“How Often Should You Visit a Memory Care Patient When They First Go In”?
This is an important question and is often a great source of anxiety for caregivers of people with dementia. The answer often depends on the actual circumstances at the time.
The answer depends on the physical and mental condition of both parties. Some caregivers are so worn out by the time placement occurs that they can only visit 1-2 times a week. The location of the facility from the caregiver can also affect visiting schedules. Optimally, daily visits are good because it allows the family to see how the individual is adjusting to the new surroundings, and if the new facility is responsive to the needs of the individual.
I pay more attention to the quality of the visits than the quantity of the visits.
One of the worse things a family member can do is to ask the person with dementia, “Do you know who I am?” These interactions result in a negative experience for both visitor and resident. Visitors who accept the person with dementia as he or she is, who happily listen to the repetitive stories or some of the “mixed up memories,” without judgment or argument, create a positive experience.
I’ve watched the opposite happen, especially around Christmas and Mother’s Day. Family members who refuse, or who cannot, enter Dementia Land and instead expect logic, reasoning, and arguments to somehow “fix” the person with dementia, often have unhappy visits and leave a very agitated, depressed, and sad person behind in their wake of good intentions. This experience further alienates them from their loved one, and creates a negative spiral where the family visits less and less because the visit is upsetting to both parties.
Persons with dementia experience the passage of time very differently.
When my mother-in-law was in a nursing home for physical therapy, I visited every evening after work. We had a routine. We would sit and talk for a couple of minutes, and then we would walk to the other side of the facility and sit outside on her favorite bench and look at the rose gardens. If the weather was cool or rainy, we walked to the same area but sat inside and looked out the windows.
I was there for probably 45 minutes, maybe an hour. But I came every day, and we had a routine.
After I left, if Mary mentioned that no one had been there to see her, the nurses would tell her that they had just seen the two of us walking. She would smile and say, “Oh, that’s right.”
Her son, however, was not dealing well with the situation and he could only handle weekly visits. Mary would ask me every day where her son was and tell me that she had not seen him for weeks. Rather than argue, I told her he was out of town on business (he did travel for work at times) and that he loved her. He would come on Saturday…and he did.
Some family members restrict their visits because they are concerned that “leaving the person behind” may upset the person with dementia. I’ve seen this happen when the family member walks toward the door and exits, while the resident stays behind.
The departure can better be handled by exiting during a natural break in the day’s activities. I would help Mary get ready for bed, and then leave–it made sense to Mary, it was her bedtime, and it was time for me to go home and go to sleep.
On weekends, when we visited in the afternoon, we left at suppertime. It was time for her to go to the dining room for her meal, and time for us to go home and have dinner with our families.
Bottom line: Come up with a routine that works for you and your loved one. Check with the staff to find out if your visits make things better or worse. If worse, then the visits may need to be limited until all of you can figure out what is causing the problems and how to resolve the behaviors.
This post originally appeared on The Alzheimer’s Reading Room.
Dr. Rita Jablonski
Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.