Facing what I think may be an unusual situation but judging by the content of other posts here, maybe it's not

Married for 20 years my stepfather (88) and mother (82) lived on a rural property about 35 min from me. He was the primary cook and general caregiver for my mother. Over the last year or two he told me that she was repeating herself a lot. I only saw her every couple of weeks, so I never really noticed.

Last fall he became ill and was hospitalized. Subsequently went to rehab to gain his strength back. Was released from rehab but still needed care. Tried a home visit, but clearly wasn't going to be enough, needed more help so we went to ALF. Since mother wanted to be with him she moved there also. She kept asking if it was "temporary". Stepfather said yes and I secretly hoped it was but knew that he had made the decision if he did not not ever get stronger and it was permanent. He started talking to me about selling the property. This conversation was never had with my mother to my knowledge.

I spent days looking at ALF properties and finally settled upon one that would meet our needs one of which was it was near my home as I would need to be involved more giving them the assistance they needed.

He moved into the ALF and within 24 hours was told he needed hospitalization due to his edema and inability to move for himself. He died a week later on Christmas Day. With the help of my siblings and her siblings she agreed that she shouldn’t move back to the rural address and stayed at the ALF. We sold the property and the proceeds went to the trust.

So now mom was in the ALF but living as an independent. I had her briefly evaluated by her doctor who said she had mild cognitive impairment. In addition mom has multiple chronic issues (among them instability, high blood pressure, diabetes (uncontrolled), glaucoma, macular degeneration )takes lots of medication and needs a walker.

In the first few weeks of husband’s hospitalization she had an accident. She was at fault and hit another car. Thankfully no one hurt. At that time the police asked me if this was happening often and if I needed to have license removed. Being that she had been under so much stress/pressure with him I said no, and left it at that.

Mom has been getting lost for awhile. She would be gone for hours and my stepdad wouldn't know where she was. So he'd call me. I put a vehicle tracker on the car and could tell at any time where she was. Sometimes would call and say she was lost and I’d go and find her and she’d follow me. While he was in rehab and I was out of the country on a cruise my stepdad called the police to the rehab because she did not show up when she said she would and it had been a couple of hours. Just then she showed up.

One other time last fall she drove almost 45 miles and then couldn’t turn around as she was lost and wasn’t sure which was the opposite way. She had driven all through the downtown area and never turned around. Finally called after driving 2.5 hours out of her way through some very congested areas.

see part 2.

I have a couple questions that I hope you will come back and answer.

Is the AL a continuing care facility?

Do they have a list of activities?

Are all of her meals provided?

I don't think you can keep her from getting depressed over loosing her ability to drive. That's a big deal, I think that is the hardest thing I have ever seen a senior give up. So acknowledge that you understand how hard it is and give her a written solution to be mobile. How to schedule the AL transit, call your local department of transportation and find out if they have a senior/disabled transport. Being "blind" in my state, you get these rides for free plus a free ride for a companion. Get her a card. Line up multiple people that can offer a given time to take her some place, ie Mondays from 1 to 4 judy can give rides, phone number. I think the more options for transportation the less scary loosing the ability to just go becomes.

You should get the list of activities and take her to them, then you engage others in conversation and draw her in, helping her make friends. This will help her find her own way to adapt, having a few friends to participate with is a huge plus.

Next, if she gets really depressed, talk to her doctor about a short term antidepressant treatment to get her over the hump.

I would make sure that she will be able to stay at this facility as things progress, you would have to move her if not and the sooner the better. You want her at "home" as she descends into dementia, moving from facility to facility is harder as it progresses and now is the time to make it her home.

God bless you and your mom, she has been through so much and she is facing so much change. Such a hard time for everyone.

Helpful Answer (2)
Reply to Isthisrealyreal
Scubaqn Apr 20, 2019
Isthisrealyreal, thank you so much for your advice. They were all very sound responses and I will investigate accordingly.

Yes it is continuing care, the memory care is a locked floor.

They publish a monthly list of activities and advertise it in the elevator on posters too.

Yes every meal is provided, she chooses to eat breakfast in her apartment which has a kitchenette.

She will never leave here, if she in fact develops full blown dementia....(I know I'm in denial.) they can accommodate her here.
Take away her license immediately.

Now, how will she get around? You mention that you sold the house and there is a trust. If you can afford it, and depending on where the facility is, you can set up a senior account with Uber or Lyft. You could contract a local cab company so that you pay them a given amount each month for a specified number of trips.

There might be a retired person or a student looking for some work, who could provide trips to the store or appointments.

If she needs more help than that, there are qualified 'sitters' who deal with elderly clients, and who can drive, who would be able to assist her.

Just check insurance for her and the driver and make sure that any liability issues are dealt with.

Then I would try to pose it as a special thing, having a driver, sort of like a chauffeur.

I know this is not going to be easy, but finding out your mother hurt herself or worse, someone else, would be a much more disastrous outcome. Just be happy that that hasn't happened yet. If this continues on it will happen, and you don't need the resulting guilt.

Good luck!
Helpful Answer (0)
Reply to Rabanette
Scubaqn Apr 20, 2019

thank you for your kind reply.

i absolutely LOVE the idea of the "driver" chauffeur --driving Miss JEAN! (her name). I am looking into the senior account with the ride sharing services. There's also gogo grandparent, but that's just a monitoring service for these ridesharing services. I'd rather her have the same person each time if it all possible. That would be through a driving service.
It helped in our experience when I began to think about how wrecked she’d be if she ever hurt anyone. Two family members were able to drive her locally, and she herself had become frightened of driving in heavy municipal traffic.

On the other side of things, you will continue to need to build your spine as her cognitive issues become progressively more serious, as they very likely will. Your transformation to “benevolent dictator” will be horrifying to you at first, if you are anything like me, and I think you are.

With a few of the early experiences in which YOU MUST TAKE CHARGE, you will begin to see that her comfort and most importantly, HER SAFETY, are in your hands.

Not to say this process EVER BECOMES EASY. There are often no good decisions to be made in caring for someone dear to you who has become unable to make decisions on his/her own. Your job will become choosing from the “less than good” decisions accessible to insure the safest and least distressing outcome.

She has proven to you that she cannot drive safely, and cannot be permitted to drive, for the safety of all concerned. Now go from there.
We who have already confronted this are here for you.
Helpful Answer (0)
Reply to AnnReid

When I asked my mother to stop driving, I made a promise she would have transportation to anywhere she wanted to go, it just needed to be arranged instead of being able to go somewhere on the spur of the moment. I believe Mom actually came to prefer our grocery shopping mornings where I picked her up and we went to the grocery stores, picked something up for lunch, drove home, unloaded the groceries, and ate our lunch together. The city ran a senior bus with $1 one way fares that she used for some standing appointments like water walking class. Other ladies in her church circle provided transportation to church meetings and events.

With the AL van and something like the senior van, your mother should have as much access to transportation as she needs. After she makes the adjustment to using her new resources, your mother may find not driving (and not getting lost) less stressful with less impact on her independence than she expected. I would encourage her to use grocery delivery services (if available) too. It's very nice to have your groceries carried into your kitchen and all you need to do is put them away.
Helpful Answer (0)
Reply to TNtechie

She has Dementia which will get worse so will her macular degeneration. She has gotten lost, she needs her license revolked. The AL should have a Van that takes them to appts and shopping. She can still have some in independence. It will effect her. Make sure the car is taken somewhere else and sold.
Helpful Answer (3)
Reply to JoAnn29

I have a voicemail from early December where she is a long way away from the rehab place and was lost and said she couldn't remember how to get there. She had been driving there every day for weeks.

In the last two weeks she turned on a route like she was going to her old home. She drove an hour out of her way, not thinking to turn around.  I get a text message from the vehicle tracker as soon as she leaves her ALF property and I saw what was happening. She finally stopped at a bank, and I called the bank to make her wait, that she was lost. I had to get my husband from work and we drove and got her.

As soon as we arrived she looked guilty and told me not to say anything. As we drove the hour home I told her we needed to discuss the elephant in the car and she needed to stop driving. She insisted that she could get back home, all she had to do was find the interstate. (!) yes she briefly drove on it and thankfully pulled off right away. I told her she would have ended up in Miami because the interstate doesn't go to Orlando. She said she couldn't hear me anymore because her hearing aids weren't working, and so we drove in silence. Ten miles later she was talking about something else. By the time we got back to her home she said "she would stop driving when she decided to." 

As I've spent more time with her during this whole affair I experienced just how forgetful she is. I look at her medication boxes regularly, there is usually a couple of days missed, but she fills them on odd days. I planned to get her medications administered to her by the ALF in the next few weeks, but didn’t know how to approach her with this.

I’m afraid of making my mother feel like an invalid.

In the middle of this we experienced another death in the immediate family.
I just didn’t have the heart to take away her license i.e. independence after losing her husband, her home, and her dog (run over in the middle of this).
It’s not that she’s not lucid. She has MCI as diagnosed by her primary care doctor.
I have considered disabling her car. I have considered telling the police to pull her over.  

Apparently I have no spine.

Recently she said she couldn’t see well. I made an appointment at the eye clinic. Upon entering they asked if she had been there before, she said no. They had records of her having cataract surgery 10 years ago. She doesn’t remember having cataract surgery. (!) She knew she had macular degeneration. She also has high pressure in the eye but it wasn’t conclusive. Her vision is 20/50. So she was given vitamins and a new appointment. We got new glasses. At the second appointment she was given more tests. I talked to the doctor and asked if she was safe to drive and she said she needed another test.  So we got glaucoma drops and another appointment in 3 weeks. The doctor said on the next test day she would do the more heavy duty test and then complete the DMV form to revoke her license. (Mom knows nothing of this.) If you wonder why I haven’t done anything about the driving I was trying to get her acclimated to the ALF so she’d see that she doesn’t need to drive.   She knows there’s a bus that will take her wherever and she just has to sign up

see part 3

see part 3
Helpful Answer (0)
Reply to Scubaqn
Scubaqn Apr 19, 2019
The deed will be done, but there's the aftermath. How do I keep my mom's spirits up after this event?

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