Visiting somebody with Alzheimer's.

It depends on the facility. My mum works at a long term care home on the dementia ward. She's told me a bit about it - residents have visitors, and they have their own rooms - the windows don't open and the doors don't lock. From what I remember when I volunteered at the same facility, the residents had free reign on their floor - there's a TV in a common area and an activity room and a dining room.

Jacob_Wallace said:

I have a character who doesn't age. He goes to a nursing home to visit his old friends that have aged. One such friend has developed Alzheimer's and doesn't remember the old hero (or sees him and thinks it's the past, haven't really decided).

The character's Alzheimer's is advanced and he barely remembers who he is, and can't function without help of 24 hour nurse care.

The issue I'm facing is, what condition would he stay in? Do nursing home patients get their own room? Are they couped up in there all day? Can they get visitors and such? Would a patient with dementia be kept away from the other patients (I'm not planning on making him a danger to anybody).

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My grandmother, Mimi, had dementia that eventually gave way to Alzheimers. She lived at a nursing home in Peabody, MA. She had her own room that had a bed, a TV, a nightstand, and a tiny bathroom. When we went to go see her we would sit with her in the common area. I remember that it was decorated in yellow, and there were a bunch of tables. We would sit at the tables and talk to her. Sometimes other patients would just wonder in and sit with us, probably because they were really lonely. Anyways, it was kind of sad.

My grandmother had this disease for four years. It started out with dementia, and got worse. I remember my mom (Mimi was her mother) would get really upset when Mimi would call. Towards the end of Mimi's life, she would use horrible, horrible language probably due to the disease. My mom said she had never heard someone swear like that before, and previously my grandmother hadn't sworn.

When we would go to see her, we would give her updates like where I going to college and what grade my sister was in. Of course, Mimi couldn't remember this so when we had to remind her, she would get really frustrated. I remember feeling so bad for her, because I think we got a little frustrated--it's hard seeing someone like this--and then she would get really mad because she wanted to remember.

Anyways, that was probably more than you needed to know lol. I know some nursing homes have fish tanks or I've heard of one who had a large cage with parakeets in it. The patients could watch them. My friend worked at a nursing home here in Tennessee, and she told me that there was this old woman with Alzheimer's whose husband would come to visit her every day and they would just watch the parakeets together.

Okay, that was WAY longer than I intended, but I hope it helped.

The documentary Louis Theroux: Extreme Love – Dementia had some pretty good insights into Alzheimer's, its sufferers and the family, friends, and dedicated units that look after them. Watching it may or may not be helpful to you and I should think it is, no doubt, available somewhere on-line.

There are also care units specifically designed for Alzheimer's patients.

Personally, I think the type of care he receives (what type of unit, quality of care, etc) is going to be most dependent on the financial resources of his and his family. That gives you an opportunity: If you want to highlight that this guy was rich, "had everything" etc, he could live in a very modern, well staff, facility designed specifically for Alzheimer's or dementia patients. It might have well tended gardens, very nice accomodations, be very well staffed, etc. Then you write something about how, "(This character) still lived in luxury, as he always did, but now couldn't tell the luxury around him from the meanest slum" or the converse talking about how the character never had much money, or squandered it, and now was living in a run down nursing home, with indifferent staff, but "luckily was too out of it to tell how bad it was."

Either scenario is realistic so pick what works.

My Mother has dementia. When she lived in a nursing facility she shared a room with another woman, but they did have single rooms as well.

She has good days and bad days. Sometimes she knows who I am, other days, not so much. You don't try and correct them, just go along with what they say, even if its nonsense. For my mother at least it was easier this was. She would get very upset if you tried to tell her that the 16 yr old visiting her is indeed my son. In her mind I was not old enough to have children and my son was to her, my brother. We were allowed to visit when ever we wished. no time limits or days we were not allowed in. We did have to sign in and out of the facility. She wore her own clothes and we brought in colorful sheets and decorated her room.

I even bought her a baby doll to hold. She was an OB nurse and she thought it was one of her babies she helped delivered.

These people have extremely short term memories, so whatever they see or hear today, they will most likely not remember tomorrow if at all.

Not sure if that helped at all, but I hoped it did.

The biggest difference in terms of both cost and care levels can be the training levels of the staff. A relative of mine was in two facilities, both very pleasant physically - rooms with views, own furniture, en suite. The first one had no staff with nursing training. They didn't cope with him doing things like go walk about in the middle of the night. They put a buzzer on his door, he worked it out and climbed out the window - the one person on duty at night would suddenly see him flit past in his pyjamas across the lawn. Usually chasing a fox, apparently. There was a big bust up literally on Christmas Eve, when he was extremely rude to the owner's husband (never did find out what he said) which resulted in them demanding his instant removal - happy family Christmas - though that was talked down to remove as soon as he had somewhere else to go to.
The second place had professional nurses with training in dementia care and was solely for "the elderly mentally infirm" rather than being a more general old people's home. They had him a lot more stabilised - eating properly, getting regular sleep, and he was less demented there even though more advanced in the disease. They treated the patients as individuals, and understood that people have different habits, but do better in a regular routine that suits them. They had amongst other patients a former farmer's wife who was up at five am every day and a former publican who was up past midnight but slept in every morning. They found that if the patient seemed out of sorts, a lot of the time it was down to their sleep pattern being disturbed.
The patients varied from confused about time, but able to chat away and seem normal for short loops of time to those who'd lost the power of speech and burbled like toddlers. There were a few who'd sit and rock backwards and forwards and moan continuously, or one who'd try to open a locked door, fail and thump it - time after time after time. It made it clear what demented really means.
They were very kind and allowed people to bring in their cats with them - there were several resident cats whose owners had died and were now everybody's cat.

There was no segregation of the demented at the first home. At the second one, which was entirely for demented and alzheimer's there was grouping by mental state and also a bit by physical ability - some rooms had steps down into them so they had to go to the nippier patients. The main house had the worst cases of the old folks, there was a closed wing for middle aged people with alzheimers and the more mentally able were in an annexe on the edge of the gardens. The annexe patients freely wandered the gardens (which were enclosed) and so long as they had enough clothes on for the weather the staff just let them get on with it and kept an eye on them. Didn't matter if the clothes were outdoor clothes or slippers and a heavy dressing gown, just so long as they were warm and dry.

The relative didn't remember who I was exactly, but knew we were family. He would suddenly tell stories of thirty, forty, fifty years back as though they'd happened yesterday. They were stories I'd heard him tell before, but not as though they were so immediate. Every so often he was more aware and that was when he was unhappy. One visit he suddenly said to me "my mother is dead, isn't she?" (He was in his eighties at the time...). I just said "Yes" and he went quiet. The rest of the time he was cheerful, complimentary to the staff and a bit flirty with the younger nurses and had a ball. He'd always been cheerful, energetic and loved telling stories and that stayed until the end.

I can't help with the veterans' home aspects, but my Nan (Mum's mum) went into a nursing home about ten years ago (for just over a year until she died). She was in a special unit for people with Alzheimer's, which had to remain locked and visitors were buzzed in and out. She had her own room, and staff encouraged familiar objects/photos/ornaments, etc. This was in South Wales, where that side of the family moved in the late 50s (they're originally from Yorkshire).

She always remembered exactly who we all were, even sons/daughters-in-law and her great grandchildren, and that my cousin was recently pregnant. But, if you said "Have you seen (insert name)?" she'd say that she hadn't seen them for weeks, even though they'd visited the day before. Her short-term memory was only a matter of minutes, her long-term memory was as sharp as sharp could be. Mum warned me to humour her, in that if she said something that was wrong or from long ago, just to agree and go along with it.

My great-gran - Nan's mum - also went the same way in her late 80s (wonder what's in store for me?!), but she used to think Mum was Nan (strong resemblance), and wasn't sure who Nan was. She always knew me and Dad though. The areas of deficit seem quite specific to affected individuals??

Hope this helps a tiny bit...

LPH.

My MIL has dementia. Her Aged Care Facility has both single and double rooms. As others have mentioned we were encouraged to bring in personal things to make it homey. She has a tv, wardrobe, wall unit with her books and photos, chairs and a bedside table. The Home has a dining room, large common room, and another couple of rooms each with a couch, tv, fridge and kettle for more intimate visits, like for family to celebrate a birthday. They have a little chapel and a little hairdressing/beauty salon. They encourage visits at any time of the day or night, by family, friends and pets. They have a resident cat that has the run of the place. Entry and exit to the building is by a numbered keypad - the PIN doesn't change. Visitors are asked to sign in and out so that if there's an emergency they know who to account for besides staff and residents. They have a music man come in to play guitar and sing every couple of weeks. They doll up the place to celebrate things like football finals, the Melbourne Cup, the Olympics etc. The residents are given lots of drinks and snacks between their main meals.

It is a public facility and MIL's aged pension covers it. The Home is in rural Australia and is apparently better/nicer than many city ones. We're lucky. Unfortunately MIL is at the stage now where she can appreciate none of it.

When my father needed more care than we could help with, the first question every facility asked was "Does he qualify for Veteran's benefits?" The VA offers benefits for dementia/Alzheimer's care at any qualified facility (although not 100% of the bill), and at most of the facilities we visited, the majority of the men had served in the military. (Regarding the money factor, just as an example, my father does not have Alzheimer's, his dementia is on the mid-lower end, but he requires intensive assistance with all physical activities (bathing/toileting/moving about safely) and medication management. His monthly bill is $4200. At an Alzheimer's qualified facility, the care can be upward of $6000 per month. My dad receives $800/month from social security, so you can see the extraordinary drain on his finances.)

Here in Seattle there is at least one large "Veteran's Home" but I'm not certain it's substantially different from any of the other care facilities in the area except, likely, in ratio of men to women. Most elderly care facilities are overwhelmingly populated by women. The guys tend to stick together.

One thing not mentioned so far, many Alzheimer's patients suffer from a high degree of paranoia. My friend's mother (who cannot even recognize her own children) can often be found hiding behind her couch because when she hears anything near the door, she thinks someone is breaking in to her home. She can also be verbally abusive (as another poster mentioned). I would think this might be a symptom for a veteran of war, although I suppose it's more determined by the level of Alzheimer's. But, just something for you to consider.

My sister owns an Adult Family Home and sometimes has a patient with dementia or Alzheimer's. The home is about 3000 s.f. with several bedrooms (there can be one or two people per room, they get to choose the arrangement when they come to live there) and bathrooms that are not private to one room. There are never more than 6 patients.

They have 24 hour staff -- the staff are nursing assistants, some had more training than others (regulations about that have become more strict and require more hours of training). They always have more than one staff person on duty. Plus my sister and her business partner are licensed nurses and live on site.

The patients are usually not ambulatory, but some are. They have decorated the home (sometimes seasonal stuff like Halloween or Thanksgiving) with their personal belongings and art (the patient's). They eat meals together at a large table. They have a big room with a TV and some people sit in comfy lounge chairs to watch TV. Or they go outside on the patio, part of which is covered for rain and shade.

They have a dog (a golden retriever) on site. They have frequent family and friend visitors and they hold monthly events where they make dinner for all the relatives and friends -- some 50 or so people usually attend. But family and friends are welcome any time and visit often. They bring in clergy or other volunteers to spend time talking with the patients. They take the patients off site to doc appointments and the like and other activities as they are able. They have a loud bell that goes off whenever a window or door is opened or closed.

This particular home only takes private pay patients and they do work with families who can't afford the whole fee, which is around $6000 a month. But in other facilities who do take state and VA payments, they only get paid around 800-1000 dollars a month per patient. I'm not sure if other state pay homes have the same amenties and staffing levels, but I can ask.

My great-grandmother had dementia as a result of a stroke. She was in a special ward of the nursing home for people who were at risk of wandering. The ward was locked, so patients could walk around freely in hallways, common rooms, etc. and not leave the building. There was a code to enter and exit. Family members had the code, but someone visiting for the first time would need to be buzzed in.

That reminds me -- in our state (don't know about others) there are laws limiting how a patient can be restrained (even for their own safety). I have a friend whose mother was in a nursing home -- she had dementia -- and they couldn't tie her into her wheelchair or anything. One night when no one was paying attention, she managed to wheel herself out an unlocked door -- and ended up going over an embankment & down 50 feet to the highway below, where she was struck by a car. She didn't die immediately -- she suffered in a hospital for several days.