Anyone here made the difficult decision to place your beloved parent into a home instead of caring full time for him/her? How do you deal with the guilt? Is it better for them in the long run too?

My mother tends to be verbally aggressive. She is resistant to help at all times. We have to keep coaxing her to eat, to shift to a better posture on the couch and to go for daycare twice a week.

Sometimes she even gets physically aggressive.

I have a toddler and another baby due in May. My helper is soft spoken. She does her work well but is not able to handle my mother when she gets very fierce and angry.

I eventually have to step in and calm everyone down. My husband will then get angry with my mother, even though he knows he shouldn’t deal with her tantrums in such a manner.

I’m thinking if a home would be a better option for all of us. I don’t want my children to grow up watching my mother get angry and violent all day. I know that I can teach my children empathy and all.

But, it’s stressful for me when I have to deal with both my children and mother throwing tantrums.

Caregiver tips:

Recognise her triggers

If you can recognise her triggers (things that result in her anger)… It will be useful. Is it boredom ? Talk and engage with her… Is it an inability to communicate clearly ? Use a communication board or pictures. Confusion? Orientate her gently multiple times a day.

It is best to make everything a routine. They need 24 hours of care. If aggressive behaviour occurs at a certain time e.g. 4pm onwards (sundowning), medication might help her calm down. It would be good to see a geriatrician.

Get adequate and experienced help – an additional helper

A helper that is good with elderly can make alot of difference. You can weigh the costs of a home VS getting a second helper. Sometimes, your helper may be overwhelmed with household chores. She may not be able to devote her full attention on your parent.

If you’re getting a second helper, you may need to find the right balance of characters that can work together. It has worked for my family.

My mum hired transfer maids. This way u can interview them and get a gauge of their skills, willingness to care and character.

Our previous helper was good at most things except that she could not get along with my grandma. Once we had a change of helper and got a second helper, the situation improved significantly at home.

Get adequate and experienced help – Engage elder sitters/ home intervention services

You can engage Alzheimer’s Disease Association or Homage to get in home eldersitters or befrienders to come weekly for activity engagement with your mom so that she don’t become too bored at home and display even more agressive behaviour. 

Identify the right dementia daycare

Do observe how she engages with activities or other seniors at her current Dementia Daycare. There is a possibility that the centre is just not suitable for her. It is best for her to go to a centre that she is most comfortable with.

The nursing home option

It is not a bad idea to send your parent to a home. Everyone has their own challenges. A nursing home may be better able to meet the needs for some families.

But, for your mom who still seems highly engageable, staying in a home may frustrate her and exacerbate more aggressive behaviour. She may eventually require more medicine to help calm her down. 

Unless you carefully select a dementia-specific nursing home that can manage behaviours, otherwise most nursing homes may result in her being given more medicine to calm her down due to staff shortage to handle her behaviour outbursts.

The problem, however, is that dementia-specific nursing homes are super limited in Singapore and thus, has a much longer waiting time — approximately six mths to a year.

I think its important to be prepared in the event that your mother’s condition deteriorates if she goes to a nursing home. It is important to accept this possible outcome so that you can mentally deal with it as it happens.

The Assisted Living Option

There are also assisted living options where seniors who are more mobile can still enjoy their independence while still have a helping hand nearby should they need the support. Some of these facilities include St Bernadette’s Lifestyle Village at Sembawang and Adam Road, Lion Home for the Elders’ Assisted Living Unit and Allium Care Suites.

Being a caregiver is a challenging and taxing. Go to a support group before you make that decision. I hope you overcome this soon.

You are doing well. Keep up the hard work.

This was a conversation extracted from an online community of caregivers in Singapore. The responses are suggestions from caregivers as well as individuals who are familiar with dementia.

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