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My wife with dementia is in the psyh ward of our local hospital. I have been visiting every day for as long as they permit, helping her with meals, removing her restraints and walking with her. Am I helping or interfering with her care? The nurse and caregivers are are so nice they would not ask me to be less involved. But I feel my being there prevents them from doing what is best for my wife, such as restraining her, and undermines their authority in her mind and is not helpful. Should I practice tough love and reduce my interference for my wife's sake.

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Warren; you have SO much insight into this! I think if I were in your shoes, I would ask the Director of Nursing or the Social Worker for you wife's case what they think.

In general, when a dementia patient is making a permanent transition to a facility, if they have been prone to throwing tantrums, for lack of a better word, some places advise families to stay away for a week while the patient gets settled. (I could never do that to my mom; she doesn't have tantrums).

But your wife isn't making a permanent transition to a psych hospital, at least I don't believe so. She's there to get her meds adjusted. Tough love works when the patient has the capacity to learn from it. Sadly, most late stage dementia patients (which I believe is how you characterized your wife in another post) no longer have the capacity to learn from experiences.

But I would be guided by the professional, supervisory staff in this instance.
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I will ask the nurse but since they are so nice I'm sure they will say 'please visit often and help in any way you wish'. That is probably what they are told to say. I'm looking for an honest answer for what is best for my wife. I certainly don't want to hinder their good work.
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Warren, from my experience with my mom, and from reading on here, if you are visiting too much, or getting in the way, they tell you. When my mom was in rehab, both her PT and speech therapist asked me in the nicest possible way to mot show up for every therapy session.
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How are you holding up? Asking her doctor would be the best thing, as described above, but I would also consider your mental and physical health. Being in a hospital in that capacity is very draining. I'd consider how to keep your reserves up, since, you are dealing with so much. As long as she's getting excellent care, I'd use some time focus on things that need attention elsewhere and to recharge your batteries.
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Thursday 8/25/2016 9:40 a.m.
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Warren - I truly believe they would tell you if your visits were detrimental to your wife. The medical staff will put your wife's care and recovery well above being cordial to you. I'm sure of it.
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Warren I think you are helping your wife by feeding her, supervising when the restraints are off and walking her around. Even nice staff will advise when you are being harmful to her treatment. From your descriptions I believe your involvement can only be helpful. She is in a strange environment and it must be frightening to be restrained.
I found it very annoying to be in a bed or chair with an alarm plugged in because they said I was fall risk and not allowed to move to sit on the bedside commode without summoning an Aide.
No one can tell how much your wife comprehends at this time but if she appears to be comforted by your presence keep up the good work you cannily do good. however i would add do take some time for yourself, you need to be strong if she returns home.
You are being very helpful to the staff because all the time you spend with your wife is time spared for them.
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babalou

What kind of PT and speech therapists are they? Many encourage family participation because it can be an aid to the patient.
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They were terrific therapists. I was inserting myself into the situation to the detriment of my mom's therapy. ( I'm also a clinician. There are times I need to do this).
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I think you could pull back a little and see what happens. Talk with the staff. Make them aware of your thoughts and that you are going to pull back some as a way to improve her independence. Then adjust as needed working collaboratively with the staff.
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As Babalou says, tough love has no applicability for dementia patients.

As several posters have pointed out, the nice professionals really would be honest about it if your visits were interfering with your wife's progress.

And as Sunnygirl points out, your strength and stamina need to be considered, too. If the visits are getting to be too much for you, it is OK to cut back some.

You are getting good advice here!

8/26/2016 6:06 AM
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My mom just spent a month in a geriatric psych facility where visiting hours were only one hour a day. My mother who is in a nursing home, is very dependent on me. It is always a problem if I leave town for a few days as she gets agitated when I do not visit, I felt like I should not go to the hospital every day so that they could have an accurate picture of the agitation without me and adjust the medications accordingly.
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Warren, you wife's situation is a little different than say, someone with dementia going into a nursing home but all the same, I believe that you are likely helping her and the staff would tell you if you should back off. Talk with the doctor about this. If he or she thinks you visit too much you'll be told.

However, you do have to consider yourself, as well. This is for the long haul and if your physical or emotional health breaks down you will both suffer. You need to take some time for yourself and do what you enjoy - guilt free.

Try to find a balance that is best for your wife and still gives you breathing room. I can only think that your visits are helpful in that people can easily feel abandoned if they don't see people they love. But every day may not be the best.

Talk with your spiritual leader if you feel that would help.

Again, balance is what it's about. Take care of yourself and you are taking care of your wife.
Carol
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Hi, interesting question, Warren, good for you for asking it. It sounds to me that you may be asking about how limit setting might be good for your wife - and I believe most people don't understand how to do that in a positive way. Having no limits or routines can leave situations that don't respect everyone's needs.

I would include some times with your wife, that you start to work on telling her you will leave in half an hour, ask her if there's "anything else" you can focus on while you're there - asking that way helps my disabled bro to suddenly find some issue, and we talk about it. When I leave, I always hug and say I'm glad to see you, you're doing great, keep it up. Then any more hugs as needed, but once you're leaving be sure to leave.

Too many people don't set any limits, and then over-commit and get tired, or when they start giving them, don't give much warning, then get upset and show anger during the departure - all unhelpful ways that don't help a fragile or frightened person to trust and take departure as part of the process.

I figure psych hospitals are not just about meds, but about the chance to have some limits placed, in a place where staff will allow them to learn to meet them, for too often in homes, limit setting involves endless conversations, which are in the end, held against the pt., but using loving, yet clear and generally firm strategies, can help all work well together.
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If the psych stay is to regulate her behavior through appropriate meds. so that she can move to another facility and your visits are keeping her under control then the goal isn't being accomplished. She needs to be able to interact appropriately with other people and the staff needs to evaluate those behaviors in order to medicate her properly. If you feel the need to visit her daily, I would suggest an hour or so but not all day.
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I meant to add, as you are leaving, tell her you'll be back soon and you love her, and a hug and then leave. I would guess you do all those things, and it sounds as if you are kind to her and the staff and they are glad to have you adding the positive parts of life to your wife's time there.

My sister spent many times in psych units. My visit was able to turn her direction around, one time, when others did not know her and kept applying general rules etc, and she thought she was evil and should be locked up. As her sister, I was able to say, no, I know you and you may sometimes be thoughtless but you have been a caring and helpful person. You're not "evil", sometimes you are "a pain in the ..." And I helped her, we did coloring together when I was there, both enjoyed. And I urged her to say thank you whenever she could, to staff - within a few weeks she was having no more crises, and she gradually recovered her identity as a leader with a good heart.
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Warren the staff might be the sweetest people in the world, but they're still professionals and they will still have their patient's best interests at heart. If you've told them to be honest with you and they are still welcoming your assistance, I really don't think you can be in the way.

There is another consideration, though: if *you're* finding it harrowing, or hard to keep up with, you must not feel bad about taking time out or just easing up a little. Don't forget this is a really rough time for you, too, and you need to give yourself the occasional break.
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Warren I applaud you for being so incolved and supportive of your wife.
Just thinking...one way to help is revisiting her meds... sometimes certain meds repel eachother causing strange reactions. Especially antipsychotics. I saw that with my alzheimers mom. When l took away antipsychotics my mom calmed down.
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Warren, good morning! It is a difficult choice especially when you have become accustomed to visiting every day. My suggestion is not so much for your wife as it is for you. As several other posters suggest, balance is the key. Take some time to develop things outside the caring situation for your wife. It will strengthen you and help her as well. Be well,
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It's very nice for you to be helpful in this specific situation because nursing homes are sometimes understaffed. What I would do if I were you is go home and pray to God about the feeling you're getting versus the situation where you're trying to help. Explain to God in prayer what you're feeling and ask him to reveal what you should do. Sometimes you may feel like you're helping, and I often say if you get a gut feeling about something that you're usually right. However, sometimes there just comes a time to pray and I feel this is what you should do to find God's will in this particular situation. Just be sure that the feeling you're getting is from God because it might be but then again maybe it might not be but just be sure by going to God in prayer to find out what you should do.
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Very trying time for your wife. What is her diagnosis, what medication is she on, what is her age, life span indicator, does she know you. It seems that professional advise requires more detail as we cannot relate her illness to dementia. This is the wrong venue but many of us could be more helpful with details.
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Normandy, My comment is not to correct you as much as inform you that Warren has a history on here over several threads. Please search for them and read to catch up, not wanting to put someone through all those questions in the middle of a very difficut time for him. Since you yourself know, and want to help as well as further your research, can we slow down a bit, approach with compassion?

Btw, I love that you are a go-getter type of person. It is just maybe this is not that type of circumstance, imo. Your interest though, is probably appreciated by Warren and others, so don't go away.
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Warren631: IMHO--
#1 Does your wife realize it's you?
#2 Does the staff say she cries after you leave?
#3 Have you asked the staff's advice?
#4 Have you asked the Hospitalist what to do? (BUMP THIS UP TO NUMBER ONE QUESTION!)
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Not going away but waiting for others to respond for a reasonable dialogue. What is canonical name for her illness and her age.
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My spell check did not catch the word as clinical
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Warren, dont let anyone tell you what to do , its your decision. Follow your heart, you're a wonderful person. Take time for you too ♡
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