Grace, in her 70s, developed a multi-infarct dementia. 

She became very agitated and went into a nursing home.  Within two weeks she had lost weight, was bruised, distressed and ended up sitting on a dementia assessment ward. She called out repeatedly numbers from 97 to 100. Sitting in a basket chair it was difficult to see what could be done to alleviate her distress or to care for her.  Judicious use of anti-psychotics and antidepressants had some benefit and benzodiazepines were used as well.  She didn't do that well but settled enough to go into a dementia specialist nursing home. There she lost weight, continued to be distressed and her husband could not bear to see her in such a way.  He asked the doctors for permission to take her home. They were rather reluctant, and thought it  a silly idea that was unlikely to work, with a high possibility of death as a result.

They had already told him that she was not likely to survive until her 50th wedding anniversary. So, they sat and discussed the possibilities.

They agreed that whatever happened,  Grace should not suffer, but felt that where she was, simply was not right. It seemed that going home would require a  miracle.

So they decided to plan one.

The nurses and specialist all said they were very worried about the plan to go home  and thought it a bad idea.  Her husband insisted, and after discussion it was agreed that this could be tried. Wonderfully, Grace did well. 

In fact, she lived at home for eight years and the doctors  were able to stop all her psychiatric medicines. She had needed these very badly, but as her illness progressed, the agitation and distress settled,  and all the medicines that were no longer needed were stopped.

Grace gained weight and was happy in the care of her husband,  along with a small but loyal group of carers who supported him. 

For a lady who was fully dependent, needed full nursing care,  including feeding, it was extraordinary to see her on trips out to shopping centres and her beloved golf club , amongst other places.

She smiled, spoke hardly at all, but watched everything that Jack did. Jack and Grace proved the doctors  wrong. They did see their 50th wedding anniversary.

Grace died quite suddenly one morning after breakfast. She was in bed. Grace and Jack had celebrated their 57th wedding anniversary.

The doctors think that Grace’s long survival was attributable to the combination of good care , with the fact that this was a Multi-infarct dementia and not an Alzheimer's type dementia.  Her dementia stabilised for quite some time and did not progress, explaining the unusually long length of time at home.

Apart from a real delight in seeing  them coping together, the specialist's reaction at the end of this experience was one of genuine pleasure in being proved wrong by Grace and Jack, whose brave decision showed him that this is a viable and a good way to care for dementia patients.  As a result of this, when others asked if they could take their loved ones home from nursing homes and if they could just stay at home he became more inclined to say “Yes”.

The Result.

In one small district, a specialist and his team  have cared for more than a dozen people at home until they die, and more have spent longer at home than they could have done otherwise.

The feedback from their carers has been very positive;  almost all have been really glad that they did what they did. A few had to give up, but having tried, they have, perhaps felt more secure in the knowledge that they did not let their loved ones down,