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I apologize because I'm fairly sure this is a duplicate of a recent post. One month ago my dad landed in a MC living situation. The anger has diminished, but he is still imagining that he's being detained by the military for questioning. He always has his possessions packed up in small bags that he's removed from his trash cans, and he forgets what he has packed away so he thinks the staff are stealing his stuff. He is always scheming on how to escape, and he claims he is going to start being more nasty to the staff to try to get out. I can distract him fairly easily, but when I'm not there he is starting to refuse to take his medications. I told him to be nice to the staff, that they are only trying to help him. I read on this forum (I believe) that it might be helpful to leave a written note on why he's there, but I cannot seem to find the post. I've been telling him "this is your home so they can keep you safe and help you with your memory". I wondered if leaving this written for him to see might be helpful or if it would just make him more agitated. Recently he underwent his 3rd neuropsych evaluation. This confirmed that he definitely needs to be in MC (They suggested that this specific MC was the safest place to administer "psychotropic management") , but also noted that he is still above average in verbal skills, "which could easily fool the untrained observer", and that "he is completely unaware of his cognitive deficits, which could make it difficult to treat him". So I'm also wondering if a note will accomplish anything (plus the note will get packed up). I've brought pictures and other items to try to make his room more "homey" but he keeps giving them to me to take and keep safe from "being stolen". It is really hard to see him so unsettled even after a month. There isn't another MC facility in my region that offers the level of services that I fear my dad will need eventually, if not now.

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Just a thought…if he thinks he is in the military and feels his “stuff” is being stolen, maybe a footlocker or a locking cabinet will give him some peace? I keep hearing that we need to go to their world, not force them back to ours.

As far as meds, maybe introduce some of his nurses as “Captain” or other such nomenclature. If it works, he’ll think they have authority to help him.

im just kibitzing here, hope it helps.
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I like the military idea. It’s cheap and easy to try. Maybe an American flag, a foot locker, pictures of Uncle Sam and Norman Rockwell, patriotic music - things that make dad feel safe and. Things the enemy would never allow. Maybe he can reframe his thinking to military base and the lockdown is to evade the enemy or because the general said so. Good luck and God bless..
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He wont remember a note. He'll lose it or forget where he puts it. It's easier just to keep repeating yourself.
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Your father is in the right place! He’s in the ‘adjustment period’ which may last a long time since he has an awareness of what has happened. His anger, hallucinations and delusional episodes (being detained by the military for questioning) are common symptoms for a dementia patient. Following his neuro-psych evaluations, did you receive a copy of his treatment plan going forward? If he’s on meds and they’re not working, speak to the doctor and ask if the dose can be increased or if he could benefit from a change of medications. My Dad – who outsmarted many a physician and firmly denied that he had dementia to the end - exhibited similar symptoms and benefited greatly from medication.

Leaving a written rationale as to why he’s been moved to MC is likely to further agitate him (why rub it in?). Instead, you could leave a note telling him when to expect your next visit to reassure him that you’re coming back. Be patient. He’s struggling. So are you. Give yourself a break.
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Dementia behavior is extremely difficult & frustrating to deal with, that's for CERTAIN! Leaving dad a note is unlikely to help him 'remember' or understand why he's in Memory Care, not at his stage of dementia anyway.

I suggest you read this 33 page booklet (which is a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it. Medication isn't always the ONLY answer for 'behaviors', either; it's more about how YOU respond to HIM that makes all the difference.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.” For people to understand that reality and context as perceived and experienced by a person with dementia, is altered by the dementia; and, that their reality and context is continuously changing as the dementia progresses, requires learning and an attitude shift; it is not ‘common sense.’

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

Another good book is Living in the Labyrinth: A Personal Journey Through the Maze of Alzheimer's, by Diana Friel McGowin. Learn all you can about AD/dementia b/c knowledge is power!

Wishing you the best of luck with all you have on your plate.
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HonorAble Feb 2022
Thanks for the helpful information. I was able to download Understanding Dementia Experience and it was so comforting and definitely gave some helpful tips.
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Hmm I initially wrote notes and / or instructions for Mum (she even had a white board) but then realised a few months later that she was no longer able to read. She loves flicking through magazines still but I became aware it was only to look at the pictures and she’d get impressions from them. If his imagining his being detained / forgetting what he has packed, how confident are you in his reading ability? Mum still has full on conversations with me but can’t read or write, she knows she’s home but has those similar attributes of thinking someone has snatched something of hers. You can give it a go but it may only work a few months. I use video suirvaillance for Mum these days. Each morning despite being in the same house I give her a little talk via that,.. like good morning, it’s Tuesday it’s a nice sunny day, open your curtains, coffee is ready, will you please look for some cool clothing. There are some ready on the chair, I will come check on you shortly. That way it gives her a little independence and assurance and time to wake up before I get there to assist with anything that is left to do. I just find it easier because she can be a bit grumpy first thing in the morning and slow. I’m trying to fit full time work in with all this caring so if she can start on the process on her own, it’s of benefit and as I said,.. helps her feel independent, like it’s all her ideas. Could you reassure via video?
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HonorAble Feb 2022
H


I will ask about video. Thanks for the idea. His room is quite small, with a separate private toilet and sink, so it might be too intrusive to set up video. Weirdly, he can't "hear" me on the phone either... though his phone and hearing aids check out fine. He just keeps talking and complaining on the phone and barely pauses to listen, then just says "I can't hear you". I was going to ask his neuropsych doctor about this because I noticed his evaluation said his auditory memory was severely impaired. Maybe he needs face to face to even process what I'm saying any more? Yes maybe video would be the key.
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No, a note won't help. He will read it and probably forgot within minutes what he read.

Your Dad is in his own little world and you play along. If he thinks he is in the military his mind is telling him he is in the military. IMO they go back in time. My Mom forgot my Dad. When asked about her kids, she had none. I think she thought I was her Mom. My GFs father did the same thing your Dad is doing, packed up everyday.

There is really nothing you can do. Seems he is on meds to help with some of his problems. They staff have ways of getting him to take his meds. Putting it in pudding or yogurt.

Everything you have described is someone suffering from a Dementia. He is in the best place he can be.
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HonorAble Feb 2022
Thanks for your helpful reply. And thanks too for reinforcing that he is in the right place for the best care.
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Have you had a chance to watch any of Teepa Snow’s videos on YouTube? They have helped me understand so very much, since my mother needed to move to Memory Care.

Teepa says that with a dementia, a person’s field of vision can change.

So, if we write notes for our loved ones, many times, they cannot even see them, let alone remember that they’re there.

Best wishes to you.
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HonorAble Feb 2022
All good suggestions! I am on a wait list for Teepa Snow at the library. It’s interesting they don’t see the way they used to either! I didn’t know! Their world really does shrink! Thank you so much for your reply.
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I hear you loud and clear! My mother is still home but is always thinking of ways to get rid of home health care aids/helpers. I don’t have any answers but understand how hard it is to see a parent unsettled daily. This forum is so helpful at calming me after I spend a few days with my mother who was such a nurturing mother over the years. I want her to feel safe but can’t seem to accomplish it.
I’m hopeful people will share their experiences with us.
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Don't waste your time. Your father lives in a world that is different than yours.
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