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PearlSpirit Asked September 2017

Does this sound like transfer trauma or could it be more?

My mom (89, dementia) moved into a wonderful assisted living facility not quite a month ago. The staff is great, she's eating better, and seems more calm overall, outside of a few isolated incidents. However her memory took a real nosedive. Before she moved, her short term memory was terrible but at least she clearly remembered the basics (where she lived, details about me and my family, etc.) But now she can't remember that she moved or where she's lived in the past 15 years, can't remember where I live or details about my family, and gets everything jumbled up. In addition to the shock of moving she also (unintentionally on her part) quit smoking and drinking, since she can't figure out how to get cigarettes or wine anymore. There's also a chance (need to get her tested) that she has a UTI. So my question is how much of all of this is "transfer trauma", the progression of her disease (most likely vascular dementia), and/or the quitting of alcohol/nicotine? Every time I talk/visit her in the last couple of weeks it seems she's even more confused. Is there a chance she'll rebound even a little, or is this the sad reality of moving someone with dementia? (Wish we had been able to do this at least a year ago.)

Colene Sep 2017
RE: Taking folks out for daily rides.

That is so sad. You tried. I am very sorry it didn't work out for you, and I can understand your decision. I hope this difficult transition will be peaceful soon. I am about 100% certain that everyone reading this exchange is also hoping things get better for you and your mom. 🌸

PearlSpirit Sep 2017
Thanks everyone for your input. My mom is being tested for a UTI. In the last week she seems slightly more stable. She's been in a good mood lately too.

@Colene - Ironically the last time her mood and cognition took a nosedive was when my daughter and I took her out of the facility for a drive and a quick bite of pizza. She enjoyed it and we were having a nice outing... until we returned to the building. She didn't recognize the building and got furious, refusing to get out of the car. Finally she made it in the building but refused to go back to her apartment and sat in the inner courtyard for a long time. Eventually she forgot that something was supposedly amiss and returned to her room. So, I decided until she stabilizes, I will NOT take her out of the building - too risky for the confusion. There are plenty of things to do in the building if she so chooses.

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Colene Sep 2017
UTI: Our mom was acting very strange, nonsensical and weak, so much so that the ER staff discussed what we would "do" - what were her end wishes etc. We felt she was in final stages. THEN the urine sample indicated she had a UTI! She quickly rallied and we had our mom for years more. After that, we always checked for UTI right away. Some places sell little home "collection" kits so her Dr can have sample tested without having to take her out.
Was your mom forced to stop smoking and drinking by regulations in her new home? My 94-year old uncle was actually kicked out of a beautiful facility because he smoked in his room. We looked everywhere but did find another place that allowed smoking. Wouldn't you know - within months he stopped (with help of nicotine patch). If alcohol doesn't interfere with her medication, could you have wine during your daily drives?
Best advice we ever got was to make sure we took our mom OUT for a short drive, a walk, an errand every day. There were two of us and we hired two ladies who each took her for a drive once a week.
It seems it would be hard to lose EVERYTHING at one time - home, alcohol & cigarettes.
I have never heard precise term "transfer trauma," but have witnessed it. Best of luck to you.
Home urine kits:
https://www.healthline.com/health/urine-culture-clean-catch#overview1

RayLinStephens Sep 2017
I think it's the reality of her age, not where she resides.

My DH is 96 and living at home, in the house we bought 29 years ago. Most days he doesn't know where we are or in whose home. He forgets where the bathroom is but asks and still uses it.

It's really sad but age will do this. The old become like babies again.

Hugemom Sep 2017
When an elderly person with dementia has their life suddenly change it does cause much confusion, irrationality and even anger. The fact that she's going through alcohol and nicotine withdrawal at the same time makes it even harder. And, UTI's can cause older people's personalities to change completely. I would try, with the staff's help and of course the doctor's, to untangle this mess, one malady at a time. There are meds for the UTI, and meds for substance withdrawal as well. I know some people don't agree with medicating the elderly, but if it helps them handle life even a little bit better, why not? Give her some time to acclimate to her new situation. But do share what you've written with the staff and doctor.

Grandma1954 Sep 2017
I bet that if someone picked me up maybe along with a few of my things and plunked me down in a totally new place with new people coming and going it would take me a while for me to get my bearings.
The fact that I have to learn all over again where my bathroom is, what door goes to the hall, figure out the strange noises at night it makes me tired trying to figure it all out and then to try to recall where things are makes me even more tired.
She may get a bit better but with every set back the step forwards will get smaller and smaller.
The fact that she is safe and is getting balanced meals should bake you feel better. She will relax and get more familiar with surroundings and that will help.

MsMadge Sep 2017
Definitely have a urinalysis done as UTIs can become a rough patch in the road

jeannegibbs Sep 2017
One month is not enough time to adjust to the move. Give that another month or two.

If she does have a uti, clearing that up will help with some of her new dementia symptoms.

Was she a heavy drinker? You could ask her doctor about alcohol or nicotine withdrawal.

Dementia progresses. Always. Sometimes it seems very gradual and sometimes it is abrupt. Nothing "causes" the progression -- it is the nature of the disease. It would have progressed the same if she'd been home.

Does not being able to remember the basics bother her? If so, try to comfort her. "It is OK Mom. You've lived in very nice places, and this place is nice, too. And here they serve wonderful meals! I think it is pizza night, or you can have that good soup you like." If it doesn't bother her, let it go without comment. Don't test her memory. (It took me a long time to switch from "remember when ..." to "I remember when ...")

She's in a good place to get prompt medical attention. The uti test should not be delayed.

97yroldmom Sep 2017
Hi PearlSpirit
Congratulations on getting your mom moved into a safer environment. You have brought up several issues that could be the problem. It is often mentioned on this site that moving does cause confusion and, of course, a UTI will cause confusion. It sounds like you are on the right track to get these items checked. I've seen my aunt, 90, become quite a bit better after having medical issues clear up. Physically your mom will reap many benefits from leaving the smoking and alcohol behind. There are so many unknowns about dementia. Try not to second guess yourself on when she moved. I'm sure you did the best you could on getting her the help she needed. It's never real clear what the best is so we just have to take one day at a time and one step at a time.  Be sure to come back and let us know how she's doing. Hugs

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