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Earlier this year I moved an aunt across the country to a nursing home near me. She had zero assets and there wasn't time to deal with waiting lists, so I chose one of the very few nursing homes that had an open bed for a Medicaid-pending patient. The facility is old but it's clean, there seems to be a lot of staff, and generally it has exceeded expectations.
Where it falls short is on proactively engaging my aunt. She doesn't want anything to do with other residents and never goes to the lounge/dining room. She cares about two things: animals, and being outside. There are pet programs, but the volunteer who brings in dogs just goes to the lounge then zips out the door, so my aunt never sees them. Outside areas are theoretically accessible, but not effectively; she can't remember how to navigate around the place and never goes out unless I am there. Early on, staff tried to lure her to activities but now they don't much try, because the answer is always no. She's sad and bored -- and yes, that's kind of her fault, but I would like to improve the situation. Here are my questions:
-- Is a different nursing home the solution? Or are they all going to be pretty much the same, particularly with regard to easy access to outdoors?
-- I am thinking of trying to hire a high school kid or retiree to bring their dog over to her for a visit for an hour a week. Is that a dumb/unworkable idea? Would the NH allow it?
-- She used to enjoy movies, but even the TV remote is challenging and she's never had a smartphone or computer. Has anyone had success with an elder with dementia using a standalone DVD player with screen? I think they are marketed for little kids to use in cars and I wonder whether that might work for her.
Any other ideas? I do visit once or twice a week and we go out to eat and for a drive or to sit in a park, but there are lots of empty hours left.

None of your ideas are dumb. I think it's beautiful that you want your aunt to have a quality of life in the nursing home. Does the facility she's in have a decent, easily accessible courtyard for the residents? If it doesn't then maybe a different facility would be something to consider.

Is your aunt still able to be taken out? Maybe getting her a paid companion a few hours a week to take her out or just spend time with her at the facility wouldbe something she'd like. I did this kind of work for a long time. Most of the time an elderly person is apprehensive at first but after a couple weeks you become friends. Your aunt might like a one-on-one activity.

Is she in a shared room in the nursing home? I'm asking because she may like to have some plants to take care of in her room. I was visiting someone at a nursing home recently that had a gardening program. It was really nice.

The standalone DVD player could be an option. So could upgrading her cable package. If she gets upgraded cable with all the channels and streaming services she can have a voice-activated remote. I'm sure there's a staff member who can take a second to talk an old movie on for her.

Just some things to think about. I think it's great that you care so much about your aunt.
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Reply to BurntCaregiver
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HollyIvy Oct 31, 2024
Hi! Thanks for these ideas. She has plants and a birdfeeder outside the window, all of which she likes. (I think she doesn't mind too much if I don't get there as planned, but if I let the birdfeeder run out of seeds, that's bad news!) There's no gardening program and she doesn't feel comfortable going outside alone (because after 6 months she still is not 100% sure how to find her room). What you suggest about a paid companion is what I think would work best. When you did this work, did you drive the resident to places, or just take them outdoors?
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You know, I don't know how active and social aunt was overall. I AM NOT. I live a quiet and solitary existence, happy enough in my own thoughts. When I asked my OWN Aunt Helen of her time mostly looking out the window of her room she told me she often thought about her life, relived memories, was content. She loved art classes. My own mom, like your aunt, loved animal visits and her face just running her fingers through their fur was something to see.

As to the place. Medicaid facility? Clean? And with pleasant staff. This is the best you can hope for and the animal visits are in fact unusual. I would visit with admins. The questions you are asking us are better directed at them. Tell them just exactly what you wrote us. Ask about a volunteer who may want to bring in a clean dog or cat that makes such visits regularly and would like to do so here. Ask about any activities and if they can give this a try.

BUT MOST OF ALL, you need now to try to stop yourself from doing this dance of "I-am-responsible-now-for-her-happiness-or-lack-of-it.
You are not.
And you cannot be.
And the days of happiness are now done.
Peace comes now with death.
There is no upside coming in age, and as an 82 year old I assure you this is correct.
It is now making peace with it, making the best of it, doing what we can, and practicing the serenity prayer over and over, something I have come to love, atheist that I am.

I am so impressed with your loyalty and with your determination and your loving gentleness. You are so kind. Just know, not everything can be fixed, you are doing what you can, and with love. This is hard to stand witness to.
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HollyIvy Oct 31, 2024
Thank you for your empathetic reply. It is good to hear from you and others that trying to inspect other facilities and manage all the admin required to make a move probably isn't the best use of my limited time.

Having never had kids, I feel like I unexpectedly had a baby (well two, but that's another story) and am confronting the difference between my ideas of what kind of "parent" I would be and the reality of what I can actually do.
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Your aunt is blessed to have you in her corner. Talk with her about what will help her. Your ideas are valid, just be sure she’s amendable to them before spending her resources on them. My dad was helped tremendously in his last few years by a small dose of Zoloft, it helped lift some of the sadness that repeated losses of people and abilities had brought. Perhaps this will help your aunt as well. I’m glad the staff has encouraged her to participate, it’s an unfortunate truth they will give up on a resident who repeatedly refuses. See if she’s just content as is, or if depression is at play. I wish you well in being her advocate
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I was just looking for an easy way for my sister to play music . She is also having trouble with TV remotes and CD player . I found one button radios . It’s just an on/off button .
You can set a station she likes and it will stay on that unless you change it . She just has to use the on/off button. I haven’t purchased one yet . Amazon has a couple . In the search bar I think I typed “ radios for dementia patients “. Some you can download music on them , however that meant more buttons to push .

Hiring someone to bring a dog is a good idea . Ask admin . Usually they want a record of shots from the vet . Or ask if there is a way to have the volunteer stop at your aunt’s room .

Are you able to go with her to watch a movie when they play one in the activities room ? Maybe if you went with her once or twice then she would begin going to watch movies . Ask activities to bring her to watch movies . Ask if they can play one with animals to entice her, or some other type of movie she likes . .

Maybe she’s not a game or bingo player to begin with and now those things could be difficult anyway .

I would not move her if she’s getting good care . I don’t think it would make much of a difference with her socializing .
Some are joiners and some are not .
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Reply to waytomisery
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Is your Aunt on any medications for depression? If not, it may be time for this.

With dementia, a person can gradually withdraw from the activities and stimuli that the used to enjoy. My 100-yr old Aunt towards the end of her dementia couldn't keep up with conversations much but she enjoyed watching animated kids movies, but only with the closed captions displayed. She would read the dialogue out loud every time she watched one. She the same ones over and over.

When my 89-yr old MIL transitioned from AL to LTC (with mild dementia and short-term memory loss) she refused to do anything for about 2-3 years. Then I think she just forgot that she refused to do things. Now she goes and eats in the dining hall and goes to all the activities that the staff suggests. We got her a Bose CD player and all she has to do it press the button to play it, but that never happens. Same with the tv remote: the staff has to do it for her. You may be projecting how she should be living and doing in the NH because it saddens us and we don't understand it. It is what it is. The staff can only do so much but I would make sure you have a relationship with the staff that expresses gratitude for their "extra miles" for your Aunt and be a partner in problem solving (which it seems you are doing).
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HollyIvy Oct 31, 2024
I make sure I greet the staff and treat them nicely but try to make my requests few and far between. I don't think anyone is really going the extra mile, but this is a mostly-Medicaid facility and I realize the staffing and activities aren't going to compare with the fancy continuing care place across town. But yes, I should do better at asking for some simple things, like turning on the tv for her in the morning. Thanks.
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I am experiencing something similar with my uncle, but luckily I was in a town over so the distance for moving isn't as great.

What you are accomplishing is astounding. It is so much work to be a caregiver (even a non medical caregiver puts in a lot of hours and work).

My uncle is in a nursing home that allows non service or therapy dogs to visit. It brings so much joy to the residents. They even had a dog costume competition and there was so much participation and smiles on the residents faces. It was moving.

Speak with her assigned social worker and explain her love of animals and if there is one at the facility to have the aides wheel her down. They will know how to entice her down to the area. Tell the SW that this is essential to her wellbeing. Maybe even an outside visit can be arranged.

The idea of hiring a companion is nice but not needed. You don't say how long she has been a resident. There is a major adjustment period. My uncle has been at his facility since March 2024 and still is not accepting of his surroundings. It is a coping mechanism that they need to work out. I was visiting every other day because I felt sad he was lonely. It wasn't sustainable. I have a full time job, husband, 2 college aged children, elderly mother and father. I am now visiting 1-2 times a week. He is upset that I don't visit like he feels because I live 10 minutes away. That weighed on me but then I remembered we didn't visit that often in his healthy days when he had his normal life. That realization made me feel free of sadness/guilt and I am at peace with the amount of times and lenght I spend with him.

I hope with time you will feel that you don't need to account for 100% of their happiness by sacrificing your life. Reading many posts on this forum helped me and I advise you to use the search engine for topics to help you learn and gain knowledge and come to the realization that you are not responsible for their failure to launch as they are gown adults.
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Hi, first i thank you for caring for Aunt without you shed have no one that really cares. Bad news is that all govt funded (Medicare) nursing homes are the same. A resident will only receive the basic needs of any human to sustain life...food water, shelter and clothing. Policy for Dementia patients is that they aren't allowed to go outside alone because they are liable for injuries or if she wonders off the premises and gets lost or anything else that could possibly happen. I'm sorry to say there's no solution. Find non digital devices like DVD players that attach to TVs with ARC cords. A Goodwill store will most likely have one for $5 or less. Walmart has new ones for around $35. Reach out to a local humane society or animal shelters because they have many volunteers. Speak only to the volunteer about your aunt. It's very probable that a volunteer will bring their own pet and visit your aunt on her own time and they can spend as much time together outside. Your aunt must be supervised but it doesn't have to be a professional . Reach out to veterinary offices they may have other resources. I hope I've been helpful and not too long winded.
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HollyIvy Oct 31, 2024
Thanks for your helpful suggestions. Fortunately she's in a place where some residents do go outside by themselves and just sit and get fresh air by the front door. We do that when I'm there but I think she's not certain how to get back to her room so won't go by herself. I like the idea of trying the humane society for people who might be willing to bring a dog over. Thanks!
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You have asked all kinds of good questions to us, but have you actually sat down with your aunt and asked her exactly what she would like?
Perhaps she's content just sitting in her room, and if she's not, that is on her not you. You are NOT responsible for your aunts happiness nor are you her activity director.
It sounds like she has plenty of opportunities for activities at her facility, but chooses not to participate in them. Again....that is on her, not you.
And if your aunt likes to go outside but can't figure out how to, just ask an aide to take her out when you're not there as I'm sure they will if you ask. Or she can ask another resident to help her get outside as well.
If the facility that your aunt is in has "exceeded" your expectations, I would leave well enough alone and count your blessings as not everyone can say that about the facility where their loved one is.
No place will be perfect and no ones life is...that's a fact, so while you may wish that things were different for your aunt, there is only so much that you can personally can do to try and make things better. The rest is on your aunt.
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HollyIvy Oct 31, 2024
You and others have suggested that I ask staff to take her outside. You're right, I should be more straightforward in asking for this. They might not do it, but it's worth a try. Thanks!
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Residents can't be forced to do what they don't want to do. Aunt is not the only resident these aides care for. All I can say is when your there, take her to the common area. If she likes the outside, make her aide aware. The one thing I found was the resident is asked "Would you like to go outside/to commom area?" The answer will most likely be no. I never asked my Mom because it would be a no. I told her "Time to get a shower" I just strolled her outside. Because I asked her not to be left in her room, she was always in the Common area where the activities and meals were.
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Check out https://www.loc.gov/nls/
The national Library for the blind will provide (free) a very simple player and a bunch of books on tape to anyone that has a hard time reading. My wife's PCP signed her form and I emailed it in. They sent it in just a couple of days. There's basically one big green button to start and stop the audio book.
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