My mother just turned 99 and moved to AL in November. It was a big adjustment for her. She was living with me for many years and lived a very quiet life. In the AL there is a constant stream of aides, cleaning people, laundry people, etc coming and going into her room. She is not used to all the hubbub. At first she didn’t like that they just enter, but she has adjusted to that, she just requested that they knock before entering.
Her mind was pretty good, but since she’s been there she is so confused and her short term memory has gotten very bad. I attributed it to the stress of the move. But I figured by now she should be adjusting. She started having trouble keeping track of her meds so now the facility is handling her med management. She is exhausted all the time, as she is getting PT and OT 4-5 x/week due to poor mobility. She can walk (with difficulty) short distances but usually they take her down to meals in a wheelchair, since it is a distance from her room.
She is not complaining or asking to come home, she realizes it’s where she needs to be. It was her decision to move there. I just wondered if this memory thing could be temporary due to the stress of moving. I was so hoping she would have an easier time there. I read other people’s posts that their parent is “thriving” in AL. That’s what I was hoping for. To me she seems to be declining.
She LOOKED GREAT, and was able to maintain a social conversation with a stranger.
At her entry, she was self identifying as a fall risk, and had refused to stay by herself in her home, and had also refused modifications to that home, where she’d been born.
About 6 weeks after her admission, she’d begun to reveal significant cognitive breaks and had become a flight risk, and was transferred to a locked Memory Care unit in the same building.
I immediately sought a formal cognitive evaluation, and the psychiatrist informed us in layman’s terms that she’d been able to construct a “donut” of lucid discourse to conceal the fact that the core of her ability to understand, reason, and retrieve information was rapidly deteriorating.
We, her family, realized that this description was what we’d observed even before she’d been placed.
As she adjusted to her new surroundings, we could see the overall effect of her dementia get slower or faster over time, until a COVID infection resulted in a more significant loss.
My guess would be that this may be a more common occurrence than some of us as loving caregivers might easily miss. We were surprised at the psychiatrist’s assessment, but soon realized that her comments were accurate.
Hope some of you may find this possibility helpful.
I should note the nursing home she was at wasn't the best option where I live and the care provided isn't as good as it could be.
My Mom was 99.5 years old when I put her into Memory Care (she went willingly). At the time, she was a fall risk and we had caregivers who came in 9 hours a night to ensure that she did not fall when she used her walker to use the bathroom (in excess of 20 times a night) and the kitchen. She could not cook for herself and was starting to piddle on the floor and say it was not hers. She wasn't strong enough to turn on a faucet by herself or cut meat with a knife. She also went to senior day care where they ensured she did not fall during the day. Although she complained, she pretty much had people ready to help her in whatever she did, She did have edema in her legs. I made her exercise nearly every night because if she sat too much, her arthritis in her back would be very painful, instead of the constant dull ache.
She went into Memory Care using a walker full time. I did not want to pay for a caregiver to watch her, therefore, we did the "at night, they come by every 3 hours to check on her." After about a month, she started falling, nothing hard, just a crumple, usually when she was sleep walking. no bruising. I became more vigilant about the exercise and she didn't fall any more. However, I did notice that the MC was trying to get her to use the wheelchair more.
...and her incontinence was getting worse so they put her on a toilet schedule...and her ability to judge distances was worse which made the wheelchair more important. However, the caregivers were so so kind to her and in fact, would jump up and get her something if she requested it, therefore, she never really had to get out of her chair, they would bring it to her. She wanted to go to point A, they would take her to point A. They would help her get up out of the wheelchair, help her stand, help her wash her hands, etc.
At the one year doctor visit, my Mom's memory was worse, my Mom's mobility was nearly confined to the wheelchair, and she was going through Depends 2-3 times faster than a year earlier. Her balance was worse also.
However, her blood pressure was closer to normal, the edema in her leg wasn't as bad. According to the doctor, at 100, she was medically healthier than when she was 99.
So, even though I thought she was worse, apparently overall, she was better. She will be 102 in July.
...and yes, I still do exercises with her. She can't do them as long, however, I've noticed that once I get her started, "muscle memory" takes over. If I skip a couple of days, muscle memory takes longer to activate. Something like stepping on or off the curb or getting in and out of the car, taking on/off the seatbelt, takes an incredible amount of brain work from her.
:)
Mom is 85, and is also having a hard time with the lack of privacy.
We are going to try to wait it out, smooth the bumps. But like you, I was hoping that mom would enjoy some of the activities and meals more. Perhaps it will take time. But I am prepared for the possibility that the decline that forced her into AL might continue at an accelerated rate... hard to accept that things might not improve. No one lives forever, unfortunately. :(
Your grandmother is in the right place, and she is lucky to have such a loving caring grandchild. We should all be so lucky to have one person at least who doesn't want us to go. But at her age she's not going to thrive. Just keep loving her and that is the best support you can give her.
Try having a heart to heart as to the reasons that you are protecting her by the move, financial, physical or social.
Ask God to direct your words.
We are all connected in our souls.
Old people like children are more intuitive than those of us tied up in daily living.
She may just need to rest more and, take a less scheduled pace for a bit. Again, talk with her; ask her what she wants and, honor that.
Practice self care for yourself!!!
Blessings
Yes, the environmental change could be throwing her but she could have been on the cusp of a mental decline before moving. Because she sounds like a private quiet person, it is a bigger adjustment than for some. Parental care decisions are so tough. My MIL has had periods of sudden mental decline with and without environmental changes.
Some have suggested that she drop PT. You might talk to the doctor. Does your mother have a good or bad attitude towards it? My MIL seems to thrive mentally after she has some physical activity. A couple weeks ago when our son was visiting from out of state, her conversation was nonsensical. We then went to chair volleyball and played with her and the other residents. She enjoyed it and seemed to be more "with it" after playing. Same is true after exercise class. Exercise programs are a key element in memory care so if you do drop PT, try to get her to any exercise classes that may be offered and maybe walk a little bit with her...as long as it is safe.
I suggest when you visit, go to activities with her. Talk to the other residents and draw your mom into conversations with them. Also, try tapping her long term memory as it is usually better than short term memory. That success in remembering certain things would make her feel good and if she doesn't remember, there is the good excuse that it was a really long time ago. I took a 1949 picture of my MIL when she was 16. It was her standing in front of a train in Denver before leaving for National Girls State. I know she had not seen the picture for a long time but she knew the name of the girl her age in the picture and that her suit was blue. She told me a little bit about that trip. She told me once that she didn't mind me asking her questions about things she did in the past.
I have written before that I believe personality plays a role. I saw many folks adjust very well. They were social and enjoyed having new friends. That was not my moms nature and that made it more difficult. She would have been happy had I been able to stay every minute with her. I was familiar and made her feel safe.
Give it time. Your mom is going to meals. (my mom would not). She may find friends that can give her new energy. I wish you well during this difficult journey.
I don't know how many will write you to say their century old parent is thriving. But I have been some years on Forum, and I doubt it will be many.
My own father, nearing his mid 90s, told me he was exhausted with life and longed only for the long- long nap as he called it. He said it was so difficult for him to get out of bed and participate. He had had a wonderful life; he had no complaints, but he longed to "go".
Many of my patients when I was an RN felt the same. They told me that they could not tell their families this because their families would not hear it, would negate every word they said. So they were left to share their truth with a virtual stranger, their RN.
You lovely Mom will not complain to you. She will likely go just as she has lived. With grace. You are so lucky to have had her all this time. My heart goes out to you BOTH.
Once a decline occurs it can take a long time to get back to "baseline" if that happens at all.
At this point I would suspect that her cognition is going to continue to decline. That could be due in part to age as well as the move.
I really doubt that it is temporary memory thing, the shade has started to draw down, nothing unusual about this at age 99.
My mother is 98 in AL, her mobility is dwindling, she is tired and at times confused, nothing serious just moments of confusion.
Her thriving days are over, it is now about safety & comfort.
Nothing in life remains constant it either gets better or worse.
Accept the decline, obviously she has.