Appointments outside of memory care are becoming more challenging. How would you handle this?

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My 91-year-old mom lives in memory care, and from time-to-time it's necessary to check her out from MC to take her to doctor appointments, etc. Months ago I'd call her the night before, tell her I'd pick her up at 9 AM for a 9:30 appointment, and when I arrived on time the next day, she'd be ready to go. It's amazed me that despite her deficits Mom's been organized enough to manage this; but still, in the back of my mind I knew the day would come when she couldn't. Sure enough, I began to notice that when I'd arrive, she'd know we were going somewhere but still not be dressed, and I'd have to prompt her to get ready. Entirely understandable. However, more recently, I've found her ready to go but furious, insisting I'd told her I'd pick her up at 6 AM for a 9:30 AM appointment, saying "Where have you been? I called and called and you didn't answer!"; essentially a catastrophic reaction with anger, hand-wringing, pouting, refusal to leave, etc. Reasoning, of course, does no good. In both cases it took a "time out" followed by a great deal of wheedling to get her out the door. Fortunately, we weren't late for her appointment. Obviously, I need a strategy to avoid more of the same. I've contemplated arriving early and unannounced to assist Mom in getting ready, but I can hear it already: "Why didn't you call me??? Nobody tells me anything!!!!" with another scene of anger and confusion. I've tried to limit outings with Mom as much as possible for my own sake (there's a long history of verbal and emotional abuse; thank you, Mom), and my sister shares in my care-giving duties; nevertheless I'm anticipating a number of future outings, and without going into detail, they are necessary, non-optional followup appointments and social engagements. So far Mom's social conduct is okay, sometimes inappropriate (but not combative) and so far I've been able to manage her okay. The staff at Mom's MC love her and are wonderful; however, they don't have time to coach residents about when to get ready, etc., and they don't prepare residents for or take residents to appointments; just a once-weekly group pleasure jaunt on the community bus. Has anyone encountered similar situations and how did you manage them? Thanks!

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Not sure what a Memory units responsibilities are but my Mom's AL got her ready for me. Doctors she had been going to for a while I had asked that her appts be once a year since her meds with them were stable so visits were "how r things going". Once she was in a NH under the care of one of her doctor's, I dropped off one and the other agreed that as long as labs were done regularly and he as consulted with any problems, he would work with the NH doctor. Mom's foot doctor came to both the AL and NH. I never told Mom when she had an appt. If I did she would be up all night trying to get ready. I would evaluate how important are these doctors. Is she stable with her meds. If so, ask her primary if he can take over her care. Going to the specialist only if needed.
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Calendar would be my suggestion. I plan to get one for next year as she used to "live" by it when still at home. It gets harder when they don't know what month it is anymore. When still in her condo she used to put the appointment down and then called me multiple times the week before asking if I could take her. I would ask her to write down that I am taking her and she'd say yeah, but not write it down. I had to be very specific and say do it NOW! While I'm on the phone!

Currently she has appointment cards with the dates on them. She typically rifles through her purse and wallet, especially in the car and waiting rooms, but still goes through it all in her room. I'm hoping the calendar can work - especially if I tear off the months that have passed. I also tend to make afternoon appointments, more so because it is easier for me, but as noted by others she is more likely to be up and dressed.

Although there might be "in-house" doctors, many elders have specialists. Our mom still goes for macular degeneration treatments, which could not be done at the MC. I do not know if there is a more local place that could do this, but she has been with these doctors for a long time and my preference is to continue with them. Keeping her eyesight is important at this point. I changed her to a local PCP, and for a couple of falls, they used ambulance/transport vans to have her checked at a local ER and return. The dermatologist is a little hike as well, because I thought it was another office for the place she had used, but we had to have a basal cell on her face checked/treated and since we had this place and I like them, we'll stick with them for now. At least that will not be often. I still need to find a local dentist, but thankfully she does not have any other conditions requiring treatments and appointments!

I recently ordered a transport chair, hopefully delivered soon, as some places have a long walk to get in/out and she tires easily. She does not yet use a walker. She did tell my brother she wanted one like another woman had - I moved the ones my dad had used to my place, both a regular walker and the one with a seat and basket, so I brought the latter one up, which is what she asked for. Then it was 15 minutes of my brothers trying to explain to her that there was no cost, we did not buy it, it was dad's on and on and on... They don't get it! I taped a paper with her name on it, but that has disappeared since.

Anyway, try any and all methods. Setting afternoon appointments and just arriving early enough to ensure she is bathed and dressed might be the only thing you can do. If he/she is balking at going, insisting they don't have an appointment, just make up something, like we are going for ice cream, or lunch or something, just to get them going!
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Part 2 of last post; mom refuses to use the shuttle - don't really know why, just won't. Maybe client will? I can but ask.....
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Madzeena, Oh those transfers,,,, There are days I have to take my mom somewhere, then my client/friend, also (I try to do it on separate days usually) and getting in and out of van and places we go with the stupid walker drives me nuts! Now both of them are barely able to get IN the van, legs don't work right; what will we do now?
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I went through the same thing you are going through now... and you are 4hrs away wow that in and of itself is bad enough.
The memory facility has a schedule I worked around so I knew she'd be dressed and fed
I didn't tell her about appointments anymore because she'd stay up all night worrying about them. Thanks be to God
I found a doctor who makes house calls. What a blessing
I don't have to make appointments get her in the car or to the bathroom 10 times
See what you can do to make that happen!
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My mom has a calendar she still manages, but she often doesn't know which month she is on. Recently I have taken away the charitable ones for 2018 that really mucked things up, and I am ripping off the past months. For appointments I do not tell her much in advance, and often just give my dad who is present the heads up and tell him to tell her with about an hours notice. She'll say she didn't remember, but she wouldn't anyhow. It's too much a challenge in the AM, so I make the appts for PM always, usually toward the end of the day so I don't miss much work. Other options are finding an MD that makes home visits (but of course that will be someone unfamiliar to begin with). Social engagements, if you don't mind my saying, I would think are always optional. Why make your life more complicated if those can be avoided...not to isolate your mom...just not for command performances.
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I understand this scenario completely! The elder's mind is no longer able to function properly. This happened to my late mother when I had to move in with her in another state. She then had to go to a nursing home...I would call her saying that I was on my way there from her house. She then got mad and forgot, asking me "why haven't you called me in days?" You may want to tell the FACILITY in inlieu of your mother of your prior eta because thinking that you're showing up at 6:00 A.M. is not even a lucid thought since no doctors' office is open then.
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My Mom was in an AL. I told them when she had an appt. I gave them a time for pick up and asked. them to have her ready. Her NH had doctors so I chose one. I also made the decision about which doctors could be dropped or go to once a year. As Moms Dementia progressed and getting her out was harder. I allowed the doctor at the home take over her total care as long as tests were done regularly and if bad, I would take her back to the specialist.
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Garden
My moms pacemaker was not one that could be checked on the phone. Wireless nonexistent in her neck of the woods. I had to drive about 10 mi in a specific direction to get cell reception. We made sure to get the pacemaker checked each time we made the trip. Pacemaker rep would come to wherever we were seeing another dr in the medical complex to do the check. It's good to know they have made improvements.
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Mom's MC staff make sure residents are dressed prior to breakfast, but in the circum- stance I mentioned, Mom wanted to change clothes (why, I don't know) prior to the appointment. The problem is when Mom anticipates an outing she gets agitated, anxious, confused.

MC does not provide transportation for anything except aforementioned weekly group outing. If friends or family cannot take her out of MC for whatever reason, there remains the option of hiring an agency caregiver, who at $22/hr at a 6-hour minimum, which is pretty expensive. There is a house MD that comes to MC to check on residents for issues. She can arrange to have a mobile testing unit come to MC to draw blood, urinalysis, and some imaging, which is a Godsend. Now that Mom's long-neglected medical issues have been addressed (prior to Dad's passing she refused to go the doctor for years), the house MD can pretty much manage all but the most specialized medical issues, so in the future, doctors appointments will be few and far between.
So I think I can expect to be taking Mom out less and less.

For what it's worth, for those who have loved ones in wheelchairs, there are medical shuttles that can easily accommodate wheelchairs who will take your LO to a Dr. appointment. Here in California it's about $100 round trip (5 miles or less one way); quite expensive indeed but may be worth a consideration if transferring your LO in and out of a private vehicle is a challenge. These shuttles are wonderful; driver places wheelchair with LO on a lift that places wheelchair in and out of the shuttle. No pain or strain for you and less stress for your loved one; a possibility if it's affordable.

Again, thanks to all. Your suggestions have really helped!
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