Two week later: Big Changes

Mom was placed in a nursing home two weeks ago today.

Today, she was discharged from the initial institution and Dad and I
moved her 75 miles to Petaluma to place her in another facility that
was better suited to dealing with her "ambulatory Alzheimer's" . She
has now been placed in the only facility in Lake or Sonoma Counties
that has a locked Alzheimer's unit that is supervised and designed
for the wandering patient.

After promises and assurances that the first facility had the
staffing and ability to create a care plan for an ambulatory patient,
Dad was contacted at the end of the first week and told that Mom did
not fit into the services provided by the facility and she would need
to be moved. This created more stress and consternation then initial
placement had just one week earlier. Dad began to scramble to find a
bed in a more appropriate facility and the stress placed on him was
tremendous. After significant urging in a phone call I made, the
original facility agreed to assist in searching for an alternative
site but ultimately Dad did all the research and had to do his own
new private placement in the next facility. Very frustrating.

The original facility failed to do a full and appropriate patient
assessment which would have indicated the possibility that the
patient and facility did not "fit" each other. But no, one week and
then a request that she be removed and a second week to find a bed.

Strangely, Mom seems more subdued and at peace with less emotion then
she expressed just two weeks ago. Dad signed the discharge papers and
a wonderful staff lady had already dressed Mom and packed her
personal items and we were ready to get in the car and start the
drive. Mom had no questions, she was only momentarily pleased to see
either father or I and then she drifted into a nap while we drove.

I was very concerned about the admission process at the new facility
and I asked Dad to enter first and ask the director to have staff
prepared to receive mother at the front door. What a difference from
the place we had just left. We were expected and the staff was
already prepared with a program supervisor and CNA and the facility
director waiting at the door to greet her. The executive director
opened the door for Mom, said, "Hello Marjorie, welcome, we have been
a expecting you."

Mom burst into the biggest smile, said, "Hello, it is so good to see
you" and gave her a hug like she was reuniting with a long missing
daughter. The two staff greeted Mom by name, began chatting with her
and taking her by the arm gently urged her into the hall and down to
the unit. With the merest hint of concern Mom walked off and never
looked back.

Dad signed papers with the director and she answered all our questions.

I learned more about what a locked Alzheimer's unit consisted of and
left the meeting certain that the facility and Mother's needs were
finally matched and the care would be wonderful. I noted to the
director that Dad had not been asked to sign a "consent to restrain"
form and she explained that they were a "no restraint" facility that
allowed the patients in the locked unit to wander at will in the
locked area. Personal items are kept to a minimum and the Alzheimer's
patients are allowed to wander into each others rooms, nap on each
others beds and not be limited to "this is yours, do not touch other
people's things." She explained, what we already knew, that the
concept of personal possessions is one of the early concepts to
"leave" with many Alzheimer's patients and rather then fight the
loss, the patients are allowed to wander.

Reality Check;

I was quite upset that this move had to take place. It was upsetting
to Dad and it all seemed so easily avoided if better steps had been
taken two weeks ago to review an ambulatory patient care plan before
admission. But all my stress was for nothing. When I saw Mom greet
the new director with the joy of reunion with an old friend, I
realized more then ever that her needs are best met in a care center
and I think we finally found a match. Mom never said my name today, I
got the same level of greeting as the director and Mom had no tears
when she saw Dad, just a rather quick greeting and on to other things.

Next step, making a visit to Mom's new home.