Love or Trickery?

When an elderly loved one needs to be placed in a facility and the response is NO WAY, what do you do?

We posed this delicate question to Janice Fitchhorn, an elder care coordinator at Truhlsen Elder Care Law of Nebraska, a Life Care Planning Law Firm in Blair, Nebraska. Janice sees this situation quite frequently.

One approach is to get your loved one in the door to experience a place they might like. Janice recommends choosing a facility and then arranging for a visit. “This isn’t about taking a tour,” Janice explained, “it’s about experiencing the facility as a resident would. Ask if you can bring your loved one in for lunch. Ask to see if they have activities that they allow people on the waiting list to participate in. Find a different way to get them in the door so that they can see that a facility doesn’t have to be that place they heard horror stories about when they were younger. Getting them in the door to see that a facility is filled with people like them can make all the difference.”

If an elder has memory problems, a different approach may be necessary. This tactic involves a creative use of the truth. When one of Janice’s clients, a physically independent woman with dementia who was still living in her own home, no longer recognized her son, the son knew he had to take action. “He didn't really realize how advanced her dementia was getting,” Janice remembered. “It was clear that she shouldn’t be living alone.”

The son’s original plan was drop off his mother’s meals every evening. “We told her, ‘You know what? It's going to be a bad winter and we're not comfortable with you being home alone,’” Janice said. “’What if your son can't get to you to bring you that meal?’ or, ‘You always want to shovel your own driveway. If you get hurt while doing that and your son isn’t able to get here, what are we going to do? We think it would be a good idea for you to move into this assisted living for the winter so that you're safer, you have three good meals a day, and you can socialize with people. And then we'll see how things are in the spring.’ She agreed to it and let us move her into the facility, which she ended up loving—and staying.”

In some cases, older adults with cognitive issues who can no longer live safely at home continue to resist leaving, even after the family has found placement in a local facility. When that happens, Janice says that a little more creativity is needed. One approach involves manufacturing a situation that requires the elder to temporarily move to the facility. Bug infestations, plumbing problems, and whole-house recarpeting are a few convenient excuses. The family then moves the elder to the facility, and the elder forgets they ever lived anywhere else.

Is this trickery? “It’s only manipulative if you’re doing it with ill intentions,” Janice added. “If you’re doing it with respect and you have your loved one’s best interests at heart, you are simply working within the reality of the person's cognitive limitations. It’s actually a very loving thing to do.”