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My Mother has dementia. She lives with my sister. Lately, it has been difficult to get my Mother out of bed in the AM. She says she is "comfortable" and happy where she is. At lunchtime, we insist she get up as she has not eaten all day. It is not every day but becoming more common. When we ask her, she says "she's fine". We know she is depressed and have tried to help her with that. She refuses to discuss it saying "I'm fine". We have offered her all kinds of activities but she is just not interested. How do we address these issues?

Dear "MSwain,"

I can understand your frustration and wanting your mom to get out of bed. My mom is 95 with Alzheimer's and became more like what you described in the past year. She started staying in bed more and more, letting the staff bring her meals to her room which they really weren't supposed to do because she was living in assisted living at that time.

Then the pandemic happened. My mom was completely mobile and able to get dressed on her own, the lockdown at her facility was March 13th and one month later she was left alone in her room near death from severe dehydration and COVID. After moving her to a new facility and into their memory care unit where she is getting much better care we brought hospice on because she could no longer walk, dress herself and had lost over 20 pounds from not eating or drinking much.

Some of her issues was that she was not and had not been sleeping well for years. Now that she is under hospice care, they decided to put her on a very low dose of a medication to help her sleep. That helped her tremendously with at least her outlook. They just added a low dose of an antidepressant although I myself am not convinced it's an issue and neither was our new hospice company 's nurse but, I said let's keep her on it for the 4-6 weeks they said it would take before it takes effect.

Finally, I had a conversation with the new hospice doctor and she said pretty much what "AlvaDeer" said about her father - they simply are tired!

My mom is just like yours when she says she's "comfortable" where she's at which is in her bed. The facility even gave her a nearly new recliner for her apartment and they try to get her to sit in it (because she's starting the bedsore situation). As soon as they get her in it, she says she wants to go back to her bed. Even the Activity Director has tried to get my mom to engage a little more and she's just not interested. Not even to play BINGO which was something my mom loved to do. So for now, she is getting both dog and puppy visits in her room/bed for at least some type of interaction.

So I'm trying to just accept that it's her being tired. She's the oldest of eight siblings; five which are still remaining and she had helped her mom take care of them since she was five years old - so yes, I think at least in my mom's case...she's very tired!
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Reply to NobodyGetsIt
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OK I checked your profile and see that she is 89 and incontinent.
While AlvaDeer's advice might be part of it I hesitate to make that assumption based on this alone, I spent many years thinking that maybe my mother was simply worn out physically and mentally but she kept right on living to age 99. I'm a believer in schedules, I really do think that most people do better if they follow them (I'm not talking strict adherence, just loose guidelines). Longer time lying inactive can lead to wakefulness at night, pressure ulcers and even contractures (as I discovered from personal experience), someone with incontinence probably should be up changing their briefs as well as making an attempt at using the toilet and washing up - lots of seniors have medication schedules as well that need to be followed. Once those basics are taken care of there is nothing wrong with heading back to bed for a long nap.
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Reply to cwillie
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You do not give an age, but I will tell you my father was in his early 90s when he told me "Kid, I am so tired. I honestly just want to go now. I just want to be at peace". When I sat on the bed and spoke with him he told me he had had a wonderful life, but was so over it. He had done it all, and tried hard still to get up and please my Mom who tried always to get him to eat, to get on the scale, to do this and do that. It is perhaps impossible to understand when you are not there. They are TIRED. They simply want to rest. And it well may not be depression. They are ready to go. I saw this countless times as a nurse. I tried to explain it to families countless times. And I will tell you that the term that is ancient, used in ancient times, which is "turned his face to the wall, and died" meant that the dying do eventually disengage with life. Even with those they dearly loved. They want to go now. It is that simple, and that difficult to understand.
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NobodyGetsIt Sep 8, 2020
Very well said, "AlvaDeer!"
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To prevent depression, I take Vit. D and magnesium. Sometimes sublingual B-12.

Please try not to make her confess that she might be 'depressed'.
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Are you thinking she’s feeling “sad” or “melancholy” when you say “depressed” or that her responses are slower than usual and she’s less involved with you and less active?

What are you seeing that makes you think that if she says she’s comfortable and fine she isn’t actually feeling what she says?
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Reply to AnnReid
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Apathy is often confused with depression and is a very common marker in dementia, I've been searching for an easy read for you on the subject and I think this is a good article:

https://health.sunnybrook.ca/mental-health/apathy/
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