The questions seem to be, why does Joyce "seem lonely" and why does she spend 5 to 6 hours a day keeping him from participating in activities? I don't think any progress can be made until we understand what Joyce's underlying fears or concerns are related to letting go of Bob. Perhaps she fears his adjustment to his new home could indicate that he doesn't need her anymore. If he doesn't need her anymore, who will she be. How will she define herself? She was most likely his primary caregiver and provider of support for many years before he came to live in the facility. We need to be aware of the loss of identity she would feel. We would definately need to make her a part of our planning for his care needs. She should be encouraged to continue to provide care for Bob when she is in the building. Make her a part of the team. Elicit her help, give her purpose beyond Bob (while including him). She will have a hard time "letting go" of her role until she sees hope of another possibility.
Yes, I agree that this is a challenging situation. We have to be careful to support Joyce and to be sympathetic to her resistance to let go of Bob and her role as his primary caregiver. Perhaps she did not really want him to leave the home even though his care was getting to be too overwhelming for her. Maybe it was the decision of the adult children to place Bob and she would still rather have him at home. She is struggling with her new role and her lack of purpose. Perhaps she had let go of her friendships and activites so to care for Bob. Her life is lonely and empty now. She needs support and compassion. Maybe she can take part in a support group. Maybe there are volunteer opportunities for her in which she and Bob can both participate in activities together. Maybe she can start by chosing SOME activities for Bob to engage in while she observes. 5-6 hours a day seems like way too much time for her to be there. Is she overwhelmed by chores at home that she is avoiding by staying with Bob? What were their roles? Someone needs to sit down and engage Joyce and get to know her and what makes her tick. She might need a referral to a physician or a therapist.
