Parents caring for the parent support thread (Part 1)

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11021

@compmom, So sorry for you and your Mom. Length made the issue very clear, even though the solution is not. My mom’s AL place allowed wine, but only at a meal (of course the independent living people ate at the same dining hall). But Memory Care had no alcohol. Can’t address the wine issue.

I can’t help exactly butI can address the change in management style… are you sure there hasn’t been an upper management change that you need to know about? I found out Mom’s director was booted out because of a complaint (might have been valid) of neglect. Staff was also way over worked.
And even though it is unconscious, I believe some staff start to distance themselves from patients that are leaving…your mom being gone showed that she would leave. The truly gifted people don’t of course, but when I think of how many losses they see working in AL, I don’t blame them.
I can acknowledge your frustration and feeling of loss. I hope that helps because there are not really good solutions.
What can you do for your mom? probably not a lot. It is a phase and this too shall pass.
What can you do for you? IDK, just look for how well over all she is treated and if not treated acceptably…maybe start looking? I wavered on moving Mom many times, but the BIG PICTURE was that she was fine where she was… for the definition of fine which included dementia and aging. Let go of control since we don’t actually get to control much except ourselves and manage our reactions.
Vent here that helps!
Take action to stay positive and let all staff know that you have your mom’s back.

It is so hard, hugs

11022

My mom’s facility does not serve any alcohol in the memory care unit. The Assisted Living section though does have a bar. Is your mom’s dementia advanced enough to warrant a move to memory care? Is there such a unit in her current facility?

11023

I am so sorry. My grandmother and her sisters fought over their mother’s alcohol dependence. Some provided it, to shut her up, some threw it out or refused to play along.

I know you’re personally frazzled to the nth degree, but some thoughts.

Past a certain point, AL isn’t “it.” The customization they can offer is limited. You know that, we all do. Unfortunately.

Otoh, how irresponsible of them to offer a cocktail hour in a way that allows over-drinking. There should be some controls because, of course, some folks may be on meds that can’t mix or, like your mom, unable to self restrain themselves. And, in the first place, your mom has dementia. She can’t be expected to remember she already had two and reign herself in. No, she can’t just have what she wants. But she doesn’t get it. It’s not in her repertory. A cycle starts and noting stops it.

No, they shouldn’t serve others wine and leave her hanging. They could offer some non-alcoholic wine subsititute, in a wine glass, no comment, no discussion, no backing down. Same at the pub: no, she shouldn’t have free will drinks (what if this were toxic to a resident? This isn’t independent living, where the patients are screened for independent thinking.)

I doubt the state specifically questioned her falls (unless they were already reviewing some care issues. Can’t imagine this, out of the blue, just your mom’s falls.) More likely, maybe the facility is truly stretched beyond their abilities, with the level of attention your mom needs, to keep her within the bounds they can manage. Moving her may cause confusion, but you’re describing someone already confused. But they can’t offer a level of monitoring her and working with you that would be what’s easiest for you. Ithink you may need to move her to the next level of attention.

So sorry.

11024

I don’t recall, when she drinks as much as she wants, what problems does that cause? Are those problems worse than this constant fight?
Having seen several senior situations, I do find that we (the AL staff, some kids, some husbands, etc) can get fixated on treating the demented person like they are normal. They are not normal, they are brain damaged and old and eventually dying (I am assuming your mom is over 80)
For example, my Dad had terminal cancer, it was untreatable, and people in the family were talking to him about eating right. I said, eat whatever you want, it’s not going to change anything. My mother is in her 90s, she eats a lot of candy & cookies & nuts. She’s 100# so it does not make her hard to handle like it might with a heavy person, so I say, “more power to ya, Mom, eat whatever you like, why not?”
What about the alcohol for your Mom? Is there a way to stop fighting yet still keep her safe? Sounds like they won’t give her a daily allowed amount at 4, which is so dumb.

I had the same experience with FIL in AL where they kept acting all helpful and then they’d just had enough of his fighting everything, his attitude, etc., and all of a sudden they were no longer my buddies. I figure, I know what I saw and what a miserable SOB FIL was to us, I can only imagine what they saw and had to deal with 24/7.

One thought for your Mom, depending on her situation and her need for socialization, we found the residents got way more individualized attention in a board and care home, 6 adults in a house with 24/7 care. That’s small enough that the caregivers could learn the person’s routine and make them happier. But if your Mom is super social, it may be too soon.

11025

Oh, this is so upsetting for you and for her too! Sending a hug. Please let me play devil’s advocate, then offer a possible solution.

Falls must be reported via incident reports. If determined that alcohol is a contributing factor, it must be addressed as part of the resolution. Yes, the AL must offer a solution or suffer loss of funding and face fines. Your mom’s care was negligent in detox unit. This does not negate that she is an alcoholic and is in an “increased fall” risk category. The alcohol is a toxic and a strong factor in contributing to her neurologic deficits. I am concerned about her Vitamin B1 levels, do you know what that level is? The outcome of Detox in the elderly dementia patient is usually not successful unless they are moved to a secure memory care unit where alcohol is not available. Sadly, they cannot cognitively understand as has happened to your mom that she already had her quota of alcohol.

Things you may want to consider: consult with a geriatric psychiatrist. They will perform a complete evaluation and exam of your mom and perhaps offer medication or appropriate solutions that will decrease her anxiety and anger. This could possibly allow her to remain in AL. The AL facility would have to give her non alcoholic beverages. The other option, that would cause another change in environment, would be a move to a memory unit.

So very sorry that you are going through all of this. Please take care of yourself, try to let go of the anger, (justified), that you feel towards the AL. Your mom’s health and safety is primary. Her falls can lead to serious injury. I hope that you can find a solution. Know we are all supporting you.

11026

compmom, I’m sorry. It’s so hard when you get in between a bullheaded senior and an unbending organization.

I don’t know if this helps, but falls are what finally got my dad kicked out of his AL. and in his case it wasn’t even caused by alcohol, just an inability to stay upright. There’s liability to be concerned about, plus in our case the state of California, which required them to report EVERY fall. Falls are a BFD with this population. They finally called me in and said “If we can’t keep him safe, he can’t be here.” That didn’t sound unreasonable to me. Their Number 1 duty, both legally and ethically, is to keep residents safe. And yeah, it created a huge problem for us, but like it or not, he had to go.

I’m kind of surprised that the booze flows so freely there. At our AL, there was no drinking allowed in the rooms. There was a happy hour every day, but the staff cut them off after a certain amount, or when the resident started to be affected, whichever came first. Alcohol + frail demented elderly just seems like a bad idea all the way around.

11027

Thanks so much to all of you. And I want to make very clear that I understand the AL’s priorities in terms of their own legal status as well as the ways in which they are required to keep residents safe.

I think what has been hard is that they have not communicated in a straightforward manner. And now they are not even friendly. We have worked together well for 3 years. I would say I don’t feel angry so much as scared. If that make sense.

My mother doesn’t even remember the two scenes over the last two nights. I just called her and joked with her that she does not need to start a revolution (the other residents got riled up by her outburst and also said “don’t treat us like children.” I told my mother she doesn’t need to be George Washington and she liked that.

AL says she is not ready for memory unit. That may have to do with the fact that she is paying for one of the more expensive rooms in AL!

They were concerned about her falling in the shower too so I got a PT and OT to both certify her safety doing independent shower. I realize that transfers liability away from the AL to the therapists, just as detox transferred it to me and my brothers.

One brother wants to hold the line. One wants to bring her gin. I am sympathetic and like to problem solve, not be either too rigid or too lenient. Either

  1. She will finally accept this new routine, go to the pub, have her two 1 oz drinks, and things will settle down. Unlikely since she doesn’t remember her scenes or our explanations. Each watery drink is a brand new situation to her despite the fact that she was outraged 30 days in a row about them!!!

  2. She will continue to be difficult and intervention will be needed:
    a) by the AL- move upstairs or eviction
    b) by family- get her some meds for anxiety, maybe depression (psych. unit put her on gabapentin that seemed to increase dementia but maybe a lower dose, Lexapro etc.) and see if the scenes stop-or move her ourselves
    c) family provides measured amount of alcohol in premixed drinks when we are around- will this exacerbate the problem? I think so, but my brother wants to do this.

She has a friend who drinks some of the day and before and after dinner. Her friend brings vodka down to dinner in a handbag. This friend has had really bad falls but they aren’t doing anything about it with her. We were told this is because they cannot pinpoint when the falls happen and therefore the cause. I joked with this woman’s daughter, who is a friend, that my mother would have been better off drinking all day then in one hour!!!

I am clear on one thing: in so many ways she is improved without the higher amount of alcohol. The public pub limits her to two ounces and her old jigger supplied two drinks for a total of 7 ounces!

None of my family accepts that she is an alcoholic. Let’s just say that my 64 year old brother had to take Uber home with his son and wife the last time they visited, because they had all imbibed too much. I am a tee totaler myself.

I joked that that jigger ruined my childhood. It was bad. (I made my own happiness). I am not about to let that jigger ruin my last years ( T

11028

Oops. Didn’t intend to send. Background for me is that I have spent 24 years parenting a kid with type 1 diabetes (hourly school nurse calls), and a seizure disorder, and she had a life-threatening brain injury (hit by a car) in 2014 and I moved in with her for 9 months to do 24/7 recovery (she is a miracle case, doing wonderful things). MY ex had a stroke and left after a year of recovering- personality change. My youngest has bipolar 1 with psychosis (doing great). And in 2015, during my daughter’s recovery from the brain injury I got breast cancer. We alternated surgeries with her having procedures for fistulas in her brain and me having two mastectomies.

Not complaining but need to put it out there as part of my vent. Just writing it makes me realize I need to protect myself.

My mother, difficult as she has always been, is a different person now, childlike, and it is hard not do be all in for a person like me. I am seeing a counselor and went to support group but honestly, this forum is the best. Lots of wisdom from experience and I appreciate the advice.

On to laundry!

11029

I guess it depends on the State regarding alcohol - and then the AL can have more restrictive rules if they want.

I agree with @LasMa that alcohol +frail demented elderly - many who have balance and strength issues already and maybe even hypostatic BP where a person standing up gets light headed or even passes out – don’t need one more thing to increase falls!

11030

Compmom, I hope I didn’t come across as unfeeling or flippant earlier. If I did, I’m sorry. This is so so hard, especially when the parent gets to that point where they can’t remember the incident from yesterday so you end up having the same argument over and over. Or when they are just rebellious for rebellion’s sake – I always thought that was a way of asserting control when they feel like they have no control, which they really don’t.

Being in a sticky relationship with the caregiving institution isn’t really something I had to deal with, but it sounds tough. Would it be possible to have a cards-on-the-table, airing-of-the-grievances sort of meeting with the top people? It might clear the air.

Of the options you listed, I like 2)b. Perhaps there’s something medical going on, and intervention would help.

You have been through a lot, even before this chapter. And yes, you do need to protect yourself, and care for yourself. Easier said than done, for someone who’s the backbone of the family, as you are. Just keep it in mind.

11031

In the wonderful world of pop psych, there’s a great expression: my cup is full, anything more will spill over.
I don’t know how you do it, compmom.

There’s “attending to,” which is what we do for our children. We’re helping them get to a stable platform so they can move forward. But there’s the opposite, just plain old doing too much for other situations that repeat themselves or escalate and barely get better, if at all.

Try to see where there’s a difference and how you can simplify.

11032

That is like the old “change what you can and accept what you can’t.” I feel we went into a bit of an abyss with the detox and kidney failure and now things are actually a lot more stable with her health. So I am backing off and don’t plan on falling into that abyss again if I can help it. Kids are still the priority! (and my tai chi and amateur art)

I’m going to problem solve- make an appt. with her doctor to discuss meds (or geriatric psychiatrist if I can find one) and talk to an ombudsman. I think a meeting with some sort of mediator would be good.

I am totally on board with the reduction in alcohol and actually think abstinence would be easier if there were no reminders around. She went three weeks without alcohol and forgot about it.

She was addicted to nicotine gum and while she was in the hospital I started bringing her Eclipse instead and she hasn’t remembered nicotine gum yet. Helps to work with dementia sometimes!

I expected the rough spot to smooth over with the AL, and am not the kind of person to get stuck in negativity. I honestly think she is driving them crazy and it spills over onto me…

Thanks all.

11033

Just, Hugs.
And to all who deal with the frustrations.

11034

So difficult with the alcohol. But I remember @compmom your mom at one time was drinking 6-8 servings a day (considering her generous jigger) and it seems to me her behaviors of being denied alcohol are alcoholic behaviors so it will be hard for her to stop at 2 drinks so I’m thinking abstinence is best. When my parents moved to the family care home, we stopped their wine at that time as someone was not there to see the negative behaviors it caused.

11035

Yeah she had two drinks that totaled 7 oz. and with her memory probably sometimes a third of 3.5 oz st times. Lifelong but inappropriate now. I am in favor of abstinence. She would forget I think, over time. The pub is exacerbating her craving. I called other facilities and none are dry. The only other path is to get an apartment with her which I considered but Things are going to get worse with her so… I did look at what appeared to be s board and care home last month but her memory is a lot worse than those residents. Maybe a memory unit at another facility. Sorry for phone typing

11036

The board and cares around here can handle very advanced memory loss. You may want to engage the services of a senior placement service. They know the landscape better than anyone, and can give you all kinds of options.

11037

I just got the number of a consultant who is highly recommended. Thanks!!

11038

The AL my mother was in had “Wine and Cheese Wednesday”, and as far as I know that was all the alcohol served; Mom was in Memory Care so she got a very tasty fruit punch in a wine glass. But I am sure that AL didn’t have a pub or a bar, because I was all around it and I would have seen it.

Also, when I was getting her signed in, I guess the Memory Care Director didn’t quite realize that my step-daughter was on staff, because she made some pretty wild promises that turned out not to be true statements. They simply can’t get really involved with one person/client/patient because there are so many varied people with so many varied needs. I held my tongue because I love my step-daughter, but if that hadn’t been the case there would have been some scorched earth around that place after my mother’s death; some things left undone that weren’t excusable.

You have mentioned moving into an apartment with her, that just worries me dreadfully every time you mention it. The main reason is that you have talked about having to do all night phone checks of your daughter’s blood sugar. The elderly simply don’t have a sense of night and day; if they are awake it must be daytime and if they are sleepy it must be night time. I went through that with my mother for years, and the week between her falling and breaking her arm, and going into the Memory Care were prime examples of that. At night, every two hours she “would like to get up now”. I had somebody with her during the day, and I slept; I was so fortunate to have a tight team network at my office that kept things going while I couldn’t be there. But what if your daughter had a desperate need of you, and you had to think about what to do with your mother? Please don’t consider that move, it would probably do you in.

11039

I also want to suggest the services of a geriatric psychiatrist. This has been a game changer for my dad and the other residents in the family care home. As you may recall, I was devastated after dad hit his caregiver and gave her a concussion. Dad’s agitation and depression have dissipated for now. It’s a great model. The psychiatrist came with her “team” and saw 4 of 6 residents. She is on-call nights and weekends. A PA on her team is assigned to the home and will come every 6 weeks and available on-call during regular hours. All the residents are happier and more interactive with each other. Dad has bonded with a couple of the residents. It seems to be a great way to extend mental health services to the many elderly in the community. I did manage to get an appointment for my dad at one of the major medical centers in the area, but taking him out of the environment for assessment and treatment would not have been as helpful so I cancelled the appointment.

11040

We are fortunate that my FIL doesn’t go down for happy hour at his AL. He watches from the balcony near their apartment. However, he does like to drink and before dementia set in he truly drank to excess and was/is a functioning alcoholic.
H and his sister control the alcohol by cutting vodka with water, up to 1:4 and he adds juice to whatever he’s drinking. If he forgets that he had his pre-meal drink, it won’t affect him too much.
He is a fall risk, as is MIL, and our fear is he will help her up and they’ll both crash into the TV. If/when that happens, there is a good chance they’ll have to go to the memory care - mostly for the additional support.

The home my sister’s FIL lived in gave him a drink every night. As long as it was whisky-colored, he was happy as a clam. (It wasn’t whisky, but soft drinks)