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At 94 she wasn't taking good care of herself with meds and meals, etc. I live 4 hours away and couldn't check on her often. She fell and broke ribs and laid on the floor for about 6 hours before a neighbor found her. Dr. said she couldn't live alone anymore because of her dementia. I moved her to a very nice assisted living apartment complex near me where she gets wonderful care and I and my kids and grandkids visit her. She is very depressed and unhappy and wants to go back home. She will be 95 in a couple of weeks and has enough memory to make herself miserable with thoughts of her house. I visit her almost every day and try to make her happy but she keeps lamenting about her house. I feel guilty for making her so unhappy and I wonder if I made the right decision. I have a sister who lives very far away and can't visit often. But we both call her every evening. I feel bad for her because she doesn't enjoy TV anymore and she doesn't read anymore either. She works on jigsaw puzzles constantly and that is her only past time. The other residents don't do much either. They just sit around and don't converse much. Weekly there are bingo games and other activities but on the weekends there is NOTHING for those residents to do and I can't blame her for getting depressed. Your input would be appreciated. Thanks.

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Helpme1 -

I understand your frustration. What I'm finding, though, is that as my mother's situation progresses (mid-stage dementia, CHF and other medical issues), she becomes more and more depressed and withdrawn - meaning she isn't the chatterbox she once was. She used to be lively, viviacious, smiling all the time, always making others happy. Now she can't even make *herself* happy, let alone anyone else. Talking to others beyond saying, "good morning" or "hello" is just not something she can do at this point. She has made 2 trips to the NH now for therapy/rehab, and gets severely depressed every time she's in there. Soon - very soon - she will not be able to come home, because her medical needs are going to outpace what I can handle. That is *not* going to be a good day when I have to tell her that.
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How wonderful of you to take the initiative and get the clients outside for a bit. And don't worry about their not remembering when they have done something. I have found that whether they remember a particular event, they do remember the feelings of joy, peace, happiness, contentment they have had, even if they don't know why. My folks will want to return to a place or like to have a particular person come see them. Just because something about that person or place left them with a smile on their hearts~
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Since posting here and getting such a wonderful variety of answers to read, I feel better about the whole situation. Yesterday I went to visit my mother and it was a beautiful day outside. NO ONE was sitting outside. Beautiful front sitting areas and beautiful back covered patio in the back and both were empty. I almost threw a fit. Those people were just sitting in front of the TV inside watching tv! I told them, "Go outside...it is so beautiful out there!" I also told one of the aides to guide the people outside. I went and got my mother, who had just come back into her apartment from sitting outside alone, I took her outside and people started shuffling their way out to the covered patio. There were about 5 people that came out and joined us and I got the conversation going as well as I could. They were all so cute! I think elderly people are adorable. So we all visited and joked around out there until it was time for them to come in for supper. My mother actually started to enjoy herself and join in......but I honestly don't know if they will all do that again ....without prompting. I learned they had had an ice cream social that afternoon and even though my mother said she knew nothing about it, I found out she had been there! She didn't remember. Oh my! Anyway, I think that after I retire I may volunteer there a couple of times a week. I enjoy them all. I now know that my mom does indeed go to events but she will complain that she does nothing.....she doesn't remember! She also helps them fold towels and table cloths but she forgets that she does it! So I know they try to keep her involved. I wish the facility had a resident pet though. I think they would all love that. I will look into that. Thanks to all of you for your input though. It is very helpful. Each person experiences different situations and they are very helpful to one another.
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Chris, there are facilities that have resident pets and others that have gardens. The one my mother was in for rehab from a broken leg had an assistive garden - a raised bed with plants around the edge.

People could wheel their wheelchairs out and spend time in the garden. For OT, sometimes they repotted plants.

I've read in some of my gardening and herbal magazines that these are appearing more frequently - it's not a "movement" yet, but some facilities are moving closer to a patient oriented focus, with a variety of activities beyond the usual standard ones.

Sunrise Assisted Living in Michigan used to have a resident pet - I don't recall whether it was a cat or dog. It wandered freely among the floors and rooms.

Some years ago the Eden Initiative was developed; it focused on a more meaningful experience for people in facilities. It was an interesting concept and progressive for its time.

Your points are very well thought out and articulated. I don't disagree with you, and really feel that staying at home or living in a facility is an individual issue, depending on the community and its support, the individual, the family proximity, and a whole lot of other factors.

Geriatric majors have been developed for interested college students. When I think back to my college days, I doubt that field would have attracted anyone. But fortunately it does now.

I think your plan is wise - you have a plan and a back-up plan. The situation you describe of your father's interaction with his community is a critical factor I think in keeping someone at home. There are neighborhoods in which that kind of consideration doesn't exist. And in those cases, the elder probabaly has more opportunity for companionship in a facitlity.

As to people being in one and not communicating, I'm wondering why also and think back to the ones I've seen, of almost catatonic people sitting in wheelchairs with emotional pain clearly expressed on their faces. I wish I knew why - I don't. But it's obviously not appropriate or acceptable in a country with as many resources as the US has.

One thing I think might help is music piped throughout the facility, ranging from patriotic and WWII songs to the popular tunes of the 40's and other eras, all geared to the age range of the population.
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My dad was unhappy living in his home alone (after mom died), he is unhappy living in my home, and I expect he will be unhappy when we move him to AL.

I sincerely *hope* that he will participate in activities and make some friends at AL, but honestly I doubt it. He rejected contact with their friends (said they were "her" friends not his) before the move, & passed on offers to socialize with the senior men in my neighborhood. Maybe the AL activity director can pull the proverbial rabbit out of a hat, but I won't think less of her if she doesn't.
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In some ways, helpme, it will get easier. We are all responsible for our own happiness. I think my folks were unhappy at times in their own home, too. And they never like change. (I am getting there,too) So now their unhappiness, is directed at those of us kids who helped them decide to go to Assisted Living. Before they moved, I finally told Mom it was her decision, to be unhappy or to be looking forward to less stress and worry for her. And it still took time for her to decide!! So......Hang in there and God Bless You for Caring Enough to want your mom to be happy!! But remember, NO Guilt, or as little as possible!
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57twin and everyone who has answered my lament.....one thread that I notice we all share is our opinion of activities for our loved ones. Even though there are music programs, games, cards, etc., it seems that every time I go to visit my mom I see so many just sitting around staring at the TV and NOT TALKING to each other. Is that normal?!?! They don't talk to each other! This is not a nursing home. There should be friendliness abound because they have a lot in common with their age and life experiences, but no one talks! This facility has a lovely front patio surrounded by beautiful tall oak trees and in the back there is a wonderful covered patio that overlooks tennis courts - which are always full of action. My mother is about the only one that goes outside to sit. She is so lonely! Tonight she lamented that no one talks to her and she sits outside all by herself. I feel so bad for her. Shouldn't the staff encourage people to go outdoors in such beautiful weather? And while I am at it, why are weekends so dead at AL's? There are minimal fun activities on Saturday and Sunday. My daughter brings her daughter's American Heritage Girls to the facility to host Bingo and rosary twice a month. And my husband and I gifted a Washer Toss game to give the residents something fun to do. It just kills me that there is such inadequate entertainment for these people. And at the price we pay monthly, there should be more attention paid to them. There. That is my frustration coming out. Thanks everyone for letting me have my say. 😠
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My Dad has been at his assisted living just a week shy of one year.
His assisted living place is great and the activities director awesome.
His place does let residents help. One man helps a bit in the kitchen, they have container plants outside to water. They have preschoolers and therapy dog visits and a piano playing every Friday happy hour. While not as many activities on weekends they still have some on the schedule.
While mom was alive she did everything for dad up until the last several months when I did the grocery shopping, cooking and cleaning. Dad did live with my husband and I for 4 months while the AL place was being built. He did go a couple times a week to adult daycare which was a way to see if assisted living would work for him.
He is about 7-8 minutes away and I visit several times a week mainly short visits.
So far so good but that will change.
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Yes, Babalou, very insightful points you made. If nothing else, once I move my dad back to his condo and it doesn't work out (thus the backup room on hold at the ALF), I will at least comfort myself knowing that we tried different options and if ALF is what he needs, then that is what he needs. I will definitely take a look at the book you suggested, Babalou, it sounds interesting.
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Chris12, reading your post attentively I am impressed by your balanced and responsible approach, and I too would like to wish you all the best with your father's continuing at home.

The points you make about the dearth of enrichment at some ALFs and similar are valid; and although I wouldn't go as far as outrage, not quite, I certainly share your reservations about priorities when it comes to elders' quality of life. I just wanted to put in a word for those professional care organisations which have already taken them on board and are doing something about it, because they do exist and their work deserves recognition. In this country, the UK, I'd single out Nightingale Hammerson, MHA and ExtraCare as models, and I'd be interested to hear what US organisations forum members rate highly. Then there are fascinating lessons to be learned from Japan, which is right in the demographic front line and going about solving the country's massive elder care problem in a characteristically dauntless way.

At the moment, our parents are the customers in this market but before too long it will be us. If we're not going to lumber our children, we can't afford to shun the industry: we need to get involved in developing better practice.
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Babalou, that was a fantastic response. Thank you.
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Chris, I certainly understand your plan to bring your dad back to his condo and I certainly hope that it works out. Living in a condo where there are others close by and literally within shouting distance is a far cry from where some of our parents live(d) in self-isolating suburbs with no access to sidewalks, public transportation or nearby services.

As to "happy" vs "safe", there is a wonderful book by Atul Gawande called something like Being Mortal which discusses just this topic. Indeed, in some ALs and even NHs, there ARE gardening activities, opportunities to help out etc. I believe that this will become a greater part of the Eldercare "Industry" in the future. But as adult children, many of us seniors ourselves, we are limited by time, distance, other obligations and money as to what we can do for our parents and other elderly relatives. I believe that our obligation is to make sure that they are SAFE. Happiness is a quality that one carries within and can't always be delivered as can a warm bed or a plate of food. And something that I notice a lot in these posts, the folks who seem to try the hardest to provide "happiness" for their parents are the poor souls who have narcissistic parents, people who will NEVER be satisfied with ANYTHING.
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Chris12, thank you for your support. I myself get fired up sometimes. And the main trigger for me is that I was ever put in this situation in the first place. This is something I will NEVER do to my own kids. For years we begged mom to move out of her house and into an apartment or to move closer to us but she was stubborn. And yes, selfish in my opinion. Although she always felt that by being independent she wasn't burdening us. Well, she was burdening us! My husband had the responsibility of taking care of two houses. Many times he would be walking around on her roof clearing off leaves, making sure the gutters were cleaned, trimming fruit trees and fixing things around the house that he could fix. . . and he is 67 years old and not in the best health. She couldn't see that?? That just boggles my mind. So, again, I will NOT do this to my children and we are already making future plans to move into retirement condos or something in the near future. I guess the frustration gets to me sometimes because I try so hard to make her happy by taking her places, shopping, lunches out.....family celebrations and dinners and nothing makes her happy. She might be happy in the moment but that doesn't last long and she forgets everything. I have learned to accept it and appreciate my time with her, after all, she is soon to be 95 and who knows how long I will have her. Caregivers have it rough and burnout is quite common. I don't want to burnout. I will continue to see her and bring her new puzzles, groceries and fresh fruit, etc, and know in my heart that I am doing all I can for her. She will not die a happy woman but I tried. Prayers to you, Chris12!
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Chris12, I certainly understand what you are saying. It sounds like your dad is a little better off than my mom. She will be 95 in a couple of weeks. When I got word that she had fallen and was taken by ambulance I drove the 4 hours as fast as I could (and I might add that incidences like this happened before....phone call that my mother had been taken to the hospital for injuries). At her house I had discovered that there actually was no decent food in the house. She always told me she was going grocery shopping (yes, she still drove!) but it became clear that with her dementia that she must have driven along somewhere and forgot where and why she was going. Thank God she never hurt or killed anyone. Her independence and strong will caused me and my family many sleepless nights. She always said that the only way we would get her out of her house was if she was carried out. Well, that happened. We tried to have regular visits from the VNA help her with her meds but she insisted she didn't need any medication and wouldn't take it. Or else she would get it so mixed up. I offered to hire a caregiver to live in or else be there everyday and she told me absolutely not. She was not cooperative at all. Yes, four hours away was hard. And no, it wasn't fair to depend on her neighbors who were all up there in age too. My mom was our responsibility and after her final fall, the doctor said she couldn't go home again. My mom refuses to believe that she even fell! If I would have left her there, I think I could have gotten in trouble for abandonment. Now, I understand how your dad is happier in his own house and I wish you all well. I hope he can enjoy life to the fullest. Really, I do. But I did have to do something for my mother's safety. And I agree with you....assisted living facilities should do more for their residents. Believe it or not, my mother helps the staff fold laundry and she is happiest when she is busy like that. I love that. But I agree with your ideas about having pets around. Unfortunately there are probably people that are allergic or something! You had great ideas though and I will pass them along at the next meeting that I have with the staff. Thank you for your response and again, I hope all goes well with your dad for many, many years. 😊
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Helpme1, your situation sounds almost exactly like mine, but with my father. He is 90 years old, has macular degeneration, is hearing impaired and unsteady on his feet (uses a walker now).

I get the feeling, after reading all the above posts, that I am not going to make any friends on this message board by saying what I am about to say, but we made the decision to take my Dad out of an ALF. He had been there for two months after a minor stroke. He has made enough improvement that we feel, with the necessary supports in place, he will be happier at home. We will get him a "Lifeline" monitor that sends an ambulance if it senses a fall and there is no further movement.

In his condo building (his home), he knows almost everyone. He knows the postal delivery worker and the superintendent. From the residents to the postal lady and everyone in between - they are all different ages and in different stages of life and have their own stories and perspectives to share about LIFE. Hanging out in the lobby chatting with whoever walked by (everyone was very kind and would visit with him whenever they could) was more dynamic than hanging around with people his own age who are mostly unhappy because of where they are now living. In the ALF, he totally lost interest in absolutely everything! He used to listen to audio books - up to 8 a week before the stroke. He hasn't finished one book since he entered the place 8 weeks ago. He doesn't even "watch" TV, therefore he never seems to know what day of the week it is. Because everything is done for him, he has no dirty dishes to wash, no laundry to do and therefore can't spend a few minutes hanging his laundry on his portable drying rack; he doesn't ask me to help him make his bed up with freshly laundered linen, he has nothing to dust and tidy; all the things he used to do to occupy his time pre-stroke. Although the home offers "activities", most of them are useless to him. He is not religious, so church services and prayer meetings are out of the question, he cannot see to play cards or bingo. It was the puttering around in his own apartment and doing little things for himself and chatting up his neighbours that made life worth living. He just hasn't been interested in life since moving in there.

The medical establishment and the assisted living industry all seem to focus on "safety", as if that is all that living should be about. If there is no purpose to life, then what is the point? Someone also mentioned that you should stay away for three weeks(!) to let your mother adjust. That reminds me of how, as parents, we are advised to treat our children when sending them off to summer camp - cut all modes of communication so they can settle in and forget about you for a while. That psychology is fine on children who we are training to become adults. What are we training 90 and 95 year old people to get used to?? They only have a few years left and we are going to "train" them in three weeks to stop missing us as if they have 30 years still ahead of them? The head of nursing at the home suggested that I not visit for a while and I bristled then at the idea.

All of that being said, however, we are keeping his room on reserve for a month while we try him out at home.

And I do understand there is a difference in our situations - you live 4 hours away while I am only 1.5 hours away from my dad, so I think that makes a difference. And it sounds like your mum was pretty alone when she was living in her own place. You are feeling the same way about your mum being the ALF as I was with my dad and I think the basis of my entire diatribe here is that I wish Assisted Living establishments tried harder to give their residents actual "purpose" when they are living there. But everything would just be too difficult and time consuming and some of these things might even be, heaven forbid, "unsafe". But wouldn't it be nice if they could dig up a corner of the yard and plant some vegetables or pretty flowers and let those interested, tend to a corner of the garden? Instead - they hire landscapers. Wouldn't it be nice if they had three dogs and five cats who wandered around and the residents took turns feeding them and taking them for walks (those that could)? How about an after-school daycare where the children of staff could come and hang out with the residents? What about letting residents who are able to help out in the kitchen (could be as simple as washing fruits and vegetables) or assist in setting the tables for meals? No, all of this would pose too many problems, instead of looking at these things like a challenge! But this would all be more interesting than bingo and sing-alongs! In my humble opinion.

I am sorry, helpme1, I didn't help you with your guilt. But I am truly going through the very same situation at this very moment and I am outraged that safety seems to be the only mantra. Safety, obviously, is important. But so is Purpose. I wish homes for the elderly could see this.
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Thank you all! I really needed your reassurance and I feel better. This is so hard!
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Poor Mom. She is really in a miserable situation. She is NOT abandoned, and yet she can't remember when she had visitors, and that is very sad. In my experience with my mother, even if she couldn't specifically remember who visited when, she eventually developed the "memory" that she was visited often, and she is content on that score. Also the staff keep telling her, "You are so lucky that your children visit so often. You must have been a very good mother." But it takes time to build the assurance. Just keep visiting often. Ten minutes twice a day is great, if you can manage it. (I do not agree with not visiting while they settle in. That just seems cruel.) If you can spare the time once in a while attending the activities with her may help her transition to getting her entertainment that way.

But, poor dear, she has dementia, and her reasoning and thinking is all messed up. She may never reach the state of contentment that my mother has reached.

No doubt about it. Mom has been dealt a bad hand. Feel sad for her. But guilt? Here is the truth. It is the Dementia that has dealt this awful hand. It is Not Your Fault. You are doing the absolute best you can to give her a chance at happiness in her final years. Her inability to take that chance (at least at this time) is Not Your Fault. (Not her fault either, of course.)

Guilt saps your energy. Try very hard to shake it.
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No, don't tell her that unless she asks you directly if it has been sold. Cui bono? All is well with the house and it is being taken care of is fine, and true - assuming its new owners love it as much as she did!

If she does ask the direct question you ought to tell her the truth, and then dwell on the upside that she now has loads of cash in the bank and need never worry about a bill? AND that the new owners are taking good care etc.
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Thanks to all the wonderful words of advice and encouragement. I needed your comments. I know she is safe and the staff does go to get her and involve her in projects and activities. She does a lot of things but forgets that she has done anything...then gets depressed because she feels she being abandoned. I know she is acting like a spoiled child. She keeps asking about her house, though, and I don't know if I should tell her the truth that it is sold. I think that would make her very sad. So I usually just say all is well with the house and it's being taken care of and then I change the subject. In all of your opinions, should I tell her that her house is gone?
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Give it time. Easr yourself with the guilt. You need that energy to care for ypurself and your mom.Not easy. I'm right where you are.
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Technique to get rid of guilt: If you cannot convince yourself with logical thought that your guilt is not rational, but just human; if you cannot forgive yourself for real or imagined failures when it comes to having saved your Mom, then try this:
Practice "thought stopping". Stop your thoughts in their tracks. Write the word "guilt" on a piece of paper, put it in a paper bag. Never take the paper out or read it. Do it again, put a piece of paper into the bag writing "guilt" on it whenever you want to entertain thoughts of guilt.
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You are not guilty of making your mother so frail that she could not live safely alone. When you feel sad because she is sad, remember what the alternative was. This option is certainly safer, and God willing - as she settles in and starts looking forward to seeing you more regularly than she used to do when she lived alone - it will become happier too.
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I am soooooo jealous..........I cannot get my parents to agree to get in assited living were they would be safe, fed properly, have companionship, and not driving.
No guilt, no how. Your are their savior.
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If you are visiting daily, it hasn't given her time to adjust. Generally, it is advised that you stay away for 3 weeks.

My mother is 96, but her nursing home has entertainment quite often. I know she is safe, well fed, clean and dressed. She wasn't when she was at home.
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It takes time for them to adjust to the new way of living. We all know that the elderly despise change. Let more time pass for her to acclimate before you second guess yourself. GardenArtist has good advice. Call the Social Worker or Activities Director to suggest that they actively reach out and invite her to participate in more activities. Also, in my experience, at their age, if they have nothing to complain about, live is not worth living...ha.
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Just another thought...could you ask the activities director if there is anyone who might share your mother's interests, and if the activities staff could ensure that she is brought from her room to any music or art therapy activities? Music has such a magic ability to bring people out of their shells and offer at least some happiness.

You might also bring her favorite music on CD or cassette and play it for her while you're with her, or when you leave so that your departure is replaced by her favorite music. It might ease the transition.

If the facility has pet therapy, ask the activities director or staff to make sure some animals visit your mother.
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Perhaps this different slant will offer another perspective.

Your mother could have broken her hip. She could have laid on the floor for longer than 6 hours. It could have been winter and if she had no blankets nearby she could have become hypothermic.

A situation somewhat similar to that worse case scenario did happen to an acquaintance. And it was bad, very bad. She was lucky she survived.

If you hadn't placed your mother in an AL facility, wouldn't you be worried that another fall might occur, and could be worse?

Didn't you do it because you wanted her to be safe? Wasn't that the primary purpose? And is she better off and safer now?

These are legitimate reasons, even though it may be difficult to keep them at the forefront of your thoughts, and even though your mother may be unhappy in her new home.

There are times when decisions have to be made on what's the better of 2 or more options, none of which are the most desirable. But one is safer. That's the choice you made.

My mother was unhappy about being in a SNF for rehab, but she was nonweight bearing for 6 weeks after a fractured leg. We were all upset about it, but knew that Dad couldn't take care of her at home, and she wouldn't have healed. That would have been worse than being in a facility.

Try to keep the positive thoughts of why you made the decision more dominant in your consideration so that eventually they'll "tip" the scale toward thinking of how you've helped her, and that you've chosen the best route even if it isn't the most happy one for her.

And I know it isn't easy. Guilt seems to be an almost everpresent emotion for caregivers.
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Babalou, at the AL she is in now, there are many, many activities offered. I go through the monthly calendar and type up a weekly chart of the things I think she would be interested in such as the craft classes, the music programs, church, exercise group, etc. The problem is that she doesn't do much. She likes bingo and craft classes. Most times she sits in her quiet apt. and does jigsaw puzzles. She isn't friendly to others mostly because her hearing is so bad that she can't hear if anyone talks to her and with her dementia she probably can follow conversations too well. She does play cards once in a while. At her home she was very alone and sometimes didn't talk to anyone for days so I guess she gets more companionship here but she is so unhappy. I think that when she sees me that triggers the memory of her home and she is like a skipping record . . always asking about her home. Then I feel guilty. I work just down the street from her so it is easy for me to stop in often, if only to say hello and give her a hug. I am just feeling bad because I don't see much happiness with her. I think she will just die an unhappy woman and that makes me feels bad.
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What was your mother doing at home that was interesting? What would she being doing if she were back there now?

We can't make our parents happy; we can keep them safe, fed, clothed and out of danger. Happiness? That's something that people have inside.

Has she been seen by a geriatric psychiatrist ? It sounds as though depression may be a problem.

Is once a week bingo really the only activity? My mom's lace had religious services, crafts classes, a stock market club, college students who came in to lead discussions. Maybe there is a more attractive options in your town.
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