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My 91 year old mom freaked out at dentist office; she needs alot of work done; Mom, 91 years old has dementia; I, 55 years old have lived with her and helped her now for 10 years and recently downsized to a townhouse which is more simple and safe for Mom; the issues are overwhelming with no relief. Mom is stubborn and does not want my advise at all, gets rather nasty to me, I ignore or try to redirect conversation, however, she argues, tells me she wants to live up where she was born (1927 in Brooklyn, shes been in SC since 1987); over past 6 months mom as become completely reliant on me and I cannot even leave the home within 30mins or so Mom calls me and wants to know where I am, though she has a white board to look at that states wHere I am ... there is just soo much, I have 3 caregivers but they are becoming very expensive; a nursing home I question as I think shed only get worse and fast! I need some direction. Thank you...

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Tribeca007,
I encountered a similar issue regarding dental work with my LO. This one place said that she would need extensive and invasive procedures. Well, with severe dementia, she doesn't understand what's going on, so the pain is not something she can understand or process. Plus, she is wheelchair bound, so transporting her in and out of dental chair, following directions of dentist, etc. I decided to take a palliative care approach. I found a dentist who understood that and who was willing to do a few extractions and regular cleaning. She did wonderfully and it has served her well. As long as she is able to eat and not be in pain, I am relieved. I'd seriously question extensive dental work on a 91 year old person who has dementia.

I'd be careful taking the first opinion too. I've heard of very different opinions and rates for dental care. Some are conservative and some are NOT.

I'd read a lot about how people with dementia may tell you one thing, like they are brushing their teeth, but, they aren't . Also, keep in mind the daily care and maintenance of a bridge. Is it removable? People with dementia often misplace glasses, dentures, hearing aids, etc. It sounds odd, but, it happens a lot. I'd focus more on the reality and practicality of the matter, rather than how your mom might have wanted things years ago. Of course, I'd respect her dignity, however sometimes, reality makes things challenging.

Oh, I would explore a facility if you are overwhelmed. I'm in NC too and there are some excellent facilities. Check it out for yourself. People say a lot of things that may or may not be true. My LO is in MC and she has done quite well there.
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Dear Tribeca, I'm so sorry that you are dealing with this, and all of a sudden, too. Many of us here have "all of a sudden" events with our parents that change things overnight and lead to a lot scrambling for answers with little guidance.

Kmow what your mom's financial resources are. Do you have POA for Medical and dinancilal affairs? Get those set up asap.

Get a needs assessment on mom from you local Area Agency on Aging and be there when it occurs. Mom may say she do things like brush her teeth and prepare healthy meals, but as you've discovered, these skills may no longer exist.

The biggest mistake we made was signing mom up for Assisted Living without looking carefully at her needs. We took her to a nice facility where other family members were already living. It was a disaster. It was, at the same time, too much help and not enough help of a particular type. Mom didn't yet need help with ADLs; she had developed severe anxiety and cognitive decline. The first was obvious to us, the second was not. Ongoing treatment by a geriatric psychiatrist, who pushed us to get a neurocognitive assessment revealed that mom had suffered a stroke that had gone undetected. She thrived in Independent Living with support like meals, housekeeping and classes, in addition to some psychiatric treatment.

Please let us now how this goes! We care.
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Your main question is about dentist appointments, but then you mention facility care. I never understand why people think that their parents will decline in a NH.

My mom entered a NH for rehab in 2013; she had a stroke, developed vascular dementia and then had broken her hip. I was pretty hopeless that she was going to survive the surgery, but she did. I knew she'd never walk again, but amazingly, the PT got her up and around with a walker.

She is now wheelchair bound due to increasing frailty and possibly more strokes. But that is not the NH's doing. She enjoys some activities, gets her hair done in the on site salon, has her teeth, hearing and eyesight checked onsite. She recieves excellent podiatric care. When she's ill, the doctor or Nurse Practitioner sees her. If her mental status changes ( and it does) she is immediately checked for a UTI and the Behavioral/Psychiatric NP is there to adjust her meds.

My mom is happy and calm. We visit and advocate for her needs.

Regarding dental work, due to mom's age and overall frail condition, we have elected not to do any major dental work, in part because it would be agitating and upsetting.
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Thank you for your response. I have just heard many horror stories about NC homes, I feel overwhelmed and do not want to make the wrong decision here. Id feel just awful if she went in and something happened. As for dental work, my mom has always cared immensely about her teeth - very important - and last week her front bridge (6teeth) fell out and now we found that she has not been caring for her teeth, even though she says she does - as 4 need to be extracted before partial. tomorrow, I actually, made an apt at an assisted living community with memory care... we'll see. I'm just too overwhelmed and no one really helps me at all here except caregivers.... thank you....
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