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Published August 18, 2012, 11:30 PM

Minding Our Elders: Mother becomes disoriented returning home from day care

DEAR CAROL: My 79-year-old mother has mid-stage dementia. She lives with us but goes to adult day care every afternoon, which she enjoys. The problem is, when she gets home she’s forgotten where the bathroom and her bedroom are.

By: Carol Bradley Bursack, INFORUM

DEAR CAROL: My 79-year-old mother has mid-stage dementia. She lives with us but goes to adult day care every afternoon, which she enjoys. The problem is, when she gets home she’s forgotten where the bathroom and her bedroom are. Also, she has a favorite chair in the living room but she can’t seem to identify it without a lot of frustration. It’s like she’s never lived here even though she’s only been gone a few hours. When we try to help direct her, she resents it and says we’re bossy. Yet she doesn’t seem to mind when the people at the day care help her. How can we make her homecoming easier? Robert

DEAR ROBERT: Change in general can be hard for someone with dementia since they rely on familiar surroundings to avoid confusion. As you’ve seen, even the few hours she is away from home can cause confusion when she returns. That doesn’t mean day care isn’t good for her. She’s socializing with peers which can be invaluable to her mental health, plus qualified people are caring for her and watching her for changes. Most importantly, she enjoys it.

Perhaps, you could study the day care center’s environment. Most likely they use pictures to label doors to the bathroom and other rooms. They may even have a picture of a cold food item on the refrigerator door if clients use the kitchen, and other pictures to help people remember where they are.

People with dementia are generally able to recognize pictures longer than they can process the written word. If you can create signs similar to the ones used at the center, your mother may find it easier to remember where the bathroom is at home. Add your own touches, too. Maybe you could draw or cut out a picture of a bed to put on her bedroom door? Think about what confuses her most and try to use visual clues to help her navigate at home. If she has a favorite chair at the day care center, perhaps you could cover her favorite chair at home with a throw in a similar color or pattern.

Your other issue is her resentment toward family members directing her. It’s not uncommon for elders to be annoyed when adult children try to help them or correct their misguided thinking. They are used to being the parent and, understandably, they don’t like giving up that role. The day care staff is different. They are more like friends so she uses her social manners.

That being said, you may want to think about your own approach. Are you so tired from your workload that you sound resentful or impatient when you answer your mom’s repeated questions or need to remind her where the bathroom is? Body language says a lot, and she may pick up on your fatigue and personalize it, even if you are trying hard to be patient.

Caring for someone with dementia is difficult. Please get as much support as you can. You may find it useful to call the Alzheimer’s organization near you or a visit the Alzheimer’s Association website at www.alz.org.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com.

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