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Over 6 years ago I bought a big house so that I could take care of my mother with Alzheimer’s. Knowing I can’t do this alone, I moved my brother and his wife in to assist with caregiving. I work 3 Days a week, for my own sanity. On my days off, I feel like the burden of mom's care is primarily on me.
My biggest concern is that my mother's biggest issue is loneliness. Her basic needs are met. Meds, food, etc. but it seems as if my brother and his wife avoid mom. Not spending as much time with her, leaving her in front of a tv all day and night. She is confused most of the time. Unaware that she is in her home, always waiting for someone to pick her up and take her to her babies. (Her babies are grandparents now)
I feel like my brother and his wife should spend more time with her.
They leave mom to sleep all day, resulting in late night confusion.
Mom is on meds for A-fib, thyroid, alzheimers, anxiety, and pain (several compression fractures in her back) her mobility is from bedroom to living room and to the car. Very Short distance walking only. Due to lack of mobility, we don’t think she is capable of wandering further than 100 feet.
Again, the question is, if none of us has the patience to sit by her side all the live long day, would she be best off in a facility where she has more social interaction? She desires constant companionship, often offering us to spend the night in her room, or sit next to her for hours.  (I’m so restless, couch potato, not my thing, I’m often cleaning or cooking, but being present) 
Her stage? She forgets anything and everything that occurs almost within minutes afterward. You could take her on her favorite drive, lunch whatever. By the time you pull into the driveway it’s all gone. Leaving it feel like it was all for not. Except for your own memory of her enjoying the moment. It’s all so hard.
We have a caregiver visit her for about 3 hours a week. 
Is it OK to just let them sit alone hour after hour?

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Yes, a facility would help her and her family. Have you checked into a day care facility? That may help. The more activities that she will do, the less boredom she will experience. She needs stimulation that activities and socialization will provide. You need to learn to enjoy the moment, that is all they have.
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I sympathize with your bro and SIL, it's hard to talk with someone who can't really "visit" or follow the threads of a conversation that is rooted in real time people and events, or to find activities when they really can't follow or maintain their attention for more than a few minutes. Do you think your mom would be able to enjoy Adult Day Care a few days a week?
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I realise what their behaviour looks like, but my goodness I sympathise with your brother and SIL's desire to escape from the room. I don't feel good or clever about it, but there were times when living with my mother felt like being sucked in to a black hole of negativity and I couldn't get away after meals fast enough.

I'm sure you're right about your mother's loneliness. Except, perhaps, that it isn't loneliness of the sort that her children can relieve. When you live to extreme old age, your peers, your cohort, your beloved are all gone and there's only you left. And while your children will always be your babies, they can never be the companions you miss so much.

Have a look at facilities, and also have a look at voluntary organisations in your area and see if any offer befriending or similar programmes. It can't hurt to see what's available, after all, and the perfect answers might be right there waiting.

I understand that it must be irritating and frustrating that your brother and SIL don't put as much of their backs into the social enrichment aspect of care as you do but I suspect you'll be on a hiding to nothing if you try to tackle them about it.
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Are your brother and sil aware of your expectations?
You say that you bought a big house and moved them in.
Do they work also, pay rent, or are you the one who pays?

I am asking because, (in the absence of them being free loaders), it seems almost anyone could sit with MOM and watch a t.v. show (unless she talks through it) and do that in shifts if there were an organized schedule.

Have a talk with your family, maybe they want to quit or make changes to your expectations of them? I think you deserve a real day off without the burdens-can you leave at a time when the caregivers are there?

How do you personally get along with them?

Families together are an interest to me, but next door as adults would be nice.
Even so, if there is some extra room in the big house, can you rent out a room?
Then arrange for a decrease in rent for duties of companion care for Mom?

I realize my suggestions may sound naive, so if there is nothing said to help you, I apologize.
A person requiring 24/7 supervision is not the same as just living in the same home with family, imo.
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I "visited" with my mom once a week, and eventually once every two weeks for about an hour. I would cringe before arriving and try hard to decompress all the way home and thereafter. I would work on my "material" in the ensuing week; mom couldn't talk much anymore and there was no "conversation". There was sharing of baby pictures, funny stories about my kids, my friends, showing her antics of various folks on facebook and a wheelchair ride to the lake to look at the water fowl and exclaim about the nice weather. It. was, exhausting. My mother was "entertained" best in her NH just by watching other people interact. Her anxiety and agitation were treated with antidepressants and anti anxiety meds.
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We found a good assisted living facility for my MIL a few months ago. She had lived with us for 13 years and with progressive dementia in the last 4 years. We took this step after she had taken a fall.

After a short adjustment period she is well adjusted and contended, and generally happy. We visit her every day. I felt bad about making the move, but it turned out to be best. There are plenty of activities that I could not provide for her at home.

I recommend looking for a good place that you all can get to on a regular basis.

It is very hard to go through this for everyone.
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Loneliness will not be cured by supervision, or even company. It seems the aged have a special kind of loneliness. My grandmother for years had so much company, up to 15 people in a day. She was still lonely. We keep my mom busy at the AL with 4 or more sets of visitors each week and outings. She is still lonely. That said, I do think your LO could use an hour or two of company in the day and at night. Plus she may need more supervision depending on her needs. A daily nurse visit may be nice. My grandmother enjoyed her home care visits.
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Loneliness will not be cured by supervision, or even company. It seems the aged have a special kind of loneliness. My grandmother for uears had so much company, up to 15 people in a day. She was still lonely. We keep my mom busy at the AL with 4 or more sets of visitors each week and outings. She is still lonely. That said, I do think your LO could use an hour or two of company in the day and at night. Plus she may need more supervision depending on her needs. A daily nurse visit may be nice. My grandmother enjoyed her home care visits.
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My daugher and I've been sharing caregiving for mom (Alz stage 6) for a little over a year. Prior to that my Dad was with her but he passed in December. Although we never leave her alone in the house we do some of what I call, "watchful" independence. She's in her room, or the spare bedroom, or the yard. We're watching and checking on her silently, frequently as she "works" on her things. She's busy 80
% of her day. The big challenge is finding the stuff she moves around. but it is her routine, and I'm sure she sleeps better at night because of it. She is very mobile. Her physical health is good. She has boycotted medications, so this "working" is good for her. She's 89 and we're getting along ok at home. In her case, constant interaction is not warranted. I think everyone needs a little "alone" time as long as their safe.
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So, you bought a big house so brother and wife could move in and help care for mom. Do they help you pay for this house or participate in the upkeep and maintenance or do you give them a free ride? If they don't help with bills, mom, house etc. It would probably be cheaper and more helpful for you to give them notice that you will be needing the space they occupy for live in caregivers. Please let us know what that situation really looks like.

Can you find some creative activities that mom can do with her limited mobility and by herself? This is beneficial in helping occupy time and mind as well as burn physical energy helping her sleep more restfully.
Adult daycare could also be very helpful.

Best of luck.
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I favor Adult Day Care the three days a week you work.
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Husband's daughter recently purchased a very large home-five bedroom, large sunroom, etc, where she lives alone. Before seeing the home I had foolishly hoped that she might offer to share this home with us-dad is in later stages of dementia. However all bedrooms are upstairs and her home is in no way appropriate to someone with very limited mobility, plus, she prefers living alone, as she has a very inflexible routine. But she wants us nearby so that she can spend more time with dad. She is a hospital social worker and does come every week or so to visit, spending about three hours, sometimes taking him out for a brief golf-putting experience or to lunch or to a home improvement store, while I watch her two shepherds, who are very active. I love that she is involved, but we are now planning the sale of our home and must be limited to rentals available in an area where I will be completely isolated from all friends and activities. I admit that since becoming his 24/7 caregiver that I have absolutely no social interaction, so I guess that nothing will be so different, but am so worried about the whole packing, "culling" and moving once again. My own health is quite compromised and as his condition worsens, the exhaustion is most days overwhelming. But-I know that this will be best for him, as we have no way to afford to place him in any facility and he refuses to go to any daycare facility. Wow! I am so sorry ! This became more about me than answering your needs. So....I'd say that you need to try your best to talk with your family about your expectations of them spending better quality time with your loved one -a certain day per week so that you can have a full or at least a half respite day, is the very least to expect of them. That is the least they can do. You haven't said whether they share expenses, but I certainly hope that they do. It seems that so many families share in your dilemma with usually only one person doing the caregiving. I truly commend you for your efforts and wish you the best.
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Just have to say...You bought this house six years ago and expect Mom to feel it's her's...I don't think she would consider it hers. The house she had before this one is probably what she feels is hers. A lot of the time it's the one they grew up in. Since Dementia knows no time, you could sit with her all day long and it wouldn't be enough. Their world has shrunk. They are confused and have no idea what is going on. If things are basically working, I wouldn't move her. If you can afford it daycare I would try that. I put Mom in 3x a week. They picked her up and dropped her off. She was given breakfast and lunch and a shower. If Mom is considered low income, Medicaid may share or pay the Daycare in full.
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I favor Adult Day Care the 4 days you DON't WORK. That would give you and her both some enjoyable hours. Since she doesn't remember activities 15 minutes after you do them....there's really no reason to make a special effort. We basically take Mom on EVERY ERRAND we do and tire her out having her push the shopping cart (ie it keeps her near us too!:), taking her along while fixing our properties (she sweeps and picks up the trash or whatever easy task there is) , and send her out to sweep off the porch every day. Or set the table. We no longer let her set the table without supervision (well unless you like drinking out of the glasses she's been using during the day or plates that may not have been washed). OR polishing/washing anything because she literally takes the shine right off before she's done! Still....we're looking forward to her finally agreeing to move into AL which I think we'll all enjoy more!
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I have seen this issue repeatedly where the care of he elder usually rests on one person and it isn't fair. Not to sound childish calling it "not fair," I think you should get the others involved. It is imperative that brother and his wife step up to the caregiving plate, else YOU WILL FALL ILL AND YOU WILL BE GOOD TO NO ONE.
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Sometimes it's about not knowing what to do with themselves, especially with dementia. If you can engage your mother in some ways she can help, she will feel useful. If you can set up a schedule with her, she will know what comes next. And yes, I would ask the my brother and his wife to allocate some specific times during the week to do things with her. They can revive a hobby, play cards or games, go to a movie. They need to do more. You are task-driven. Your mother needs relationship driven.
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