Alzheimer's Disease
Easing the Pain

Should the Patient Be Moved?

SADLY, the deteriorating condition of people with Alzheimer's disease (AD) may require that they be moved from their own home into a relative's home or into a nursing home. However, before the decision is made to move a patient from familiar surroundings, some important factors should be considered.

Serious disorientation can result from a move. Dr. Gerry Bennett gives an example of a patient who used to wander about and sometimes get lost. Still, she managed to live on her own. Her family, however, decided that she should move to an apartment closer to them so that they could give better supervision.

"Unfortunately," explains Dr. Bennett, "she never accepted the new place as home. . . . Sadly she never settled, and indeed was made far more dependent because she no longer could function in her new environment. The kitchen was strange, and she could not remember the new way to the toilet and became incontinent. From the best motives came a personal disaster and the eventual outcome was institutional care."—Alzheimer's Disease and Other Confusional States.

However, what if there seems to be no alternative but to move the patient into a health-care facility? This certainly is not an easy decision. In fact, it is described as "one of the most guilt-producing" decisions facing caregivers, often making them feel that they have failed and have abandoned their loved one.

"This is a normal reaction," says one nurse with extensive experience in treating AD patients, "but an unnecessary sense of guilt." Why? "Because," she replies, "[the patient's] care and safety would be the most important consideration." Doctors Oliver and Bock agree: "The decision that one's own emotional resources have been exhausted and that the disease has progressed beyond the point of home care is probably the hardest one to make." Nevertheless, after weighing all the factors in their particular situation, some caregivers may well conclude that "nursing-home placement is . . . in the best interest of the patient."—Coping With Alzheimer's: A Caregiver's Emotional Survival Guide.

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