I never thought this would all come on so quickly.

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my 92 year old mother has lived with me for the past 3 years and although our relationship has always been complicated and difficult, it has worked out OK. last week she got a minor infection on her arm and had to go to the hopsital for 4 days. they said she would need IV antibiotics and so needed skilled nursing care. Since her hospital stay she is confused and really doesnt know much except that she recognizes me. I can see a decline over the past 3 months but it really was some forgettfulnees, some repeating, some confusion about day, etc...now she thinks she is in once city and then the next. she thinks i have children, which I dont. it is all so upsetting since I dont know if this will be permanent. I live alone and teach full time so I cant bring her home, even if she gets some better. I am exhausted and worried. she seems content where she is but they say she asks for me very often. Is this permanent, can she afford long term care, am i doing the right thing, all this is running in my head. I feel alone but I am grateful for the good care she seems to be getting. 40,000.00 a year is frightening.

11 Comments

I am so sorry that you and your Mom are going through this. From my experience, an infection can make the memory issues much worse. Nine years ago my mother-in-law came down with pneumonia which brought on congestive heart failure. Her cognitive abilities declined along with her heart and lungs. The doctor gave her 6 months to live. She is still with us, and her abilities returned in both body and mind. Over the past year her memory has deteriorated a great deal, but we think that is due to her age (97) since she has managed to avoid infections. I pray that once she heals from the infection, you will see her confusion abate too.
I know what you mean. My 90-year-old mother has lived with me for many years now, and the road's been a little rocky from time to time, but mainly ok. But she's had some mental decline in the last few years, and it seemed so sudden that she really needed me to help her sort through some confusion in her day-to-day life. I had been working full time, coming home at lunch to check on things. Then that wasn't quite cutting it, and I was fortunate to be able to work at home a good bit of the time. Then it became just impossible to balance work and care, even when I was home basically all the time. So I retired a year early, and here we are. I've read that mental decline following hospitalization is pretty common for older people. This Web site has a discussion: https://www.agingcare.com/Articles/cognitive-decline-after-hospital-stay-147836.htm. Also, I found a book helpful in trying to think through the logistics of the future for my mom: "A Bittersweet Season: Caring for Our Aging Parents and Outselves" by Jane Gross. The author had more connections and money than most of us, but her story was helpful, and the book has a good list of resources. For me, gathering "facts" calms my mind and helps me move forward. Good luck to you.
It's VERY common for the elderly to have cognitive decline during any hospitalization. The frustrating thing for families is that the hospital personnel don't pay much attention to it; sometimes even failing to note that it's occurring. I know that for me, regardless of why I was hospitalized, 'losing my mind' would be the 'condition' I'd want the most attention paid to! At the end of my life, I hope to go before, or soon after my mind does.
When my FIL was hospitalized and quickly declined from fully cognizant to pretty severe dementia, we were continually having to remind the staff that "he didn't come in like this." They were so focused on 'fixing' his ailments. We were constantly informing doctors he wouldn't want them fixed if he was going remain in a severely compromised mental state. They shrugged it off and scheduled the next test or procedure. They tormented him like that for a couple of months and then discharged him to hospice.
Dear Sullivan,
If your mom is staying w/ you for last 3yrs, perhaps there is no estate left of her own??? If so, she can qualify for medicaid and community long term care. If she is able to come home, CLTC will send an aide in to help with her ADL's 2hrs/day 5 days a week - she can also qualify for companion care for an additional 2hrs/day. If you need more coverage, with a dementia/alzheimers diagnosis, she can qualify for hospice respite help. They will give you a $500 voucher to use as you need to pay for someone to come in privately. They can only do it once/yr for each patient though. Between all these resources, perhaps it will buy you enough time to take a breath and find some other resources. You may want to advertise in your local paper for a private duty CNA. With the economy the way it is, there are people looking to supplement their incomes and most CNA's are only part time and get paid very little. I started my own Help at Home business. I am a CNA and a licensed hairdresser. I am 'paying it forward' as I was in the same predicament with my mom after my day passed and she lives out of state. I do respite sitting - that's only sitting as a companion - for $5/hr. If you could get the CLTC and Companion care set up for morning hours, perhaps even a church friend or neighbor would be able to fill in a few hrs in the afternoon until you can get home from work. There is such a stigma attached to social services and medicaid but for my mother, they have been a Godsend!
I would tried to get her qualified for medicaid. Ask for a social worker and they can help you with your options. If she is a nursing home right now sometimes they can offer a room with a medicaid pending designation where you can pay some of her income towards the room until medicaid is approved. I do this with my aunt. They allow the drafts for medicare supplement, and drug plan, and dental insurance and what is left I pay them and they have her as medicaid pending. You just have to fill out and provide what they need for the paperwork. I had to provide her sources of income(soc. security etc) Last three months bank stmts etc. they will let you know. I would ask and don't beat yourself up. You are doing the best you can and it is obvious you love your mom. Sometimes it is for the best for them to be put in a skilled nursing facility. It doesn't mean you are bad or have failed them in any way. My cousin who is far away from the aunt I take care of pays for her a cell phone so they can communicate every day.
I would tried to get her qualified for medicaid. Ask for a social worker and they can help you with your options. If she is a nursing home right now sometimes they can offer a room with a medicaid pending designation where you can pay some of her income towards the room until medicaid is approved. I do this with my aunt. They allow the drafts for medicare supplement, and drug plan, and dental insurance and what is left I pay them and they have her as medicaid pending. You just have to fill out and provide what they need for the paperwork. I had to provide her sources of income(soc. security etc) Last three months bank stmts etc. they will let you know. I would ask and don't beat yourself up. You are doing the best you can and it is obvious you love your mom. Sometimes it is for the best for them to be put in a skilled nursing facility. It doesn't mean you are bad or have failed them in any way. My cousin who is far away from the aunt I take care of pays for her a cell phone so they can communicate every day.
The first thing I am wondering about is if your mother actually has undiagnosed dementia going on. From what you describe, it sounds possible. My mother has mild dementia and chronic urinary tract infections. Every time she gets a UTI, her dementia symptoms worsen, and get better when it is cleared up. It also seems that with each UTI it makes a little chink in her dementia, she never quite recovers all the way from where she was.
You may want to research the antibiotics she is put on during infections. Some Antibiotics and anethesias have dementia as their side effects. Some permanant, others can see improvement. Prescriptions also have dementia as side effects so changes in meds, even how they are taken daily, may contribute to a marked decline. It is important to have the doctors communicating the reasons for the meds and balance them so the patient advocate needs all meds recorded and reviewed by each doctor consistantly!
thanks for all your helpful and supportive comments. my mother has been there going on 3 weeks now and she is settled but still very confused as to the last 3 years. i dont push it. she has good days and bad days and my prayer is that she can remain calm and not begin to stress and want to leave to 'go home.' now the mightmare of delaing with medicare begins...and my mothers estate. she has a bit in investments and both our names are on the savings. i wonder if that money is now locked in. i hear horror stories of how the govt/irs can come back for 5 years to claim money you might have spent from 'her' assests. since she lived with me we shared many expenses and her life dream was to 'leave me something.' now i wonder if her monies are set and can not be shared with me to help with my basic expenses. i never budgeted on my own income while she was living with me. i dont want what is hers but she has alwyas been so generous and now if i need some help with expenses (i recently had a flood in the house becuase of a broken hot water heater). I am the only child with POA and if she goes in to private pay i certianly understand that her assests should pay for that but what if she gets to the end of her assets...can the government come back to me for anything she might have spent while she was living here. 1st is the shock and stress of going in to nursing car...then the shock and stress of delaing with the money issues.
Dealing with the money issues is indeed very stressful, cnsulliva. Applying for Mediciad, especially when funds have been co-mingled, is not a do-it-yourself project. Please consult with a lawyer specializing in Elder Law (the specialty is important!) and find out the best way to separate out the funds and to spend down mother's assets so she qualifies. Once she is on Medicaid she will basically be on an allowance for personal expenses. She will not have any income or assets to help you out. Making sure you set things up in the best possible way now is worth the legal fees.

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