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When I tell her that I was just there an hour ago, she gets upset that she doesn't remember. Which is more distressing for dementia patient in assisted living?

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I think the most distressing thing for anybody would be to feel abandoned. I would do everything I could to assure your loved one that she is loved and cared for -- short of arguing with her about her memories.

My sibs and I visited our motherly several times a week. She enjoyed the visits while we were there but she didn't always remember them. We tried to reinforce the awareness that we cared and we came often. I learned that if I asked "Was Ray here last weekend?" I sometimes got a confused look and sometimes a tentative "Yes, I think so." So I switched to saying, "I heard that Ray was here last weekend. I know he likes to come as often as he can. I suppose you played cards." I'd also say things like "I see you have new magazines. I know Rita brings them to you." And the staff helped by often saying, "You are so lucky, Jean, to have your children visit so often!"

Sometimes we'd write on her whiteboard.

I wouldn't want to argue about whether someone was there an hour ago, but I would casually and frequently remind her that you come a lot, and others do, too (if that is true.)

My mom knew she had memory problems. We'd reassure her that it didn't matter -- she would be taken care of. "It doesn't matter if you don't remember lunch, Ma. We are so glad you are in a nice place where helpers bring you to the dining room for every meal. You don't have to remember, they'll help you." And, "Ma, it doesn't matter if you can't remember that Sue was here yesterday. We all come and enjoy being with you. It is OK if you don't always remember."
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I think that is the best you can do, Mjlarkan. When our loved ones have memory loss or dementia or mental illness issues, we cannot make their world perfect; we cannot fix everything. Just keep doing the best you can.
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What usually helps is to have something up on the wall - either photos of people the patient would remember from a long time back, or family. Places usually mean less than people. And also have a whiteboard or corkboard where you can put up different pictures or messages and swap them around when you visit. Also leave kind messages on pieces of paper in any pile of papers the patient has around.
My Alzheimer's friend used to be a secretary and is manic about filing papers, opening up every folded paper to read it before putting it back into the pile, left tidily in a new position. So one cheerful message or greetings card will last for weeks or months. She reads it as though it has just arrived.
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Sorry I meant to add that it is often an effort for Alz. patients to remember visits, because that is coupled with effort to remember what was said or done. That means stress, to be avoided. So when visiting my friend, I only say "do you remember xx or yyy" when pointing to a picture or photo on her wall, and if this doesn't trigger anything, I just make up a story. As she doesn't retain any new information longer than 2 minutes max, I think of her as living in the moment. One day she won't remember who I am, although I have been caring for her for 10 years, but I've already decided that that won't matter. As long as she smiles when seeing me, that is enough.
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My cousin used to beg me to come and see her in AL, as if she hadn't seem me in days, when in fact, I had only left an hour earlier. She had no short term memory, so I just started saying that I would come as soon as I got off work. She would forget that too within minutes.

I just had to deal with the moment we were speaking to assure her. When the short term memory goes, no amount of reminding is sufficient.

Now, her short term memory is even worse, yet, I still call her in between visits to chat and ask her if she needs me to bring her anything. She always says no, but, I still bring her favorite treats, which she loves. I think she's forgotten what her treats are, until she sees them or I bring it up.

I know she can't recall the phone call, but, for that one minute, I know that she's smiling and being told that she is loved. She says it back too, so, I think there is something positive from it.
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Sing for her and hold her hand. Music and touch are deeply embedded memories.
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My dear Dad used to ask me how I'd managed to find him. I assured him I would always be able to find him, and even if he was sleeping, I'd look in on him and come and hold his hand. Staying calm and giving a loving answer may help reassure your Mum in her moments of doubt.
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You might buy a copy of "The Runaway Bunny: by Margaret Wise Brown" and read to her every time you visit. It may get lost in the NH, so keep it and bring it every time you visit.

I remember seeing the movie "Wit" in which Emma Thompson plays an English prof. who has ovarian cancer, and late in the movie, when she's dying, the only visitor she receives in the hospital is her former graduate school professor who reads her excerpts from "The Runaway Bunny". At that time, she is nearing death and is pretty much out of it. So I've always wanted it read to me on my deathbed (how morbid), but it seems like it'd be a reassuring thing to read anyway.

Just a suggestion.
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Again, thank you. I am just sad tonight. No real reason. I know better than to second guess myself.
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You are wonderful to visit everyday - I work long hours and can only make it 3-4 x a week but I try to have personal caregivers there everyday for 4 hours so she can have some one on one attention - a dear friend visits weekly as does our housekeeper - doesn't make up for her other kids and grandkids ignoring her but it's way more than most who have no one
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