It’s been an eventful day. In ways that made progress and in difficult ways. Truly truly at my wits end.

Spent time at the SNF with mother today. Got to observe a speech therapy session, and talks with both the psychiatric NP and the facility doctor. The short version is that she demonstrated some cognitive deficits in speech therapy. Had told the therapist the previous day her name was something different than it actually is. Today she could not tell the therapist where she had lived before the hospital stay. and then the psychiatry NP says she’s pretty sure she has mid stage dementia. I was very careful to point out that up until the hospital stay she was able to carry a conversation and Cook, etc. But had psych issues made bad choices, etc. That I was not convinced this isn’t just temporary delirium. The NP said most of these people that have delirium actually have dementia that has just been uncovered. She found the fact that my mother’s daddy had Alzheimer’s plus the fact that this is mother‘s fourth episode of post hospital mental status change to be significant. She plans to do formal testing in a couple weeks when mother’s medical issues are better controlled.
Mother then suddenly out of nowhere became agitated. And looked at the facility doctor and demanded a private conversation. And again she was being belligerent. She had to emphatically tell this doctor that some random person on the other side of the room was somehow related to her ex-husband and this was a big deal and a big problem and a secret. So she flat out, demonstrated a delusion right there for the doctor.
I had some hope. Hope that I can just get some long-term Medicaid. She’ll qualify and be able to stay in this nice local facility. These hopes are being evaporated. This evening they called me several times because she had started to be very, very agitated and abusive to staff. they couldn’t get her to sit still and were afraid she was going to fall. She started to be belligerent about cigarettes and some smart ass. Nurse acted like she expected me to hop on up there and bring her some cigarettes. I said no I cannot do that. She is on oxygen. and do people really do that? And then the next phone call from the same facility number was my mother herself. And she was extremely ugly. And asked me if I was enjoying the games I was playing. In her horrible mean ugly tone that has been that way my entire life. And then she said “that won’t end well. “. They wanted me to come talk to her and I refused. A few minutes later, the next phone call was a different nurse, a nicer one, saying mother was upset about her dog and wanted to know where her dog was. I informed her that the dog was with me as was previously agreed as our plan if mother is ever ill and the dog needs care. I provided reassurance that the dog is in great shape and happy. I offered to speak to mother on the phone, but mother declined because she was in a snit. I told that nurse they need to get some med orders for the evenings. She said she was working on it.
my concern is that this is a SNF rehab unit. She is disrupting the whole unit. If they can’t get this straightened out, I have a feeling they’re gonna ship her off to geriatric psych unit. And from there, I don’t know where she will stay long-term. She’s not staying with me. I certainly can’t manage somebody who is sundowning. I really shocked that the facility does not seem to have as much of a plan to manage her. But I think she might need a psych ward at this point. I don’t even know if memory care would work. But again, she has a PICC line so that will be a challenged place. I am smooth worn out. I’m about ready to give guardianship of her to the state. I haven’t been able to do it up to this point, because she’s not been declared incompetent. But I think we are there.