My 88 year old mother had a stroke several years ago. She rehabbed well physically, but eventually her short term memory began to decline. Any words of wisdom? - AgingCare.com

My 88 year old mother had a stroke several years ago. She rehabbed well physically, but eventually her short term memory began to decline. Any words of wisdom?

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She was able to live alone for about a year until, with her agreement, we moved her into assisted living. That was 2 1/2 years ago. In that time her short term loss has accelerated, now to the point that she cannot keep track of what we're talking about during a normal conversation. She's seen doctors on a regular basis since her stroke, never been diagnosed with alzheimer's but was on Aricept a couple of times (but the side effects weren't worth the supposed benefits.) I see her 2 - 3 times a week, and she always asks how my kids are doing, where are they, are they out of school (they both graduated from college years ago and moved out of state), what's new in my life, etc. etc. I know this is not uncommon in the elderly. But not long ago, she asked where her husband (my father) was, and I reminded her that he passed 17 years ago. She said, "Oh that's why he hasn't been around." The other day she said, "I know this will sound like a dumb question, but is my mother still alive?" So I reminded her when her mom passed, how old she was, and so on. But it's the lack of short-term memory that's so frustrating, for her and those around her. Again, I suppose this is not unusual, but during a typical hour-long visit, she might ask 10 - 15 times, When is Christmas? What are the plans? Do I need to do or bring anything? (as if.) And then ask randomly, again 10 -15 times, So what day is today? And what is the month? October? September? Oh, December? Have we had Christmas yet? What are the plans? Then again, What are your kids doing? Where they now? What's going on in your life? Sometimes I take the time to give her complete answers about my kids, their college years, current occupations and cities they live in. Other times I just breeze through short answers. She is unwilling or unable to do anything, like go to exercise class, try to read, etc. She picks up the TV remote when trying to answer the phone, randomly looks at a calendar/notebook/daily schedule that my sibs and I fill out for her, looking for information about -- for example -- what year her mother died. On that one, I had to say, "Mom, I don't think that notebook is going to say anything about when your mom died." She's mobile with a walker, but has a difficult time getting out of a chair (over weight, but who isn't?). She's getting assistance with dressing, showering, etc. She has not gone through any personality changes or mood swings. She still knows the names of her 6 kids and recognizes me when I arrive. She's able to laugh at her forgetfulness, or the lack of logic in her asking if her mother is still alive -- when you take the time to do some math with her (her mother would be like 140!) But again, it's the short term memory problem that's so frustrating. We've all accepted that she is incapable of forming new memories (and starting to lose some old ones; however, she can recite poems she learned in grade school). I try to just focus on the moment and enjoy the time together. But I find myself rambling on, trying to keep her mind engaged, see if anything I say will fill in some gaps or trigger any recollections of her own. Or I'll Google something we've been talking about or saw on TV and simply read from the search result. Add to both our knowledge base! I've to her read from old journals she kept, old letters to and from her sister that my aunt saved, my Dad's old WWII POW "memoirs" that I typed from pages of scribbled notes, watched re-runs of Ed Sullivan (Hey Mom, that's Jim Nabors. You remember him, right? No.) But whatever I do or whatever we talk about, she will have completely forgotten about it maybe 5 - 10 minutes later. I don't get angry, of course. It just all seems so pointless. I guess I have two questions. First, in the absence of things like personality changes or irrational mood swings, could this very severe and accelerating short term memory loss indicate alzheimer's? Second, is there anything I can do to make these visits more enjoyable, or maybe...I don't know...more meaningful? Any words of wisdom?

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A couple thoughts. First, the pros and cons of a powered-lift type chair are legitimate questions. She's forgotten, for example, that the brakes on her walker are like bicycle brakes. She only remembers that she can lock them, and she's forgotten that they are also useful for controlling speed going down hill. Which again brings into question her vision -- or more specifically her depth perception -- because even the slight grade on a handicap ramp seems to her like a steep incline to her. Second, she's never been "a dog person," which I think is unfortunate. We always had pets growing up, either retrievers, because my Dad was a duck hunter (great family dogs, by the way), or strays that we, as kids, managed to coax to stick around with food. Plus, her mom had several small dogs in her later years. And all my siblings have, or had, pets at some point. But Mom simply cannot warm up to animals. I think its a shame, because the love of a dog is unconditional and so rewarding, IMHO. Cats, not so much. But I love cats, because they are fun, wonderful and fascinating in their unique ways. There is nothing like a cat that deigns to allow you to hold it on your lap and stroke it (to your great satisfaction!) Unfortunately, pets will never be a part of Mom's life. So I guess it comes down to finding what gives Mom a sense of happiness and not trying to impose my values or judgement on how she should react or feel. Again, as a layman, I must say that it doesn't seem to be Alzheimer's. She simply she doesn't exhibit the irritation, anger, lack of recognition, or irrational paranoia, (beyond the frustration she feels with her diminishing abilities) that seem to be associated with alz.
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Something is definitely amiss if she didn't even recall that her loved ones died.
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From alz.org:

"Dementia is not a specific disease. It's an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as "senility" or "senile dementia," which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging."

My understanding is that dementia is a term that one can liken to a large umbrella that covers a multitude of afflictions, with Alz being the most common and vascular as the second most common, as noted in the ALZ quote above. We did not have mom "evaluated" to determine the cause, mainly because there is not much one can do to treat any of these. She was over 90 and it is not likely to be the thyroid or vitamin issue. A few conditions have an underlying cause which CAN be treated, but in general dementia is not treatable. We attempted to maintain mom in her condo, but the aides hired (started with one hour daily, mostly to check on her and ensure she took her meds from a locked daily dispenser) only lasted a few months before she refused to let them in.

What you are describing is what we were seeing. Initially some difficulty doing "routine" things like paying bills, some repetition of questions or comments and so forth. Nothing to worry about too much. The car came up first, and we had to take it away before she injured herself or someone else. Unfortunately since she was living alone there were other issues that over time we could not witness. We did install cameras, partly to ensure no one took advantage of her, the aides were really there and partly to monitor her - one just inside, one outside and one in finished basement. Eventually she started the OCD behavior, mainly at night (sundowning) - initially this was a few repetitions and eventually became an hour to an hour and a half marathon checking the door lock, sidelights, dishwasher and LR over and over and over. The repetition of questions and comments became worse. It is so frustrating to have to keep answering/discussing the same things over and over. Grin and bear it! If it becomes too much for you, one thing that can work is redirection/refocus. This is like moving the needle on a record that is skipping. This is easier to do in person than over the phone, but generally if you can change their focus onto something else you might get some relief. Of course, it might mean repetition of something else! Getting her to focus on something that interests her and can keep her occupied, or going for a cup or tea or coffee can break the cycle, even if it is only for a short time.

We finally decided mom needed to be in a safer place. She was NOT amenable to moving in with any of us, wanted no part of people coming in AND was adamant that she was fine, independent and can cook (not), so she had no desire to move to AL of any kind (for years she would go to the free lunches and check these places out - now that we needed to go that route, nope! That refusal to move is what brought me here in the first place. You were lucky with mom agreeing to move!)

She managed to injure her shin and end up with an ulcer that delayed her move (literally days before we had the move planned and she could not tell anyone how this happened!), but she moved in early January this year. For the next 9 months she kept asking when she could go home to her condo. My younger brother would try to explain over and over why she could not. She would not accept his responses and would keep asking WHY. Typically she harped on him, not me (thankfully!) During visits, despite her really bad hearing (none in one ear, limited with hearing aid in the other), the repetitions of questions and comments continued. However, one day about 2 months ago, she asked if I could drop her off at her mother's on my way home. Ummm, not today mom, it is kind of late and it is not on my way. Maybe tomorrow. Okay. Her mother passed away almost 40 years ago! This is one topic that I felt was better to avoid the truth. Shortly after that query, she asked if I had a key to the place they had lived in before (not the condo). They sold that 23 years ago! Ummm, not with me - maybe at home, I'll check when I go home. Okay. Again, no need to try explaining. Her reality is changing, moving backwards in time as more and more short-term and more recent memories are lost. This is what you have to expect. At some point, home may be where the person grew up! People from the past may populate their "current" memories.

So, it does progress, there just is no timeline provided to us. It is kind of like how kids grow - some walk or talk earlier, some later, some roll over before you anticipate it, some don't, etc. In most cases, the end result is the same - kids grow up and become self-sufficient. People with dementia decline until they no longer know who we or they are and can no longer care for themselves. Each person and/or cause of the dementia has its own timeline, just like kids grow and learn at their own pace.

From what you have described, it certainly sounds like some kind of dementia rather than any age decline. It is not just brain glitches where you forgot where you left your keys or why you came into this room - THAT is normal. You could have her tested to determine what the underlying cause is, but why put her through that? It is what it is, and there is nothing really that you can do to stop it. What you are currently doing with her sounds great! The only recommendation I can suggest was noted above - learn how to redirect/refocus! You do not have to do it all the time now, but it does come in handy. Use it sparingly now and then, but as this progresses you will be more proficient at it AND thankful to have this "tool" to use! Sometimes it requires making little white lies too, but this is not done to be hurtful, but to avoid hurt! That was hardest for me, as I do not like being deceptive in any way, but it is what it is and sometimes works for the best.

Although a lift chair is an option, I have to agree with akdaughter. Would your mother know/remember that it is a lift chair and/or remember how to use it? Given that your mother is having issues with short term memory (troubles with TV/cable/remote, etc), it may be difficult or impossible for her to learn how to use this kind of chair. It seems like a huge expense to have as a chair (which is all it would be if she cannot operate it!) The rent/borrow option is something you could try, but I suspect it will still be a waste as she is not likely to be able to use it. Our mom asked for a walker, like the others in her MC place have. I brought the one she had for our dad. She does not use it, yet. Even though it is in her room now, she just walks by it and leaves the room. Thankfully we did not have to fork over money for it!!

So keep on with what you are doing - sounds like you have a good handle on it. Many of the suggestions here are good to keep in mind too. Best to have all the tools in your pocket for when they are needed!
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Your mom sounds a lot like my mom. My mom had atrial fib and was on Lipitor for quite some time until I took her off. I believe meds and a lack of oxygen to her brain probably caused her lack of a short-term memory. She lived to 97.5 and died this last May. I just wanted to say that my mom was very stable and didn't decline (as one would expect with Alzheimers). Her pleasant personality remained the same but she could remember something one day and forget it the next. Her short-term memory was just about non-existent, but every so often she'd surprise me and remember something newer. I never had her formally diagnosed because it wouldn't have changed her treatment.

It was hard sometimes not to lose patience with being asked the same thing over and over and her inability to solve any kind of problem. But mom never was hostile or paranoid or any of the behaviors that can show up with different kinds of dementia. I was blessed in that way. She lived in Independent Living until her death, with a LOT of help from me. She had her daily routine and as long as she kept that routine, she was OK.
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Anger is one of the stages many with Alzheimer's experience. There are anti-psychotic drugs that help with that without doping her up. We took my friend to a geri-pysch ward in a hospital to find the right drug and dosage that would work. That took 3 1/2 weeks, but she ended up with something that worked perfectly for her.
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My experience with my mom was similar, although a neurologist diagnosed her with “moderate dementia, probably of the Alzheimer type” in 2010. She moved to AL in early 2011. There was a steady decline until late in 2014 when she became angry. I think her anger was mainly due to frustration at losing control over her life and her inability to remember things. One day she called me to complain that I never visit. I was still in the parking lot of the AL facility after visiting her! We had to remove her phone when she began to make repeated calls to me and calls to random numbers at all hours of the day. She was moved to the memory care wing in February of 2016, and did fairly well until this past summer when she began to decline physically. She died October 28, just a week shy of her 91st birthday. She recognized me as someone she knew until the end, but sometimes referred to me as her sister during the last few months. The anger and aggressive behavior was the hardest part to accept. I tried to joke and laugh with her during our visits, but if she started to get angry, I had to make an excuse and leave before she got too worked up.

I agree with bringing familiar music. Music was the last thing that mom remembered. She liked the old church hymns so I bought an Alan Jackson gospel CD and the staff and I played it repeatedly. Even when she had trouble finding and forming words, she could sing along. If I sang with her, she would sing harmony!

Mom had a lift chair, but couldn’t remember how to use it, or even that it was a lift chair. Maybe you could rent or borrow one to see if it works for your mom before investing in one for her.
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She needs to see her physician for a proper diagnosis. You will want to know if it is indeed vascular dementia.
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Lots of wisdom and good ideas in these replies. It's clear that many share the same experiences, and more. And I'm realizing that things could be much, much worse. I can't imagine how difficult it must be for a spouse, for example, to care for a partner who is essentially unable to communicate. If nothing else, I'm going to try to be thankful and more accepting that it is what it is, and it could be worse -- as Mom always says (repeatedly :-) "You take what you get and don't throw a fit." And no doubt it will get worse over time. So acceptance and letting go of frustration sounds like a key.

I like the thought that she's happy when I visit, even if she won't remember it. if she's happy for that brief time, good enough. I also like the idea of getting her off cable. Although watching TV is about the only thing she can do, sometimes she gets the cable box and power to the TV out of sync, so there's just static. Then, the other day I stopped by and she had the TV on Channel 1127 -- there's definitely nothing on that station she watches. She's got dozens of recorded shows, however, because she obviously hits the record button while tying to do something else, turn the TV off I assume. Or the remote will just be missing, and she'll have no idea where it is (usually the bathroom). It does make me chuckle sometimes, and I can tease her a little -- but never to the point of making her feel bad. She does sometimes use humor as a way to cope, but I know there's deep frustration with her diminishing abilities. She frequently says, "I used to have a brain," and sadly, being in this condition was the biggest fear she had as she aged.

And thinking about things like misplacing the remote and her then pointing to some random object and asking if that's it, I'm wondering if her vision is getting worse. She also can't see her digital clock very well (it shows the time in big numbers, then day, date and month in smaller figures.) She often squints at it while asking what month it is. Getting her vision checked is something I could be proactive about and it might actually help her.

Also, a powered chair that would assist her in standing is a great idea that never occurred to me.

And of course, I'll continue to monitor how she's doing. Her beginning to lose longer-term memories is concerning.

Anyway, a lot of food for thought, and simply reading the perspectives of others who share similar experiences has been very beneficial.
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My friend, Jim, has similar problems. I am his POA and have him in a memory care apartment where he is receiving excellent care. He his physically healthy, but can't remember from one moment to the next what he has been telling me, so I hear the same things repeated over and over. I listen patiently, add my two cents as he goes along, and after about 30 minutes, leave to check with the head nurse or some other care-giver in case there is something I should be looking into. There are no children or close family members near, so it is me as his friend that sees to everything. He is a well-educated black man and we joke about being brothers of another color. It's more than a joke, of course. We very much feel this way. He loves to read, but reads less and less because of not making sense of it without that short-term memory. He speaks coherently but can only speak about a few things. We go through a list of things he and I are thankful for and always end on a positive note. I am grateful he is not alone and eats with his "friends" 3 times a day and that the staff monitors him daily and tells he nurse of any changes they note. He never asks about his wife or parents, so we don't go down that path. He remembers what happened to her and when isn't important to him. I don't mind the repeating himself, but I only have to listen for about a half hour at a time. I would just keep responding in a loving way and voice and have patience. My friend does not have Alzheimers according to the tests and symptoms, nor frontal temporal dementia like his wife had--just a failing memory. Both Alzheimer's and FTD follow particular, recognizable stages, and he is doing none of that. It sounds like your mom isn't either.
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My words of wisdom, develop a good sense of humor! Next practice counting to 10. Last but not least enjoy every day you have, because the next may not be as good. It really doesn't matter why it happens, the end result is the same. They simply loose their many of their memories and ability to do things for themselves. I went through this with grandpa in the 90s, grandma shortly after, and now mom is going down the same path. The only thing different this time I have a grandson assisting. Thinking if I teach him well how to be a good caregiver, just maybe if one day I go down the same path, he will know what to do.
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