My mother has Alzheimer’s and refuses to move to senior assisted living. Now what?
This is a very tough – yet common – dilemma. You know it’s not safe for your mom to be left alone and you feel irresponsible if you don’t do something to protect her. On the other hand, you’re trying to respect your mom’s wishes, and you don’t want to make her feel that she’s been placed under house arrest or traumatically remove her physically from her home.
But because your mom has Alzheimer’s, “reasoning” with her will be very difficult – you don’t share the same reality. Here are some steps you can take to get her into a safe and nurturing environment such as senior assisted living while respecting her self-determination.
If your mother has not had a comprehensive geriatric assessment to arrive at the diagnosis of Alzheimer’s, get one by a physician certified in geriatrics. If she’s had this, arrange an appointment with her doctor and explain that it’s no longer safe for her to be alone. Provide the doctor with a list of examples that show she can no longer perform the tasks of daily living. Also describe your family support system and let the doctor know that you can no longer provide supervision for her at home. Ask the doctor if he could “prescribe” a week at a center for necessary treatment for her condition. If this is coming from the doctor in the form of a handwritten prescription rather than from her overprotective kids, your mom might listen.
By making it a temporary situation, you’re not backing your mom into a corner. Also, if her sense of time has been affected, the “week” might easily transition into a permanent solution. Another way of easing her into the idea might be to ask those in charge of the facility if you could bring your Mom over for lunch and eat there as you would in any other restaurant.
Dr. Roger Cadieux is a clinical professor of psychiatry at Penn State University’s Hershey Medical Center who practices adult and geriatric psychiatry. When asked how he would handle this situation when he has the hard data from a geriatric assessment, he said: “The approach that I use is to sympathetically but firmly present the findings and then state definitely that there is now a need for a higher level of care. There is usually a great deal of distress but the anger, if any, is directed toward the physician and not the family. I make sure that the patient understands that I am their advocate even though I am imparting difficult information. The trick is for the family to find a physician who can and will take this approach.”
Dr. Cadieux recommends giving the patient the opportunity to participate, if possible, in the process of finding a facility that provides a higher level of care. When warranted, he added, medication, especially low doses of antidepressants and/or antipsychotics, can make the difference between easy acceptance or abject refusal of this necessary move.