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My mom had a stroke about 4 months ago and has been in rehab/SNF ever since. Her left side was affected by the stroke. Her memory/cognitive abilities are just fine, except when it comes to absorbing her health and care needs. She remembers everyone, all the aides' names and family members, what my kids did yesterday or an hour ago, what she had for breakfast, dinner, etc. She is finally going home to 24/7 care on Friday. She is thrilled to be going home, but understandably freaked out that she (who has lived alone for 35 years) needs someone there all day and night. She KEEPS asking me to explain why she needs this level of care and I KEEP telling her it's because she can't get out of bed or wheelchair alone, etc. She'll call me back five minutes later to ask me again. And then 5 minutes after that. It's driving me crazy. I get annoyed and start yelling at her, which of course makes me feel guilty and terrible. What is the right thing to do here? Repeat it over and over? Block her calls? (I do that lately.)

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xinabess: Your mother's brain was dramatically affected by the stroke. She MAY be able to relearn skills depending upon her age, health, living conditions, if she eats clean and other factors.
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Xinabess, thanks for the update and good thoughts for going forward.....you rock!!
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Forgot this: Thank you for writing in. So often, while trying to "help," someone, it is I who learns. Best wishes!!
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Wow, it's like you know us!
Oh my! I would be so confused! My mom is different in some ways, and an exaggerated version of herself at other times. If I didn't get argument back, I would not know what to do! My mom and I are perfectionists. Now that she makes mistakes that are not her fault, I keep getting confused. I want to correct her and admonish her for her mistakes, as she would to me, but that doesn't make sense; and now she makes more mistakes. She does, however, still correct me, and is sometimes wrong, but no less harsh. I learned to be passive aggressive from her. Now that I'm trying to learn to be more assertive, I don't want to put up with that stuff anymore, but she was never going to change anyway, even long before. Being blamed for so much still stings. Additionally, I am a highly sensitive person (HSP) and our brains work differently. I like the insight, observation and prediction abilities it gives me, but it is not respected in western cultures, and adds to the difficulty.
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True, Joanne. It's so hard to break the usual mother-daughter dynamic where we irritate each other and argue frequently. Post-stroke, my formerly argumentative mother has become so sweet and compliant that it's unsettling. I feel guilty anytime I get annoyed with her, but, as we all know, caring for an elderly parent can drive you crazy. We have always been very close and loving, but there's also been a lot of strife and conflict. So this new dynamic is weird! and unfamiliar. She is thankful and sweet and I am too, to a point. I am used to pushback from her and without that, I am kind of confused.
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For me, what sometimes works with the repeated questions, etc.; is that if that person wasn't here I would do anything to hear or answer the same thing repeatedly a thousand times straight.
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Thanks for the update, xinabess!
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Well, drum roll .... my mom is home! What a day. She is thrilled to be back home (after 4 months), but being at home and being so dependent is harder than being at the SNF, since home is associated with her living on her own terms.

The Fri-Mon caregiver is lovely, very low-key. What a day of mishaps though. First, the aide sat on the IKEA bed I built for her and it broke!! I mean, she is large, but not massive. Poor thing was very embarrassed, as was I. Maybe I put it together wrong--oy. So I've ordered a box spring.

Later, I crawled under the hospital bed to plug in a lamp and my mom started lowering it!! I was almost crushed to death. Fortunately, I survived. Yeesh.

I stayed over (in an extra bed in my mom's room) and was happy that she slept soundly through the night. (I feel like I have a new baby.)

Now I am home and very glad to be here myself. Hoping all goes well. No call from anyone yet, so that's a good sign. At the SNF, my mom called me countless times per day.

Thanks for all the support! I hope to offer more to others as they go through this stuff.
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@Xinabess: Have you met the caregiver? (You said 'mysterious...') We lucked out with the caregivers for my dad. The one at home, he had time to get used to, and she was very sensitive about giving him time to get used to her invading the bathroom. The woman who ran the adult family home was exceptionally kind, especially after we'd met a three or four others and rejected the places for assorted reasons. She was also sensitive to Dad's embarrassment at needing women to look after him again in his 80s.

@ Babalou: Are you a fan of the Hitchhiker's Guide to the Galaxy, by any chance? (The "large friendly letters" made me laugh out loud!)
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xina, It seems that especially in the elderly we find they are unwilling to remember those things they find distasteful. Sometimes this works to your advantage, in time! DO NOT re-explain a situation that she is trying not to remember the "why" of!! (Subconcious or not) The large note and posters sound great and the encouragement and reinforcement of her progress is sure to be of help!! If you can keep her spirit at least on an even keel, then both of you will be happier. And remember that coming home will not be what she is expecting, regardless. It Just Won't Be.. It is up to her to make the best of it, to decide if she can be satisfied that so many people love and want to help her!! God Bless You!! I Pray all goes well!
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Thanks, all. The big day is tomorrow. Her apartment is all set up and we are hoping for the best with this mysterious caregiver who is staying for the weekend! Then entire population of the nursing home, staff and residents alike, know she is going home. It's like she's been touched by a golden wand. She is so excited, though of course wondering what this new life is going to be like.
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Xina, the brain is fascinating for sure, as is the mind! And my mom has been the Queen of Denial as well, although in comparison with the rest of her family, she looked like Dr. Phil!

People with any kind of cognitive impairment need reminders. Old habits and patterns of thought die hard. Even BEFORE her stroke, mom would call my brother about broken items in her Independent Living apartment, and me about other issues. " Tell the staff", we'd remind her. We made her a laminated sign that said that, in large friendly letters.

After my mother in laws stroke, she kept trying to get out of bed in the nh. My bil, a scuba diver, made her a large sign with a shark that said " the shark will get you if you try to get put of bed". She'd laugh, and remember what her son had said about how dangerous it would be to try, as dangerous as it is when HE encounters sharks.

One more thing. Anyone here can tell you that I'm a big fan of psychopharmacology. My experience has been that even just the beginning of of cognitive impairment brings on terrible anxiety. Anti-anxiety and antidepressant meds have made my mom's life liveable. She's not doped up. She's just not agitated anymore. You might want to talk to mom's docs about this expecially for the move.

You've got an ambulette service moving her, yes? Let them manage her. You take the subway. At least for me, i always need an escape hatch and i want the ambulette folks to do the wheelchair management, otherwise, my mom assumes I'm going to do all the heavy lifting and my knees don't do that stuff anymore. If possible have her new aide meet you at rehab and have HER ride in the ambulette. If not, have her meet you at mom's.
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I can understand, xinabess. Your anxiety will be picked up by your mom and not add to her calmness! Try to relax, at least around her. And I know very well that anxiety isn't something you can turn on and off at will! Just do your best to overcome it for short periods around Mom ... but don't let that effort make your anxious!
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Thanks, Jeanne. Oh she is the major queen of denial, has been forever. So now that dovetails with cognitive impairment. I just wonder how it's going to work out when she's home. Very anxious.
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Thanks Babalou. I know her cognitive abilities are affected, for sure! I'm not trying to pretend otherwise. But the memory issues are for now entirely around her situation. I was thinking of making a list of FAQs for her! The brain is fascinating--in her case it simply blocks out things she can't accept. Mostly, I am wondering if it's worth it to keep trying to explain to her over and over or just not pick up the phone.
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Even without cognitive impairment, many of us can block out unwanted information. My mother was Queen of Denial -- and I don't mean the river in Egypt. It can be a coping mechanism, until the reality can be accepted and processed. Your mother probably has some cognitive issues from the stroke, and she is doing the best she can to cope with unwelcome reality. I hope you can cut her some slack and refrain from yelling, no matter how frustrating this is for you.

Maybe it would help to emphasize the progress she's made. For the past 4 months she has had to be where many people with specialized skills have been available to help her. Now she has progressed to the point where she needs only one person around, and it can be in her own home. That is truly wonderful. You are so glad that she doesn't need to be in a skilled nursing facility permanently. Who know what progress she may make in the future? But for now you are thrilled that she can get along with one helper, to get in and out of bed, etc.

I say this MIGHT help ... but her denial may be stronger than her logic at this point.

Try to be patient. Babalou has some additional practical suggestions that might help.
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Xinabess, im really sorry, but your mom's cognitive abilities have been altered by her stroke. My mom, three years post stroke, knows everybody. That's not an accurate measure of her cognitive ( thinking, reasoning, logic, inferencing). She needs a neuropsych workup at someplace like Rusk.

That's my take on it. Perhaps other posters will have other thoughts.

In terms of dealing with her phone calls and questions, can she comprehend what she reads? Type her an explanation ( simple sentences...you had acstroke. It's not safe for you to be alone).

You need to make sure that the home aides understand that they can't leave if she "fires" them. Make sure her building management knows that even if she calls 911 to have the aides arrested, they can't leave.
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