There are some good drugs/drug combinations to assist with depression and other aging issues. My mom was expert at masking her dementia - so once it became evident, she was on memory medication.
In our skilled care facility, sometimes residents go to a psych hospitalization to get on the right combination of drugs when they need to have more tweaking of the drugs beyond what are the first line standard drugs.
The term ‘resiliency’ is something talked about in a publication on the news stands now “Mayo Clinic Guide to Healthy Living”.
The elderly can do well as they learn to accept their own limitations while continuing to enjoy ‘quality of life’ things that they still can enjoy. The decline is depressing for anyone. I like the physical things that one can do and they do them - like the chair exercises mentioned in post 9599. A can of soup in both hands and doing some arm exercises. Walking with a walker to gain strength while walking safely.
I have been following this thread for quite some time and have gained much wisdom from advice given to those who are dealing with the many challenges of aging parents. I’m now in need of help dealing with my father who had been living with my mother until Tuesday afternoon when he was to be admitted to a memory care facility… but instead was admitted to the hospital with a bilateral subdural hematoma which required a craniotomy to drain 150ml of blood which had accumulated between his skull and brain from a slow bleed we weren’t aware of over the past several weeks. The pressure on his brain caused a rapid decline in his mental and physical condition as well as incontinence and loss of control of bowels. He went from moving about independently to needing assistance getting on and off a chair, and support when walking.
He came out of surgery much improved, but the problem is, he is now extremely fidgetty!! Trying to remove IV, head drains, … The staff was able to use wrist restraints initially, however, he cannot be discharged from the hospital until he goes 48 hours without restraints. In the meantime, we are paying 80% of the memory care costs ($11k/month!) to hold his room.
Of course reasoning with someone with dementia just doesn’t work. I’m looking for any suggestions to keep his hands and mind occupied so that restraints can be avoided and he can be discharged from the hospital. A fidget spinner will be on my list.
A friend’s husband with dementia was hospitalized and the hospital supplied a “fidget blanket” ( not sure that is the correct term)
Fidget quilts- they can be designed with the interests of the person
SnLMom, that is a tough one obviously. It depends, in my experience, the nursing staff and their ability to handle dementia issues. I have no suggestions just support.
SnL, you are in a rough place, as you well know. How much can you and other family members stay with him? Can you walk with him to get him tired, keep him up in the chair as much as possible? Are they trying to get on top of the figity behavior with medication? Ask for a consult with a geriatrician, or advance practice nurse. Try to have music on, as it can calm things in some cases. Some hospitals have video monitoring, to call staff to the room when he goes for the Iv or other lines. Sympathies!
The fidget quilts are interesting. Might help if it would have the right challenges. One nurse actually brought in a child’s activity blanket, but it didn’t keep him busy for long. Fastening the button was the only “activity” of interest.
As for walking more, YES! I can’t believe they aren’t getting him up to walk more than 1x a day when PT/OT come in to evaluate him and the couple times they help him to the restroom. It’s require that a staff member be present when moving about (fall risk, liability, tubes and monitors hooked up…), so not something we can work on independently,
but something I will strongly advocate for today.
To give you an idea of the extent of the challenge, he is fidgety even while sleeping. Hands are rarely still. So sitting in a chair is not much different from lying in bed if there is nothing to keep his hands busy.
According to my mother (she spent the day with him yesterday), they were prepared to try a medication, but there was some concern about his heart that made him borderline for use of meds. sigh…
Will try calming music instead of TV today. I have also gathered a few things like coins to count/sort/stack, deck of cards (previously wouldn’t play cards, but might sort them), Lincoln logs for building, and fidget spinner. Keep the ideas coming. It takes a lot of activities to fill a 24-hour day.
^ perhaps a stuffed animal, with a soft texture, might provide some relief if he ever had a pet. I.e. A stuffed cat or dog?
Search on Pinterest for ideas for men with dementia, or fidget quilts for men with dementia and you will find a ton of ideas.
I.e.-
Some men like to construct with small plastic pvc pipes from hardware store- your Lincoln logs are same idea.
The pvc fit together nicely
Also, I used pandora and played frank Sinatra songs for my mother in my cell phone when she was in rehab. It always seemed to calm her ( she doesn’t have dementia )
Why is this a rule ? Doesn’t it seem the longer he is confined the more agitated he will get, not less? This seems like an unreasonable requirement. When my friend’s husband was hospitalized I think they assigned a special nurse to be with him when his wife had to leave for short times. She spent the nights with him, and yes he tried to pull out Ivs.
As you know a problem with sedatives is that they increase risk of falls when he walks so it’s a catch 22.
Also, my friends husband couldn’t follow tv shows so TV didn’t distract him, making for anxiety unless a family member was with him.
It’s such a frustrating situation for your family now hugs
Please don’t give him coins or objects that can be swallowed or cause choking. Think toddler type, safe toys. Ask about what medications they considered and potential side effects.
Do they think that he could be discharged to the memory care center? Do they have PT at their facility. You can also check with them for ideas on the fidgeting.
When he is discharged, it will be to the memory care center which does have PT/OT and it expected to be utilized once he is there. Will have to get clarification on the 48 he discharge rule.
My mother and I will be spending most of the day with him, and if necessary, will stay through the night if it helps keep the restraints off.
As for the coins, they would only be provided under our supervision.
He finally seems tired today and is getting some sleep after spending the past 36 - 48 hours or so running in overdrive. I’ve made a playlist of favorite songs on Spotify and brought a stuffed animal, both of which have been useful so far. Good suggestions. One hour without restraints and counting…
Part of the tv issue is how fast the imagery changes. It may not bother us, we’re adjusted. But someone with cognitive issues can be affected. Somewhat same as the effect in infants and young toddlers, unless the program is geared to their attention needs.
Your father just had brain surgery, effects of anesthesia, stress of being in hospital. In addition, I learned from the
Alzheimers meetings I attended ( father in law passed in 2015 from dementia) that the vision gets progressively worse, the field of vision narrows significantly, something to keep in mind. As people come into the hospital room he may not be able to even see them from across the room.
Also, I was informed that it takes 19 seconds for the Alzheimers mind to comprehend and understand what is said to them. Try counting 19 seconds after each thing that it spoken- it’s an eternity!
So related to @lookingforward comment about television with quickly changing images and sound, it’s overload, and I comprehensible. Although nice nature shows may be enjoyable !
When my 96 year old mother with dementia was hospitalized for a fall, the hospital provided a sitter to calm her don and keep her from pulling out things. I do not know if they used restraints as they released her in a few days back to the assisted living where they were great with handling her. It was so fast I did not even fly up there. I honestly think if I were there with her in the hospital she would have acted up. She did better with strangers than with family. Everyone is different.
The 48 hours sans restraints or a sitter is a rule I know well. Social workers tend to say that the facility will not accept anyone who cannot go for those 48 hours without restraints. So I am not sure if this is just a defacto sort of policy or a law of some sort. We don’t use restraints where I work.
The other approach is to have noting that would pose a risk on a person. Can he get rid of the IV, the cardiac monitor, the catheter, etc? If he is ready for discharge regardless, maybe he could be freed of those things that are an issue? Ivs can be covered with various sorts of sleeves as well. If in an upper arm, they are less obviously a target for play.
Today has been a relatively good day for him. They have repositioned the IV and removed the heart monitor. Catheter was removed yesterday. I think the biggest safety concerns at this point are keeping him from picking at the staples on his scalp (7 on the left side, 8 on the right) as well as trying to get out of bed without assistance to use the restroom.
I guess it makes sense that his memory care facility will not have 1 on 1 supervision to protect him from falls and pulling out staples, but neither does the hospital.
Tough situation @SnLMom and one I could see myself in any day now. I was going to suggest removing IVs, monitors, etc. but others beat me to it! In my experience, there is not much to be done besides constant supervision to prevent such. But, it seems to me that he would be “busier” with other things at the memory unit which might distract him. As to medications to calm him and some sort of interaction with the heart, is he still being treated for cardiac conditions? I hope I don’t come off as callous, but with my parents, both with dementia, I’ve worked hard to work with doctors to not use treatments with goals to lengthen life as opposed to enhancing quality of life. I actually hoped for some sort of medical crisis before having to admit to a locked memory care ward. Is that terrible?
I found the golf channel was pretty good as a distraction. It’s slow with just enough drama to capture interest. My mom was entertained for about 25 minutes yesterday with an adult coloring book. The only thing I can do with my dad is bring him for a walk.
I mentioned earlier that I was planning on moving my parents from their independent CCRC to a family care home. The plan was mid-September-October. However, when I arrived there yesterday, dad was out wandering and mom said he was trying to work “this business with John (his brother who live many states away).” Of course, the business is something made up by dad but what was surprising is that mom went along with and believed that “John” had been there to visit (“I didn’t see him”) and there was some sort of business (something financial) to take care of that required dad to go out to take care of. Needless to say I need 24 hour caregivers now and a move to more supervision ASAP. My hope is possibly unrealistic that this very fidgety man will adjust to such a move. But, I can still get him into the locked memory care at the CCRC if the adjustment doesn’t work.
For my dad’s wife, a very fidigity woman, the board and care was perfect. She went through all the homes (3 out of 4, in small town) and the 24 hr care in her own home. Something about the board and care just clicked.
I’ve also thought of moving Mom closer, but where she is takes pretty good care, and is the same distance form my brother. I keep thinking it will end before long so no need to do all that hassle. I’ve thought that for 3 years now.
Sorry I haven’t any suggestions on the hospital transitions, haven’t had that happen yet. When Grandma was fidigity in her own home (Mom kept her and lived with her until she died), Mom parked her in front of the piano and turned on piano music on the stereo. I think Grandma thought she was playing it. Or she gave her old silverware to polish. Even when she couldn’t speak or dress herself, she could polish silverware. She had worked in a hotel as basically a child and that was one of her jobs. When she got too tired though, she had to be watched not to eat the paste. Then she just got to polish with a rag.
When I check this thread for new entries it is with mixed emotion–I want to commune with people who get what we’re going through but new entries always means someone is having trouble. Sorry things are tough SnLMom.
My 91 year old dad has been hospitalized many times. They provide a “one on one” because he is always a danger to fall and usually will pull on IV, catheter etc. Even when he is being released to skilled nursing the criteria is to go without the “one-on-one” for at least 24 hours.Each independent living, assisted living and skilled nursing has their own criteria. Maybe states differ but our hospital can’t use much in the way of restraints and limited options for anti-agitation meds… Skilled nursing can’t use real restraints–primarily alarms. (Like the seatbelt that the patient can un-velcro which causes a loud alarm.) In the most recent episode I preferred he stay as long as possible in the hospital because a “one-on-one” is preferable to and safer than the alarms he would get in the SNF. Medicare would have paid for the SNF for a rehabilitation period but he was released from hospital too soon and therapy couldn’t work with him due to excessive tiredness. Then he lost eligibility for Medicare to pay.
As for the expense of holding a room–I always held the room if it was his recognizable room. Didn’t want him to return “home” and suddenly have to turn left to go to dinner rather than right, etc. Plus didn’t want to move all his stuff.
Most recently he had only been at the SNF a few weeks when he was hospitalized again so I gave up the room to save the $400 a day. (Taking a chance that there wouldn’t be an opening when he was ready to come back.) He had only minimal possessions in the room at that point and they bagged them until his return. Always a difficult decision because no guarantee when he would get out and the $$$ start adding up.
As he has less and less to get in trouble with and his brain heals you might see rapid improvement.
Just checking in to say I am thinking of all of you. This can be so hard some times, and I hate to burden my IRL friends who may have lost their parents or who may not understand what is exhausting me mentally these days.
My parents are now in a good personal care community (aka assisted living?) but mom is not really happy I can tell. She is always fussing about something and I think it’s misplaced anger/grief at the change in her circumstances, which were brought on my dad’s medical needs. My next thought is to find some sort of counselor or therapist that can help her work through this.
Does anyone else feel like they could write a book about caring for parents? (Except who would want to relive all these details. . . )