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My mom has been in an AL facility for two months she has undiagnosed dementia and can be confused about what day it is, and what time of day. The past few days she has been really confused about time and has missed meals in the dining room. Even though she has a clock that tells the time, date, and even the time of day, she is unable to process if it is 11:15, time for lunch. Yesterday, she had nothing to eat until I called her at 2:30. I told her that she needed to go to dinner (starts at 4:15). She said she would do that. I found out today that she went to the dining room way too early where they were having an activity and serving watermelon. She told me "dinner was bad, all they had was watermelon." So, she didn't even realize she was at an activity. She has food in her apartment but if she is not hungry, she won't eat. Some days are better than others and she manages to get to the dining room on time. I've already talked to one of the aides and they really aren't able to remind every resident that it is time to eat. So, now my plan is to call her at lunch time and at dinner time and tell her to eat. I would like to keep her in assisted living as long as she can stay (rather than a higher level of care) but am worried that she will end up in the hospital because of not eating. Has anyone had this problem??

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I'm really surprised that AL lets that happen. When Mom was in AL, every person was given an assigned table. There was a rule, they could only miss one meal a day. If they didn't show up - someone went up and got them. Mom had dementia and couldn't keep track of time either. So someone went up and got her. She often didn't want breakfast, so they made sure she was escorted to lunch. If she didn't feel well, they brought her a tray.
Do they have levels of care in your AL? Mom's did, and included in her "level" was to take out and put in hearing aids, give meds and make sure she went to meals. You might want to talk to the director. Assisted living is what you are paying for and if they don't make sure she eats, what are they assisting with?
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After several days of meal reminders from the staff at moms AL place, it appears mom is heading to the dining room at the proper times and/or they are escorting her. Today when I called at 2:30, she told me all about what she had for dinner and how windy it was at dinner. She also laughed at herself and said she was wearing the same clothes she was wearing for dinner. I realized she was talking about lunch because today at lunchtime it was windy. She had been sleeping and was disoriented with the time. Based on the advice I've received here on this forum, I've realized it is not important to argue with her and convince her that she is talking about lunch, not dinner. Who cares? She is eating, is in a safe place, seems to be getting along fine and is actually enjoying reading a book and some magazines from the library of her AL place. Who cares if she thinks lunch was dinner? Last week I would have tried to convince her she was talking about lunch, which would have added to her confusion and been upsetting for both of us. Gosh you all have taught me a lot!
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Add my surprise to that of the others that someone won't remind her about meals. That not only just doesn't seem right, it seems inappropriate and inconsistent with some of the purposes of AL.

The only thing I can think of to help her remind herself is kind of a rube Goldberg operation: Get 3 alarm clocks and set one for breakfast, one for lunch and one for dinner. Put "go to breakfast", "go to lunch", and "go to dinner" tabs or stickers on each clock. What I don't know though is if shutting off each clock would actually be a reminder, or whether the clocks need to have the alarm buttons re-activated each day.

It's been years since I've relied on alarm clocks and I just don't remember whether they need to be reset after being turned off.

I think part of the issue is associating the time with the meal. You could put up signs, but that might not trigger the association. I'm trying to think of some kind of recording, or bell, or something that would activate like an alarm clock but offhand I'm not thinking of anything.

Are there any other residents your mother knows who might create a "buddy system" and come and get her for meals?
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My mother also has little sense of time. Calling her on the phone seems like the best option. Memory care is more expensive, so I understand why someone would want to avoid it as long as possible. It is frustrating when they lose sense of time. I feel like I'm trying to round my mother up all day. She's liable to start doing something else right at dinner time, so it takes a while to get her to fix a plate. We have to take it one meal at a time on many days.
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ALG1447, my Dad is now at that stage where I need to call him at his facility around 4:30 to remind him to start getting ready for dinner. More than half the time I wake him up as he was napping, and if he was in a deep sleep, he can be quite confused.

Dad does have his caregiver who spend the whole morning with him, thus she will make him breakfast and lunch [he lives in Independent Living]. But once she leaves, Dad is on his own, and he won't look in the refrigerator nor the cabinets for something to snack on. For my Dad, it was years of training by my late Mom for everyone to keep out of her kitchen. Mom did this because she was losing her eyesight and didn't want anyone to move anything.

I am also surprised that your Mom's assisted living isn't able to remind those residents who are clock challenged that it is time for dinner. That is something I will need to check for my Dad as I had signed him up for another level of "assisted living" care where he can continue to live in his apartment without needing to move to the Assisted Living side of the complex.
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In my moms AL, they have an Aide standing by the elevator and she checks off the names as the Residents arrive for meals. If you don't come down, they call the Resident on the phone and if they don't answer someone goes to get them.
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About the time confusion - my mom would go through that on and off. Where the confusion started, I think, was because during these periods she was sleeping more than usual. At some point it became "normal" for my mom to be extra confused when she woke. But during these particular points she wouldn't be able to decern whether it was am or pm. I would get calls in the middle of the night with her asking was it 3:00 am or pm or she would call at 5:00am and say "it's 5:00, I thought you were coming by today" - thinking a whole day had passed instead of just starting - fun, huh? I tried to show her the lighted dot on her digital clock which indicated am or pm and also on her computer where the time stamp was but it did no good. Worse was that she couldn't logically figure out to look out the window to see if it was freakin' dark out! But like I said, these periods with time confusion came and went. The other thing that occurred to me is - it would be like my mother to claim confusion about time and meal periods as a way to keep me from nagging her to go to the dining room and eat - mom would rather eat in her room to avoid socializing. Since your moms only been there two months, could that be a possibility? But I stand by my original reply that the AL people saying they can't remind her is sooo lame! As you can see from the other posts, this is something that is routine in most AL communities. I'm sure your paying quite a bit for an apartment that would rent for half the price if it were outside a retirement community - you should be getting more for your money than just medication management.
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Rainmom, I was thinking the exact same thing about the confusion--the sleeping/napping schedule and not looking out her window to determine if it is dark out--this is exactly what I was thinking contributes to the confusion and disorientation about what part of the day/night it is. I have also had the middle of the night calls--1 am thinking it was 1 pm. And yes, my mom is not a very social person. She just stays in her apartment and watches TV. When I go for a visit, I get her out of there even if it is to sit on the patio for a bit. Sometimes when I call and ask her if she is going to lunch in the dining room, she will say "they are not having anything good" as an excuse not to go. They have two choices for each meal plus they can always choose the "regular" items. This is TOTALLY a bogus excuse for not socializing. She won't go to any activities either, always saying she didn't know about them or she doesn't like bingo or it hurts her back to work on the puzzle. She is very stubborn and I have to remember that she is making these choices and I can only offer suggestions of things she can do.

Based on everyone's comments, I will be talking with the head nurse this coming week about meal reminders. This is my first experience with AL and I'm not sure exactly what services they offer other than the ones we are already getting. I'm on that and thanks to everyone that has commented about that particular issue.
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So ALG, I think you probably have your answer regarding why it's so difficult to get your mom to the dining room - bottom line, she doesn't want to go. If she is like my mom - doing as my mom did, not being able to determine meal times because dementia, over sleeping, not being happy to be there - getting someone to remind her isn't going to be a total fix. You'll start hearing from her that no one cued her when in fact, someone did, that there was no where to sit, or a woman at her assigned table was mean to her, plus the same "didn't like/want what was being served" - even though there were alternatives. It's the same as the variety of excuses to not go to activities. Either she will or won't adjust. If she adjusts to being there - great, she will have some quality of life ahead of her - may even come to like living there, among peers and being somewhat independent. If she doesn't adjust - I'm sorry to say, at some point she will begin to decline and a facility with less freedom, more structure - a nursing home - may be on the horizon. Try as I might, I could never get my mother to understand the consequences of her bull headed behaviors. Of course that was back in the day when I still thought she could be reasoned with - I had no real understanding of dementia. I'm sorry to say you might have a long, bumpy road ahead of you. Please know you can only do what you can do - the rest is up to her, whether she can reason that through or not. You can lead a horse to the dining room but you can't make him eat.
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I would like to thank everyone who has commented. Today, I discussed my mom's issues with the director of nursing in her AL place. They are going to start meal reminders and escorting her to meals if necessary. This is all new territory for me and your help has been wonderful. Since mid March of this year, mom was in the hospital, then a rehab facility and now in AL. During this time, I cleaned out her condo, had an estate sale, sold her condo and pre paid for her burial. I have POA, and am waiting on veteran's benefits. I have no help in any of this as my dad passed away in 2014 and I don't have any siblings. Everyone on this forum has been so helpful with my questions. I'm sure I'll continue to have more as I'm realizing things can change on a daily basis with the elderly. THANK YOU!
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