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Hi, all. My husband and I have been caring for his grandmother for the last three months. She's now bedbound from a fall, and has also suffered two subdural hematomoas this year, leaving her with many dementia-like symptoms. She's receiving hospice care, but we've reached the point where we can no longer care for her full-time, as the stress of caregiving has induced psychosis in my husband.


Thankfully, an amazing assisted-living company from a neighboring town has just opened up a 5-bed, assisted living house here in our town, and they have one spot left that grandma can have. It can only be described as an answer to prayer, since a place like that was just what we were looking for (neither of us wanted her in a big, institutional facility). She's set to move there within a week.


How do we tell her about the move in a way that doesn't make her feel like we're "getting rid of her" or that she was "too much for us?"

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If she has dementia, she likely will not be capable of wrapping her mind around what is happening, but you do owe it to her to at least speak to her about the change.

Likely she will be upset, but with dementia, she will adapt. Your hubby needs care himself, and all of this is falling on you.

Make her room as 'homey' as you can and let the facility do what it does--and get some care for your DH.
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Are you sure an assisted living will take in a bedbound client? They know that. Right? I am just asking because bedbound on hospice, who cannot go to the community lunch area and not able to go to community rooms for enrichment programs, is more of a candidate for SNF.
As far as telling her of a move, the marketing person should have a lot of suggestions. You will need to keep it simple and repetitive as far as your answer.
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MavisBacon Aug 2022
I've confirmed that they do take bedbound clients on hospice, and regularly work with hospice providers in the community.
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You don’t tell her. You describe a pleasant homey place where she can receive the help she needs at every moment of the day and night, how close by you’ll be to one another, how there will be pleasant companionship, interesting things to see, good food……just stop short of AND YOU’RE GOING THERE WEDNESDAY AT 1:30 pm!

This IS an answer to a prayer thought, spoken, or otherwise.

If this decision has been made with love for all involved, any sense of negativity she experiences during her first days or possibly weeks there will quickly be replaced by the environment, and all its advantages, that you have chosen.

It’s VERY possible that you’ll experience her tears, complaints, and perhaps anger. Ask the social services contact at her new residence how they suggest you handle any negative reactions.

Hopefully you’ll be told to bring her calmly and peacefully to her new “home”, hug her and tell her you love her and that you’ll see her soon, and leave calmly and quickly.

You are doing what needs to be done. However she reacts it will be far harder for you and your husband than it will ultimately be for her.
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Saying in a nice way that she is too much for you to manage might be good. That could help her wrap her mind around why she is going there. Most of us don’t want to be a burden to our loved ones, and she probably doesn’t either. “Granny, you know we love you, and we want the best care for you. We’ve found a wonderful place, and…” blah blah blah. Then “we don’t have the training to make sure to do everything right,” blah blah. No mention of getting rid of her.
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iameli Sep 2022
I agree. I don't know why it would be so bad to tell her she needs more care than you can give, that you want her to be well taken care of. I'd think it would be better than no explanation, or one that doesn't ring true.
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My Mom was in her last stages of Dementia when I placed her in an AL and then LTC. Both times we told her she was going to new apartment and would meet people there.
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When we dropped my Mom off, they strongly suggested we not visit Mom for a week to help he to integrate and adjust better. We moved her in prior to lunch, ate with her and stayed all day. Leaving her was the hardest thing I have ever done. But I followed their advise and I think they were right.
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Can you tell her what you told us? Her grandson is so distraught that he can’t fix this situation that it’s affecting him in substantial ways and because you both love him, you and grandmother need to get her a level of care DH (dear husband) can’t manage. He can, fortunately, provide the best care at this local residence. You’ll call and visit. It’s just down the road. You made an appointment and move in next week. It’s a must do because it’s affecting DH’s career, health and he’d have would have lifelong guilt if anything happened to his beloved grandmother under his watch.

You know, throw hubby under the bus. Run a few tire marks over him for good measure. But it’s the truth, you haven’t blamed his grandmother and if she loves her grandson, she’ll understand you both need to do right by him. Better than, you’re getting demented and we’re shipping you out the door.

Good luck!
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Approach it as a team effort: this is the best way for us to take care of you. You will have 24/7 and we will be able to manage your care as well as our mental and physical health. Stick to the story till it becomes a mantra. “What is best for us, is best for you in the long run.”
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If she has dementia where she doesn't remember things, it is not beneficial to discuss it at great length ahead of time. It may be best not to use the word "hospice." That scares some people. Can you do her packing the same day that she will be moving? Just take what she'll need at the time she moves (clothes, personal items, TV if they don't have one in her room and if she watches TV, etc.) You can bring pictures and other things later, if they allow that. Don't bring valuables or personal papers with private information. On the day of the move, let her know that she is going to a place where she'll get the kind of care she needs and do your best to visit her often. Call her once a day if she can handle phone calls. Let her know that you'll be standing by her and visiting often. You'll be overseeing her care, so get the names of her case manager, and hospice personnel. When my mother had advanced dementia, she was miserable going to the hospital, so we added "no hospitalization" to her medical directives. Every change of venue is disturbing to seniors, with unfamiliar places and people. Would she be comforted by a visit from a trusted counselor, such as a religious counselor or a grief therapist? If so, talk to hospice about this. Her facility may also be able to arrange this. It takes time to adjust to moves, so don't panic if she asks to come "home." She needs more care than you can give, and she's better off in a facility that can provide good care. With my mother, who was in memory care, it worked best if I could time my visits so that I was leaving at lunch time, so that there was a distraction. Try not to feel guilty about the move. She'll be in a good place, and visit as much as you can to let her know that you're there for her.
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"The doctor has required this for rehab. Once the doctor releases you then you can come home" Yes its a lie but put the blame on the doctor. Usually patients accept the "doctor excuse" before they will accept anything else. I did this with my Daddy and he was good with it. His ALZ was bad and he still hated me but I put all the blame on the doctor. He didn't know what doctor and it doesn't matter.
prayers for you and your situation - been there
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Have u moved her in yet and if so, how did it go?
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MavisBacon: Perhaps you can something akin to 'Grandma, we love you so very much that we want you to have the best care.' You could be honest and inform her of the lovely home.
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I am so happy for you to have found what sounds like such a good situation for your husband's grandmother. A 5-bed AL right in your town! You might describe her new residence as her new apartment with a great staff to help her do those things she cannot manage on her own. Her being bedbound sounds like she must need a higher level of care than just AL, but if this facility can provide what she needs, congratulations. You might build it up as being lucky to get space in this new "apartment house."
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Grandma has dementia. No explaining will make it easier for her as she will not retain any explanation you give her.
A statement like:
"the doctor wants you to have more care than we can give you at home"
"the doctor wants you here until you are better and he says you can go home"
After she has been in the ALF for a bit just keep telling her
"grandma this is home." "you are home" "you are safe"
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