What are your thoughts and experiences regarding the extent of care for a mom (96) who now needs more care than I can handle?

Thank you all for your input and support. The doctor prescribed calming meds, lowest dose and it has worked somewhat, but may need tweaking as she still gets argumentative with her aides. We have a follow-up in 10 days.
Hugs to all

From your comments, IMHO the stage will not pass as you stated it has become more combative and aggressive. The same happened to me with my dad. I had hoped for the best, but then the punches began. While I am in no way saying your mom will actually start throwing punches, I am saying it is most likely time to start seeking an alternate plan for her care. You have provided a wonderful environment for your mom to this point. But, as I see it you are heading towards a 24/7 care provider in a no window situation for you and your husband.
Juse in case this crosses your mind, you are not a failure for seeking professional help such as AL or full-time care. You are doing what you should be doing in order to do what is BEST for your MOM.

You seem to have worked through all the stages that it is reasonable and loving to accommodate at home. Now the loving and caring thing to do is to let her live somewhere that has more ability to cater for her needs. It isn't that you can't do it, it is that you rightly have your husband to think of and cannot be 24/7 7/7. Find a memory care facility that you are happy with and let them provide the round the clock care so you can visit as a daughter not as a stressed carer. You have done a wonderful job of caring so far, now you need some help from experienced people, and are making a caring decision.

Smschaff34: Sadly, Alzheimer's does not improve. It would be wise to have your mother move into an MC facility in the not too distant future or at least plan accordingly.

Dementia usually reaches a point where the behaviors become unmanageable for us to deal with at home. If meds aren't helping your mom, then I suggest you look around at Memory Care ALFs in your area.

My mother is 94.5 and has been living in a Memory Care ALF since June of 2019. The team takes wonderful care of her and my DH and I always say that her life has been extended because of their immediate reaction to health issues. She has activities and 3 hot meals a day, and gets to socialize with the other 20 residents which she enjoys. She has no issues with the caregivers, and they love her to death. With me she's angry and combative, which is typical of a dementia patient: they act out with relatives and loved ones and tend to exhibit exemplary behavior with carers who aren't related to them. My DH and I go visit her on the weekends and I speak with her daily. It works for all of us, and our marriage isn't stressed to the gills in the process (nor is the majority of my sanity). Not everyone wants to subject themselves to demented elderly behavior in their homes day in and day out, and that's fine. There is no shame in placing a parent in a good Memory Care ALF where they are safe and well cared for.

For what it's worth, I've witnessed my mother's decline on a regular basis for the past 5 years since she was diagnosed with progressive dementia. She's never gotten 'better', only worse with time and as the condition progresses.

Wishing you the best of luck coming up with a solution that works for YOU as well as for your mother. Everyone's wellbeing is important here, not just hers.

I have to add this to my answer, after reading others before me...DO NOT LET ANYONE GIVE her Seroquel (anti psychotic), since when my mom was on hospice (in the nursing facility), my sister found that you should not give it to elderly or dementia patients. My mother had a stroke from it, and when she couldn't move (or talk, or swallow) anymore, we said our goodbyes and she died the next day. The hospice nurse (and her boss) were fired, but my Mom already had the stroke.

Sounds like what happened to my 90 year old mom. When she couldn't live on her own, she was going to be placed near my sister. On the interview she became combative (within a few seconds), mad look in her eyes, like Jekyl and Hyde...I once had to hold her down in bed, since she wanted to leave the house. The next morning, she said this strong stranger was holding her down. We eventually placed her in a county nursing home (excellent) near my brother & I. After a week of observation, she was placed in their memory care, and said she had "Sundowner's Syndrome." It usually happens in late afternoon, when they turn into a complete, malicious stranger! I visited her every weekday, my brother on the weekends, and my mother only wanted to go home, but we convinced her that this way we can see her (she lived in different state). Your mom needs a qualified healthcare facility that handles memory care patients. (They know the stages). She eventually went on Medicaid. My Mom lived there for 4 years...they had parties, live bands, bingo, movies, fresh food, picnics, BBQs, and excellent 24 hour care. We were very fortunate to find that county facility in NJ. I hope you can find the same for your Mom (check them out first), and wish all of you the best of health.

Things will only get worse. I would look into a facility for her. She has had a long life so now you need your life.

She is sick, stubborn, old and has dementia - I personally would never ever under any circumstances allow this behavior and have it affect me negatively. I would place her at once as I would not want my life destroyed because of her attitude.

It can be a stage if you work through it with behavioral and medical changes. Believe me, there are things you have to learn to deal with when they come up. This is one of them. Many people give up and quit rather than find the way through it. This could be a stage requiring a 1/2 mg of Lorazepam. You should tackle it both ways. A third thing and the most important is to give your loved one a health food regimen that fights inflammation of the brain. That means you have to study about brain inflammation. I have never had a health food anti-inflammatory that interfered with Alzheimer's meds. And the results I have achieved are considered a turnaround. I removed my mom from all her lorazepam and half her aricept by treating her brain inflammation. Most people don't have the brains or guts to try it.

I find it better to not worry about wiping her hands off. It isn't going to kill her to have a little grease on her hands.

You never know where their brain is and they always need to know what's going to happen before it does.
Next time ask her if she would like something to wipe her hands.

My 96 yr old Dad is always asking for something to wipe his hands and face but he absolutely hates the wet wipes. He likes using a sift face cloth. Hands towel or a handkerchief.
You might just hire some Caregiver help to allow you to get some free time.
Your mom won't be happy in a Senior Facility and they are always understaffed.

They also tend to over medicate, leaving the patients more like a zombie but it makes their work and care easier.
Patient's also tend to loose their will to live once being put away.
Hope you can work things out with your mom and she can live her remaining life at home.

Prayers

Usually combativeness is a sign of anxiety and frustration. Talk to her doctor about getting a mild anti-anxiety medication to use daily. It will make her a bit sleepier until she gets used to it. Also make sure to keep her routine and environment consistent since that repetition helps folks with dementia to function better. Always be slow, patient, and explain before touching her since she may not understand what you are doing.

Usually when there is a change in our Loved Ones behavior something else is going on. Your mom is just not going to tell you, and perhaps she does not understand or is afraid to let you know. Sometimes as Alzheimer’s and dementia become worse we ignore problems or we do not know how or what to do. Oh you do not need to rush and take mom to a doctor, but the situation will either get worse or suddenly she will just shut down. A mom event will occur that will take you and your family to another place.

God bless you. Ten years! Chances are that this behavior will accelerate. Also, some facilities will not accept a patient that is aggressive or combative, so definitely get ahead of this situation with appropriate meds. My 90 year old Mom was always paranoid, mercurial and aggressive but Alzheimer's made her murderous (wanted to slit my father's throat and mine if there wouldn't be repercussions, screamed and spat in our faces for days). She is on a combo of Seroquel (anti psychotic) and Lexapro (an anti-depressant). Stunning difference. I now see the Mom she could have been years ago and she charms everyone. I Just put her in a nursing home after three major falls and the caveats for admission included being non combative.

Unfortunately, it's a stage that many seniors go through with this disease. It can last a long time.

The immediate solution is to have her physician prescribe some medication - if she will even agree to take it! (It may or may not work.)

You may recall the story of the singer Glen Campbell, who developed Alzheimer's disease. He was a physically strong man otherwise and became combative with the disease. There were 5 family members, rotating shifts, trying to take care of him. It became dangerous for them to continue to try to care for him. So, they had no choice but to place him in a memory care unit.

You stated that this was your "tipping point." It sounds like a different care arrangement is needed now.

If your mom has vascular dementia there are periods where they can suddenly step down and the behavior changes suddenly and sometimes dramatically. My dad had this type of dementia and once when he lived in the NH he became very combative, striking out and hurting the staff. The doctor prescribed tegretol. Also Depakote can help. Definitely seems she needs something

Getting mom to a good geriatric psychiatrist may result in a prescription that will alleviate your mom's perception/delusion that she is under attack.

You don't need to know the names of the meds to ask for; just get her to a good geriatric psychiatrist and describe what you are seeing.

And no, not "drugging her into a stupor". Giving her brain the chemicals it has stopped making.

10 years Caregiving, job done brilliantly WELL DONE I say!

⚠️ Trickier times ahead. Time to re-assess the plan..

Short-term plans:
* UTI? if so - antibiotics
* Meds for 'mood'?

Longer term plans?
What is acceptable to you?
What are Mom's values?
What is affordable?
What is available?
At what point does the tipping point between 'caring at home' become just too burdensome or dangerous?

(((Hugs))) to you for the process of change that has started.

Thank you for you suggestion on calming medication. Would you happen to know the name?

I read through your previous posts. You have 3 or 4 brothers, yet you are the one who's taken care of your mother. You have done enough! Time to place her! Good to read that you know about the spend-down for Medicaid eligibility.

It would be helpful to know the actual timeframe when you say she went "from 0-60" because when a behavior or cognitive change happens in the elderly "suddenly" it can often signal a UTI. Elderly women are extremely susceptible to them, no matter how good their hygiene is as there are other factors that can cause one, and they often have no other physical symptoms except the behavior change. Sometimes they will have a fever. If I were in your shoes I'd take her to Urgent Care to just discount that this is possible cause. If it is a UTI it can be treated with antibiotics and her behavior will improve. If untreated it can turn into sepsis, which would be life threatening. If it isn't a UTI then you can call to discuss with her doctor if you think medications are an option to keep her more calm.

Sorry to hear what you're going through.
My sister cares for my mother and told me she asked the doctor for calming medication when my mother began having episodes of hitting and swearing. I initially objected but now see how it's needed after I had my mother stay over for "one" night. I decided not to give it to her because I didn't want her drugged. Well, that turned out to be a big mistake! The medication really works! It calms her and doesn't make her sleepy. It's an option.

P.S. Memory care isn't a terrible option either.