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My mom lives in an assisted living facility but is currently in a skilled nursing facility. She is constantly agitated about everything going on around her. No one does anything right.

Answered by David Troxel

January 13, 2014

My mom lives in an assisted living facility but is currently in a skilled nursing facility. She is constantly agitated about everything going on around her. No one does anything right. She tells vivid stories of how the caregivers in both locations will not let her go to the bathroom or make her go on the floor in the middle of her room. She says they force her to eat things she doesn’t want. Example: She asks for whole milk. When they give her whole milk she says what they gave her is not whole milk and argues about it non-stop. She gets obsessed with things and will not let them go, even if a doctor tells her the correct answers. She had an infection in her legs, which is now 100% healed, but she insists they are going to cut her legs open to biopsy her leg and see what is wrong. The doctor tells her she is 100% cured but will not believe it. She becomes very combative with me and the staff. And to top it off, she says that we all think she has dementia but she knows she doesn’t. No one can redirect her in any way, so she just complains and argues 24/7. How do I deal with this? I feel bad when I see her every day, and every day is another battle of complaints about what everyone is doing wrong. How do I handle this? Thank you for your help.

Your mother’s routine in the assisted living community was clearly disrupted when she went into skilled nursing. She may have some legitimate complaints but it also sounds like she has having delusions—fixed, false ideas about what is happening around her.

A few tips. I would write up her life story and personal preferences for the staff at the skilled building in a simple, one-page format with bullets. It might help if they know your mother loves her milk a certain way, likes to talk about being a nurse in the army, or is an award winning cook. This would allow staff to make a more personal connection with her.

Develop a script for the family and staff to follow that provides reassurance, e.g. “I’m so sorry that you are here right now but the doctor wants you to build up your strength. You’ll be headed back to your apartment before you know it.” When everyone is on the same page it can makes things much better and provide reassurance.

As always, try to make her feel that you are on her side. Apologize for the problems, let her know you are working on things.

When my own father went into rehab after a fall, he was not a happy camper, but it cheered him up when I brought in some McDonald’s coffee and his favorite sausage biscuit with packets of catsup. Bring in some of her favorite treats.

I hope this will pass soon and she will get back to her more familiar environment.

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