It is great being a part of an amazing association, National Association of Senior Move Managers, where the members all provide a lot of support to each other. Here is a question that was asked recently through our forum followed by a response provided by Marie-Claude from Helping Seniors.

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Question:
I am a Senior Move Manager and have a consultation with a parent who is expressing total resistance to moving from an independent living community into an assisted living community. She is experiencing dementia and is not recalling previous conversations the adult children and doctors have had with her.

Her son does have a POA for this type of decision.

I would love any suggestions for communication tips or how to deal with this situation in general – I know this won’t be uncommon. Thank you!

Recommendations:
Julie, I deal with this type of situation all the time. I am in Canada so please if anything I mention might aire on the side of legal stuff please obtain consultation to ensure the client you are assisting is well protected, protect yourself as well.

Here are some thoughts or comments that might help you:

From independent living community into an assisted living community:
First it is always a conversation with the independent community where she is living now. What is upsetting the balance for her right now? Is it that she is trying to leave the building(not secure anymore), cannot navigate the building, not eating, aggressive…. the list can be long. Can they support her?–can they add services/support to meet her current needs? If the community can’t offer more care/support is the son willing to hire private care, if the community allows that, to fill in the gap of care that she currently needs?
First explore if she can stay where she is. It will help her with whatever knowledge she has of living in the space that she is currently in.
If this is no longer the proper environment for her then a move sooner than later will be better. Sooner a move, will allow her to tap into as much memory as she currently has to allow her to establish new routines and familiarize herself as much as possible while she can.– more memory will allow her to settle in quicker.

Her reasoning:
She might not recognize the need to relocate. I can guarantee you she is still quite intelligent but might not recognize all the moving parts, or the need to move even if she is not in a ‘safe’ environment.
Can she still make her own decisions or is her son in charge of her completely? This could change things for the final outcome.
If she still has the right to make her own decisions then she can refuse to move—unless the community can no longer handle her –then the community might have to apply pressure for her to find a safer environment.
Memory loss is very ‘sticky’ in the sense of how to protect a person from themselves and to encourage them to be their own person. Not knowing her level of judgement it is hard to know what you need–discuss it, if you can, with the staff and the son. (careful here in terms of confidentiality and legalese stuff that you might get into! Do not go there if you do not feel protected legally or not comfortable with whole conversation)

Communication tips:
In communicating with her, communicate as simply as possible. Few words, not many steps or details. Go with her flow. Have her write notes on a piece of paper if she needs or whatever works for her.
Should you be in conversation in front of she please speak with her and not about her. Put yourself in her shoes at all times. She needs to be treated as a full person at all times and throughout the whole process.
If the conversation gets delicate and held back because of her presence, find a way to do it out of sight and out of hearing range.

Guilt level:
The son might feel guilty and unknowing how to move forward. He is facing a loss in his life. Remind him that what he is doing is to help his Mom be in safe environment. It is all about Mom and her current needs. Yes it is hard, but it is to find an environment where his Mom will bloom on a daily basis. (I get laughed at regularly for saying this but it is truly the ultimate goal of this whole process, and it is possible! Trust me.)
To remove some guilt and help the conversation remain open I strongly feel that the language used in every conversation is very important. Often we say to ‘place’ or to ‘put’ a senior in a retirement community….change that one word to move or relocate and it will change the whole conversation. My experience in this specialized field is that the level of guilt increases when we say to ‘place’ or to ‘put’ someone somewhere–they are not an object, they are simply a person with changing needs. Encourage the son to think of it that way, it should help him and the whole process.

Goal:
The ultimate goal is to find an environment that will provide the right level of care on her worst days and on the her best days an environment where she can bloom. An environment where is surrounded by people she can connect with and where she fits in culturally and socially as well as level of care.

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Should you want to discuss your current situation. Please call us or drop us a line and we will go through all your specific moving parts and guide you through this difficult step. info@HelpingSeniors.ca 514-748-7485