Coming home for visits: Good idea or bad idea?

My 76 year old father was diagnosed with vascular dementia and moderate Alzheimer’s earlier this year. He also started having small strokes. This diagnosis came after several episodes that eventually lead to him asking us to take him to the hospital in the middle of the night. The most dramatic episodes seemed to stem from when my mother got sick last winter. She had some fairly significant medical issues that forced her to spend a month in hospital. When she was in hospital the rate of decayed in my fathers conative functioning was very visible. It seemed that he had no idea where or how to start taking care of himself i.e. what to do with mail (bills), how to feed himself etc. He was always very capable around the house over the past couple of years had becoming increasing confused over simple things. He eventually starting leaving burners running on the stove, starting electrical/wiring projects and not knowing how to finish them (getting electrocuted), falling and hitting his head while walking the dog. Doing plumbing jobs and causing the house to flood etc. The medical issues with my mother seemed to push him right over the edge. He eventually hit someone with his car and lost his driver license. The person was ok (thank god) but immediately following that event my father sank rapidly.
After a month in the hospital and family meetings we determined that my father needed to go into a care facility because my mother, although back home and partially recovered, does not have the ability to take care of him and her own issues as the same time.
Now my father is in a care home and trying to adjust. It is only a couple of miles from home so it is easy for my two brothers, my mother and myself to visit. My sister lives about 30 miles always so it is a bit more difficult for her to visit. This brings me to the point of the story. Although we have all been dealing with this in our own way we are all, with the exception of my sister, in agreement that my father cannot come home. He is very likely to burn the house down or work with power tools and injury himself, fall down stairs etc. My sister has been taking it upon herself to visit the care home and take my father out which we do no have exception with. She has, however, been brining driving him by his house which has been causing us all a great deal of concern. He seems to now feel he is working towards coming home and it is causing him great distress in the home after one of these events. The next day there are several phone calls to my mother from him asking/pleading for her to come pick him up. He is packing all of his belongings and putting them by the door. To make matters worse my sister actually brought him home while my mother was out (without her blessing) and sat around the table for a chit chat. She feels he is entitled because it is his home. We have asked to stop making these decisions on her own (unilaterally) but she will not. She feels she somehow knows better and that is it good for him. In the interim my mother is working at getting the home ready for sale so she can move to some type of supportive living facility.
Has anyone ever dealt with something like this? When, if ever, is it good to brining an Alzheimer’s patient to their old home for a visit that he can never really return to? How do we deal with our sister on this issue?
Any help or advice would be greatly appreciated.

My Mother is in an Alzheimer's facility, and has been for the past 6 or 7 years. She is now 86 years old and has deteriorated to the point that she no longer shows much recognition of our presence when we visit. My sister is a nurse and she lives only about 30 miles away from the facility. She visits with regularity, every week or two......my brother also lives a similar distance from Mom. However, though I am retired, my home is 300 miles north of her. I try to get down to see her every couple of months, and get frequent progress reports from my siblings, esp. the sister. We always try to get together as a family, with the grandchildren in attendance also, when I go down on one of my bi-monthly visits. She seems to enjoy being a part of the group, even though she might not be able to recognize us as individuals.

In the earlier years, we made an effort to check her out once in a while and take her out with us to dinner. She was always calm and manageable, never made a fuss in public. On holidays, especially Christmas, we would take her over to my sister's house for the big dinner and give her little gifts, listen to Christmas music and show her the tree and its ornaments. She seemed to get a kick out of the whole get-together and we all enjoyed having her with us. Certainly, Alzheimer's is "the long goodbye."

In time, she began to show discomfort and anxiety when taken out of her element at the facility. She had become co-dependent on her nursing caregivers and she loved being in their presence and they seemed to love her as well. She was pretty easy to take care of, and they all called her "Granny". She always seemed relieved when we took her back over there after one of our little dates with her. So, in time, we stopped taking her out altogether. We just sit in the common room and talk with her there. We often take turns feeding her and making a fuss over her. Alas, her response to us has diminished greatly over the last year or so.

Well, I would say to you...be observant for this kind of metamorphosis in your Dad. When he starts to show more nervousness and discomfort when he is taken out of his environment than he demonstrates enjoyment......you have crossed the line in the sand. Leave him there and try to make your visits as loving and uplifting as possible. I often ask myself if I am being selfish in hoping that Mom lives a few more years. Dad has been dead now for 20 years. Should I just be gracious and let her go and join him? But, when you can still wrap your arms around that little, 98.6 degree woman who brought you into the world, and can look into those tortured, sweet blue eyes, it is so hard to release her to a better world.

Good Luck with your Father, and God Bless you and your family.

Hello .......

I know this post is a month old, but I wanted to address this issue.

It really depends on the individual patient.

We regularly kept my father going as long as he felt like it and his nurses and doctors encouraged it. And we would take him by his home and to the cemetery to visit Mother's grave if he desired it, but he understood that he couldn't stay at home due to many factors including the need to be treated with medical equipment at the nursing home. One thing different from the above situation is that my mother was gone and home was not home to him any more. He eventually didn't want to go there anymore.

Every Saturday my sister had her big family come for an evening meal and someone would always pick him up and take him back even though it was a 60 mile round trip. We all shared in his outings and it helped keep him from feeling like a prisoner. His sister lived close to the nursing home and her children would pick him up for a visit to her house. It helped keep him from even more depression. But my father's illness didn't lean toward any violent outbursts as some patients unfortunately can. We did have to watch that he not suddenly decide to relieve himself on the spot since he had his bladder function compromised and his AD made him uninhibited at times.

Family members do disagree at what's best and if it's where all can sit down and talk about what's best for both father and mother it makes things a lot easier. An Alzheimer patient is still in need of connections to their former life. If a family member is willing and can handle the patient outside the nursing home AND if they aren't going against his medical treatment or putting him or others at risk, let them do it. With this situation, the father might be less inclined to try to go home if he's allowed to go home, if he knows he has that to look forward to each week. When the time comes that it doesn't work, that's when you rearrange the plans.

My family didn't always agree as to what's best, but you sometimes have to compromise. We had to pick our battles for our father's sake.

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55 yr. old--CD over 43 yr. Hemi-colectomy '01; spinal cord injury '01; fistulae since '97; enteropathic arthritis, chronic pain, muscle spasms, scoliosis, rotator cuff injuries

Sometimes I have a wicked sense of humor, other times I have no humor at all, but most of the time I just have no sense.