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VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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My spouse was deemed unsafe for home and discharged to a memory community after 911 taking him to hospital where he was diagnosed with mixed dementia (CAA and ALZ) and stayed for 10 days of medication management. Seroquel has leveled out his sleeping and most obnoxious behaviors. His level of cognition fluctuates greatly. He is most difficult when his cognition is higher but not high enough to realize he has dementia. He has many different delusions to explain to himself why he is where he is. These delusions include many different personas for me, sometimes his wife, or girlfriend, or boss (I own the facility and he is my employee), and lately his older sister. A frequently re-occurring conversation starts with the title of this question. He thinks that he is there because of legal charges that he was abusive or combative, thus this incarceration. I play along with the other delusions and personas but this one inevitably sends me into flight mode. He can talk me into a corner and all I want to do is escape and have him leave me alone. I usually start with this is not a legal issue but medical, which with his anosognosia, is obviously denied and "if I love him, I would be on his side and get his out of there". Any suggestions as to a better initial response or other way to approach this?
You are trying to reasonably explain to him why he is there, and he is unable to comprehend your explanation. I think you both might benefit from a little more separation. He is looking to you to "rescue" him from this and he knows instinctively how to persuade you. I'm sure he can sense you weakening when he makes this plea.
It is unfortunate that he has these delusions which I'm sure are confusing to him. But you can not fix that. You can not reason with him. Even playing along with his delusions until he asks you to help him leave.
It might be more stressful for him to see you come and go, while leaving him there. I would try backing away for a while and allow him to assimilate to his new surroundings. Let him learn to trust the staff and recognize, if not befriend, other residents. I wonder if seeing you is triggering him to think about going home. I take care of my husband at home. He is non-mobile, in a hospital bed, with dementia. Every time I walk in the room, it triggers him to "want" something. He doesn't always know what it is he wants, but seeing me just triggers an automatic response because he sees me as someone who will "do" for him. I'm thinking it is similar for your husband to see you as someone who will rescue him, so he will continue asking you every time he sees you.
Tell him this: every time you bring this subject up, I'm going to end my visit here. You are here UNDER DOCTORS ORDERS to be here and that's the truth. I love you but I'm not able to bring you home. Period.
Then stick to your guns and leave every time he starts in. You have a life too, and it matters. All this stress is not good for you. You need a standard line of defense each and every time with this man so you both are on the same page, no question. After awhile, he'll likely stop asking you, if he wants your company. If not, you get to leave early.
Your husband likely needs a med adjustment because agitation of this caliber isn't good for him either. Ativan worked well for my mother. But when she got ugly, I left her presence. We all lose when dementia is in the picture. Nobody gets off scott-free, ain't that the truth?? So it's imperative we take steps to protect ourselves from this soul destroying disease when it turns our loved ones into snarling people we no longer recognize.
Wishing you the best of luck with a difficult situation.
Don't make this any harder than it has to be. You just tell him that he's there because the doctors said he has to be there and he'll be there until the doctors say he can come home, which you already know they'll never say he can come home. Then you change the subject or walk away. And like CaringWife said below you may have to cut back on your visits and when you do go, try and make it during the day when his facility has him involved in some type of activity which will make it easier for you all the way around. Dementia sucks anyway you slice it. I'm sorry you're having to go through this with your husband.
There's a frustrated resident in my husband's memory care unit. He "knows" he doesn't belong there because he's not like the other residents. etc. Actually he can talk better than they can, and his mobility is better. But there's no question that he belongs there. His cognition is slowly fading; he's 96 and incontinent. He's also very angry at his wife who locked him up and never comes to see him (she did place him there and comes to see him several times a week).
How the staff handles this: When he starts his "let me out" routine, one of them will stand directly in front of him, blocking his view of everything else in the room. She tells him she knows how he feels, but the doctor has recommended that he stay there and this is where he lives now. Basically the same wording every time. She might take his hand or pat him gently on the shoulder. This conversation ends with her telling him that he is a valued member of the community or some such, and would he like some ice cream, or some other activity that he enjoys.
You might try some variation of this routine with your husband. I agree with others that you are over explaining. Keep conversations simple and consistent. Be firm. You do not have to defend yourself. You do not have to cheer him up. You do not have to fix his delusions. Good luck, and I'm sorry that you're having this problem.
Lots of great replies here for your question. My dad also had anosognosia and would swing between anger for being placed in memory care and delusions where he prepared tiny slips of paper to release through the small opening in his window into the public park below that said “this place is corrupt. Call the police or military. I’m being held captive “.
I want to offer support to you as you try to imagine how to respond to the ever changing thoughts and emotions that can be expressed by a loved one with dementia. It can be absolutely exhausting to hold a conversation even when they are calm and relatively oriented. Throw strong emotions, anger and delusions into the mix, and you must give yourself boatloads of grace at those times when you have to cut your visit short or when you set a boundary and stop a conversation. Learn to take home only the positives- a brief hug if you received one, or the thought that you made an aid feel valued. Leave the negatives at the facility. Hopefully you will find something to say that helps YOU feel better when your husband wants you to take him home. For my dad, I learned to say “Your doctors have you here to help with your memory. When your memory is good they will let me take you home.” Mostly my dad would say he didn’t have memory problems and I would reassure him that I’d make sure the doctors knew that he said his memory was fine. Occasionally he’d agree that his memory was bad. Good luck.
Ask the staff how is he when your not around. You maybe a trigger and as such you may want to cut down on visits. You don't have to be there every day. And when you are there, you don't have to stay long.
You cannot cure him, its going to get worse. Find something for you. Get involved somewhere. Start reading those books you have been wanting to read. If you sew, knit or crochet finish those projects you have been wanting to do. A friend of mine started going on cruises with friends. Her husband was in Memory care being well taken care of.
If he thinks he is there for something he did, you may just want to go along with it.
I’m wondering if it might actually help for you to go along with his delusion that he is there because of “legal charges that he was abusive or combative”. That you CANNOT “get him out of care if you want to”, because of the legal charges. They give you a special waiver to allow you to visit because ‘they’ know you love him, but ‘they’ won’t let you get him out.
Could this make anything worse? Could it get you off a difficult ‘hook’?
Agree,enter their reality and then gently redirect. Yes, the doctor said you needed to be here, look at this Apple I brought you, I think it’s your favorite.Would you like it with peanut butter or cheese, I have both.
“I’ll ask your wife when I see her” when he thinks you are someone else. The doctor ordered when that fits, the sheriff or the judge when that’s the case. Just let that be your go to. Never argue or ask if they remember something or try to overly explain. Walking out of the room is also good. It’s perhaps like a program playing in their mind. Each time you arrive, the channel has changed.
I did use the “I’m leaving if you continue that” on my DH aunt. She liked to tell a risqué story about an incident that happened to someone else. She knew I didn’t like it and would stop if I walked in on her telling it. It was odd that she had such short term memory but when I would ask her aide if she told her the story, the aide would say yes, she talks about it all the time. But she didn’t talk about it in front of me. So, it’s worth a try. She never wanted the aide to leave but the aide would put her purse on her arm and say “it’s time for me to go” and out she went. No problem. You might try that. No explanation just time to go. And go with purpose and no lingering.
This type behavior stops when they become less anxious as the dementia increases. Or that was my experience.
It Is so difficult And so sad when we see that our loved ones often have such a break with reality and they can accuse us of so many things. Perhaps as a former CNA I can give you some perspective from their viewpoint. They truly know at times that something is wrong with them but they can't piece together that it could be dementia or Alzheimer's. They may think that someone is doing this to them against their will. That they're being poisoned or held captive etc. I knew a loving couple who had been married over 60 years. The poor dear wife ended up with dementia and at times clearly thought that her husband had done something to her. She kept trying to escape and would open the windows and yell for help. This was so heartbreaking. The best thing you can do is redirect redirect redirect if you can. Try to break the chain of thought. Keep working with the doctors to see if adjustments in medications could be made. And most of all please remember that is terrible awful disease is no one's fault. It's not yours and it's not your poor loved one who is afflicted. Give yourself some love and grace.
I’m so sorry you’re in such a sad and frustrating position with your husband. He’s fixated on you being the solution, no amount of playing along or explanation is going to satisfy for long. I’m sure distraction also only works for so long. A broken brain is still capable of so much. Outside of the possibility of a different medication regimen to calm him better, seems you need to protect you both by not engaging in these conversations. Stop them when it starts, by changing the topic or leaving if needed. No answering or explaining, that will only cause further upset and more conversation that can’t be satisfied. Visit from “around the corner” with him not seeing you if needed on his most agitated days. I wish you both peace
I don’t disagree with all the advice to blame the doctor or redirect the conversation. If that works and is helpful, I agree with using that approach. In my personal situation, in caring for elderly emotionally immature parent, it’s important for me to say, I won’t take care of you. I deserve my own life and happiness and I will not be your caregiver. I will make sure you have paid caregivers and advocate for you. I will not be your caregiver because I have my own life. I realize it’s different than a spouse, I made no vows of matrimony. But in terms of my emotional growth and healing from a childhood with emotionally immature and enmeshed parents, it’s important to me to speak my reason and put myself first. Will old parent ever understand or accept this, probably not. I won’t get reactive and may loop in other things like doctors orders etc if necessary, but it’s important in my journey of self differentiation from enmeshed parents that I say, and hold true to the word No.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I think you both might benefit from a little more separation. He is looking to you to "rescue" him from this and he knows instinctively how to persuade you. I'm sure he can sense you weakening when he makes this plea.
It is unfortunate that he has these delusions which I'm sure are confusing to him. But you can not fix that. You can not reason with him. Even playing along with his delusions until he asks you to help him leave.
It might be more stressful for him to see you come and go, while leaving him there. I would try backing away for a while and allow him to assimilate to his new surroundings. Let him learn to trust the staff and recognize, if not befriend, other residents. I wonder if seeing you is triggering him to think about going home.
I take care of my husband at home. He is non-mobile, in a hospital bed, with dementia. Every time I walk in the room, it triggers him to "want" something. He doesn't always know what it is he wants, but seeing me just triggers an automatic response because he sees me as someone who will "do" for him.
I'm thinking it is similar for your husband to see you as someone who will rescue him, so he will continue asking you every time he sees you.
Then stick to your guns and leave every time he starts in. You have a life too, and it matters. All this stress is not good for you. You need a standard line of defense each and every time with this man so you both are on the same page, no question. After awhile, he'll likely stop asking you, if he wants your company. If not, you get to leave early.
Your husband likely needs a med adjustment because agitation of this caliber isn't good for him either. Ativan worked well for my mother. But when she got ugly, I left her presence. We all lose when dementia is in the picture. Nobody gets off scott-free, ain't that the truth?? So it's imperative we take steps to protect ourselves from this soul destroying disease when it turns our loved ones into snarling people we no longer recognize.
Wishing you the best of luck with a difficult situation.
Then you change the subject or walk away.
And like CaringWife said below you may have to cut back on your visits and when you do go, try and make it during the day when his facility has him involved in some type of activity which will make it easier for you all the way around.
Dementia sucks anyway you slice it. I'm sorry you're having to go through this with your husband.
How the staff handles this: When he starts his "let me out" routine, one of them will stand directly in front of him, blocking his view of everything else in the room. She tells him she knows how he feels, but the doctor has recommended that he stay there and this is where he lives now. Basically the same wording every time. She might take his hand or pat him gently on the shoulder. This conversation ends with her telling him that he is a valued member of the community or some such, and would he like some ice cream, or some other activity that he enjoys.
You might try some variation of this routine with your husband. I agree with others that you are over explaining. Keep conversations simple and consistent. Be firm. You do not have to defend yourself. You do not have to cheer him up. You do not have to fix his delusions. Good luck, and I'm sorry that you're having this problem.
I want to offer support to you as you try to imagine how to respond to the ever changing thoughts and emotions that can be expressed by a loved one with dementia. It can be absolutely exhausting to hold a conversation even when they are calm and relatively oriented. Throw strong emotions, anger and delusions into the mix, and you must give yourself boatloads of grace at those times when you have to cut your visit short or when you set a boundary and stop a conversation. Learn to take home only the positives- a brief hug if you received one, or the thought that you made an aid feel valued. Leave the negatives at the facility. Hopefully you will find something to say that helps YOU feel better when your husband wants you to take him home. For my dad, I learned to say “Your doctors have you here to help with your memory. When your memory is good they will let me take you home.” Mostly my dad would say he didn’t have memory problems and I would reassure him that I’d make sure the doctors knew that he said his memory was fine. Occasionally he’d agree that his memory was bad. Good luck.
You cannot cure him, its going to get worse. Find something for you. Get involved somewhere. Start reading those books you have been wanting to read. If you sew, knit or crochet finish those projects you have been wanting to do. A friend of mine started going on cruises with friends. Her husband was in Memory care being well taken care of.
If he thinks he is there for something he did, you may just want to go along with it.
Could this make anything worse? Could it get you off a difficult ‘hook’?
Yes, the doctor said you needed to be here, look at this Apple I brought you, I think it’s your favorite.Would you like it with peanut butter or cheese, I have both.
“I’ll ask your wife when I see her” when he thinks you are someone else. The doctor ordered when that fits, the sheriff or the judge when that’s the case. Just let that be your go to. Never argue or ask if they remember something or try to overly explain. Walking out of the room is also good. It’s perhaps like a program playing in their mind. Each time you arrive, the channel has changed.
I did use the “I’m leaving if you continue that” on my DH aunt. She liked to tell a risqué story about an incident that happened to someone else. She knew I didn’t like it and would stop if I walked in on her telling it. It was odd that she had such short term memory but when I would ask her aide if she told her the story, the aide would say yes, she talks about it all the time. But she didn’t talk about it in front of me. So, it’s worth a try.
She never wanted the aide to leave but the aide would put her purse on her arm and say “it’s time for me to go” and out she went. No problem. You might try that. No explanation just time to go. And go with purpose and no lingering.
This type behavior stops when they become less anxious as the dementia increases. Or that was my experience.
Try to break the chain of thought. Keep working with the doctors to see if adjustments in medications could be made.
And most of all please remember that is terrible awful disease is no one's fault. It's not yours and it's not your poor loved one who is afflicted. Give yourself some love and grace.