My husband and I suspected that my MIL was in the early stages of dementia for almost two years now. We have offered to take her to the doctor, but my MIL refused to seek medical care. February 2022 she was at her bf's house when she fell down about 12 steps and was unconscious until getting into the ambulance and going to the hospital. We noticed that her memory got 10x worse after the fall, it was a very sudden change.
We were able to get her an appointment with a neurologist who has done several tests. During the initial appointment, she was given a few cognitive tests, which she did not do well on. After that appointment, the neurologist prescribed her Aricept (which she refuses to take). Next week we will get the results of all those tests that she has taken so far. Based on our interactions with her and her behaviors, we know she has a form of dementia but of course we are waiting on the official diagnosis from the doctor.
Since the pandemic she has stayed on and off with her bf (77) and his mom (96). She has her own house which is about 15 min from his house. She will go home to “check” on her house but then leaves out soon after. She is very attached to him, she can’t be away from him for a long period of time and has to call him constantly (when we take her to her appointments). She says she doesn’t know where she would be without him and always sings his praises. What she doesn’t know is that when she fell at his house, he and I had a conversation (he doesn’t “talk” to my husband but that is another situation for another day). He told me that he couldn’t do anything with her anymore because she didn't remember anything. He said she often doesn’t remember where she is and that she is mean to him, he said he couldn’t take care of her and she needed to be with us (not an option). I told him I understood and that we would get her a caregiver until we could find out what was going on with her. He then said well she can come over for the day and now that day has turned into months and he is all of a sudden ok with her being there. My MIL is close to her bf’s mother and she claims she stays there to help out with her, even though his mother is older and has arthritis she is fine overall. He goes bowling twice a week with his friends and she stays there at the house with his mom. He likes to gamble(his money not hers) so he takes my MIL to the casino with him about twice a week sometimes maybe more.
We know that staying with him is not the best placement for her for a number of reasons. She is not eating as she has lost about 25 lbs since February (he says she doesn’t want to eat or just wants snacks) he has stairs at his house, she has no mental stimulation while being with him, and honestly he doesn’t want her around.
My husband and I have toured a few assisted living facilities that are closer to us (she lives about 45 min-1 hr from us now). She isn’t going to want to leave him as he is her safety net in her mind. My question is how do we place her in the ASL/memory care without her getting depressed or withdrawn? Do we wait until he says he has enough of dealing with her and he somewhat tells her she has to go somewhere else? My husband is the only child, his father passed away 30 years ago. His mother stopped communicating with her family so we are all she has to make this decision.
1. If she ends up in the hospital for ANY reason, this is your opportunity to take her straight to AL/MC. You can just tell her that she cannot be alone at home anymore and she needs to be somewhere where people can assist her. Obviously you'd need to do the research to pick out the location in advance and just have this as a back up plan that's on ready, in case this happens.
2. Keep following up with the neurologist, as well as picking out a AL/MC place. My mother REFUSED to move anywhere and couldn't remember her diagnosis/what is denial about it. I did a bunch of research and choice a AL/MC place. These places generally have staff on hand that can really assist you in these situations in helping get your relative in there, especially if it's a memory care placement.
In my mom's case, I made a follow up appointment for neurology. I wrote up a letter basically BEGGING the neurologist to talk to her incensantly about how she could not be alone at home, that it was dangerous, and that she had to move. We spent a 1/2 hr easily having the same cyclical converstation with her until we could get it in her head. Then I took her to get a quick burger at her favorite place followed by a planned out visit to AL/MC. We met under the guise of just checking out the facility, but ultimately they were doing an assessment on her. If she truly has dementia, the assessment will show this, and they will need to take her. This is basically what happened in our situation. Now she's in lock down MC and it's the best thing in the world for her and me.
I wish you all the best with however it unfolds!
I couldn't answer your question directly, so I'll repeat it here:
do you think that us or her bf telling her she is going to a facility to help her memory would convince her to try it out?
I think that getting everyone on the same page & presenting a united front will be a big help. I know there's the issue between your husband & her bf, & your husband & his mother, but it's more important to get your MIL to a safe place.
Does your MIL acknowledge she has memory problems? If she thinks she doesn't, then what you say could fall on deaf ears, but if you plant the seed incrementally, it might help. You could tell her they have therapy that can help her with memory issues, so that when she gets better, she can come back home. Approaching the facility as a trial or temporary solution could be a way to ease into it.
Try to say something that your MIL can relate to. It won't help to overwhelm her with too many facts or facts she can't understand.
When my LO was in the hospital waiting to be transferred to hospice by ambulance, I tried to explain what was happening. He thought he was going home, & then he couldn't understand why he couldn't, & then he wanted to know why it was taking so long & when could he get dressed. After a while, I told him a couple guys were bringing his clothes. They were coming to pick him up in the truck, but they were stuck in traffic. I hate to lie, but he was able to wrap his head around those simple, concrete things. By the time the ambulance came, he had gotten a pain shot, so he was somewhat sedated, & later, I don't think he realized he was in another facility.
btw - he wasn't easy with everything. He had a mild objection to getting a caregiver at home, but when I had to get an overnight caregiver so I could sleep in another room, he had a tantrum - separation anxiety, I guess. He told me he hated me, to get of the room, the house, & more. The caregiver was coaching me as this went on. She told me to speak calmly & slowly, step away in case he tried to hit me, & don't try to explain. So I agreed with him. I said I was sorry, I'd do better, & I left the room. Of course he called me back, & it started again. I repeated what I said & left him to the caregiver. I didn't take it personally b/c I knew it was dementia talking, & he didn't remember it the next day. He thought he slept all night.
Dementia can make people say & do terrible things, but they can't help it. Your MIL knows something wrong, & it scares her. Refusing Aricept - which could help symptoms - somehow gives her some control. She may have tantrums, if she hasn't already. You can't stop that, but you can control your reaction.
Take a deep breath.
Be calm.
Be firm.
Be kind.
It's not easy.
If the MD put mom on aricept where is the diagnosis?
What is the diagnosis?
Who is the POA, boyfriend or you?
If there IS now a diagnosis of Mom's incompetency then it is too late for her to make out medical POA or financial POA and someone will need to do guardianship. That may be you if her SO doesn't wish to do it.
Firstly and most importantly is the diagnosis. Was it done by neuro-pscy. If not both you and BF toGETHER need to sit down and say this is crucial.
As to aricept and whether she takes it, there is no know treatment or cure of alzeheimer's so I am much less worried about that.
Mom may need guardianship if she is too demented now to assign a POA and that is up for an examining attorney to discuss here.
Until there is a hard and fast DIAGNOSIS of dementia and until there is a POA no one can tell Mom to do anything she doesn't wish to do, and it would be a waste of breath to do so.
I sure wish you luck. Sounds like this has been left a bit long and I can't actually even now decide what diagnosis Mom has/has had made.
So step one is the diagnosis. If there isn't one you are powerless. Step 1A is if there isn't a diagnosis you need POA so that when this comes to worst case screnario someone can act on Mom's behalf.
My SO was dependent on me. He also sang my praises, & when he slipped into dementia he became extremely clingy - he panicked if I wasn't in sight. You MIL seems to be exhibiting this behavior. Near the end, my SO also got confused & began blaming me for whatever was going on with his mind/body.
Any transition will be difficult, but it has to be done because her BF isn't equipped to care for her, nor should he be required to. I don't think that making him the bad guy is a good idea. When I had to do something my SO didn't like (getting a home health aid, going to the ER, or staying in the hospital, for ex.), I told him the dr. said he had to do it, or it was doctor's orders. A doctor holds a position of authority, so he accepted that, rather than raising objections to me. At first, I told him getting a home health aid was to help me. You don't have the same situation, but the point is that I tried to give him a reason that wouldn't create a negative emotional response in him. Telling your MIL that her BF wanted her out will an unpleasant scene, & will not be forgotten, even with dementia.
The fall could certainly accelerate any cognitive difficulty, or it could be temporary. My SO fell & hit his head a few years ago & had issues for months. But at this point it doesn't matter with your MIL. You recognize that she needs care. That she stays with her BF makes it complicated. So does her refusal to take Aricept. You need to get her on board with that or talk to her doctor about that.
Good luck. It won't be easy. She's lucky to have you.
do you think that us or her bf telling her she is going to a facility to help her memory would convince her to try it out?
If he is okay with her being there, let it go and do the waiting game. Tell him that he has to be the one that tells her she has to leave but, he needs to give you enough time beforehand to get a facility lined up.
If his mom is okay, then I wouldn't worry about the what ifs. She (BFs mom) can call 911 in the event something happens and he's not there.
Intervention is not always the best course. They are making it work for now. Be thankful and prepared for the day it no longer works. Because the only thing certain about dementia, is the uncertainty.
Her BF should not be leaving her home alone and either should you. Dementia is very unpredictable. You never know what they will do next. He probably likes Mom there because it gives him a chance to get out of the house. Moms obsession with him is probably the Dementia.
"Donepezil/Aricept is used to treat confusion (dementia) related to Alzheimer's disease. It does not cure Alzheimer's disease, but it may improve memory, awareness, and the ability to function. This medication is an enzyme blocker that works by restoring the balance of natural substances (neurotransmitters) in the brain."
In the early stages this drug may help but there comes a point after the desease progresses that it doesn't do anything. So IMO if Mom does not want to take it, thats OK.