We are trying to keep my MIL with moderate dementia in her own house as long as possible. We monitor her on security cameras as she refuses to wear a fall alarm. It is not a good solution, but she is super stubborn and fights almost everything we do. What are we supposed to do? Staple the alarm to her? We cannot force her into a care facility. Her PCP says she should be in one.
A new problem we have encountered is meals. We had been stocking her freezer with frozen meals (Marie Calendar, etc.) and her fridge with deli items, grab and eat and things I had cooked as she hasn't cooked in the last two years. I found a freezer meal in her microwave Friday. It was still there Sunday. What is she doing with food? We can't tell what she eats and what she throws away.
I tried something new. I pulled granola and cereal bars out of their boxes and put them into a basket as she was not eating them out of the boxes. That seems to interest her more and signal FOOD. I had been leaving each food item I had prepared in a plastic container with a red lid in her fridge. Recently, those don't seem to have been opened. This week I have tried plating her food into meals on divided plates with clear covers. My husband say he observed her taking a bite or two out of each of the six meals I had plated yesterday. She lives 3 miles away and we are newly retired, so running food over two or three times a week is not an issue. How can we do better on her being able to recognize and access meals? We don't do going over for every meal. Living with us is a no go. We do have our boundaries too.
We know that some type of care facility is in her near future. We know we are only playing a delay game to make her remaining time a pleasant as possible. Her doctor is arranging a visiting nurse to help with things she won't let us do like personal care and bathing.
Do whatever it takes to get her transitioned. It may require a call to APS if no one is her PoA or legal guardian. Or, a trip to the ER where it may be possible to work with their social worker to get her directly admitted to a facility.
I do not know why people keep saying it is unpleasant, my mother has made new friends her own age, bus trips, activities. Being alone, eating alone is not the answer.
Take a good long look from the outside, this is not about what your needs are, what you want to do....it is about what is best for her, it is always better to do this before it becomes an absolute necessity, they adjust much better.
Might be time to reframe your thinking.
You say in your post you can not "force her into a care facility"
Why not?
Is your husband POA? If not who is? The POA is the one that makes the decision that can place her in Memory Care or not. Particularly since her PCP states that she should be in Memory Care.
Actually if anything happens to her while she is living alone there is the very slight possibility that APS may be contacted as it might be considered "neglect".
Unless you or someone else is going to be there with her for meals there is no way that you can be assured that she is going to eat.
That is the least of the potential problems.
What if she goes to get the mail...and decides to take a walk...and gets lost.
What if she leaves the water running ... how soon would it be before you discovered the flood?
Is it possible that she could leave the stove on or have you disabled it?
I would be very uncomfortable allowing her to continue to live alone.
We do have POA and healthcare POA.
As far as wandering, she is unable to walk very far because of arthritis. So that keeps her home.
She could leave the stove on. We do have cameras that monitor the kitchen. I have not caught her using the stove. She uses mostly the microwave.
I’m not going to go into ideas for meals, I’m sure others will.
But here’s what I want you & hubs to pause & seriously, SERIOUSLY, think about: what if there is a fire? Do you really want her putting something in the micro and setting the dial on till forever and having a fire happen? Do you actually want her reheating food on the stove? Even if she has an induction cooktop, there still is burn risk. Do you think she has the ability to tell if a food is safe to eat? I’d be really concerned about this, especially in the current heat wave across the US. The way you describe her, she does is not seem competent or cognitive enough to safely be able to live on her own and be able to judge if something is an issue or an emergency.
Did her MD tell you she needed a skilled nursing facility aka a NH or did he/she leave it more open ended? If so, please have her get a needs assessment done. It’s usually Where a duet of RN and SW come to her home to talk with her and observe her to see what her abilities are so that they can recommend what level of care she needs. You don’t want to be wasting time and energy looking at AL or MC when it’s a NH that she most definitely needs to be in.
Sometimes IL or AL type of facilities will do “play dates” rather than a required outside assessment. My moms did: we went for a tour and lunch, they had her eat at the residents table and then she went off to participate in a regularly scheduled residents activity (maybe arts & crafts, or gardening) that’s interactive. All done to see if she “fit” in for ADL & social level somewhat expected. Mom even tho in her 90’s was good for IL. FWIW the IL had regular fire drills and if a resident could not do them (the big fail was waiting for elevators), the resident got a 30 day notice they needed to move to higher level of care. Fortunately my mom aced the fire drills, her final straw to go from IL to NH were wandering hallways at night and imaginary animals.
I’d also be really concerned about MiLs dehydration. If she doesn’t understand eating, I bet she’s not drinking enough fresh water. If she gets confused and goes outside in current heat wave, it’s really a health concern if not a crisis for folks. One advantage should this happen, is that she will be taken via EMS to the ER/ED and it is a way to get her out of her home permanently so instead of returning her back to her home she goes into a facility. Just sayin’….
Her PCP ordered home health care. He feels it will be better for an incident to move her from the ER to a facility.
We are aware that there are risks to leaving her in her home.
I can't even get to her a beauty shop. I don't know how I can get her to look at AL.
We tried to get her to agree to look at AL two years ago. She adamantly refused.
We think she would prefer to die in a house fire, awful as that sounds. She insists she will not leave home, that she wants to die there.
The kicker: she was once a discharge planning nurse. She put people into NH.
But it won’t. Mom can’t handle living alone at home anymore! One suggestion might work fine for a week or two, and then something worse happens like she’s peeing in the corner of her room because she can’t remember what the toilet is for. And she’s still forgetting to eat and take her meds. And so on.
She has a serious illness that will eventually kill her. In the meantime, she’s engaging in harmful behaviors and being enabled by her loving family.
Take off the blinders and stop looking for hope because that’s holding up finding a place where this poor sick woman can be cared for 24/7.
I see you are checking off all the boxes.
PCP care plan with HHC on the way. Cameras, Legal Advice, Boundaries…
Good for you.
Re: Food
What I learned along the way is make it easy for them to see what is available.
Make it attractive. Cut sandwiches in four neat squares. Or strips or triangles. If you use the divided containers you can put a couple of sides like apple slices with peanut butter or a little box of raisins or a scoop of pasta or fruit salad. A small piece of chocolate. or a few kisses if she likes chocolate.
Don’t put too much in the fridge at once. It is overwhelming to them. Puddings, fruit cups, sandwiches, deviled eggs, cheese sticks, etc all can be placed in a dish with clear plastic on top or in a baggy. Easy to see what is in it.
You can also put a couple of your red topped containers to see if she is curious enough to open. She probably won’t remember what you tell her is in them. Notice if they are easy for her to open, carry etc.
If you make a batch of dinners ahead of time, put a freezer tape strip on top with the date. This is for you, not her. This way you can quickly discard what is past its date. Store them in a garage fridge or one at your house. When you go over, take just enough in. Put small cups of ice cream in her freezer if she likes ice cream. Aunt loved it but after her dementia advanced, she would forget about it unless a commercial came on for ice cream.
Near where she usually sits, place a protein drink and several small bottles of water with the lid loosened. I usually put 2 or 3 at a time but they were checked daily. If you won’t be back for 3 days, put 6 out. Pay attention to how many are gone. She may drink tap water if that is her habit. Fill a few glasses and put where she will see them.
The chocolate FairLife brand is a good protein drink (30 grams) to try. We need 90 grams of protein a day. Hard to get for most of us. We also need a good deal of fiber 35 grams is my goal. Also hard to get. Read labels. Benefiber is tasteless and no unpleasant texture. Just stir a couple of spoons in her drink when you visit. But don’t give too much fiber if she isn’t drinking enough liquid. A good multi vitamin, Vit D3 and fish oil are all helpful supplements. Vit D can help her mood if she is deficient, most are. She probably is.
Put a lined garbage can near wherever she sits. Pay attention to what is in the garbage. Sometimes you might find things you would rather keep. (teeth, glasses, remote, spoons). Also find those things in her chair, under the bed etc. At min you will know what food she threw away….unless she has a dog she is feeding the food to. That happens.
Put a pretty dish by her chair with spoons. Also have napkins, wipes handy. I kept a bowl of fruit nearby. A couple of bananas, cuties. Someone recently recommended a small frig near where they sit. They are very reasonable these days and she might look in for watermelon or a quick sandwich if it is right there.
I always brought fresh flowers on the regular. Balloons were a treat as well.
If you could find someone who would work a couple of hours each morning it’s the best help. I had to find some one to give thyroid Med before coffee. Hard to hire someone for just one hour. But I found a great lady for two hours. She made a hot breakfast each morning, helped aunt take meds, get dressed, watched out for the dog, interacted with MOW, therapists, home health, ran the vacuum and mopped. We loved her. Later on she worked 3 hours and would get lunch ready before she left. Would come when an antibiotic needed to be given, the plumber was on the way, etc etc.
Take the knobs off the stove and ask home health to bring in a therapist for evaluation. Will help with the arthritis, balance etc.
fridge. Thought that should last 3 to 6 days. Two days later there are
still 6 meals, some with bites missing....I think I need to take them
over 4 or less at a time. She has eaten the strawberries out of them. She also ate the bowl of melon pieces. She ate a bunch of fresh pickled cukes. Would not touch them before I sliced and dressed them although she has salad dressing in her fridge. She had potatoes on her counter for months but didn't do a thing with them. I turned them into mashed potatoes and now she sees them as food. Will just have to see how this develops. Hoping the HHC nurse will be able to asssess the situation better and make recommendations. She snarfs baked goods like cookies and muffins. She is also diabetic, untreated. A1c is 7.9. She denies being diabetic. Denial is so huge.
The second night she was there, she attacked me while I was sleeping. Had no idea that I was her daughter who has been close to her for my entire life. I'm lucky she did not think to use a kitchen knife or something equally as dangerous. It was the single most horrifying situation I've been through. She was delusional and hallucinating. My own beloved mother. I would never wish that on anyone. And getting her into a memory care took a few days. It was awful to have to barricade my bedroom door every night to ensure that there wasn't a repeat of the attack. I was lucky and had scouted out several very nice MC near my home. It helped to already have the contacts and be able to get her someplace that was safe for both of us.
We do not know how our loved ones will react when they have dementia. I had a difficult time believing some of the stories I heard from others until I had to live through a nightmare.
If someone with dementia can get this far with such hallucinations, no telling what the next hallucination would cause him to do, such as harm to someone in the household. Never think it couldn’t happen. They do not and cannot think normally.
I have a Bullet and make yogurt, fruit (incl a couple of prunes) and many other things. If she'll drink it, she'll get lots of nutrition.
I add:
banana
yogurt
piece of ginger root; piece of garlic (you cannot taste it)
Cinnamon - 1 teaspoon
strawberries (I buy from Costo / frozen)
Collogen (powder)
Chia seeds (don't recommend as they can / do get stuck in teeth)
Lion's mane
a bit of almond butter or (raw) almonds
You can try out different things. It all blends although be aware of the crunchy tings like almonds, if she can't chew them up.
Liquid: coconut water, juice, or some kind of milk-like liquid.
You can also freeze juice in an ice cube tray if you want more cold.
And, I make enough for two days. You can put in previous water bottles so keep a few on hand.
Gena / Touch Matters