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My grandma is 82 has dementia and bipolar 1. She has episodes of being very depressed for months having to be in hospital. She also has episodes of being very very manic having to go back into hospital. She is taking a lot of different kinds of medications. She wants to get implants for her bottom teeth. These last few days I have noticed she is starting to be manic again. I dont think she should get them. I think it will send her back on that rollercoaster. She does live with me and my family I am her caregiver and granddaughter. Should I be ok with her getting implants??? I don't know

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Shannon,

Thanks for your response to my questions. I feel for you. You have a lot to deal with. You should have a contact.

Your first responsibility is to your immediate family, husband and child. I hope that you are able to manage it all. Being a caregiver is stressful. I’m sorry that your dad is struggling with his issues too.

Please don’t over extend yourself. Check with a social worker to see what needs to be taken care of to set up future care for her. Caregiving only gets harder, not easier.

I don’t know if your grandma could handle the implants after hearing everyone’s details. Personally, I feel that you need to concentrate on her mental health before her teeth.

Vent here when you need to.
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Reply to NeedHelpWithMom
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At her age I would be surprised if her bone was good enough for implants. That’s where I would start before agreeing to anything. I paid a lot of money (upfront like a dummy) for one implant, in the end my bone was not strong enough, and the implant would not hold, and my age at that time was 64. By the way even cadaver bone did not suffice.
Good Luck
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Reply to Getkicksonrte66
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" I think i got in way over my head taking her in but had no choice. And I'm scared to death when she does run out of money and try to get Medicaid in Oklahoma she will get that penalty for paying me $2000 a month without have a contract done at the time."

And so you will have to suffer the effects of that penalty -- care for her without any money for the number of months until she is Medicaid-eligible?

This is SO WRONG. It is not YOUR FAULT. I get so annoyed when families foist off all the work and responsibility on whoever is the most naive.

When she "runs out of money and tries to get Medicaid," does that mean you will put her in a facility?
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Shannon1217 Mar 6, 2020
I really don't know what will happen when she does run out of money.. My aunt ( her sister in law )is POA over her money. I dont think she kept track of everything.

Thank you for your response. It helps alot. I just get the run around from everyone
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Good morning, Shannon,

Others have addressed the issue of why it fell to you to be your grandmother’s caregiver. I’m going to narrow it down to the bipolar and teeth issues.

Bipolar disorder is a manageable condition IF the right medicine is prescribed AND it’s taken properly. If your grandmother is having constant hospitalizations she needs to be admitted to a geriatric psychiatric ward or see her psychiatrist to get her medicine levels stabilized. My mother had frequent hospitalizations also until we made ourselves responsible for her medication. Bipolar is like many other disorders that convinces the sufferer that they don’t have it, so they go off the medicine and back to the hospital they go! My mother’s hospitalizations for bipolar disorder have become very rare as there is careful monitoring of her medications.

Now to the teeth: I understand that different dentists and oral surgeons handle the procedures differently, but getting an implant is not for sissies! It has many steps, extraction (if necessary) of tooth, then bone graft, followed by healing, implanting of post into the bone followed by healing, placement of abutment on post and then the crown (tooth). So far, I have had anesthesia twice during the process - one for the extraction and bone graft, and another for the implanting of the post. Now.....I have a friend who just had local anesthesia for his implant.

As you can see, it is a long process, and enormously expensive! My mother recently flew the idea about getting some implants but changed her mind after I described what I have been through. Besides, we would never permit her to go through the pain, and with her level of dementia and immobility, she would not be able to properly care for the implant sites. I suspect that the implant idea is part of your grandmother’s manic phase. Getting her medicines stabilized is the first order of business. If her psychiatrist can’t do that, get another one who will. Don’t be afraid to consult a psychiatric nurse practitioner. We have found them to be highly effective.
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Shannon, my sig other is going through the implant stage with his teeth and it's been going on several years due to how complex this process can be. I know we see ads on TV saying it can be done in one day..... hmmm, in what world is that happening?

If your Grandma's bones in her gums are now thin, then she needs to have cadaver bones put into place and that in itself can take months to make sure the cadaver bones will graft. As MountainMoose had posted, there is lot to do in the meantime with meds, mouthwashing, not eating on that side, etc. etc. etc.

And as Geaton777 had posted, the cost. Medicare will not cover the whole cost. Nor secondary insurance. My Sig other says he now has to pay $5k out of his own pocket as Medicare had turned down what the doctor had turned into Medicare.

Once the gum bones have graft, then comes to the screws that need to be put in. Again more time to wait. Then making of the new tooth that will fit in that space, which your Mom's regular dentist probably would be assigned to do... oh how I hate that play dough stuff the dentist uses to imprint a tooth.

So, my vote would be "no" for your Grandmother to go though that complex project.
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Reply to freqflyer
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Shannon, I'm generally in favor of implants at a younger age. #1: you need to have healthy bone mass to do it. If you don't, they put in bone grafts. If she doesn't follow medical instructions to a T, it will be a problem. My periodontist made me wait 3 months from pulling tooth to implant. Does your gma know this? #2: implants are very expensive. Do you know for a fact she has the money to cover it? #3: there may be other options if she is missing more than 1 tooth in a row. Has she explored alternatives?

If you believe she will be unable to responsibly care for herself during that entire process, I would not support her having it done until she was stabilized and proving she can care for herself fully.

Also, ditto to the comments about you providing care for her. Who is her durable PoA? Has she ever had a cognitive exam by a doctor? If she lives with you and you help her, one unbreakable condition should be that she assigns you as her durable PoA. And you definitely need to get the payment thing on the up-and-up legally or it WILL come back to bite both of you on your tushies. I wish you the best, let us know how it goes.
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Reply to Geaton777
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I had an implant placed a few weeks ago. There are a lot of stitches in the gum. I must not chew on that side for at least a couple weeks. These are not dissolving stitches so after A MONTH they can be removed. The periodontist made it clear that I can't allow my tongue to "explore" that area in order to not tear the gum. The perio also gave me SIX prescriptions ranging from antibiotics to a mouthwash that's a sanitizer for the mouth several times a day.

With your grandmother's dementia, I'm concerned she would forget to protect that area and chew on those stitches, possibly tearing the gum, use her tongue to explore those stitches that she forgets are there, or stick her finger in her mouth to try to pick them out.

My mom had dementia and she had trouble hearing. I got her hearing aids and she would constantly fiddle with them since something was in her ears.
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Shannon1217 Mar 6, 2020
That is what I think she will do. The dentist wasn't concerned about medical history or medication she is on. Its alot of medication. I just got her at normal stage for last 3 months before that every month she went into hospital fro severely being depressed or from being very very manic. I think i got in way over my head taking her in but had no choice. And I'm scared to death when she does run out of money and try to get Medicaid in Oklahoma she will get that penalty for paying me $2000 a month without have a contract done at the time.
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"I am caring for my grandmother Dottie, who is 82 years old, living in my home with alzheimer's / dementia, anxiety, and depression."

and

" Last June I had 2 days to be ready for her to move in with me my husband and 16 year old daughter. I gave up a job that I really liked to take care of her."

and

"She has been lost in system for years no one has really done anything but give me the run around about everything."

Okay. Straight talk here. You are being taken advantage of. It is NOT your responsibility to be taking care of your grandmother. You have now given up your job with all of its benefits to be the 24/7/365 caregiving slave to a mentally ill woman. She's only 82; is it the plan that you kill yourself taking care of her until she dies?

She is lost in the system without anyone really doing anything for her because the professionals figure as long as family keeps her, they don't need to be concerned.

You will need to really really push the issue. Don't let your father, your aunt, or anyone else tell YOU that YOU need to take care of her. What does your husband say about all of it?
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Reply to CTTN55
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I'm not sure I understand your concerns over the relationship between bipolar disorder and implants. Are you concerned she cannot remain in the dental chair during a manic phase? Or she won't attend follow-up appointments? Or that she wouldn't leave the implant alone during the 6 month healing phase?
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Shannon1217 Mar 6, 2020
Im worried she will become severely depressed again or very manic having to be back in hospital. When depressed she doesn't want to move,walk or eat. Manic she is to much
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It sounds as though your grandmother's bipolar disorder is not under control. Are you or your parents in touch with her mental health team?
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Shannon1217 Mar 6, 2020
She has been lost in system for years no one has really done anything but give me the run around about everything
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What does the dentist say? What do your parents say? I am surprised to see how many grandchildren are caregivers to grandparents.

I have seen several posts by grandchildren. How long have you been a caregiver? What about your future? Are you being paid to be her caregiver? Are you in school? Do you want this responsibility? How old are you?

I can’t answer your question but perhaps others have experience in this area.

Best wishes to you and your grandmother.
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Shannon1217 Mar 6, 2020
Im 45, my dad is her only son he has problems of his own along with a wife that pretty much forced my gma out of her home years ago. Last June I had 2 days to be ready for her to move in with me my husband and 16 year old daughter. I gave up a job that I really liked to take care of her. My Aunt (gmas sister in law) has POA of her money they pay me $2000 a month. The more I read on here. I think I need ed a contract. I dont know. This has been thrown upon me. We have ner been close or have a good relationship like she has with my sister who she always liked more.
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