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Thursday, December 5, 2013
Transition to Dementia Unit
My family is moving my mother into an Assisted Living unit for dementia patients within the month. She`s been diagnosed with FTD (frontal temporal dementia) and has an attention span of approx 1 - 2 minutes (sometimes less). I`m not sure how to handle the transition of moving her into the nursing facility. If we tell her exactly what is happening, I know she`ll be very upset. However, I don`t want her to wake up in a strange place, not knowing what`s going on. Realizing that everyone is different, are there some approaches that are better than others?
Thanks for a very good question that I commonly get asked. Moving your loved one is never easy, but I do think there are some tips to make the transition possibly smoother. First off, I always recommend that families do preliminary moving and arranging of the person's furniture and possessions in the new assisted living apartment. Make it look homey and have several items of importance and familiarity in the apartment on the move in day. Items like pillows, afghan blankets, or quilts on the bed or and/or couch, familiar family photos on the wall or in a scrapbook, a favorite chair, etc.. can all be helpful in trying to create a warm familiar environment.
I understand that you feel it will be disturbing to your loved one if you tell them in advance of the move, and often they will forget this information quickly. I recommend that on the day of move-in you make it a "special visit" to the assisted living and refer to the facility as the new "senior apartment with wonderful services". You don't need to call it an assisted living facility with your dementia loved one, as they may feel they don't need assistance, even though they do (persons with dementia often have decreased insight in to their own deficits).
I encourage that you to schedule the move-in process to coincide with having lunch in the assisted living dining room, as this helps the person to see that this new apartment will have opportunities to eat good food and socialize with others. Join a table of other residents, introduce your loved one, help guide the conversation and interject about how lovely everything looks and how friendly everyone is. Then after lunch have the admission staff take you and your loved one to the new apartment and help familiarize your loved one with this new environment (bathroom location, call light, light switches, phone, etc.).
Then after you have spent some time trying to acclimate your loved one to their new home, you will need to prepare to leave. Often again the admission staff can help with this transition and come get the person and have them participate in an activity or continue on a larger tour of the complex while you leave. Let your loved one know that you will call later in the day to check on them and then will return soon to visit them. Yes, the person may be very angry about being left there, but that's when the assisted living staff needs to take over and work on engaging the person in the routines of the facility. Sometimes families will tell the person that the move is only temporary, they may say things like the old house is getting repaired or use some other reason for the move. This approach can be useful if the person is extremely agitated, but I do think that this can confuse the person who may continue to think that they will be leaving and may resist getting involved with others at the facility because of this.
Sometimes the facility may suggest not visiting again for a couple of days after the move-in, but I usually recommend the next visit occur the following day and can include bringing more items from the old home to the new assisted living apartment and possibly accompanying your loved one to an activity. Maybe make the next day visit brief, as you want the person to be encouraged to settle in to their new home and for the staff to work on building a relationship with your loved one. Most persons will adjust to their new homes and often enjoy all the activities and socialization. Remember, your loved one's dementia requires that families provide for their continued safety and care, as the person no longer can make these judgment calls and decisions. Good Luck!
Rebecca A Davis, RN, LISW
Clinical Research Nurse of Neurology
College of Medicine
The Ohio State University