By Roberta Satow, Ph.D.

Moving my mother from an assisted living facility to a nursing home was an agonizing experience. This is our story.

I packed what my mother would need for the first couple of weeks at the nursing home and put the bags in the car. As difficult as this was, my mother’s dementia was so severe that she needed more care than the assisted living facility provided.

I was moving her alone, without my sister or brother. My sister was moving her husband from the hospital back home. At first my brother said he would come with me, but then he decided it was too upsetting for him. He assured me I would be fine without him. I was not so sure.

A few days before I had asked to speak to a social worker to discuss the “best” way to move my mother. The admissions person said: "Hold on, I'll get someone to talk to you." She came back a few minutes later and said: "The social worker said there's no problem. Just tell her where you're going. Don't lie. That’s it." I wanted to yell at the woman, but I decided it was as pointless as expressing my anger at my brother. I knew that was not “all there was to it.” I knew it was going to be painful and that I would feel guilty. I wanted someone to say: “It’s going to be horrible; you are going to suffer alone for the whole day. But then it will be over.” No one was going to say it, so finally I said it to myself.

I purposely did not talk to my mother about it beforehand. Since she has severe dementia, I knew she wouldn't comprehend it and there was a good possibility she would become angry and hostile. So, I decided to tell her we were going for a ride at first and tell her the truth when we were on our way.

Too Much Guilt

At the Assisted Living facility, I deviated from my plan. I felt too guilty letting Mom leave without saying goodbye to Lisa, the aide whom we’ve been paying to look in on her daily. Lisa is a blond Russian woman with a thick accent and a happy disposition. She comes from a culture, like many of us, in which she is expected to take care of her mother. It was not an option for Lisa to consider putting her mother in a nursing home, and I know she was angry with me. I knew Lisa would also miss my mother—she was genuinely attached to her. Against my better judgment, I said: "Mom, we're going for a ride, do you want to give Lisa a hug?"

My mother has dementia, but she is not stupid. The jig was up. She didn’t want to go; she refused. My mother was looking at me as if I was a total stranger trying to abduct her.

"I'm not going anywhere," she shouted as she held onto Lisa’s chubby arm. I felt like an abuser. I imagined old women with their walkers and their aides lined up in the lobby whispering to each other: “Isn’t it terrible?” What a shame?” “Look at that.”  Part of me wanted to grab my mother’s skinny hairless arm and push her in the car, but I controlled myself. Instead, I spoke in a calm, controlled voice:

"Mom, we have to leave. You need a lot of help and you can't get it here. You need to be at a place with doctors and nurses; a place where you will get exercise each day."

"I'm not getting into that car." She scoffed at me.

I tried rationalizing with her in an attempt to feel like a reasonable person. "Mom, we cannot afford to keep you here any longer. It's very expensive and the other place is beautiful, it's like a park, and they will take care of you better.” She was unmoved. Finally, I blurted out: “Mom the other place is free!"

Mom had turned to look behind her. "Who are you? I'm not going with you!"

"Mom," I pleaded, "this is Vladimir.” I pointed to the heavy set, 50-ish man with tussled gray hair that my brother sent in his stead to drive my mother and me to the nursing home.

"He's old enough to be my father! I'm not going with him." My mother shouted and grabbed Lisa more tightly.

I started to laugh, but tried to stifle it. “Mom, Vladimir is waiting for us.”

"Sure,” she said in cocky tone, “but I'm not going with him.” 

My mother turned to Lisa who looked uncomfortable and glum despite her robust pink cheeks. "Are you coming with me?" She asked.

Lisa was torn: if she said "no," my mother wouldn’t get in the car and I would be angry. But she didn't want to lie to my mother. She was silent; her blue eyes looked up at the sky as if God would offer the answer to the conundrum.

I looked at my watch. We were supposed to be at the nursing home at 2 o’clock and this was making us late. I imagined finally getting my mother there and a smiling nurse saying, "Sorry, it's too late. You'll have to bring her back tomorrow."

I felt stuck; I didn’t know how to get my mother the car. We were at a standoff. Finally, after what felt like an hour I said, "Lisa has to ask her supervisor for permission to come with us. Why don't you get in the car and she will ask permission?" I lied to my mother. Lisa was not going to ask permission.

"Why don't you help my mother to the car?" I beseeched her.

Lisa walked my mother to the car and opened the door with her left hand, holding my mother’s arm with her right hand. My mother obediently got into the car and I put the seat belt around her and buckled it. She didn't fight. I breathed a sigh of relief and closed the door. I knew my mother was furious, but I didn't know what else to do. "Bye Lisa," I waved to her. My mother looked out the window silently. I decided to be quiet because I was afraid she would start yelling that she didn't want to go or try to get out of the car. 

The ride took an hour and a half in midday traffic. Just before we turned into the park-like lawn next to the nursing home, I said to my mother: "Isn't this beautiful, Mom?"

To my utter shock, she turned to me and smiled. “Oh, I didn’t even realize you were there.”

Roberta Satow, Ph.D. is a Professor of Sociology at Brooklyn College and a practicing psychotherapist in Manhattan. 

She is the author of Doing the Right Thing: Taking Care of Your Elderly Parents Even if They Didn’t Take Care of You (Tarcher/Penguin 2006 paperback).