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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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Could you hang a small message board in her room? The night before an appt, make notes on the board as to the time and nature of the appt, what time you'll be by to get her, etc. It may help her to see it in writing, but then again it may not. Eventually as the dementia worsens, not even notes will make sense. When you arrive to Mom's anger and frustration, just apologize and try to appease her. "I'm so sorry, Mom. I must have misspoken yesterday. I can understand how that would be distressing for you. Will you forgive my mistake? Hey, after our appt, let's stop by your favorite place and get some ice cream! What flavor would you like?" Try to enter her delusional reality (meet her when/where she is), then see if you can help guide her to a safer place. Hugs to you!! You've got this!!
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Dear friends: Thanks so much for your ideas!

Mom is up half the night and has all night to fret about a morning appointment. I'll make sure to ask for afternoon appointments right after lunch, inasmuch as I can.
The message board is a good idea; unfortunately I live 4 hours away so there's no opportunity to get reminders up on Mom's board in time.

But yes! I always take responsibility when things "go wrong," like yesterday: "Mom, I don't remember you giving me your pajama tops to let out the seams; I must have forgotten! I'm so sorry! How forgetful of me! Blah, blah." It's just easier. Let her have the day. Take the blame and the trouble generally diffuses. (I'll go out and buy new pajamas.) She reminds me often that SHE doesn't have dementia, only a "little memory problem," but she "knows SOMEONE that's got a serious problem (her emphasis, not mine) and looks glaringly at me! LOL

Wish I could take her out for ice cream or some other goodie; but she's diabetic! (Sigh) And as for sugar-free alternatives, I'm learning now that artificial sweeteners raise glucose levels much like sugar.... Maybe a cup of Starbucks with cream will have to do!

Thank you guys, you're the best!
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Ah, I remember trying to get both of my very elderly parents ready for a doctor appointment. Mom was great, she would be sitting in her kitchen chair all ready, coat and scarf already on, purse in hand, etc.

Dad was the opposite, he would think he was ready but the search began for his cane... then his eye glasses... ok Dad you have your wallet?.... time for a bathroom run.... then the struggle to get into his favorite jacket... now, what baseball cap to wear. Then getting them into the car was no easy feat. I use to tell my parents their appointment was 30 minutes earlier than it was.

Eventually no matter what you do, with memory issues, it just becomes more complex. Lot of trial and error until you find one certain way that works. I had used what MAC above had mentioned, pick a time that works well, when Mom is the easiest to work with.
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I'm anticipating times when this task will get worse. I plan to bring back up...a gal pal. Mom usually behaves better around my friends For now our few appointments go well. Staff remind her...i arrive 1 1/2 hours early and we arrive at the appointment early and look at magazines. She just loves getting out and for now we have fun. I know it will change.
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Everyones situation is different. My mom was very healthy other than the CHF. She lived at home and had HH. They (HH) were able to do routine blood work without her leaving home. They would fax results to the doctor. Any medication change was called to me and home health. Prescriptions sent to the pharmacy. She only saw her doctors once a year all on the same day for the most part. I didn't tell her we were going until the day before because she would stress about it. Usually she would remember from the previous appointment that it was coming up but we didn't discuss it. I would leave it up to her. If she didn't want to go I would tell her it was her decision. I was always careful to let her know she was able to make her own decisions. I was available to take her but not willing to engage in an argument about it. I would remind her that the doctors wouldn't continue to give her the Lasix and blood thinner if they didn't see her in person at least once a year. Her pace maker couldn't be checked over the phone. We would talk about what that meant. She always decided to go. The day of, I would call her to let her know I was almost at her house. It was a three hour trip one way and we were both always very tired afterwards. She enjoyed the trip for the most part. I can't relate to frequent doctor appointments. But then, she was very compliant with her diet and seldom required a change in medication. I had help twice taking her and I agree there was less acting out when another person went along. (I may have behaved better with another person along as well).  Early on, before he died, my older brother would bring her half way to meet me. Of course, she never gave him a bit of trouble. Lol
So I guess my suggestion would be, little advance warning, few trips, distraction with others in attendance and remind her that it is her decision. You need to mean that by the way. They can tell.
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I just returned from taking my mom to a doctor's appt - follow up to a fall yesterday- and started reading this thread. I choose late morning appts because the staff at her Memory Care facility have her dressed, breakfast eaten, meds given, and toileted. When I arrive (and I give myself an hour to get her out of building) it's still a lot of reminders of why we're going to the doctor, getting her coat on, glasses, shoes, etc. But always dangling the carrot that we will get lunch on our way back.
It hasn't always been going this smoothly. Took lots of trial and error and once even having to cancel the appointment because she refused to move. So just when I finally have a "system" down I've pooped out. I admitted to the facility director when I was leaving this afternoon that I did not think
I could do it again. It's all too much for me. My mom weighs over 200 lbs and just pushing her around the clinic in the chair is exhausting. Not to mention the transfer from walker to chair to car to chair to exam table to chair to car to chair to walker. She has to be prompted for every movement. The director reminded me that the facility provides a transport van that I can ride in with her and it would cut out at least four transfers in and out of her chair. Duh!! Sometimes we forget the obvious because we get locked into the way we've been doing things. Next appt we'll be taking the van! Hopefully the driver won't mind going thru the drive thru at the local burger chain so I can still treat mom to lunch out when we get back to Memory Care.
Also mom checked out fine from the fall.
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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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Most facilities here have doctors that are on-site. The doctor has a day or two a week that is spent there. Sometimes it may be a PA. That is the easy and obvious answer.

If this facility does not have a house doctor perhaps a private caregiver, or a geriatric care manager would be able to transport.
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jjkmummert: I totally, totally understand your logic. It’s brilliant. But it’s also sad, because now 2 fully-functiong adults need to upend their schedules to get your momma to the doctor. That’s the rub with eldercare. The ever-increasing interventions that are required ....to facilitate mundane tasks. 
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My parents are both in memory care and having to take them out is a big problem for me. They do have a doctor who comes to the facility but they don't have a cardiologist or any specialist.. so if you need to go to one of those then I need to take them.

I usually don't say anything ahead of time.. schedule afternoon appointments like others have mentioned. I might call in that morning and tell the facility to let them know an hour or so before I get there. They should be ready and dressed unless you go early in the am... or they had some accident that need to be cleaned up for.

Last time I took my mom to the Dr., when I came back she didn't recognize the memory care from the outside... wanted to know what we were going to be doing at this place and just take her home! If I can at all avoid taking them out.. I will .... Its sad because I would like to be able to take them out at times but am nervous about how they will react when we return... or if they will even go back in.

When I took my Dad to the Dr last.. the electricity went out at the Dr.'s office.. and we were on the 3rd floor in total darkness.. with my Dad.. with dementia! What an experience. The staff had to help us down 3 flights of stairs..

Needless to say. ... I do not look forward to their Dr appointments!
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