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Mom is almost 87; moderate dementia; serious short term memory issues. Dad died October 2020. Mom announced her decision to leave lifelong home and move to S NV to be near me. She has lived alone in her own home 700’ from husband and me. Her mismanagement of meds and inability to learn new neighborhood, simple route to bank/groceries/CVS (2 turns) led us to seek Neuro/ Neuropsych work ups. She eats with us daily; we do pm med administration at dinner & leave am pill bedside for next morning. She was increasingly unable to manage the am pill, despite Alexa reminders. Her “loop” was getting shorter and shorter. It became a safety issue when she was shutting off the AC and opening front/back doors because there was a “breeze”, not recognizing the outside air temp was ~110. She is physically strong, but her cognitive function continues to deteriorate, exacerbated by her choice to isolate. She is a very social creature by nature.



For months my brothers and I suggested she’d be happier in a community environment, where not driving wouldn’t affect daily quality of life. She agreed to give it a try. Our first choice Community did their intake assessment and said they couldn’t accept her into AL, only MC. We learned a lot about NV state endorsements for AL/MC/SNF communities.



It’s important to note that Mom’s incidents of am confusion in her whereabouts have been increasing. I have two companions who visit her 3-4 days/wk. Both noted increased confusion over past 2-3 mos. We did labs; everything is steady-state. Most alarming were 3 incidents where she left msgs (I swim for an hr 3X/wk), crying, saying she didn’t know where she was, didn’t recognize anything, no one’s around and she’s gonna call the policeman.



Needs are increasing. Occasional companions are no longer sufficient. I brought a Social Worker in for a needs assessment for in-home care and Mom said she doesn’t want anyone in her home. So, for safety, moving to AL was the best/only option.



How long will these calls go on? What can we do to alleviate her pm sundowning? AL keeps her busy all day, although she doesn’t remember what she did all day, but once she’s in apt after dinner, it falls apart. She’s miserable, calls us cruel, says she didn’t choose this, wants to go home, etc.



Suggestions on how we can help her? I’m exhausted and have taken to letting her calls roll to voice mail, so I can gauge which personality is calling before I engage in conversation. She misses NY. Blames everything on change in geography. We have no remaining family/support system in NY. We had no idea there were issues beyond grief when she chose to sell her home and move. It’s heartbreaking. Thank you

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Ignore her night time calls. You placed her in AL for a reason. So she could be cared for and supervised by professional staff.
She is not there for free. If she needs something at night, they will help her.
Ignore the phone calls and let her acclimate to her new living situation.
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Your mom needs Memory Care Assisted Living where the caregivers will recognize her Sundowning and know how to deal with her behaviors. In the meantime, Ativan .25 mgs helped my mother a LOT with her Sundowning in the late afternoons where she exhibited agitated behaviors, wanting to 'go home' and insisting on visiting her parents and siblings, and riding the 'subway' to see them, all deceased for decades. The Ativan was increased to .5 mgs by her hospice team as her behaviors deteriorated. Of course dementia is a heartbreaking thing for everyone to deal with; watching a parent deteriorate like this is nothing short of cruel for ALL concerned. Mom's attitude towards you is heartbreaking too, but not something she can help b/c the dementia has broken her brain, making her blame you for her situation rather than old age and infirmity.

Learn all you can about dementia because knowledge is power. That will enable you to help your mom by understanding her thought patterns as they are NOW, with dementia at play, rather than how they once were as your mother at a younger, healthier time of life.

 
I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

You have the right idea by letting her calls go to voicemail; I used to call my mother ONCE a day and visit her once a week until she declined when hospice came on board. Then my husband & I would go a few times a week to see her. She was quite ornery and difficult to deal with prior to that sharp decline, so we'd leave her presence when she'd start sniping at us. When the dementia got advanced enough, she stopped sniping & saying horrible things to me, so that's when we were able to visit more often b/c the time with her was more pleasant (albeit sad & hard to see her in such a condition). Same when I'd call her and she got to saying foul things to me on the phone: I'd let her know that it was NOT okay to say such things to me, and that I'd be ending the call or the visit and calling her back or seeing her again when she was in a better mood. She DID understand why I was leaving or ending the calls, too, even with dementia at play. Sometimes they want to lash out and hurt us; their filter is gone now due to the dementia, and they WANT to cause pain & anguish, that is my belief. My mother said things to me during her run with dementia that no decent human being would EVER say to a daughter they professed to love. Period. So there's that to take into consideration. Diseased minds say and do things that have no rhyme or reason to them. WE have to take care of OURSELVES too during this horrible process. We know they are cared for in AL/MC, so if we back off and stay away for a little while, THEY are ok. Meaning it's ok for US to take care of ourselves too. Hopefully your mom will adjust somewhat and stop all the venomous calls to you in time. Let's hope.

Wishing you the best of luck.
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I think that your assessment is spot on. Mom will very soon need memory care. A period of adjustment is to be expected. Generally, in memory care, there are no private phones allowed for these calls. Mom may need assessment by her MD after some adjustment period, and she may require medication. That's always a bit of a between the devil and the deep blue, because medications that may help sooth Mom, even mild antidepressants, may also make Mom more of a fall risk than normally would be the case.
I sure hope you'll update us and I wish you well.
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