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My mom has lived alone over 50 years, made all her own decisions without anyone to argue with her, and ate alone. Now 91, she is in IL/AL where all meals are in a dining room where everyone eats at round tables seating 6-8 people. The facility has a varied calendar of activities and entertainment, and a large gathering area to sit and watch people. Living here was her decision/choice and has been fine for just over one year until she fell on her face two months ago due to a UTI. Now she is in AL, has help throughout the day, and doesn't have to do anything herself. She has ALWAYS been obstinate, argumentative, and life-long chronically depressed. She now has early dementia ("people are stealing from me" when she forgets where she put things-usually in her pocket) and uses a walker. The AL just contacted me to say mom is now "refusing" to go to the dining room for any meals and sleeps all day. They independently contacted her Dr. who set up an appointment for her and for a psychiatrist, and called me to take her to this appointment which is scheduled for two days from now. I live over 1,000 miles away. In the last two years I have spent more time with my mom than I have in my own home with my own husband. I have only been home for 2 weeks from the last 3-week stay after her fall, and now I might have to go back. We are retired and are spending from our 401K accounts to travel back and forth. I have no solutions. My questions are, 1) why does a 91-year-old need a psychiatrist - how would that help her?; and 2) if she simply decides to eat in her room is that what they are calling "refusing" as in "she is refusing to do everything"? She is not refusing her meds and she has always lived alone so why would she suddenly want to join an active social schedule? I'm wondering if I should move her to a smaller facility like a Board and Care home, but she likes where she is at and she chose to live there vs other places we looked at. Maybe I don't even know what questions to ask the AL...

Frankly, at 91, she should be able to live how she wants (within reason.) My dad is 91 and I let him skip meals whenever he wants and let him have crackers and cheese in his room with some dark chocolate. It makes him happy. He earned this right by virtue of being 91! No way does she need a psychiatrist (this is just my opinion, obviously, so take it at that).It will most likely just lead to more medication, and more work for you.
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Reply to dldykstra
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The appointment might be a good thing for her. But call the assisted living place and say point blank say that you are 1,000 miles away and cannot come and take her to the appointment. She is in assisted living and living with dementia. The UTI probably brought about more changes and should be addressed sooner rather than later but you shouldn't be running over there for everything. This time, stay home and say that you can't be there for every crisis but want to be informed. Setting up that appointment and giving you such short notice is pretty crappy. Someone said something about a care manager and it would be helpful.
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Reply to Evermore99
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When my mother first showed signs of dementia, she had a complete evaluation by a geri psych which was helpful as she was found to have vascular dementia and given meds to deal with the paranoia and delusions. I am a distance caregiver too, and support you telling the facility that you cannot come. If your mother has the funds you nay want to hire a care manager or someone who can help her with things like appointments. For a while mother had a "senior helper" she paid for who helped her through her medical appointments and other things when I was unable to be there. Please protect your own retirement funds. You need them.
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Reply to golden23
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Call the doctor and talk to him. Tell him there is no way you can make it back in 2 days. Ask if he has a Nurse Practitioner that can go to the facility and evaluate. Tell him that when u were there, except for a little Dementia ( which still could be caused by the UTI) she is no different than she ever was. If she wants to be alone, why can't she be alone? If she doesn't want to eat in a dining room, why should she. The AL is now her home. She is a resident not a patient. If she doesn't want to join in, thats her prerogative. She is paying big bucks to live there.

I have no idea why a Psychiatrist. Ask the doctor. I took Mom to a neurologist. Talk to the RN at the facility. Ask her why she felt the need to see a doctor. She and staff may have seen something you didn't.
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Reply to JoAnn29
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Thank you so much to everyone who posted replies to my question. You encouraged me so much. Finally I did hear from everyone I contacted regarding this situation. The quick summary is this situation was a combination of miscommunication, missed communication, a shift change of personnel, language barrier, and a convergence of coincidences. It was something sorting everything out, but the result is my mom will see her doctor for a regularly scheduled follow-up visit, but since I got to talk to the doctor, I got to mention other concerns that he will address at this visit. She is better, too, for now anyway. But as we all know, that is temporary, but I will take it for however long it lasts until the next bump in this long rocky road. Again, thank you everyone. I am grateful to you.
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Reply to Live247
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You simply cannot drop everything, leave your family (again) and run out to take your mom to an hour’s psychiatric appointment. If she requires all this input care from you, the IL/AL is not doing it’s job. Simply tell them you don’t feel this psych appointment is necessary and don’t go. I may be misunderstanding what care involves in an IL/AL, but why did you have to spend 3 weeks taking care of her if Mom is paying all this money in a facility for just that? If she needs a higher level of care, the facility should ask for a Care Conference with you (FaceTime or Skype) and discuss it.

It sounds like they’re just doing CYA. My mother was in skilled nursing and she seldom joined in their activities unless she was forced. She had 9 out of 10 meals in her room and no one ever said a word. She just enjoyed her own company more than anyone else’s.

Before you run out there again and spend any more of your retirement fund, call a meeting and firmly but calmly explain to them that you are not “around the corner” and cannot keep dropping everything and putting your life on hold.
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Reply to Ahmijoy
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Your mom sounds a lot like mine. I think this is my mom's biggest fear when it comes to thinking about some sort of assisted care or living facility, that she will be forced to "join in". Not only has Mom been a loner, did I say loner, some might call her a hermit though she gets along with others just fine, most of her life she has been deaf in one ear so groups have always been hard or her and now that she has lost 50% in her good ear and has aphasia, well she dreads anything social in a group. I would ask for a team meeting (if they do them) that includes the director and or coordinator as well as her main caregiver at least and explain who your mother is, that "not joining in" and wanting to eat alone is perfectly normal for her, in fact if she were doing those things you might wonder what was going on.

I hear you on the psychiatrist but to tell the truth it's encouraging to hear they are that on top of things to be trying to get that going, for many residents these would be signs they might need some interventions and by the sounds of it many facilities don't think of much less arrange for this kind of assistance. That said it doesn't sound like that's necessarily what your mom needs, again she is behaving normally for her. You mention life long depression, is she on any meds for that? The doctor they made the appointment with, is it one she has known for a long time? If so I would hope that doctor knows this is normal for her, if not I guess they need the same conversation, sorry. I'm just curious, if you are her primary family and support what keeps her so far away? I mean if you don't have other family in her home town and you are considering a move anyway maybe moving her to a place closer to you would be helpful so you aren't making these trips because I'm not sure they are going to stop. It may settle down for a while but in my experience so far just when things are going along smoothly something happens needing a support trip. Just fair warning. Now again, if you can meet with the right people and get her care team all on board you are probably better off leaving things status quo if she's happy there, I was just thinking if you decide you want to move her.

Good luck!
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Reply to Lymie61
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Don't move her that would be very hard on her. Consider hiring a geriatric care manager to help mom instead of you having to travel.

The geriatric psychiatrist will look at her behaviors and meds to see if there is a different medication that may help with what may very well be depression.

She is in assisted living which does not include room service. In AL meals in the room, if permitted at all, would be an additional charge.
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Reply to gladimhere
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Please come back and tell us what u find out.
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Reply to JoAnn29
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Live247 Oct 1, 2018
I will. So far I’ve only gotten voicemail.
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Your mother did not surrender her rights to AL. If there is a charge and you can afford it, by all means, let her eat in her room. She should not be forced to see a psychiatrist either. People who have lived alone all their lives and who are introverts are not suffering from a mental disorder. If you permit them to take her to a psychiatrist, be aware that they will, in all likelihood, prescribe something. Don't let them get started down that road; psych drugs are killers for the elderly. She sounds a lot like my mother - who also didn't like socializing that much. Pushing someone to socialize when they don't want to just makes matters worse. Most people would object. It's human nature.
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Reply to ItHappenedToMe
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