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Angela Lunde
read biographyclose windowBiography of
Angela Lunde
Angela Lunde is a dementia education specialist in the education core of Mayo Clinic's Alzheimer's Disease Research Center at the Abigail Van Buren Alzheimer's Disease Research Clinic in Rochester, Minn.
Angela Lunde
The transfer of information about dementias, as well as understanding the need for participation in clinical trials, is an essential component of the education core.
Angela is a member of the Alzheimer's Association board of directors and co-chair of the annual Minnesota Dementia Conference. She is a member of the Dementia Behavior Assessment and Response Team (D-BART), a multidisciplinary outreach service assisting professional and family caregivers in understanding and managing difficult behaviors often present in dementia. She facilitates several support groups, including Memory Club, an early-stage education and support series, and more recently, helped to develop and now deliver Healthy Action to Benefit Independence and Thinking (HABIT), a 10-day cognitive rehab and wellness program for people with mild cognitive impairment.
Angela takes a personal interest in understanding the complex changes that take place within relationships and among families when dementia is present. She is particularly interested in providing innovative and accessible ways for people with dementia and their families to receive information and participate in valuable programs that promote well-being.
"Amid a devastating disease, there are tools, therapies, programs and ways to cope, and it is vital that families are connected to these resources," she says.
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Alzheimer's blog
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April 21, 2009
Making the move to a care facility
By Angela Lunde
Several of you recently have asked the really tough question, as Bess did last month: "When, and how, do we make the decision to put her (our mother) in a special Alzheimer's unit?"
The reality of persons diagnosed with Alzheimer's disease or a similar progressive dementia is that many will ultimately need to make a move because they need more care than can be provided at home.
Families can sometimes lose sight of the fact that the demands of full-time caregiving are more then any one person can realistically manage. Understandably though, they may resist the thought of moving a loved one to a care facility.
In making the decision of when to move, there are no right or wrong answers. All caregivers, families, and persons with dementia are unique and will have different circumstances. Friends, doctors, and individual family members will each have opinions about when or if someone should be moved.
However, for most of you the decision to move a loved one is based on a combination of practical, psychological and/or medical reasons that may include one of more of the following:
- Caregivers own health is being compromised (including sleep deprivation).
- Caregivers own physical limitations (lifting, mobility).
- Caregiver is experiencing loss of work and/or the inability to manage other household or family responsibilities.
- Sufficient respite support or qualified home care are not available or become unaffordable.
- Symptoms of the disease are evident and challenging to manage at home (incontinence, aggression, paranoia, wandering).
- Person with disease needs more supervision than can be provided at home.
- Home environment is no longer safe (negotiating stairs, getting in and out of bathroom, narrow doorways).
- Person with disease is becoming more dependent with more activities of daily living such as eating, dressing, bathing.
- Person with disease is experiencing weight loss, dehydration or simply refusing to eat.
- Proper medication management is compromised.
- Person with disease no longer recognizes home as home.
Even when a thoughtful decision is made to a move a loved one, caregivers are bound to feel sadness, grief, fear, and probably plenty of guilt. These feeling are normal. Caregivers may feel guilty over not upholding old promises to parents or spouses, or they may fear what others will think or say, or fear that the care will be inferior. In addition, the decision underscores the inevitable decline of their loved one, resulting in further sadness and grief.
Once the move is made, many families say it was harder than they had imagined, and that they probably waited too long. The degree to which you can reasonably adjust to the transition is often associated with the planning that was done before the move. In other words, accepting the move seems to be less painful when families feel that they took the time to explore options and then made the best decision they could.
Keep in mind that the role of caregiver doesn't abruptly end once a loved one lives elsewhere, it just changes. You still play a vital role as your loved one's caregiving advocate. However, without direct care responsibilities, you can resume with renewed appreciation the time you spend with other loved ones.
Finally, if you love someone with Alzheimer's disease, remember you are entitled to have a life of your own. Taking care of yourself is a gift to your loved ones as well as yourself. You simply cannot meet every demand. Your thoughts and feeling are normal. You feel guilty because you love.
"The promise to always keep mother at home might have been made with the best intentions and hopes, but inherent in that commitment is the idea that the family will do what is best for Mother. It may be a promise that should be broken, because keeping mother at home may not be best for her."
— from "The Best Friends Approach to Alzheimer's Care"
33 comments posted
April 29, 2009 7:37 p.m.
Does anyone know where you can download a sample Letter of Medical Necessity that relates to the necessity for placing your loved one in a facility? If you have one and wish to email it to me, it would be greatly appreciated!!! djboca@gmail.com Thank you!!!
- David Rubin
April 29, 2009 2:08 a.m.
Yes, the decision to place a loved one in an institution is difficult - but not placing them may be even worse. My 93 year old father even refused having caregiver at home. He insisted on taking care of my mother by himself. Well - both of them fell while walking and my mother was hospitalized for a gash in her head and a crack in her knee. After retuning home, my father again refused any help. My father had difficulty physically moving my mother so she ended up sitting on a chair and sleeping. This caused her to develop a blood clot in her leg. Further hospitalization caused my mother to catch, in the hospital, C-diff Bacteria in the intestinal tract and later she caught in the hospital VRE - a dangerous bacteria in her blood. Needless to say my mother has totally gone down hill in a short time and has stopped eating and drinking. It looks like we are headed to hospice care. My mother was still doing pretty well until this incident. This could have been prevented had my father gotten 24 hour care or placed my mother in a safe dementia unit. Please - leave the guilt and do what is best for your loved one. If you are a caregiver of someone with Alzheimer's/Dementia who has reached the stage where they are incontinent and having physical challenges - be kind to them and get the needed help/facility!
- Oran
April 28, 2009 3:48 p.m.
Reading the reasons for helping an aging parent into a nursing home make me realize that I wish I could care for myself the way a good child cares for his parent. It becomes ever more difficult.
- Leslie Aitken
April 25, 2009 10:13 p.m.
first time here also. My dad who just turned 65 appears to be in the mild to moderate stage. This is SO tough because he has been out of our lives for over 30 years (divorce, alcoholism) and since his medical needs have escalated he is calling me. All of the time. I think he forgets that he calls and leaves me tons of messages. Two doctors are differ in their diagnosis for him. One thinks he is depressed and the other alzheimers. I am married and we have 3 children. Completely at a loss, and overwhelmed. I want to show compassion, forgiveness, and love to my dad. I am taking him to the doctor next week. The one doc told me that depression can manifest in alzheimer like sypmtoms. Anyone else have this experience?
- annie
April 25, 2009 5:23 p.m.
I'm not sure where to start, first time here, my brother is 58 and we are told he is in stage 2?? we havn't seen any papers. His wife broke down and is in a ward so the family brought him back from Tx and drop him at our home. There is lot more to write but my sisters wants to be caregiver and I will help. Where do I start. Are their stages? Can he be let alone? Will the doctors tell us more?
- Linda Key
April 23, 2009 11:02 a.m.
The decision of move my mom was ultimately decided for me because of a quick decline in her abilities. She remained in a special dementia unit for nearly 4 months until she passed away a few months ago. I still have doubts and guilt about it but I do appreciate the fact that the facility we chose took good care of Mom.
- Robyn
April 22, 2009 2:53 a.m.
My father (95 or 96) 'should' have gone into care long ago. My mother (89yo) and sister have been struggling to cope with sister holding down a stressful FT+ job as well. A year ago my mother 'died' 3x and was brought back notwithstanding DNR instructions because the staff realised that she was struggling to live to care for Dad. She decided to have a pacemaker put in and has recently had a few TIAs. A recent fall resulted in broken collarbone, hospitalisation and now rehab care...but she may go home soon. Meanwhile I sit in Australia worrying about all 3 of them . . . My sister is often close to breaking point and my brother gets called to come and see either or both of them at each new emergency...not to mention his efforts to attend birthday and holiday occasions. My last trip back to USA was in 2006 but I have now retired and my pension will not allow more trips back and forth. When I retired my husband and I moved into a retirement community....we are relatively healthy and happy and feel that we will at least have spared our children what we are going through with my parents and their refusal to give up living in their own homes with help so difficult to find.
- Ellen
April 21, 2009 4:34 p.m.
After going through the struggle of keeping Mom at home with various caregiving for over 10 years, I have placed her in a Dementia Unit. I found one that had a 24/7 RN and a high ratio of caregiver to patient. Even with that I find I have to be a constant advocate for her clothes, health, hearing aids, glasses, food, and peace of mind. UGH! I am in counseling to deal with these years of giving back to a wonderful mom who is no longer able to care for herself. She is 98 and probably as healthy as I am!
- Sue Trowbridge
33 comments posted