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My father has had Alzheimer’s disease and dementia for a couple of years. In the last month or so, the disease has progressed rapidly. Therefore, we had to put him in a nursing home and just told him that he would be in a hospital until he got better. Our problem is that he keeps trying to escape, and we don’t know if it would be better to just be honest and tell him that he is in a nursing home, or continue with our current explanation. Also, we try to visit or call every day, and wonder if we should stay away for a little while so that he could get used to being there and perhaps settle down.

Unfamiliar surroundings—such as a move to a new home—can sometimes increase an Alzheimer's patient's confusion and anxiety, which can lead to escapist behavior such as you have experienced with your father. It can be very difficult to speak openly with a beloved family member who is suffering from the disease. However, in order for your father to begin to accept his new environment, he needs to be told the truth. Some patients may become angry about being told they have been placed in a nursing home. Others sometimes become depressed because they feel rejected and alone. So by all means continue to visit your father as often as possible, as he will need your support and reassurance that he has not been "abandoned." Your father will require continual calm assurance that the facility is now his new home, that he will be well-cared, and that he is safe and loved. Because of the nature of Alzheimer's, you may have to repeat this many times. If your father becomes angry over the news, it is not a good idea to argue with him as this may cause him to become more agitated or distressed. Instead try redirecting his attention to a new subject or activity. If your father becomes depressed, talk to his physician about the possibility of prescribing antidepressants.

You can also try labeling various personal belongings with his name (such as "Joe's room", "Joe's chair", "Joe's hairbrush", etc.) as visual reminders of his surroundings. It may seem trivial to you, but it can help to relieve a patient's anxiety when they are in "unfamiliar" surroundings. With patience and a good daily routine, he should eventually begin to feel more secure and "at home."

Posted 31 Dec 2008

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