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May/June 2014 Issue

Placing a Loved One in Assisted Living
By Allan S. Vann, EdD, MS
Social Work Today
Vol. 14 No. 3 P. 30

Seven months after placing my wife, Clare, in the dementia unit of a nearby assisted-living facility, I unexpectedly plunged into a weeklong bout of serious depression. Until that time, I thought I had been dealing as well as could be expected to Clare no longer sharing a home with me after more than 46 years of a wonderful marriage.

I had been visiting Clare daily from 3 to 5 PM, leaving when she went into her dining room for supper. Clare enjoyed participating in all of her facility’s activities, but there were no scheduled activities between dinner and 7 PM, and that time period was becoming increasingly difficult for her. She would ask aides where I was, telling them she missed me and asking if she could speak with me by phone.

The social worker told me that Clare was so anxious that an aide had to be with her one on one to keep her calm, taking that aide away from being available to help other residents during that time. The social worker suggested a one-week experiment to ease Clare’s anxiety during this time period. For one week, I’d either hire an aide to be with Clare or I would stay with Clare during that time. We’d reevaluate the situation after seeing the results. It sounded like a good idea, so I said would stay with Clare the next day.

The social worker also shared with me that Clare had followed another gentleman to his bedroom the previous night, thinking that he was me. By the time one of the aides noticed Clare and figured out what was happening, Clare had already hugged him and kissed him on the lips while wishing him a good night.

I nodded my head when the social worker finished and said something like, “Well, I knew this day would come eventually, so what you’re telling me doesn’t come as a complete surprise, but I didn’t realize we were already at this point.”

What I didn’t say to the social worker was that I was devastated. Clare already had been experiencing difficulty remembering our children and grandchildren on some days, but now she was starting to forget me or, at the very least, she now was confused at times with respect to knowing who I am.

I had reached the place in my life that many Alzheimer’s spouses eventually come to know all too well. I had to accept that Clare and I now had a relationship more like father and child than husband and wife. I had to accept that I’m now both married and widowed at the same time.

Toward the end of my weeklong depression and after much soul searching, I finally came to accept the reality that my life was forever changed. Not that I didn’t know that earlier, but it took me nearly seven months of grieving and a bout with depression to fully accept the words in the Serenity Prayer. I knew I needed “the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” I now was alone in our house, and Clare would never be there with me again. I had to accept that, although still married, I’m also a single man in many respects, and I have to take back control of my new life.

Here are some suggestions that social workers may want to offer to caregivers based on my own experiences to help those caregivers take small steps toward building a new life for themselves as a single person:

Make a to-do list. I made up a list of items that I needed to attend to and then arranged those items in order of priority. My first item was to decide whether to stay in my home or move. Other items on my list included personal appointments, such as meeting with my attorney and financial advisor, as well as scheduling various repairs and house maintenance.

Once I made the decision to stay in my current house, that led to an expanded list of to-do items that needed attention, such as going through all of Clare’s clothing and personal items and going through the entire house room by room to make it more livable according to my needs.

Remain active with friends and family. I set up dates for activities with friends, mostly involving taking Clare out of the assisted-living facility to join them for lunch or supper but also to enjoy time with them by myself. For example, I have a weekly lunch date with friends and a weekly breakfast date with my daughter. In short, I’m committed to getting myself out of my house to be with others.

Talk about your feelings with others you can trust. Fortunately, I’m still in a loosely defined caregiver support group that meets weekly for lunch, and we often call or e-mail each other between those lunch dates. I shared my feelings with my group members in the wake of putting Clare in assisted living, and their support helped a lot. I did the same with my best friends and close family members. Each of them in their own way helped to snap me out of my depression. They continued to tell me they were worried about me and, most importantly, they reminded me how I had to remain strong to be there for Clare—sufficient motivation to get myself well.

Memorize the Serenity Prayer. When I placed Clare in her assisted-living facility, it was an emotional time for me, but I hadn’t fully realized just how much my emotions continued to be strained even six months later. After my bout with depression, I was more accepting of the reality that Clare and I now lead separate lives except for the few hours per day we will spend together at her facility or on a day trip. I must make changes in my life to be healthier and more productive, and I can’t let myself dwell in those dark places and think about what might have been or should have been or what will no longer be. I must fully internalize the five words I’ve often said these past few years: It is what it is.

Seek professional help, if necessary. If you’re feeling delayed postplacement depression similar to what I experienced, and you feel you can’t apply these suggestions to help snap you out of your funk and have tried unsuccessfully to apply other suggestions from people you trust, then you should immediately seek professional help. And if family or friends suggest that you seek professional help, don’t be shy. Take whatever steps are necessary to end your depression, if for no other reason than to remain strong so you can be there for your loved one.

— Allan S. Vann, EdD, MS, is a retired public school principal writing to advocate for increased awareness of Alzheimer’s disease, stimulate greater research funding, improve diagnosis and treatment for people with Alzheimer’s, and enhance the lives of fellow caregivers.