<p>Takeitallin… meant to reply to you and your Mom’s ring. You did the right thing. Put the real one in a safe place away from her. But then go get some sparkly one from a garage sale or vintage sale, costume bank. My mom loves wearing her jewelry and she can’t tell the value of anything really. Everything is really valuable, including the crystal earrings we bought to replace her diamond ones. She is just as happy wearing them and I am not stressed if they go missing.</p>
<p>Another “lie” that isn’t and helps keep things peaceful.</p>
<p>" she also thinks people put things in her house to confuse her!!! "</p>
<p>My mom kept pointing to a particular teapot and claiming that her friend must have put it on her shelf as a joke. She couldn’t remember where it came from, so made up this scenario of her friend sneaking in and putting it on the shelf.</p>
<p>We were finally able to place her in a memory care section of an assisted living facility about 3 weeks ago. The transition has been harder than we ever could have imagined. She went from merely forgetful to full blown delusional within two weeks. We worked hard to recreate the feeling of her home in the room with her furniture and decorative items. For the first 10 days she packed everything in the center of the room each day and called us repeatedly to “pick her up from the hotel” or “pick her up from the hospital”. She now believes she’s in her childhood hometown and tells people her parents are coming to pick her up soon. She’s made numerous escape attempts, and even managed to cut off the ‘wanderguard’ ankle bracelet that alerts staff when someone is exiting the building. We’re getting worried she might get kicked out of this place (which is very nice) if things don’t improve.</p>
<p>The doctor’s solution has been to start loading her up with medications. When she entered the facility her only prescription was for glaucoma eye drops. He started her on Risperdal, Aricept and Celexa within a week. He thought the Risperdal might be making her worse, so he’s switching her over to Seroquel. Fortunately he did provide a referral to a neurologist, so we can have a second opinion. I had asked him if there was anything she could take to reduce her anxiety (thinking the typical sedatives), so perhaps he thinks we want her doped up. He said the classic anti anxiety meds cause more confusion in elderly, but I can’t imagine a steeper decline in cognitive function that she has experienced. Perhaps it was inevitable and the move just speeded things up. We (her 3 kids) thought we would sleep better at night knowing she is in a safe place, but now I wonder if we should have found a different solution.</p>
<p>So glad to use my extra hour today finally revisiting this thread, I have lots of catching up to do.</p>
<p>When a person with dementia moves to a new place, it’s not that the dementia suddenly gets worse. Rather, it’s that the dementia shows more. Everything is new, and with the inability to form short term memories, the symptoms show up more.</p>
<p>I hate this idea that to deal with dementia we have to medicate. Is it possible to go more into your mom’s reality, momsquad, and find a way for her to come to believe she is where she should be? I love this idea of fake bus stops for people with dementia. Is there something like that which could work?</p>
<p>I’ve got things better than many but my mom is slowly going down the dementia track. I think I need anti-anxiety meds or something for every time I talk to her.</p>
<p>but on the humorous end, she did cataract/lens replacement. She now sees perfectly but doesn’t see the difference (I think that’s brain related but at least I know she can see since she still drives, some) She told my brother, and then me as well, that she wishes she had her old eyeballs back. We tried to convince her that it’s the same eyeballs, just a lens. I’m not sure she believes either of us. She wants to know what they do with all the old eyeballs. My oldest D said to tell her they give them to underprivileged children overseas to make her feel better.</p>
<p>momsquad, my dad and stepmother used to go to Florida every year for several months. The last year they went, my stepmother was extremely disoriented for a few weeks when they got there, and for a few weeks when they got home. The last trip ended a year and a half ago, and her dementia is much more advanced now, but she did recover quite a bit once she was in once place for a while.</p>
<p>Watch the Aricept–it was discontinued for dad and stepmother, for her because after a while, it gave her terrible diarrhea. I don’t remember why it was discontinued for my dad.</p>
<p>As for the the other drugs, maybe she should see a neurologist or a psychiatrist. Is the prescribing doctor connected to the place where she’s living? I don’t want to be alarmist but I have heard of doctors overprescribing psychoactive drugs to assist in patient management. Celexa has been prescribed for many years as an antidepressant/anti-anxiety med, but Risperdal and Seroquel are newer and not well-studied for treatment of dementia in elderly patients.</p>
<p>Risperdal is a antipsychotic with a lot of side effects, including, in older adults, increased risk of stroke, and in everyone, increased weight gain. Some of my friends have autistic sons who take Risperdal. My friends do not like the side effects in their children. This is not a drug that ought to be prescribed lightly.</p>
<p>Momsquad, what your mom’s physician is prescribing for your mom’s dementia is not shown to help. Aricept is only for early dementia which your mom is way past. The atypical anti-psychotic drugs of Risperdol and Seroquel are for symptoms of dementia as a last resort, such as sun-downing so the care givers can get some rest which may be appropriate. Celexa may help some of the agitation but should be removed if not working. Unfortunately, there is no drug to fix this. But your mom should be checked for a UTI and possibly a head CT to check for a head bleed rather than making the assumption the dramatic change has to do with the move. </p>
<p>There was a great article in the New Yorker about a Alzheimer’s unit which allowed the patients to set their schedule. They went to bed, ate, watched TV, took baths and wandered whenever they wanted. It dramatically cut back on the meds they are taking.</p>
<p>They have some amazingly creative solutions to common problems. They put a black mat in front of the elevators because the dementia patients perceive the black as a hole in the ground and won’t cross it. Brilliant! i also love the idea of the fake bus stops used in some German facilities. </p>
<p>My mom’s doctor is considered “the” geriatric expert in her city. He is head of the local Alzheimer’s Association and has a long list of credentials and awards. I thought we were in good hands, but it looks more like he’s just trying to make things easier for the caregivers. He is also the medical director of her facility. At the last appointment he did suggest she see a neurologist, so we have a mechanism to change her treatment without questioning his decisions directly. I’m heading up next week for 4 days to get a better handle on her situation.</p>
<p>I think the best advice from everyone is to try to think like the patient, and not try to bring them back to this reality. A link in another thread had some simple guidelines; never ask a factual question, as the Alzheimer’s patient can’t find any facts in their memory, and never refute anything they say. It’s going to be an interesting visit, I suspect I’ll be discussing lots of dead relatives as though they are still alive.</p>
<p>My mom has hardly been out of her new residence since she entered. Does anyone have experience, good or bad, taking their dementia parent on an outing? I’d like to take her on a drive and perhaps a walk on the beach, but don’t want to cause undue stress or additional confusion.</p>
<p>Certainly the meds he is giving her are ones that are given to patients with dementia. I’m just surprised by the cocktail of 3 medications at once. But, he is the one who is seeing and evaluating her. I think a referral to the neurologist is a good one. </p>
<p>Yes, that is the Alzheimer’s unit I was referring to. They were giving in-services to facilities in NY. Yes, it does no good to argue. I still ask questions about my parent’s lives to show that I am interested, and they will tell my how they remember experiencing it. I don’t expect a factual answer.</p>
<p>momsquad–when my MIL was in the middle stages of dementia she loved going for a drive along the Massachusetts shore, to the area where she & her husband used to have a summer place. I’m not sure if she recalled specific areas, but it all looked familiar to her and brought back happy memories.</p>
<p>My mother had her first cataract done this am. So far, so good. The staff were wondering if she was feeling any weakness. She told them how many push-ups she does and that she did her weights this morning before she went. (A month ago she remarked to me that she wasn’t able to do a push-up until she was 84. ) They all wished me good luck getting her to take it easy for the rest of the day!</p>
<p>Best news is that she seems to be ready to move on to addressing her hearing loss.</p>
<p>Great news, consolation. Maybe there is hope for me and my push-up (in)ability! I hope all goes well with the drops and follow up. My mother was so happy after her cataract surgery. Unfortunately, now, she is very reluctant to getting a hearing test. She does not acknowledge her problem (we mumble or speak “away” from her). My grandfather drove her crazy with his hearing denials, and now she is doing it. The TV is full blast and I know mom misses a lot. Her best friend (who my mom swears has MUCH worse hearing loss!) is going to Costco next week for hearing aids. I hope the friend has a fabulous experience both for her (lovely lady) and so that my mom will be encouraged.</p>
<p>I will have been to visit my mother (2 flights, car rental, hotel) 4 times in the past 8 months counting this coming weekend- when I reminded her that I was coming in a few days she said ‘I hope you stay longer (usually 3 days) because you only come once a year’ I reminded her the months I had been there and she said I had it wrong. This really should have been more upsetting than it was to me. Somehow this was a relief for me. I now realize that it is not an issue of timing as much as just checking on things. It is what it is.</p>
<p>Update on Mom’s “stolen” stuff: Today I got a call from the AL Director. He wants me to come meet with Mom and himself, in hopes that somehow we can calm her down or something. Even though last weekend all of the missing things were found or accounted for, she continues to harass the young man whom she’s decided is the culprit. Apparently she called him an S.O.B. which is NOT like her. When we meet tomorrow, I think I’m going to try a different tack, something like, “You know how protective I am of you; you’ve seen me do battle on your behalf with the bank and Comcast, etc. If I thought the staff here was stealing from you, I’d have you out of here so fast your head would spin. I promise that if I ever think that, that’s what will happen. In the meantime, you can relax and know that I’m looking out for you like I always do.” Maybe address her emotional needs of feeling vulnerable and not in control? As momsquad says, trying to convince her of the real-world facts has gotten us nowhere.</p>
<p>I think Mom’s memory is worse than any of us suspect, because she’s so great at masking it even with family. If any of you were to talk to her, you’d have no idea she has any memory problems at all. You’d find a lady who’s vivacious, appropriate, funny, sure of herself, and completely engaged in the conversation. It’s only when you start digging that you find out how much is missing.</p>
<p>That’s a tough one, LasMa. In your mother’s mind, the blameless young man is a thief and she knows it. I can’t even think of how to enter her reality and play along. And telling her that you don’t think the staff is stealing is just denying what she knows to be true. I was going to put quotes around “knows,” but we can’t tell the difference between knowing something true and “knowing” something untrue. And even when you demonstrate that she is wrong, as you did with the wines, she’s just going to forget it, and remember that Joe is a thief.</p>
<p>The AL Director must have some experience with other clients with the same difficulties.</p>
<p>LasMa, I have no experience in dealing with these situations, but is there any possibility that you could get through to your mother by laying it all out–the supposedly stolen items, right there–and telling her that what she is doing to this young man is VERY wrong, and seriously so? She sounds like a person who would be horrified if she could be brought to realize that she is actively doing harm to another person. I’m sure she would find this upsetting, but it seems that pleasant reassurance and reasonableness is not getting through to her. Perhaps you could follow that up with the speech regarding protectiveness you describe above. I could be totally off base.</p>
<p>LasMa, have you talked to Joe and assured him (and the director) that you are confident in his integrity? I’m sure he is concerned for his job. Such a difficult situation for everyone involved!</p>
<p>LasMas- quite a dilemma. There is probably not a quick fix, or maybe even a fix. Here are some thoughts addressing a different aspect of the situation that may be relevant at some point. When a person is either losing things constantly, even if temporarily, and blaming others, or perceiving their home as unsafe, they often have a lowered quality of life due to stress. I think this is true regardless of the cause of their misperceptions, though the way to address them would vary by etiology. </p>
<p>Your mother currently can not manage all the things in her environment. It may be that the field is just too broad for her and her present capacities do not allow her to sort out aspects of her days, including many things that used to be automatic. I do not know what is right for her, but I want to put my experience out there in case it resonates for others. Sometimes an environment geared to a higher level of care (ie a skilled nursing memory care facility vs assisted living) does more than the obvious provision of increased care. The frequent presence of staff that you get to know better (higher ratio to residents usually = more time with each resident), coupled with a streamlined room without extraneous things to be confused by, a structured activity program with prompting for schedules, etc. relieves the emotional toll of trying to keep up in a world that moves too fast or is too complex. I moved my father from AL to skilled nursing memory care when he just couldn’t create the kind of life he enjoys for himself. I was in no hurry for the poignant move, but in hindsight, it was the best thing I ever did for him. It was taking more than he had to find his way to the dining room, after 7 years there, never mind scheduling a meet-up with other residents. He is still social and “not out of it”, but for having 0 short term memory and fading long term memory. My dad is easy going and chronically happy, but he is now really relaxed. The smaller environment is a better match now. Sometimes the decisions are harder on the care partners than the elder.<br>
I hope your meeting goes well. Shy of moving her, perhaps some time with a companion, etc. could help her be less overwhelmed.
Best to all the elder-heroes on this thread.</p>
<p>CountingDown, I haven’t talked to Joe himself since he works the overnight shift, but every time I talk to a supervisor or director, I emphasize that I don’t have any suspicions that Joe or anyone else is really stealing from her. I’ll reiterate that this afternoon; thanks for the reminder.</p>
<p>Consolation, reality checks haven’t worked. For example, last weekend she was insisting that her wine was stolen – even as I held up both bottles in front of her. I’m afraid we’re past the stage where logic and reality can change what’s in her head. Because Fang is correct; that’s her reality now. She has told me that she can see it in her mind, plain as day, and she will not be convinced otherwise. That’s why I’m hoping an emotional approach will work better, but who knows. </p>
<p>travelnut, I do think you’ve hit the nail on the head re she’s just not able to manage the stress right now. Her husband of 65 years is on his deathbed, which by itself would probably knock anyone off the rails. And since he’s now in skilled nursing, she’s living alone (albeit with AL staff nearby) for the first time in her life. Not sure there’s much we can do about that; she’s physically too healthy for skilled nursing. Maybe I’ll check into Memory Care. We’ve also thought about moving her to a Board & Care – much smaller, calmer environment. Two things I can do right now are spend more time with her, and address the physical condition of the apartment. The clutter is getting out of control, and that always ratchets up my own stress level. Maybe a good weekend cleanout will help us both. And hopefully reassuring her that I’m looking out for her will get through somehow. Because I do think you’re right that the source of all this paranoia is that she feels that she’s not controllling anything anymore.</p>
<p>Agree about the Aricept issues. My grandmother had been diagnosed with early dementia by her doc. Long story but it was later corrected to normal age-related decline. More a slowing down than a memory or processing problem. The Aricept diarrhea caused a host of problems with fluid balance, itself a risk for the elderly. </p>
<p>I’m also surprised by the cocktail. “Normal” doses can be excessive for the elderly (and depending on weight,) so you need to see what those are. Plus, can’t be said often enough: UTIs can cause what seem to be dementia symptons or an increase in people with dementia. Need to request a culture, not just a urinalysis. </p>
<p>LasMa, glad you spoke with supervisors.</p>
<p>Adding this, re: complaints and accusations: can’t always use normal reasoning with people in decline. Can’t “prove” anything because they aren’t processing the detail. Sometimes all they do hear is the dismissal. It can also be tough for them to even listen through a complex explanation. We found it helped to keep responses very short. Or radically change the subject. But you have to have some idea what switch will get their attention, engage them in a different direction.</p>
) They all wished me good luck getting her to take it easy for the rest of the day!</p>