My 87 year old mother, who is fairly mentally sharp, except for brief episodes of dementia, was moved to a nice facility 2 weeks ago for LTC because she cannot walk after a pelvis fracture in August.(Up until recetly she was still paying bills/writing checks with some help)
After pelvis surgery, in rehab, she resisted/did not participate in PT and OT, and was moved home. My 87 YO father took care of her, with help. The delay in moving her to LTC was related to paperwork and the Mass Health app (for state supported care). That is in process, we're working with their Elder Care attorney who advised us what to do to apply for Mass Health.
We had Medicare supported help for in home PT and OT and also hired an outside agency to supplement her care. She subsequently qualified for "hospice" which meant more supplemental care, plus the private agency. We cannot afford 24 hour in home care for her. I found a place for her and we are paying privately until the Mass Health application is approved.
She has her own room and is complaining bitterly about their responsiveness, etc. She is threatening suicide (I think for attention and manipulation) and is self-harming - she picks at her fingers, teeth and scalp with a toothpick. She does have some low level dementia/Alzeimer's, but reads the paper every day and is pretty together except insisting that she can go home with housekeepers help. She won't acknowledge that she needs more help that a housekeeper for a few hours.
Yesterday she apparently cut her leg with her comb, so they addressed that, took away the comb and toothpicks (apparently self-soothing her anxiety with that, even before she moved out of the home). My brother reminded me that one of the helpers noticed a cut on her leg at home a few weeks ago).
My brother visited her today and she was a total b***h, telling him to leave, we put her there, etc. I am going there tomorrow (I live in Chicago, they are near Boston).BTW, my father is alive and is going to the same place for rehab after spinal surgery. They are not planning to have them in the same room but I am envisioning a screaming match when my father sees her.
Are facilities used to this awful drama? I am embarassed about how awful my mother is. She is upset since she hasn't seen her husband for weeks, but she can be a total nightmare. She has always HATED the idea of nursing home, so in some ways her response is not a surprise. it's hard to tell what is her, and what is dementia.
I appreciate your advice.
It sounds like your mothers dementia has gotten much worse, and that perhaps it's the family(including you)that has been in denial about it. Being in denial helps no one, especially the one suffering from dementia.
Picking on ones nails, skin, teeth etc. are all signs that often come with dementia.
Perhaps it's time to be looking into placing your mother in a memory care facility as they are more used to the odd behaviors of a demented person, and their doctor can prescribe the appropriate medication to calm her down a bit.
Best wishes in finding the right help for your mother.
I agree to test her for a UTI.
If she doesn't have a UTI then I totally agree she needs meds. Even without a UTI she may still need meds, which would be very common.
Dementia robs people of their ability to use reason and logic so they cannot bring their own minds to a place of calm anymore. They now need help to do this. Dementia also robs them of their ability to have empathy for others: not wonn't, but literally can't. They lose their sense of time and space, their memory, and she now suddenly had a very profound change in her life (injury, loss of physical abilities, new environments, etc) and it's difficult enough for someone with dementia to adjust to changes, let alone this level of change.
"In all your free time" (facetious tone) try to watch some Teepa Snow videos on YouTube so you can learn why your Mom is now left being a person she formerly was never. Recentyl our good friend's Dad (who had mild dementia and memory loss) had a stroke and he went from being a dignified, mostly capable man to an unrecognizable monster who cussed out everyone, had paranoid delusions about why he was now in the NH and was a constant escape risk. He did pass after a few weeks but...such a hard passing. And he was in an excellent NH (my MIL is also there so I vouch for how good it is).
I learned a lot from the Teepa Snow tutorials. She's an expert in dementia and caregiving. You'll get great strategies for engaging your Mom (and maybe your Dad in the future) so that your interactions are more peaceful and productive.
May you receive peace in your heart on this journey.
Evaluation by a geriatric psychiatrist is definitely in order.
Not won't but can't. She most probably cannot understand as dementia robs people of judgement.
Please get her Doctor involved asap. Suicidal talk & self-harm should always be taken seriously. There may be uncontrolled pain due to pelvic fracture.
I don't know how happy your mother was with life ordinarily throughout a long life, but if she WAS happy, then I am here to tell her, at 81, that old age isn't where it is for happiness.
Along with that truth, here comes another one.
YOU are not RESPONSIBLE for her happiness.
That isn't doable. You are not a caregiver, but a daughter.
Yes, you are sorry, but this is what it has come to.
Let her mourn. Let her be angry. She has a right to grief and tell her that you are grieving right along with you, and when it comes YOUR TIME you will be very angry and upset about it.
That doesn't mean there's an answer, because there isn't one.
Do not take on the mantle of guilt. You didn't cause this and can't fix it. Don't take on any inclinations of throwing your living body onto her burning funeral pyre. It won't help either of you.
There, hard facts are done.
Now on to one that is even harder.
If you imagine that spending your OWN MONEY for your mother's care until she goes, then I must ask you your plans for your OWN care, because I doubt your children will make that mistake of buying your care rather than saving for their own. I sure hope they won't.
Given care in these times your mother may have another decade left. It won't be a happy decade. But she's had a long long life, and she surely by now is aware that it isn't all about happiness.
I am dreadfully sorry, but these are the stories we see here every single day and there never IS an answer to happiness in it all. It is a very very sad time in which there is life, but the quality of said life is a crucible for those suffering it and those standing witness to that suffering. It leaves us glad to see death, relieved that there need be no more torment.
The fact that your mother's dementia manifests as it does makes me think there is perhaps some frontal temporal dementia, or another sort that manifests with episodic anger, and rationality. Has any neuro-psyc eval been done for her.
The other thing is that low dose antidepressants and even gummies work for some in care now. AARP magazine this month has an article on the latter, and I have seen an amazing turn around for a friends mom who was non verbal and depressed. In a Tx. home she has been on gummies for a while with a huge increase in satisfaction, appetite, participation and verbal participation. No, still doesn't know who her daughter is, but is in so much better spirits.
Now you may be made of money. I can't know. But if you are not, and if you are not truly wealthy (I am talking something over 2 million earning good dividends) you may be robbing yourself for the care of an very unhappy woman, who will not be made the happier for it.
Lastly know I am so sorry. But you have to accept that this isn't fixable. This is what it is and it is grief and anticipatory grief. Treasure each second there is any joy. I am again so very sorry.
I think the staff is good and I will support what they recommend. They have more experience with this, but for my brothers it is new territory.