Mailbox Response

The question was submitted 13/08/2008

Subject: Risk of moving patient

My uncle suffers dementia. He was put into a hostel with his wife about 5 years ago when he was about 65. His wife died shortl after and his sister became his power of attorney and guardian. I'm not sure what type of dementia he has, but his main problem is disorentation and sometimes quite vague. As far as I can see you can still hold a conversation with him, my mother plays Yatsee and cards, he still plays bingo, and keeps up with sports. He probably needs prompting to remember distant relatives, but certainly knows the familiar ones. He does not have children of his own and is reliant on primarily his two sisters.
The hostel he is currently living is an hours drive from where his sisters live, so he often goes a month without seeing anyone. This is our delema.
We would love him to be moved to a hostel closer to family. My mother is an active 79 year old who has had numerous operations to her foot which has affected her walking, she is the one who would love him to be closer so she can pop in more to see him, take him to her place for lunch and even give him a game of bowls, all which is very local. My son plays grade football, which he could come and watch. We feel he would get a lot more visitors and his social life would improve.
Now the problem.
My aunt who is his guardian doesn't want to move him, eventhough she lives in the same area as my mother. She said to move him could be distressing and he is better off where he is until he is eventually placed in a lock up situation, eventhough he has voiced to us he would rather live closer to all his family. From my point of view he fully understands and even adds input. He does remember when people have visited him and how long it has been. I phoned him yesterday and he was able to tell me about the opening of the Olympics what day it was and what time is started. Unfortunately my aunt makes out he knows and remembers nothing.
I am interest in your feedback on moving him to a hostel closer to family at this stage.

Answer from DementiaNet

The question raised is a very relevant one about the pros and cons of leaving a person isolated in a familiar residential environment versus moving them an alternate one closer to family.

There is always a risk that when a person with dementia is moved to an unfamiliar environment they may become more disorientated and confused for a short period of time.  This is very easily managed by staff being sensitive to this and family providing a lot of attention.  It is also important that the family members make themselves available on a daily basis for the first period of time to allow for settling in and adjustment. 

Once the person has made this adjustment then the advantages of being close to the family are enormous and far outweigh any possible inconvenience associated with remaining distant from their family.  It could even be argued that it would be cruel to leave a person isolated from close relatives. 

If there remains resistance by the guardian to allow the relocation to take place, then the other course of action is to apply to the Guardianship Board in your state to have an alternate or an independent guardian appointed who will be able to consider what is truly in the best interest of the person with dementia. 

In the process of relocation it is important that the GP transfer relevant information to the new GP so that the patient can be seen shortly after arrival.

The answer was published on DementiaNet 28/08/2008