We just moved Mom into a nice assisted living facility yesterday (without her consent, as she has no logic or reasoning ability left at this point.) I believe it was the right decision but how do I deal with the feeling that I betrayed her trust? When I call to check on her they say she's asking over and over to go home. I know this is to be expected, but does anybody have any thoughts on how you can ease this transition? We've done the familiar furniture, photos, etc. What is missing is us, her family. The facility director recommends we stay away for a period of time to let her adjust, and I know this is probably necessary but how do I deal with the pain of knowing she's scared and not understanding why this is happening? And would I be doing her a disservice (getting her offtrack?)by calling ? How can I let her know we haven't abandoned her without interfereing with her getting settled in?

I know most facilities say to stay away for a period of adjustment, but consider the personality of your mom. We moved mom into an ALF against her wishes as well. Moving day was horrible when she realized she had to sleep there.
I went everyday after she moved in and sat with her talking to other residents somewhat "breaking the ice" for her to feel comfortable.

I encouraged her to go to activities and took part in this with her as well to help her feel comfortable.

Every person is different and if she wasn't open to new ideas before the disease she will likely be more apprehensive now especially without the coping mechanisms that most Alz patients lack. As I said before you know her the best and if you feel reassurance is what she'll need from you then visit.

Expect the adjustment period to last several weeks. Mom become alittle more relaxed as each day passed but throughout the two years she lived there there were always periods of "I've lost my house, I want to go home".

This is so timely. I, too, moved my mother to an ALF this week. I share your feelings of guilt and betrayal. They left it up to the family about when and how to visit, but did suggest if we visit we make them very short. We opted to send her adult grands (with babies) to visit briefly each day just to reassure her. She doesn't have the same expectations of them moving her home. I did go yesterday for a 15 min visit. She seemed ok with the statement -- Dr. ____ said you needed to stay here until you're better. This is indeed one of the hardest things I've ever done.

Thank you Lori & Cathy for your help. I finally just called and let her know I love her and I know where she is and I'll come see her just as soon as I can. Seemed to be OK. What a great resource this website is. Never had time to look into it till the last few days...

A Brighter Day...

Transitioning a loved one into a long-term care facility is often wrought with numerous emotional challenges including feelings of heartache, guilt, and pain, among others. And second-guessing oneself is only natural, particularly in the absence of any clearcut answers to questions that constantly occupy our thoughts.

There are two general schools of thought on how to best facilitate a loved one's transition into a new, outside living environment. The hard-line approach would be to do as you've been recommended - to abstain from any contact or visitations for a set period of time in the hope that the person will have adjusted to her new surroundings during the interim. At the same time, others take a more humane approach and suggest that you try to visit often during the first few weeks to help our loved ones feel secure.

What's tricky here is that caregivers are often trying to balance their own emotional needs with that of their loved ones, i.e., visiting a loved one to address one's own emotional needs while inadvertently making adjustment more difficult for a loved one. The point is that there may be tradeoffs as what's best for you emotionally may not be the best for your mom and vice versa.

All in all, I tend to side with the latter approach, and thus, would recommend that you contact or visit your mother as often as necessary to help her feel as secure as possible in her new surroundings. As has already been pointed out, every individual is different and circumstances may change daily, so a lot of this will likely boil down to just playing things by ear. I hope you find this discussion to be helpful as you consider your approach to the situation. Please feel free to call us at 800-272-3900 for any additional assistance.

We placed our mother two weeks ago. She has a phone and does not call during the day, due to the many activities at the ALF( for dementia). However in the evening the phone calls start along with the agitation. She has packed up her things five times since arriving. She keeps trying to leave--she's on a GPS monitor-. I had 18 calls on my answering machine today. Tonight when I unpacked her things and put up her pictures again, I didn't put the phone list in an obvious place. I didn't get one call tonight. However she did get her mild tranquilizer on my request tonight. I don't want a drugged momma but I feel she will adjust if she gets more sleep. I was informed she may not be able to stay in this wing of ALF if her behavior does not change. She'd be moved to the next level of care. I need some advice as to how to handle both the phone calls and agitation. She is sure she will be coming home every day I see her. In der independant mind she is still driving, and managing her affairs just fine. Sorry this is so long.

Dear Georgene,

What a difficult transition for both you and your mother. I am glad to hear that she has been able to remain active and engaged in activities during the day but it's got to be quite hard for you to have come home to up to 18 voicemails from her in the evening. Your idea to keep the phone list out of obvious sight was a great one. You probably already have, but I'd also encourage you to communicate with the staff about the phone calls and discuss ways that they may be able to assist with the problem. It is a fairly common one, though that does not make it any easier to handle.

Agitation is also a difficult thing to handle sometimes. It makes sense that she would be a bit agitated since she just moved two weeks ago. People with Alzheimer's have difficulty learning and retaining new information so this new home for her may not start to feel familiar for a while. Often, the best way to handle agitation is to find the right balance between behavioral interventions and medication. When you are with her, remind yourself that you are handling only one moment at a time. In each moment, reassure her that she's safe, that people care about her, and try to divert attention to other things. It will likely be a repeated conversation but if you're able to stay calm and keep your responses simple, she will likely pick up some of that energy. I think you are right in considering that she'll feel better and be less agitated overall if she is getting some good rest. So if medication helps with that, continue to work with her doctor on finding the most appropriate balance.

Lastly, it sounds like she is at significant risk of wandering and that despite the GPS device she wears, there are some concerns about whether they can keep her safe where she is. Another transition would surely be difficult for everyone but remain open to the possibility that it could also be the best thing to do.

Remember that there is no right or perfect way to go through something this difficult. Please feel free to keep using the Message Boards and also to call our 24-hour helpline anytime at 1-800-272-3900.

Sincerely,