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My MIL entered ASL after an at-fault car accident. At the hospital she was diagnosed with moderately severe vascular dementia. We moved here 10 years ago and she has been spiteful to me ever since. She's hateful & narcissistic. At rehab they could not coach her to understand how to take her meds or test her sugar-too much confusion. The family decided that ASL was needed and she agreed, reluctantly. She has long term care insurance thanks to my deceased FIL's foresight (a wonderful man she never stopped criticizing).
She eats only carbs at ASL and substitutes ice cream for her veggies. Her leg wound has worsened. Today we got a call from the nurse saying that MIL keeps sticking her finger in the wound every time the dressing is changed 2x's a day. So off we go to spend the afternoon at Medstat. Doctor tells us it is her out of control sugar. MIL brings out the same song and dance about how the facility, nurses, dietician and her doctor know nothing about controlling her diabetes and all she has to eat is carbs. These are blatant lies. I told her in front of Dr. and the favorite son who was visiting that there were substitutions and she was choosing poorly and that ice cream was not helping. Told her that she could lose her leg. Dr. agreed. I requested and got a script for her to get nutritional counseling. This is bogus. For decades she lived at home and co not roles her diabetes well. A nurse friend of mine, who knows the whole story of my MIL's antics says that my MIL is eating poorly to exercise control.
My SIL who is a wonderful person suggested that we purchase here some better food to keep in her room. My MIL has lots more money than we do but is a miser. Plus there are good choices available,
I am so tired of this woman eating like a two year old and blaming everyone for her problem. BTW she worked in food service as a kitchen worker - no degree in nutrition, so you can't tell her anything-she knows it all. The staff nutritionist is incompetent, the nurses are incompetent etc. I feel like nailing her to the wall verbally. I am 99% sure that the dementia isn't affecting the food choices. Also, she doesn't know that the facility keeps the sheets she uses to make her selections at every meal. Yes, she can select her food at every meal.
I feel like tell the her, "The next time you have to go to the Madstat or ER due to your poor choices the ambulance will take you and you can wait by yourself.
It has been one unending power play since we moved here and I am so sick of it.
She is in a great facility known for it's great food. She has a corner room apartment with loads of light. We live across the street and see her 2 - 3 times a week. I treated her like gold during the move
I saw the wound again today and she has a second wound opening about 2 inches from the first.
She has always hated being told what to do, but who would endanger their health just for a power play? I really hate the lying most of all. She lies mostly by innuendo and has been doing it ever since we got here. It makes me want to scream to hear her twisting the truth and vindictively maligning people. I know she does it to me because people have told me about it.

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Bookdiva, I understand so well. My mother is diabetic with vascular dementia. She makes poor diet choices, then blames others when her sugar gets too high. I make a nutritious meal in the evening, but she gets just a bit of the green vegetables, loading up on meat and starches. Then she eats sugar-free cookies and crackers, which, of course, have carbs. When I tell her to eat more vegetables and less carbs, she knows that it won't help. And then she says she doesn't eat the cookies, crackers, etc. I try not to buy these things, but then there's war. What to do??

We can only do the best we can. We can't stand over them with a rifle and make them eat green veggies. We can't make our own lives miserable living through a war of not buying crackers or sugar-free cookies. But with dementia, we can't depend on them to make good choices for themselves. So... we just do the best we can do, which I know is all the AL facility can do.

I realize this answer was no help at all. I really just wanted to say I understand where you're coming from. Some people with vascular dementia are very stubborn. Not accepting responsibility or blame goes with the territory of the dementia (from what I've seen). I wouldn't be surprised if this precedes the dementia, since not accepting responsibility for sugar levels or blood pressures can contribute to vascular dementia.
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Why is this women your resposibilty? You need to begin detaching yourself from her. Let others deal with her. My mother is not mean and nasty like this but I have the same battles with her about diet, insulin and her pain pills. I've all but given up. I've been through it time and time again. I'm all she's got but I've had to re adjust my attitude the last few months.
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Get her on a decent insulin regimen. Cover her poor choices with insulin and give yourself a break. It sounds ridiculous, but you will get nowhere with trying to change her through education.
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Bookdiva, you should also understand that if she has moderate to severe vascular dementia now, she almost certainly has the beginnings of it 10 years ago. I don't know if that helps at all.

I don't think the ALs I'm familiar with would limit food choices, just textures. But it's certainly a coversation you should have with the nutritionist and DON.
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I am wondering where the AL is in all of this. Is there a nurse on staff or is it a home environment? The ALs I have experience with would monitor food from them, if not what is in the room.

Things you can do? Remove inappropriate food from her room during visits (on the sly, of course). Suggest that the health care proxy request that MIL have gauze gloves put on her hands when the wounds are treated (I have seen these used in the hospital). Suggest that the family speak with the AL about giving a different set of food choices to MIL for selection. Control issues or not, I don't believe that someone with 'moderately severe' dementia has the ability to make the proper choices.

Things you can't do? Make your MIL behave as you or I would in her current condition. So I agree with the others, you will have to let it go.
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I agree with all that Jeanne says, but will add that the next time she needs wound treatment, the facility sends her with an aide. You are " unavailable".

Not your monkey, not your circus, as the saying goes. If husband or one of her other children want to accompany her, fine. From here on in, you are " unavailable". Practise that word.

If she needs increasingly frequent wound treatment, a nursing home ( which would also provide a strictly controlled diet) might be the better level of care for her.
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Detach with love.

If this were all new behavior since the dementia I'd tend to be more sympathetic to MIL. If this has been going on the entire 10 years you've been nearby to help, I'm sorry for the woman, but far more concerned about you.

In any case, her eating and wound care seem to be out of your control. Buying healthy food for her would be a waste of time and money. She already has plenty of healthy food available to her. If she refused to eat that, why would she eat what you provide.

Give up all pretense that there is something you can do to save her from herself.

When you visit, keep your conversation light and pleasant. Don't talk about what she eats or her health. Ask what activities she's gone to, which ones she likes best, etc. Anything but her health. There is strong evidence that that doesn't help and may only make her dig in her heels more.

Detach with love.
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