Hello everyone, My 96 year old MIL lived with us for the past year, but recently moved into a small Assisted Living only 3 miles away. My husband visits her almost everyday to help smooth the transition. He is her only child. Her care was increasing and we were unable to travel because she had problems with any hired help or respite care. "Sheila" (name changed), has short-term memory issues, decreased hearing, and some periods of anxiety and confusion. She was seen recently by Geri-Psych, but she refused medication for anxiety or depression. She passed the cognitive testing, but the issue is not intelligence, it is judgment, mood, periods of confusion, and anxiety. Sheila has always been adverse to Senior Centers etc, thinking she had nothing in common with them. She likes to watch the news, Jeopardy, old movies, and feels that other people her age have no ability to relate. She did live alone and drive until last year when we became aware of some serious forgetfulness like bills and losing items. She describes herself as a "liberal," and and an "atheist," and makes this known to people around her on a regular basis. The issue now is that she is having occasional outbursts at group mealtimes. She does not really try to know that other people, but wants to talk all about herself. The other residents are not yet interested in her subject matter. A resident asked her to quiet down last evening, which resulted in her shouting and going to the director with complaints. Afterward, she called my husband to tell him that someone had told her to "shutup." She was hurt and did not mention anything else. This has happened several times with extended family and at an assisted living respite care. She does not remember her part in the matter. She becomes very defensive if we discuss these things (which is not very often). So, we are trying to help her understand how to settle into the new living situation, but feel that she may continue to be somewhat "obnoxious." This will prevent her from making friends and being happy there. I am a nurse and understand some of the neuropsychological issues going on here, but am not a geriatric specialist. I do feel that some sort of anti-anxiety med could be considered such as Seroquel, but we will discuss this with the geri-psych MD. I guess what we are asking is: How do we help her in the meantime? Should we discuss the events with her? How can we help the staff and other residents to understand? We are at a loss today. Thank you.

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Some have a lot of narcissism which causes problems in relationships, and makes things more difficult when dementia sets in. I have known some elders who manage very well, and are flexible - a 90 some year old aunt, for example. But if you have pre existing narcissism and dementia sets in, the person can become very difficult. I am an elder at 80 and I can change, though it does take work lol, but that is true at any age. Professional help made all the difference for mother. Hope things work out well for you and "Sheila".
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Thanks golden!

Good insight on the narcissism, although I think we all have a little bit of that. It is good to realize that elders cannot change much but just need some redirection and professional help.
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(((((snow)))) I think that meds are your best recourse if she can be convinced to take them. Mother scored high in cognitive testing but was making bad decisions, got paranoid and finally had delusions and became suicidal. She had refused meds too, but once she was suicidal she was placed in a geri psych hospital and after some months there finally agreed to take the meds ( an antipsychotic) . Your mil sounds somewhat narcissistic. Has she always been this way? I am not sure at this stage of her disease that you can reason with her. Mother became verbal abusive to some staff. I was in good contact with the facility and they did a very good job of helping staff understand that it was the disease. Fortunately she did not do this to other residents. There was no reasoning with her at that time.
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Thank you, Windyridge.

I know that Cymbalta and Ativan can be helpful for anxiety, pain, and agitation.

It’s hard that our parents do not see the need for assistance. They crave independence but cannot have it. So they are angry. I find myself hoping that I can see reality when I am their age!
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My mom is not quite as militant as your MIL but there are some similarities. Mom went into AL last month after a series of bad falls. She’s very mad at me, last living child, for putting her in prison. I have detached for now, don’t visit, 12 hr dr, or call her.

When I was getting her settled in she felt she was the queen bee, these are all old people who are really bad off! Why am I here?! This from an 87 yr old women who needs a 2 person assist to transfer from bed to wheelchair, who’s eaten  nothing but cereal and snack cakes for the last year and I don’t want to even think how long since she had a real bath.

I can’t convince her of why she needs to be in AL and don’t try any longer. You can’t penetrate the dementia.

I do talk to staff every other day or so. My Dad is now there also with severe dementia. OH BOY, A TWOFER!!

I came home after a few days after getting them settled in, got to see how the place worked and got to know several staff folks.

I signed them up for the in house doc and meds program, best thing in the world.  They call me, say we’d like to do such and so, I say go for it.  No hauling them around for exams.

Moms on cymbalta, I think, and Dad is on Ativan. Without calming meds my guys would probably be getting kicked out about now.
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