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She has six children and many grandchildren but very few rarely visit her, much to our frustration. My sister lives with her and cares for her. My mom gets anxious with too many people around but we do want to celebrate her birthday. Any suggestions?

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A slightly different approach would be to make it spectacular but short. We did a 'party' when MIL turned 90. Candles on the table, balloons tied to the chairs, funny hats on everyone. I think we managed sparklers! MIL was brought into the room when it was all happening, and cried with happiness. She said ‘No-one has ever done anything like this for me before’. Everyone sang ‘happy birthday’, lined up to kiss her and then almost everyone left. The exciting bit lasted less than 10 minutes. Photos to remind her. The next bit was very quiet and low key, mostly three of us saying the names of everyone who turned up. It was a Saturday evening, all the younger people were on their way to something else. They were happy to put in a short stint, and in fact helped to get everything in place.
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SparkyY Apr 2019
That almost made me cry. How great that it made her so happy! I there is still a picture at the apartment building of me when I was 18 dancing with Grandma at the birthday party the place had every month for the people with birthdays in that month. It's the same place mom lives now and I'm fifty lol. Unfortunately they don't have the monthly birthday parties anymore.
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If your mother doesn't like many people around, why not just have you and your sister, with her favorite meal or cake. If other family members want they could send cards or gifts for her to open. Or, have them call in their birthday wishes or faceTime them. If you're able, you might make a photo album with lots of photographs from the past. Is she still able to recognize family members? A lot would depend on how much she is able to recognize. With my LO, birthdays were not something she could comprehend. It meant nothing to her, but, she like that we showed up with balloons, festive spirit, ice cream and cake!
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My dad turned 93 last year shortly after going into SNF.

Not terribly clever, but we arranged with the SNF to reserve a sort of party room at the facility, invited his siblings, nephews, other close friends, bought a cake all tht.

I know you said your mom gets nervous with many visitors, but perhaps a few close ones?

While my dad was losing it by then, we wheeled him in and he loved it . You could tell he suddenly came to and recognized people and when they were swapping old stories from the past he didn't necessarily join in but you could tell he was following the conversation and knew what they were talking about (kind of a side, but some of the stories were how hobos wandered by their farm during the depression and my grandma would feed them, and the kids had funny names for all the hobos and how they had favorites)

We sang Happy Birthday and my dad joined in happily, not totally realizing it was him we were singing to. He had a great time, and he died less then two months later, so happier memories on his last birthday.
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NeedHelpWithMom Apr 2019
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My mom is also turning 90. (She said yesterday that she is 47. She said this while looking at me, who she knows is her 70 year old daughter). I am going to bring her from assisted living to my house and make her a nice simple meal, give her presents, let the rest of the family know we are here, and if they want to come, fine. Most won't, so I know she will not be overwhelmed with too much company. I'm sure there will also be a celebration of sorts for her at the assisted living house. She'll be pleased with all this, but will pretend she hates the attention. I will notice the little smile and brightness in her eyes though.

Her sister who lives in another state asked if she should send a card or call. Okay, she asked, so I gave her more suggestions: send a card because my mom no longer knows how to answer her phone, and include a letter about how everyone is and photos that I can talk about with her, especially photos of my cousin's dogs - my cousin lives with my aunt and uncle and always has beautiful dogs. My mom loves dogs and she remembers my cousin when I tell her about the dogs. I really enjoy when memories float back. It may seem to my aunt a lot to ask for, but I've decided that when someone actually steps up enough to enquire about my mom, I'm going to give them a suggestion on how they might help in the smallest way I can think of. Maybe, probably not, but maybe they'll do it and more.
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Short answer:. It doesn't matter she won't remember anyway 😉 lol. Just s little attempt at humor. Maybe to soon? If your mom gets nervous with too many people around then the best birthday you could give her would be a very small one. And don't try to put 90 candles on the cake. I learned that the hard way.
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Good advice from Sunny Girl.  My Mom dosn't even know that it is her B-Day anymore.  And she never believed me when I would tell her how old she was.  I think like a lot of us we never really feel our age!  LOL  Just make her feel really special and compliment her a lot!
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I think the relay idea is best. Get together a list of the people she would like to see, and give them time slots, not too many at once and not too close together.

Have any of the absentees made enquiries about what's happening on their mother's/grandmother's big birthday? I'm wondering if you're safe to assume that they will get their finger out for the occasion, or not so much.

Then cake, balloons, flowers, Champagne if she likes it, you and your sister put on your Sunday best clothes, display her cards nicely, play her all-time favourite music, and away you go. May she have the loveliest day!

[As far as possible don't create extra work for your sister; it would be nice if all she had to do all day was sit by your mother and share. If you can corral willing grandchildren into catering and cleaning up in the background - using your best kind-but-firm aunt technique - so much the better.]
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Ahmijoy Apr 2019
I agree with you, as usual. 😁. The biggest mistake we ever made when my mom was in her facility was to visit her at Christmas, bringing her grandchildren and great grands. There were 7 of us, so not a huge crowd but large enough. I didn’t notice her becoming anxious until she practically jumped out of her chair and headed for my husband, yelling for him to “get out!” She had a fear of men, and even though she recognized him when we came in, she “lost it” somewhere along the way. The following year, I went alone. She had little idea it was her birthday, but it made my heart feel better that I’d acknowledged it.
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I think the relay would be too much. People with Dementia tire out easily. Mom was always ready to leave a place after an hour.

I think a nice party with just you and sister would be enough. Maybe with ur kids attending. Her favorite meal with a cake for dessert. Could have birthday plates and tablecloth.

I would contact everyone by email or a note. Explaining that Moms ALZ has approached the stage where a big party would be too overwhelming for her. That you plan on a small one in her home. That you realize that all can't make it but she can enjoy cards, flowers, a phone call, etc. Even a picture of their families together so she has something to look at daily. You may be surprised, some may want to be there. Keep her in her comfort zone.
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For us, it depended on mother's health and also who was interested in coming.

When Mother (vascular dementia) was in an ALF and more able, we invited family (about 14 people) for her 104th and had snacks, coffee and juice, and an ice cream cake. She recognised everyone and enjoyed it and the bake, though wasn't able to interact. The next year there were only 3 people there, she was more tired, and we just got her an ice cream sundae. For her last birthday, 106th, her dementia was more advanced, she was not happy much of the day, only my sis and I and our partners were there and she had ice cream. Each time we gave her flowers as well. I don't know that the last two years she knew it was her birthday, but it was special for her having close family there and having a treat..

My suggestion would be to have a few people and serve something simple that your mother likes and can manage, give her flowers (if she likes them). It is not about the guests, it is about making your mother feel special.
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I say, keep it about her. My Mom has Alzheimer's also, just turned 87 and was sick that day, throwing up, etc, She didn't even know it was her birthday. It's not about 'us' anymore. It's about them. So, whatever will make her happy? Then do that. Maybe keep it simple? Whatever is best for her.
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