My FIL got kicked out of AL for his racist comments, he was also near the end of his ability to stand unassisted, but they were giving us time to figure things out and then one day, I got the call to come move him immediately. B&C was great with him, they had enough one on one to know him better and not generally allow him to get so angry. I was very happy with our B&C experience for each, MIL & FIL, in different homes.
Yes I am relieved and I can catch a bit of breath. I know a moment of relief it is temporary but I am grateful for current respite and trying to relax instead of waiting for the “next shoe to drop.”
@tx5athome a POLST is a good idea. I was assuming memory care for my parent’s, but really felt more comfortable with the board & care option. My dad gets much more interaction with the staff than he would get at memory care and they can, like @somemom says, roll with the moods. I think they do well with dad showering is there is not set time for this activity. He wakes early, between 6-7, and they know, though it’s not a convenient time for them, it’s a good time to get him in the shower. I suspect they would never get him in later in the day. The negatives are less structured activities, though there was coloring today while DH was visiting and often music is turned on.
I have never heard of board and cares.
My mother’s assisted living wants to send her to a senior psych. unit for a work-up. They also talked today about us hiring outside help even though I am there for hours each day.
The last week she has fallen twice, with lots of bleeding due to Coumadin,requiring wound care and overnight checks. At least one of these was after 2 oz of gin, or maybe even 4. l. But she is dizzy all day honestly. And breathless due to heart.
I diluted her gin (she has two drinks a night!) but just read that the alcohol just floats on top of the water! Had the talk with her but am going to have to actively limit her now, perhaps by leaving 2 oz with her each day until she gets off alcohol altogether.
She was sick with what we thought was bronchitis and asthma for 3 weeks last month but her BNP was 4,369 indicating congestive heart failure so it may have been misdiagnosed. Along with the wound care, she is requiring a lot of attention from nurses and I have been expecting them to start talking about other options.
Two days ago, at lunch, she banged a hematoma on her hand (from Coumadin) and blood spurted all over the place. Yesterday she choked and then coughed and gagged dramatically for 10 minutes until the nurse came and took her up. Both times were a bit of a spectacle.
Cognitively she is worse every day. Today she called for supper to be brought to her room twice. I left her a note saying that dinner was coming up. She called me twice before I got to the elevator asking me about it.
This is vascular dementia, not Alzheimers.
Just have kind of a sense of a gathering storm.
Medical providers just have an attitude that she is 91 so nothing really matters. Am going to insist on an echocardiogram.
Have had some 9 hour days lately, doing things with and for her. Going away for 5 days for something I cannot miss and nervous.
I will look up board and cares…
So hard @compmom. It is frightening to think the place your parent is at may no longer be an option for her. And, you are putting so much time into being there to help support the situation. Perhaps the 5 days away will be good. It may help assess how things are without your constant support (though I know your will be putting a lot of contingencies in place). Plus, I know you need the respite!
Thanks GT alum. Five days in NYC for one of my kid’s performace will be heaven but it is indeed hard to leave.
I was up last night trying to think of solutions to the alcohol problem which is of lifelong in her case. She persists in saying she “only” has 4 oz no matter how much I explain how different her brain is now. She just cannot understand.
I am going to buy some of those small plastic bottles for airline trips and leave five of them, each with 2 oz of gin. I will label them with a day of the week and put them in her cabinet. Cognitively she may not be able to handle this but perhaps I can set it up so aides help her. I am nervous about withdrawal so until I can meet with a medical person about safe removal of gin, I am going to try this.
If she falls again I am convinced they will kick her out, and her uncontrollable behavior after a drink or two the other night signaled a change in the assisted living’s attitude. They see her differently now.
I researched and they CAN kick her out- for falls, for needs exceeding their services, for being a danger to herself. The aid told me her head just barely missed hitting a table. They can also require that we send her to the psych. unit, or that we hire outside help.
I teach a class at this facility and have been told they “consider me part of their team.” It helps that we all get along but now that some lines are being drawn, we’ll see how much that holds up!
@compmom , try to enjoy your son’s performance, but I know you will worry about your mom the entire time.
You can get the MD to order the alcohol as a standing order and the nurse will give it to her. That way your mom will not have the alcohol in her room and she will only receive a specified amount. Speak with an alcohol and drug specialist about the safest way to decrease the alcohol without withdrawal symptoms that will affect her cardiac and mental status.
Difficulty swallowing is often seen in impaired elderly patients with heart failure. This can lead to aspirate pneumonia. Have you been advised on this possibility and the ramifications of treating or not treating this with antibiotics? Her diet may have to be addressed at this time.
So much happens at once, sending hugs.
@compmom, I am a couple of years removed from being embroiled in this sort of mess. Please please, do enjoy 100% your days in NYC. You are doing all you can for Mom, she is in what should be a safe place, if it’s not, well, then, time to change. Change is scary and a lot of work, but it may take her to an even better place for her.
Your Mom has lived a long full life, your son deserves your undivided attention and you deserve to enjoy the moment. You’ve no reasons to feel guilty, either she is in a good place or she needs a change. Go do your thing and see what the answer is when you get home
But it does you no good to go to NYC if you cannot relax and enjoy it!
@compmom Alcohol is a tough one. My Dad drank a lot. I feel like it masked his dementia for a long time. We just thought he was a drunk. I was in the emergency room twice with him a few months prior to Memory Care (he stayed 2 weeks in a psychiatric facility prior to Memory Care). Both times his blood alcohol was over 0.25. He said he only drank wine or beer, but we would fine vodka or gin bottles hidden in his room. When we tightened that up he started drinking some sort of Chinese Herb tonic (made in a rice wine base) by the bottle full. The amazing part was he never went through withdrawal, and sadly there was almost no difference in cognition between when he was drinking (and not eating) and when he was not drinking and eating regularly.
My FIL drinks. A lot. H and his sister dilute the vodka with water about 1-4 and refill the bottle when it empties. They tried the little bottles, but he’d open them and empty into a large vodka bottle. He no longer notices the strength as he mixes with juice or Gatorade and has little memory. That’s a problem if he can’t remember if he’s had one drink or 6.
My mom went straight from rehab to an adult family home. In WA they are licensed for up to 6 residents. They took such good care of her and were much better able do to deal with her deteriorating self. Showers were particularly hard and she fought them a lot, but the caregivers knew when and how to handle her and got the job done. My in laws need help bathing in the AL and scheduling is a pain. It is too early or too late or interferes with a meal or something.
I’ve heard of two people this week who were asked to leave their AL as their dementia was getting worse and the facility felt they needed more care.
When we looked into AL for mom, the facts that she was unable to care for herself when the door was closed and was a fall risk, meant no place would take her - even with outside help. One of the people I heard about was in the AL only 6 months.
My siblings don’t understand the seriousness of this situation. Sound familiar to anyone?!
The last two days she has been really bad with the dementia. She immediately consumed two days’ worth of the little bottles, which means that during my trip she will run out. I am afraid of withdrawal.
So while I am gone I will put her gin bottle back and then deal with it on Tuesday. (My daughter is a composer and is having a piece played in a cathedral by candlelight at a major festival = very exciting)
The suggestion of a doctor’s orders is excellent, thank you.
It seems that AL does not fit her situation and did not fit many of your loved ones either.
If they send her to a behavioral unit I have no doubt of the outcome- nursing home.
Massachusetts or at least my area does not seem to have these board and care homes. /adult family homes. Next.
week I will call elder services
Nervous but going to NYC. It may be my last break for awhile and so happy for my daughter.
I was afraid the little bottles would be consumed. Way back when I was giving my mother a week’s worth of medications at a time, in little “daily” portions, she cherry-picked the pain pills. I was absolutely livid, because there went another vestige of my freedom. At the end, I had a wonderful electric (with battery backup) device that delivered the correct pills at the correct time.
I know you are incredibly proud of your daughter, and I hope you have an amazing experience!
Thanks so much all. This has been really helpful.
I have a resident that is adjusting to skilled care after rehab. At first she was thinking she was only there due to a wound (not true; lots of personal furniture moved in for it to be home). She had a shower (residents have showers scheduled every other day, and get fresh bed linens at that time too), and later complained to me about modesty issues. So her shower was due yesterday; I went in to talk to her, with CNA in tow, addressing her modesty concern - she told me “if Jesus Christ was here, I would be fine going to have a shower; no problem”. I was a bit shocked as she is kind of a gentile lady. Her daughter is coming a lot, doing her laundry, making sure she has time with her. I didn’t expect such a dramatic turn around, from avoiding a shower to essentially saying “bring it on!”
To comment on Ativan - for some, small doses work well. Some have a contrary reaction. I just did an admission where the doctor listed it as an allergy because of the negative effect on this individual.
I’m sorry to just jump in here, but I thought maybe someone on this thread could help. My mom is in her early 90s and is doing fairly well. She lives on her own in an apartment in a “Life Plan Community.” A few months ago she had what was probably a stroke. She recovered most of her abilities, but she now seems really confused about numbers. This wouldn’t be a big issue except she won’t allow any of us to take over her finances She gets stressed out because she can’t track how much money she has in her accounts. She tends to think (for example) she has $4,000 when she actually has $40,000. It wouldn’t be surprising if she wrote a check for $10,000 and not $1,000.
Do any of you know of a basic math test that is aimed at seniors to let them know when they should stop covering their own finances? She has always been a rational person and I feel as though a pen and paper test with a label on it that said “Find out if it is time to hand over your finances to your kids” on top would convince her better than any conversation any of us could have with her.
I’m on the other coast, so it would be one of my sisters taking over and they are not looking forward to the conversation (They have started it before and couldn’t convince her.) I feel like a test would feel more acceptable to Mom (like when my kids were preschoolers and it was the timer buzzing that meant the fun had to end and not me.)
Thanks!
@PNWedwonk sometimes seniors will take the advice of a professional - like ‘the doctor says…’ or have the MD or other health care professional state what you want her to turn over…FIL always wanted the control, but he has allowed his son to set up automatic payments, be a signatory on the account, and take care of most of the finances.
Welcome @PNWedwonk
I would start with a speech therapy consult. When my dad had trouble reading following a stroke, she came in and helped him with some reading strategies. However, she also worked with him on executive functions and evaluated his thought processes. She was the first health professional to truly understand what I saw with my dad’s progressive dementia. A speech therapist maps the cognitive processes which go into recognizing, reading, writing, and speaking. Likely, there is one assigned to the life care community but will need a doctor’s referral. Typically they come to the apartment or hours in such a community.
Her/his report should give you whatever information is needed as well as recommendations for further management as well as strategies for her to not confuse numbers. For example, the speech therapist worked with dad on strategies (all that he soon forgot) but also called me to make sure I understood his executive function and re-existing cognitive issues.
Good luck. So difficult for the distant daughter.
I have been through this and I’ve realized that, at least for my mother, it was all about control. She can’t stand not knowing where her finances stand but it was taking her hours to pay even one bill since she double, triple, and quadruple checked everything she did and the anxiety was making her so stressed out. After much cajoling and arguing, I convinced her that I could tell her (every day, if necessary) what was in her bank accounts and that she would still get the bank statements to review but she should let my sister and brother-in-law take over the actual bill paying. The turnover has not been easy, and I often have to remind her why we’re doing this, but I know it will be better for her. We’ve found that appealing to that sense of relief, rather than inability, has made her more willing to cooperate. She, too, lives independently and can still take care of herself in many ways, but the bookkeeping was taking too much out of her. I am the distant daughter but I seem to be able to reason with her in ways that my sisters can’t.
I am starting to think that we need to hire people just to talk to seniors. I teach senior exercise (among other things) and I had one guy just about follow me out of the room trying to tell me about his health stuff. Then I had more stop me before I could leave. I am not complaining -I have just been struck lately with how much people crave human contact, especially as they age.
They love to talk to each other as well -which I get -but sometimes it is like having middle schoolers when you are trying to teach a class.
Thank you! @SOSConcern, she was a nurse, so has trouble taking doctors seriously(!), but a speech therapist (per @GTalum ) might work. Part of it is anxiety like for @runnersmom’s mom, but part of it is control. She writes checks for specific relatives and feels like she would lose access to them if she stopped. It’s sad because my sisters would continue to make those payments, but we all wonder if the recipients would keep showing up if there wasn’t a check to pick up. Maybe she would give up paying all of the other bills if we left her in control of one account to make those payments. My sisters are really the ones dealing with this, I am just trying to find some way to help. She definitely wouldn’t listen to me any more than she would them!
@compmom -
My aunt had vascular dementia. She wasn’t a drinker but she popped Ativan and Xanax like candy until I was finally able to get them away from her. She seemed to be ok for years. When she was 90 and seemingly still together mentally, we moved her from her home of 35 years to an apartment near me so H and I could more carefully supervise her. We got an aide, starting at 4 hours a day. I took the checkbooks home and had the bank statements sent to me. I made myself joint on her accounts because I was the only legal heir (she had disinherited my sister years earlier) and she didn’t give me an issue about paying the bills as long as I left her some cash. After a year, we moved her to AL because it was cheaper. After another year, they wanted to move her to memory care. I resisted for way too long because I didn’t want her money to run out. They finally sent her to the hospital and refused to take her back. At that point, my only option was to get a hospital bed and set her up with 24/7 care in my MIL’s spare room. The day after we moved her in, my aunt went essentially catatonic. The doctors said it was the final stage of vascular dementia. She died about 3 months later. She always told me she didn’t want to live like that and had signed a DNR very early on. She died in her sleep with no pain or struggle.
I am sorry that you are struggling with your mom’s issues. In the meantime, enjoy your D’s successes.