My 93 year old mother has been in Memory Care for three weeks. She transferred from the hospital where she was being treated for syncope (fainting) caused by dehydration. Before that, she lived in my home and suffered with mobility issues, urinary incontinence and moderate dementia, which sometimes resulted in combativeness when she got a UTI. However, she was able to toilet, feed, and dress herself, and usually follow a simple conversation or tv show.
While hospitalized, she was given Seroquel and Haldol because she became combative and wouldn’t accept treatment. The dosage has been reduced since admission to the memory care facility because Mom was so lethargic she was sleeping all day and wasn’t eating or drinking. Despite the change in dosage, her regression has continued. She now has fecal incontinence, is unable to change her Depends, dress herself, or even sometimes just put together a coherent sentence. When she is clearer, she tells me that she actually likes the food and her caregivers are “okay”. Nevertheless, she refuses help from the staff. Often when I visit I find her in the common areas either dressed in the previous days’ clothes or in her pajamas. I also have to change her Depends.
I know this situation can’t continue! In addition to it being unwise, it is also unsustainable since I am scheduled for surgery next month and will be unable to visit or help for several days. (I was originally scheduled for this surgery when Mom was discharged from the hospital but postponed it to help ease her into memory care. To cancel again would put my own health at risk.)
My questions for this group:
- Is this degree of regression a “normal” part of the transition process into Long-Term Care?
- What should I expect from the staff when Mom refuses to let them help her? Although some aides say that Mom can be nice, I have been told that at least one aide won’t go into Mom’s room because she hit her!
- Have others had similar issues and how were they resolved?
Wishing you and your loved one well!! 😙
If I were you I would try to find someone who can check on her for you while you are out. Maybe that person could come to a care meeting so they know the proper protocol and understand what the issues are.
And yes, I believe it does take time to adjust to change and you and your mom have had a lot of that.
I would also call that care meeting right away so that you can understand their procedures with
noncompliant patients and be reassured they will work with you.
You might not get things perfect before your surgery but you can get the main things lined out in order to focus on your own health AND recovery.
You appear to be doing the best you can in a tough situation. Thank goodness you got her into the memory care. Let us know how things are going. Good luck on your surgery.
I know from working in a Memory Care community that care givers cannot force a resident to accept care, be it a shower, a Depends change, a clothing change or whatever. We cannot even clean their room if they refuse to allow it! If you find your mother in pajamas in the activity room sometimes that means she is accepting of help getting changed SOMETIMES, right? So it's an on and off behavior she's likely exhibiting. Maybe a talk with her doctor and another medication adjustment is warranted.
I know from experience that dementia patients take steps down from time to time. They'll be functioning at a certain level for quite awhile....even a couple of years,,,,then bam, they take a big step down to a whole new level and stay there for awhile till the next step down occurs. I guess that's how the Stages of the disease are determined. It sounds like your mother took a step down recently, and this may be her new norm.
That said, she may also need time to adjust to the new environment she's at. Having all this new stuff thrust upon her, and new people, is very disorienting for dementia sufferers and they tend to decline in general for awhile. Give her some time to acclimate.
Joys suggestion of a care conference is also a good idea. The facility has seen this behavior before and will have wisdom to share with you, and advice on how to proceed, I'm sure.
This is tough, but she's where she belongs, it sounds like, especially if she's declining with the disease. It tends to reach a point where home care becomes impossible. Take care of You now, too, and good luck with your surgery. We tend to focus SO much on them that we lose ourselves in the process.
I am just afraid that she will be kicked out for being non-compliant and combative. If so, I have no idea where Mom could go.
When things deteriorated to this level, which happened more than once, I would call a Care Conference immediately. I would ask that everyone who cared for my mother be there. We’d brainstorm about what was going on and how things could be made better for her. I was literally going right to the source. Mom did not attend. Most often, things were ok for a while but I always called another meeting when they weren’t.