Part of the problem is a busy schedule. When I worked in a nursing home ministry in college and then visited my mother-in-law in various facilities, I figured busyness was the primary reason so many residents seemed never to have a visitor.
But now I think perhaps people don’t visit elderly loved ones because they feel it’s futile since the person doesn’t even know them any more.
Dementia is one of the saddest afflictions. It’s heartbreaking when a loved one can’t remember who you are or how you are related.
But I can’t encourage you strongly enough to keep visiting. Why?
Because you remember.
Their biggest need is to know that they are loved and not forgotten. For the few minutes you spend with them, they are receiving personal attention.
We don’t know what they actually remember.
When a loved one can’t process thoughts well, we don’t really know what’s going through their minds. It could be there is a flicker of familiarity, but they can’t express it. Or they might remember, if just for a few moments, that you were there.
Assisted living and nursing home facilities can be lonely places.
Some residents are able-bodied and/or social butterflies, but many sit by themselves. Most of the activities involve bringing the group to the common area rather than doing anything with individuals Most of these places are overworked and understaffed. We found a few gems in each facility my mother-in-law was in, but too many of the staff were burned out, uncaring, just punching a time card. We observed as they talked to each other over her without ever looking her in the eye or talking directly to her. One aide had eyes glued to the TV as she fed Jim’s mom rather than interacting with her. Can you imagine an existence where most people just handle you or do what’s necessary without a smile or a kind word?
Personal, focused, loving attention is the greatest gift you can give them.
You can’t assume they are well taken-care of.
When you visit a facility and arrange to place your loved one there, you assume the best. The administration sounds competent, the brochures look inviting. But we could tell you dozens of stories from our own experience, not to mention that of others. The residents often can’t speak for themselves. They need advocates to visit them frequently and bring any issues to the management’s attention.
When you do visit, here are a few things to keep in mind:
- Don’t ask, “Do you remember . . .” people or situations. John Zeisel calls this “testing” in his book I’m Still Here: A New Philosophy of Alzheimer’s Care. He says such questions just set them up for a test they are sure to fail and can increase anxiety, agitation, and feelings of incompetence.. Sometimes they can remember the distant past more than the recent occurrences, but don’t assume. Just start talking about the person or situation you have in mind. If your loved one remembers, they’ll chime in. Instead of asking, “Do you remember me?” just say who you are. “Hi, Mom! It’s me, Jim, and your grandson son, Jason, and great-grandson, Timothy.” Mention the names but don’t make a big deal about them.
- “Don’t alter their reality” was the cardinal rule at the nursing home my mother-in-law was in. In our college nursing home ministry, one blind lady spoke as if she lived on a plantation, even encouraging us to pick some flowers. We didn’t know whether to go along or try to bring her back to reality. Now I would know: either go with the flow or try to bring up a different topic of conversation. If they think they are in another state, or their husband is waiting for them at home, or whatever, it only agitates them to say otherwise. When my mother-in-law was in a memory-care unit, we often saw residents get quite upset if they stopped to ask us to take them somewhere, and we said we couldn’t. We learned to say, “I’m just here visiting my mom, but maybe this lady could help you,” and point them to an aide. That was better than saying, “No, I’m sorry, I can’t take you,” and having them get upset, and an aide having to come over and calm them down.
- Divert or distract rather than arguing. If your loved one starts asking about someone who died, or asks to be taken somewhere they can’t go, or says something that doesn’t make sense, don’t try to “talk sense into them.” Jim’s mom sometimes asked to be taken to her daughter’s house 2,000 miles away. I used to remind her that she had moved to TN. But later on, I’d just say, “We can talk about it when Jim gets home.” She was mostly silent her last two years, but she would still sometimes ask about her sister, who had died long ago. Our caregiver would say something like, “I think she’s still asleep” and then start talking about something else. We tried never to lie to her, but we did redirect the conversation.
- Have some topics of conversation in mind before you go. Sometimes it’s hard to know what to talk about. Family news is always good. But conversation can sputter after that. This is something I wish I had done better with my mother-in-law. I saw her almost every day, so when she would ask what’s new, sometimes all I could come up with was, “Well . . . I got the laundry done.” She loved news or little interesting tidbits or real-life stories. I wished I had looked for things like that to share with her when I visited. I also wished I had asked her more about her past.
- Some might be able to play games, put together puzzles, do small crafts. If you have old family photos of people you can’t identity, this is a great time to bring them and ask about them.
- Be cautious about gifts. Most times, they don’t really need or have room for anything. But if it’s a special occasion and you want to bring something, be aware of their situation. Don’t bring food unless you know they aren’t on any kind of dietary restrictions. And then bring food in a form they can eat (someone sent my mother-in-law a fruit basket, but she had no way to slice or peel any of it. She couldn’t have a knife in her room.) Cut flowers in a vase might be better than a plant no one has time to care for. Some other ideas:
All-occasion greeting cards (if they still send them)
Stationery and stamps (if they can still write)
Pens and pencils
Lotions (some might have skin sensitivities)
Bath items: nice-smelling shampoo, body wash, powder. Avoid bath oils – too slippery
Large-print books, magazines, crossword or word search puzzle books (if they can still read)
Small individually wrapped chewable candies (if they can have them)
Small packages of cookies (ditto)
Small throw blankets
Socks (slip-proof, if they are still mobile) and slippers
Nice nightgowns or pajamas. (or hospital gowns if they are bedridden. We used this place often.)
Small photo albums with pictures of your family. (Big ones are too heavy.)
Pictures colored by a child
If you have a project-based ministry to the elderly in your congregation, please take the items to the person rather than sending them home with a loved one or dropping them off on the porch. The visit means more than the things.
What if you don’t live near your loved one?
Don’t stop communicating because you don’t think it will do any good. One lady who used to write to my mother-in-law would check with me occasionally to ask if I thought it was still worthwhile. I told her I honestly didn’t know if Jim’s mom would know who she was or would remember the note I read five minutes later, but for those few moments, she knew someone cared enough to communicate with her. We’re more inclined to send texts or Facebook greetings, but it’s worth the time to send a personal note to an elderly person who doesn’t have access to those other venues. Sometimes a FaceTime or Skype call can be set up. One of Jim’s brothers used to do this even after Jim’s mom no longer spoke. She could at least see him and his family and would sometimes wave a finger.
What if your loved one is being cared for by a family member?
It still helps to visit or at least communicate for a number of reasons. Your loved one needs to know you still remember and care for them. And it greatly encourages the one caring for them to have the rest of the family still participating. Caregiving can be weighty and lonely, and the interest and care of the rest of the family can be greatly encouraging. By contrast, it’s immensely saddening to have birthdays and Mother’s Days go by without hearing from anyone, even if the loved one doesn’t know what day it is.
It can be hard to visit an elderly loved one.
It takes time and slowing down. It’s hard to acknowledge the effect of years and to know they’re only going to keep declining. Their might be messy or smelly. My mother-in-law was easy to get along with, but some dementia patients are angry or combative. It might be easier to remember them as they were than see them as they are. Most people’s main regret when a loved one dies is that they didn’t spend more time with them. Do all you can while you can to avoid that regret. Even if they don’t remember you, you remember them. I’m not trying to heap guilt on you; I’m trying to lessen it.
Godly love is about giving and isn’t dependent on what the other can do for us.
They don’t have to remember you in order for you to minister to them. Our blessing them comes from:
1) The example of our Lord, who blesses us every day of our lives even though we can never repay Him.
2) Gratefulness because of all our loved ones did for us.
3) Doing unto others as we would want them to do to us. (Matthew 7:12)
It can be especially hard when the relationship has not been good, when issues have never been resolved and there’s no hope of dealing with them now. Some of my friends have exemplified 2 Corinthians 12:15 with their parents: “ And I will very gladly spend and be spent for you; though the more abundantly I love you, the less I be loved.” Loving like Jesus means loving people even when they don’t “deserve” it. Love costs a great deal sometimes. As we pray to love more, we can ask that our “love may abound more and more, with knowledge and all discernment” (Philippians 1:9) and ask God to “make [us] increase and abound in love for one another and for all” (2 Thessalonians 3:12).
I’d love to hear from you about this topic. What have you found helpful when visiting elderly family members?
(I wrote a series of posts from our experience caring for my mother-in-law called Adventures in Elder Care. If you are in a caregiving season of life, you might find something helpful there. A couple of the posts there most related to this one are Am I Doing Any Good? and It’s Not for Nothing.)