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Hi - My mom has dementia and has been in an ALF for 3 years. They are very attentive to her, but she has always kept her room extremely warm. That's OK with decent temps outside, but in central Florida, it's sometimes near 100 degrees. With her keeping the door closed and the AC shut off, she starts hallucinating due to dehydration. Oh, and she refuses to drink water or anything else between meals - where she drinks sweet iced tea or decaf coffee, both dehydrating. She also insists on having the door closed whether she's in the room or not.


The AC units in each room are the long, low ones underneath the windows. We've tried taping down the door that leads to the controls. We've tried taping over the "off" and "heat" buttons, but she just takes all the tape and covers off. Any ideas for another way to dissuade her from doing this? She becomes very upset if the AC is on - it's a rolling AC that automatically turns off when it reaches a certain temp (we've put it at 77 degrees) -- so it's not on constantly. But whenever it is on and Mom's in the room, she goes right over and shuts it off. I'm at a loss now, as are the ALF staff. Thoughts?

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Thanks to all who have given me their thoughts - they are helpful and supportive and it's so good to always realize I'm not alone with these issues! After a few weeks of this, it seems Mom is allowing the AC to stay on most of the time. She's on an hourly check from the staff. She also has a wonderful companion from a local organization who visits her 2-3 times per week and has been with her for 7 years - so the AC is always turned right back on if it's off. I'm hoping that leaving it on will become a routine. That seems to be what happens with everything in her life now. Thank you again for everything!
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In my opinion she is beyond assisted living since she is a danger to herself...put her in a nursing home. I'm surprised the assisted living facility did not call you to organize her departure due to eviction--they should since her care is beyond their scope. If I were the supervisor there that's exactly what I would do. If she is on Medicaid this would not be difficult. At first sign of risky behavior or dehydration due to willful conduct, I would have called 911, send her to the hospital, and refuse to take her back.
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Is it the blowing cold air that bothers her maybe? Putting a timer on it so it cools the room down when she isn't there and then doesn't come on or changes to a higher setting so it won't come on as often when she is in her room seems like a good idea, maybe there is a way to divert the air so it isn't blowing right at her or move her furniture so that isn't happening. The fluids thing is a frustration for us too, it's hit or miss but sometimes flavoring her water works for a while, fresh lemon, lime or orange slices. If she can be reasoned with or retains some information maybe warn her that you know how hard it is when you aren't thirsty but if she doesn't drink enough water throughout the day not just at meals in the hot weather and gets dehydrated (which happens easily to all of us in the heat) she might end up needing an IV to get fluids in her (that might mean a trip to hospital) because it can be so dangerous to her and no one wants that. We have this whole set up with 2 bottles of water a day that need to be drunk and having her drink 8oz or so every hour, Mom hates it but she is diabetic and on a diuretic for CHF so when she doesn't drink enough water it wreaks havoc with her kidneys among other things as well as making her hallucinate. It's a never ending frustration and battle for my brother and I...so I can relate.
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You cannot, unfortunately, save a person from herself. If your mother gets too hot, or too dehydrated, you'll meet the ambulance at the hospital, like I've had to do many times over the past few years. Sigh. Nothing, and I mean NOTHING, I've tried has worked with regard to getting my stubborn mother to drink fluids. Nothing. It's really a miracle she's still alive at 92, to tell you the truth, given all the stunts she's pulled over the years. I officially give up trying to save her from herself.
Best of luck to you!
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She should not be drinking caffeinated beverages. Make sure the iced tea is decaf. Sugar in large amounts is dehydrating. The body needs a certain amount of sugar but extra sugar is excreted in the urine and takes water right along with it. Find a substitute for sugar or a combination of less sugar and mint and/or lemon. Read labels on the beverages she is drinking and avoid those with large amounts of "added sugar".

AC removes moisture and if she's cold that's worse because elderly people don't have the muscle mass they used to have in order to shiver and warm up. Get her a box fan or two to circulate air in the room. Keep her curtains drawn during the heat of day e.g. 12pm-4pm. Make sure her clothing is light weight and billowy. Keep lightweight throws nearby.
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I wonder if there is some sort of cover (like for thermostats) that can be attached and only opened with a key? Let me tell you our fridge story: To begin with we didn't recognize this as a beginning sign of dementia. And when yelled at about it, mom claimed it was because dad didn't like his OJ cold (she was making the fridge too warm and food was spoiling quickly). I tried everything...the tape in teh same color, the thought of driving a nail through it...one night in sheer rage I reached up, grabbed the dial and yanked...and it came, easily off...which no one had told me, even at the company could happen. So it worked for a while...and then my little darling (not) turned the little bit of stem that remained. The real solution which isn't going to happen for you was that dad decided he wanted a new fridge, and with the digital controls and no knob, she's clueless. What a relief! She also was OCD about yanking the plugs out of one outlet. We got something in the baby proofing category that is a switchplate you switch out, and then this clear cover, with an opening for the cords snaps over it...but the switch plate must be screwed in and the box is a challenge to lift off...not something you would want to do all the time. I'm sure the staff must hate going in there for anything when it is hot. Get her something polar fleece!
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Speak to the maintenance man just in case there is a way to override the controls.
Im going through this right now with my aunt. Not to the degree that you are. We are having a smart thermostat installed so that we can control the air. Doesn’t sound like that would work in your mom’s room. If it could come on whenever she is out of the room at lunch that might cool the room a bit longer.
Aunts recent blood work indicated she was a bit dehydrated but her salts were good.
She was actually sitting outside this past weekend because she said it was too hot in the house!
We keep the small bottles of water readily available for wherever she sits. We give her protein drinks which her doctor likes. Watch for a yeast infection under your mom’s breast. We had that to contend with one summer.
My FIL was kicked out of my MIL rehab room because he kept turning the AC off. MIL
roommate said she just gave up and was going home. Not sure if she was cutting her therapy short or not.
I thought a nurse was going to spank his hands.
Finally they said he could only come to the commons area.
Today I put a fleece jacket on aunt and she seemed fairly comfortable at 75-77. Good luck. Let us know if you find a solution.
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I have to say I'm with Mom - air conditioning? I live in the high desert and it gets 100 degrees F in the summer - we use a swamp cooler and frankly even that can get too cold. If I'm not moving around, I start to feel like I'm in a walk-in freezer. When I was working I used to go outside to thaw out.  Too much cold is very debilitating, I find.  How about leaving the setting 80 degrees +? May be too warm for you, but not for her.
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There may be a way having the engineering crew install a keyed lock of some sort on the cover. Or installing a screw to secure the cover.
I think 77 is a bit too low for her. You might have to set the thermostat at a higher temp for her comfort.
Remember that an air conditioner is also dehydrating as it removes moisture from the air as it cools the air.
Is she refusing to drink all liquids or just water? If it just water you might try flavoring it with a bit of the water flavorings like MiO. I used that trick to get Luz to drink water. The MiO is just flavor with almost no calories or sugars or any other junk in it.
Best of luck to you.
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gdaughter Jul 20, 2019
Your idea is probably the best, but you don't want to screw it shut because people still need access from time to time.
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