. And it's a lot of love we give them when we help them to have a life as healthy as medical science and a clean environment will provide for a very ill mind and physically weakened body. I'm so glad you have psychiatric aid for her; that should relieve you about understanding how her intellectual functioning has been transformed. It's good that she sees her roommate as a sister. Hopefully,  the other woman has a positive view also.  Try to have some social life away from the <institution>,  <name>. You need to maintain your psychological health while you're enduring this,  and friends who play bridge--if you do--would enjoy having your company. Give time to your husband's interests if you are married,  and look for the day when you will have learned through this relationship that you did the best anyone could do under difficult circumstances that are hard for anyone to have toendure. You will be blessed for your sacrifice.  My prayers will go up for you and your mother from time to time,  and I hope you will continue to post as you feel the need.  <name>Post Edited (<name>) : <date><time> (GMT-6)
