Question:
my FIL has frontal lobe dementia and congestive heartfailure. He has memory loss, mild aphasia, delusions, sundowning issues (wasstrolling the halls most of the night at the hospital, not sure about thenew placement), and gets aggressive when he feels threatened. He has been ineither a NH or psych unit since mid January. The current medical plan ismeds to manage behavior and to manage to CHF. Scans show frontal lobeatrophy so Aricept isn't even being considered. The hope is he'll succumb tothe CHF (there is a DNR), but who knows when that might happen.

My MIL is a very stoic New Englander. Goes along with what the doctor says;doesn't question and isn't the type to be very proactive about medicalissues (except for insisting on minimal treatment and DNR, for which I thinkshe is quite wise). Very stressed out with this entire process; sad butrelieved to no longer be the caretaker.

Now she is feeling stressed that the only NH placement the psych ward couldget is 35 miles (about 50 minutes) from her home.

I don't know how to help and support my MIL right now. I would makedifferent choices than she has made. Ex: I think the first NH didn't overseehis psych meds well enough and then dumped him when he had two violentepisodes. There were no violent episodes in the psych unit at all. Mynatural inclination is to find out details (with which the first NH hasn'tbeen very forthcoming) to find out the extent of the two episodes. I suspectthe first NH just dumped him because he hadn't been stabilized on the medsyet and they didn't want to deal w/his behavior. I'd like to know whetherthe state has anti-dumping laws which apply to NHs. Since having him in amore local NH would be better for everyone involved, I'd also like to findout what other NH's might accept someone w/his issues and perhaps get on alist for a closer one (though I'm not sure how helpful it is for him to bebounced around from place to place).

Answer: Does your MIL attend any type of support group? Even if she is nolonger his full time CG, she is his advocate and will therefore remainhis CG until his death. It may be helpful for her to discuss issueswith others in the same predicament. Her local Alz. Assoc. can directher to an appropriate group, and a world of information that may behelpful.

As a caring DIL, it's very hard to sit and watch and not take theinitiative to help those you love. If your relationship is a good one,she may welcome your support and help in researching some of thesethings, but IMO, you need to tread carefully. Obviously, you don't everwant to make her feel that you don't agree with the choices she's made.She might misconstrue your actions as being judgemental, so you have tophrase your words in a supportive, diplomatic way (and I would only dothis if your husband is in agreement! Perhaps do it together, so sheknows she has HIS support too). Tell her you want to help in any wayyou can, that you're concerned about the stress and the impact it mayhave on HER and HER FAMILY to have him so far away, and that you'rewilling to gather info if it would provide a better situation. She mayhave real fears about moving him again too, but getting informationdoesn't mean she HAS to act on it. It might just open up options fordiscussion, and therefore be less threatening. Offer to find out aboutthe "dumping laws". Both she and your husband need to be consulted onevery step you take.