I've written to you before. My question was about how my mom was miserable in AL. I received lots of good advise about how it would take 6 months to a year for her to feel like this is her home. She now has had at least 3 episodes of sundowners syndrome. She thinks shes in a school and we won't let her come home. I visited her this morning and she still kept saying that it was a school. It appears that her mild dimentia is getting much worse. How do I handle this? I made the mistake Friday night of telling her that she was living here and she picked the place. She had a meltdown since she thought it was a school. She's also getting extremely paranoid hiding things etc. She has a huge argument with the wait staff and the kitchen telling them that they stoler her wine. When she had put in in her room. She is so unhappy. I'm thinking of suggesting an antidepressant.
I also read a recent article here that said that dementia can get worse if the person is not doing chores etc. She doesn't have to do anything in the AL. She walks and sometime exercises, but that's about it. She is not a social person at all. Any suggestions at all would be really appreciated. I feel so guilty about putting her here. Even though she couldn't live alone any longer.
Dementia is progressive. It gets worse over time. That is what it does. This is not caused by moving into a long term care facility or by not exercising enough or by daughters missing a daily visit or by wearing pink bunny slippers. Progressive dementia progresses. I'm sorry to be so blunt, but I think it is essential to accept this truth to make any forward progress.
First, toss out the guilt. We do not fully understand the causes of dementia, but it is a certainty that you did not cause your mother to have the disease. You did not cause it to get worse. You helped her find a safe place to be as the disease does its thing and Mom inevitably gets worse. Congratulations. You did good. Enough already with the guilt.
Accepting that the disease is going to do what it is going to do frees us up to respond in ways that improve the patient's quality of life. Accepting her current reality, or at least not trying to disprove it, is one way to help Mom stay calm. She thinks she is in a school? Fine. Fall break isn't until next month -- that is why no one is coming for her right now. What is her favorite school subject? And don't beat yourself if you "say the wrong thing." Sheesh, how are we supposed to know what is going to set someone with dementia off? Learn from your "mistakes" and try to approach things differently next time.
Depression is often a component of dementia. I think you are on the right track to talk to her doctor about an antidepressant. It won't cure her dementia or stop it from progessing, but it may relieve some of her unhappiness.
Paranoia and hiding things goes with the territory. If she weren't in AL she would be doing it at home. I'm sure the staff is well aware of this. Again, I'd try to accept her reality while trying to soften it. "Oh look! Whoever picked up your wine must have done it by mistake, and now they've brought it back."
If she can still walk (no wheelchair) then walking is absolutely excellent exercise. And participating in group exercises is good, too. Getting in the movement is what is important. You can go for walks with her when you visit, and encourage participation in exercise sessions offered by the AL.
You can't cure your mother. You can't stop a progressive disease from progressing. But you can (and I am sure you do) bring her comfort and ease her burden.
Best of luck to you both on this very difficult journey.
If I see signs I question it, I raise my concerns within reason. Medication not given correctly can cause unstability. Confusion and unstable environment can cause unstability. Conflict can cause unstability. Communicating with the staff about care and meds etc. should be discussed if there is an issue of concern. I make sure it is noted when Mom is having a good or bad day. This helps the Dr's and staff help her. My Mom thinks she works in a hospital. I go with it. Sometimes she tells me she working, so I say I was passing by and thought I'd see if you could take a break and she says Ok I'll take a break. Instead of fighting her mental state I go with it. It works for me and she seems content with her reality. She is safe and happy in her own reality so why should I burst that bubble. She is clean and eats and gets exersize and I know I could not provide her with the care she needs daily but I also am very aware of the care she's getting and that her daily needs are met. This is all I can do in the situation. I am actively aware and make my concerns known and do not rest until they are resolved.
But now he is afraid of the change. He just moved here one year ago and it was a total shock to him; he has declined rapidly. I hesitate to 'push him out' though I feel his social isolation contributes to his decline.
So it scares me to hear of people actually doing worse in AL than better. Of course, all the AL folks tell you is that quality of life will improve. I realize they are salespeople.
OP, Good Luck with your situation. Jeannegibbs always has awesome words of wisdom!
In your situation, I think an important factor is whether or not your father has dementia. If he does, chances are it will get worse -- that is what dementia does. If the progression is very slow, it may not make a difference in this decision. But if it progresses faster it may mean that assisted living will no longer be suitable. He may need more care than an AL can provide. Does the place you are considering have a "next step"? Do they have a memory care unit or skilled nursing unit he could transition into if/when the need arises?
There can defintiely be improvements to quality of life, whether he has dementia or just age-related decline. But with dementia it is important to realize that improvement to qualtiy of life is what you can hope for -- improvement in the disease itself is not realistic.
Best wishes to you as you struggle with this.
And thanks for the kind words, by the way.
Please don't feel guilty about putting your mother in AL. From what you said, she was unable to remain in her home alone. Yes, it is a huge adjustment to her to be living in a different environment, but a necessary one for her safety.
It is so hard to see our parents decline and see them so unhappy. I would recommend that you check with the doctor about putting her on an antidepressant. I did the same with my mom. Unfortunately it can take several weeks for antidepressants to take effect, so it will be awhile before we know how much it helps Mom.
Give it some time with your mom. Know that you did the right thing, even though it feels really bad right now.
long story short, it's a beautiful facility with activities. but have found that the activities are the same each week and they are short staffed. mom is getting worst and wetting to bed and sometimes the sheets aren't changed. i change them. i'm thinking of looking for another facility because she needs some one on one attention and for $4600 a month i just don't think she's getting the best care. a beautiul facility is Not always the answer. any suggestions.
No you suppose your mother needs a higher level of care? Maybe "assisted" is no longer enough.
Ask them to evaluate for medications and make sure she has no infections or other treatable conditions. Get her some non-alcoholic wine and tell her you found it. Do some of the activities there with her, tell her you think the classes she gets to go to are pretty neat. It does not sound like you need to feel guilty, but focus on making any good memories that you can and giving her as much quality of life as she can have. Even if she does not really remember it specifically the next day, I think it helps in some way. The exact same behaviors and concerns could happen and do happen all the time with people recieiving care in their own homes.
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