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Saturday, 9 January 2016

With dementia timing of placement into care is important

Mum and I talked about the nursing home again when I went up to see her there today. We had only had this conversation the previous week. It is probably a conversation we will have again however, even though I think that mum is quite happy living where she is. She said it to me again today: "I'm happy living in the nursing home." And I don't doubt it for a second.

But I did tell her how she had resisted moving from her apartment in Queensland to a nursing home. We discussed how she had used to say "I don't think I need to go into a nursing home yet," and when I recounted this phrase to her today she was quick to add in her own voice "yet" to chime with mine at the end of the sentence. As if that made any difference to the meaning of what she had used to say in order to preclude a move. Of course it didn't make any difference if it was "yet" or otherwise, but for some reason mum likes to think that she was being reasonable by adding that one small word to the end of the sentence.

As if she would have been happy to move at some point down the track but not yet. As if. And it wasn't as though she were living independently. She had me coming over every evening to make dinner, and during the day to take her to appointments. Then she had her housekeeper doing the shopping, cleaning, laundry, and ironing. She was supported by two people all the time in that apartment, and that was the only way she could live there alone.

It had taken months to get from the diagnosis of dementia in March 2014 to the move in December of that year. It was around July - when I had brought the accountants into the discussions of the nursing home - that she finally started changing her tune, and accepting that a move was inevitable. But when we talked about it today we didn't talk about the accountants. "I'm sorry," mum said to me, in order to divert attention away from her previous recalcitrance in regard to the move. I told her it was ok, that we had made the move successfully. But I did underline again to her how important it was to move into care earlier rather than later for people living with dementia. I pointed to the problems we had had with dad, who had never really accepted that the nursing home was his rightful abode.

I think mum understands now how well the move had been managed. And in fact I feel quite smug about it all when I look back on all the things that had to be done in order to bring it about. It was a huge displacement of people and accoutrements - two households had to be emptied, and one relocated to Sydney - and even then it was not without hiccups. There was the scene when mum - having slept one night in the new nursing home - had packed her bags ready to leave with us when me and her housekeeper - whom I had invited to come down to Sydney for the move into the nursing home, in order to make sure it all went smoothly - arrived in the morning of that first day.

Now I look at mum ensconced in her lazy chair in her room and realise that she is perfectly settled in. She never asks when we're going home. There's always a compliment about the place on her lips. It's not a trial keeping her in place, as it had been with dad. With dementia you have to move sooner rather than later. Don't put off the shift into care forever, hoping to preserve wellbeing just for a bit longer. If you leave it too late they will never settle in the new environment, and they will always be fretful, anxious and worried. Timing is important when you are talking about putting someone living with dementia into care.

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