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My mother in law suffers from dementia and has lived with us for over ten years. We have seen a progressive decline in her abilities to manage on her own. Her short term memory is all but gone. She remembers things from the distant past,but anything from say the last twenty years is gone. Some of the behaviors we have seen are constant pacing,inability to focus on even simple things,loss of any semblance of hygiene unless we are right there to remind her,repeating the same questions over and over,constant eating because she can't remember that she just ate,etc. We have her going to adult day care three days a week and the other days my wife watches her. Yesterday my wife went out to walk the dog while I was cleaning the driveway from the last snow. I hear a noise and see my mother il law opening the door. I ask her what she is doing and she replies she is going to look for Cynthia. Cynthia is my wife. Mind you she has no idea where Cynthia is. Last night my wife's work schedule changed which threw my MIL all out of sorts. I had to have my wife call and tell her where she was. Five minutes later it is back to the same topic. It started at three in the afternoon. She decided she wanted to eat dinner. I told her that we wouldn't be eating dinner for a couple of hours,but that she could have something in the interim. She had cake,a muffin,and a bunch of chocolates. This morning I heard her up pacing the house at four thirty. She was in the kitchen trying to turn on the stove. She had a coffee mug full of water. I said to her put it in the microwave for two minutes. She had no understanding of what I was telling her. Later this morning my wife caught her trying to put a mug of water in the toaster oven. She caught it before she turned it on,but is these things that have us worried. She will not sit still and just paces always ending in the kitchen where she starts getting into things,trying to turn on the oven,toaster,or microwave. We are afraid she will forget that the oven is on and something will catch fire. We have found the oven on before with her nowhere in sight and claiming to know nothing about it. Her leaving the house in search of my wife has happened a couple of times. Last night because my wife had to work my MIL paced even more constantly searching for my wife's car. I told her on more than one occasion that my wife was working. It didn't help. I guess where I am leading is if we turn our back for a minute she is into things. My MIL is up at all hours of the night and doesn't go to bed until seven thirty in the evening. Even then she still gets up claiming she hasn't had dinner. We are frazzled.

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Your welcome, JimL. This is difficult so please keep coming back to remind yourself that you're not alone.
Carol
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Thank you Carol.
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I agree that you've done all you can and it's time for help. For your mother-in-law's safety and your sanity she needs 24/7 supervision. Likely a memory care unit. A neurologist can help determine if this is correct, but it does sound like time. No guilt - promise? You have done so much and we all have limits. You are considering her safety and well being.
Take care,
Carol
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Thank you all for your thoughtful answers. My wife and her brother do have power of attorney all set up. We as many of you are responsible for our loved ones care everyday. We have not had a break for a long time. Last night for the first time in months we went to a movie. My MIL went to bed after dinner and my son was home with our grandson so there was someone there to watch if she awoke. The issues in the kitchen are a problem. My MIL is obsessed with the kitchen. When she starts pacing it is from her room to the kitchen. If there is anything near the sink she immediately goes there. Because of the hygiene issues we don't want her there,but if I or my wife turn our back for a moment that is where she is. We have tried redirecting her to another activity,but her focus is so brief she is right back to the kitchen. I am in agreement that she should be in a center. My wife continues to hope she can keep her in our home. I plan to speak this week with the head person of a facility here that My MIL goes to three days a week and get perspective on what they are seeing .
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Riveroaks514, I didn't respond to your question & I just read the whole comment so I wanted to give you some feedback. Your mom sounds a lot like mine would be if it weren't for my dad being there for her. At least until his dementia started. She has become antisocial, had no friends, couldn't participate in the group activities she used to, and didn't have her own hobbies anymore except for reading, TV and doing crosswords. She didn't get most days and didn't even get out of bed unless she knew I was coming over. And she was also vehement about not wanting to move to an ALF. My recommendation would be to talk to your local area on aging office (look up 'area on aging' and your county, or call your local senior center or your mom's doctor to ask for a referral), find out what facilities are available in your area, and start visiting them in your own. Pick one to start with and take her there for lunch. She will probably dislike it but a free lunch is a powerful incentive. :)

You didn't mention whether you have a durable power of attorney yet - if you don't, it's a very good idea to get that in place now. Both medical and financial.
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A memory care unit would probably be what she needs. I had to place my mom in a memory care unit in the nursing home. All she wanted to do was pace. At the nursing home she continued to pace everyday until she passed. They had a lot of space to walk. She would not sit still. A memory care has locked doors so you don't have to worry about them leaving. The nursing home was a safe place where she could pace. They also give meals at certain times and help them shower and get dressed. One of the most important things was that they didn't have to say no to her. Here at my home I felt like I was telling her no all the time. Because they are not normal they do not do normal things and you can't expect them too. It was hard for me and I hated that I had to put her in a nursing memory care unit, but at some point you can't control how they think or act. They didn't say no to her in the memory care and let her be who she was.It gets more difficult to take care of them as they progress, especially if they are mobile and pacers.
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Probably the hygiene issues are something that an ALF can handle via services, but I have yet to talk to an ALF that was comfortable with wandering. They uniformly have told me that because they have an unlocked door policy and legally speaking (in my state anyway), they are not allowed to stop someone from leaving the building. Based on your description, though, she might indeed be ready for memory care. Particularly with the stove incident. Unless you can watch her every moment or hire someone to do so, it may be too dangerous to have her continue to live in your home. The advantage of memory care is that the simplicity of life can be very comforting, and isn't really achievable in a home environment.
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My mother has always been very independent, sharp, and drove her car until she was 90. Three years later she is very different. She has several health issues, and uses a walker to ambulate, but she is still unsteady on her feet. She has fallen 4 times in the last 18 months. The most damaging fall was 8 months ago, at home, when she went down in the kitchen while a pot of food burned on the stove. She has no idea what happened, only that she felt herself falling but couldn't stop it. She did not break any bones but tore her rotator cuff. Surgery was not an option. Since then her long term care has paid for in home health care. Aides come twice per day for 2 hours each, but she often sends them away after only 1 hour. She has become a "frequent flier" during the last 3 months, having been admitted to the hospital 3 times, had surgery once, and was sent to rehab for PT and OT. She is stronger now but has little appetite and is still a fall risk. She is certain that she is just fine at home and refuses to entertain any thoughts of moving to an ALF. She wants to stay in her home and continue with the home health aides and therapists. She complains about never seeing friends or going out, but she refuses to go check out the senior center in our area. She was always very social and enjoyed being with people. Now there is always an excuse not to go. I am having trouble discussing even visiting an ALF with her. I feel that she clearly needs to leave her home, that she is no longer safe in it. My entire day is spent worrying about her when I am not actually assisting in some form of care or supervision of services for her. My husband and I cannot plan anything or leave town for any length of time, such as vacation. This does not seem to bother her. She is going downhill rapidly mentally as well. She is unable to make decisions, and I have taken over the financial duties and see to all arrangements for care and maintenance of her aging home as well. I'm frazzled, just as everyone else is. I do not have siblings to share the responsibility. I am ready to make the decision for her, since I do not believe she can see the whole picture, much less desire to see it. How do I convince her that moving to an ALF is best for her health, safety, and well-being? Do I do this slowly or do I just move forward? There is a facility in our area where a good friend of hers lives, and I know that she would enjoy all the activities there, as well as seeing her friend often. She would be safe, receive better nutrition, medical management, and enjoy living again. We would finally have some peace of mind knowing that she is being looked after and cared for appropriately in a safe environment.
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Thank you for the topic I was wondering myself
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Sounds like your wife is in denial of just how bad off her mother is. That is not helping her mother at all.
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While you're looking for a place, I'd suggest taking the knobs off the stove and attach some baby proof door knob covers on your doors. Some microwaves also have door locks. You haven't 'lived' until someone with dementia places aluminum into the microwave. The toaster needs to be off limits. Believe me when I say this, it's impossible to tell anyone what people with dementia can get into until you experience it for yourself.

If your wife isn't telling the doctor about the 'dementia', she isn't doing all she can for her mother. There are tests the doctor can give to see how far along she is, there are medicines that can be given for sleep, for the paranoia that sometimes accompanies this disease, the list goes on. While it's not curable, there are management techniques, if you choose to keep her at home.

My mother ended up in skilled nursing care (nursing home to us old folks) after a fall in the doctor's office. She was taken via ambulance to hospital, then to rehab. I liked the place and discovered there were many activities she seemed to enjoy. She made 'friends' with others. She has her own phone, a little bureau, a television. While she wants to come home, I tell her how nice it is there, how much she likes it there, etc. She seems to accept that. Now instead of losing sleep, I'm somewhat relieved she's in a 'safe' place with a bracelet that triggers an alarm when she decides to get out of bed in the wee hours of the morning to go outside.

I visit her a few times a week. We play Bingo. Tuesday we watched a singer with a bad toupee. She gets her nails done, there's a hairdresser there. There's a dining room, arts and crafts. She complains about the food there, I complain about the food at home. When I leave, I kiss her, tell her I love her, and I'll be back. She doesn't seem to have any sense of time.

My knobs are back on the stove, I can open my doors, and the only person I have to worry about placing aluminum in the microwave is me.
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Jim,
Your mother in law is beyond the care of an assisted living. Her hygiene and wandering are both a problem. No assisted living would take her if she is a wondering threat. That's too much of a liability. Mom need 24/7 care and attendance. Please listen to me and others who have answered your letter. Your wife isn't doing her mother any favors by not telling the Doctor everything he needs for her care. Get going for her own safety.
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^ Wanders off.
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My MIL is in AL. All it is is a small apartment and a staff that helps with baths. You are completely on your own and can come and go. Your MIL needs a NH. It is the best thing for her. (My mother is in a NH.) What happens to the lady if she wonders off, turns on the stove or if she outlives your wife?

You are right to look for some answers, now. Good luck.
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Thank for your answers. They reinforce what I know to be true. My wife would like to keep her mother at home as long as possible, but is beginning to see that the time is now for us to place her in assisted living. My MIL has seen a doctor twice in the last few months. Before they gone I have told my wife she needs to be forthcoming to the doctor. I am not sure why she won't do this. She really doesn't go into all the issues we see on a daily basis and therefore the doctor only goes on what he sees.
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You have done all you can. She needs professional care in a safe professional setting.....a setting where she does not have access to a stove or other potential household hazards.
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Sorry. Past the time!
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It may be passed the time for AL and time for Memory care. You need to have her evaluated by a geriatric psychiatrist to see meds can decrease her agitation and sundowning. It is clearly no longer safe to leave her unsupervised.
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