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snooky48 Asked May 2011

A friend told me my mother has what's called "failure to thrive"; would moving her to a nursing home be the right choice?

The doctor says there is very little physically wrong with her other than slightly high blood pressure and fluid retention, but she has does have dementia. I had to take her from her apartment into my home because she was falling and not able to care for herself in general. She didn't want to comb her hair or wash, and the apartment smelled strongly of urine. I was meeting all her needs (shopping, cleaning, washing clothers, etc.) She did not want to go out or do anything, and she wasn't eating properly. Since she's been living with me, she's eating better and she's clean, but she's extremely apathetic and still doesn't want to go out or do anything more strenuous than watch TV in bed. I've gotten her a word search book, but she no longer can do it or even use the phone. I have companions come in 21 hours a week, and that helps give her some social time. Due to the dementia, she thinks my adult daughter has stolen from her, and has cut off ties to her and my granddaughter. She was blunt, somewhat cold and could be difficult even in the best of times, so there are no other people that want to visit her, leaving only me. We were never really close, so I find it hard to be close to her now in this situation. I'm a very good caregiver, so her physical needs are more than met, but I really don't know what to do with her on an emotional level. It seems that she has no interest in talking or interacting with me, and comes out of her room mostly when my husband and I leave the house. My friend works in a local facility that's has assisted living, nursing home, hospice, etc. and keeps suggesting that this would be a good idea for my mother because of the activities and socialization. I had never heard of failure to thrive, but it seems as if that might be what's happening. My mother was a very independant person, and now that she's dependant on me, it's like she's just given up. Would anyone have any ideas about this. Even though we don't have the typical mother/daughter relationship, my mother was a good responsible parent and raised me to the best of her ability. I want to do what's best for her, so the thought of her wasting away in her bedroom scares me. Would a high quality facility like the one my friend works at be a good idea?

EXPERT Carol Bradley Bursack, CDSGF May 2011
I think your friend has a very good point. Your mother isn't doing well now, and you are doing all you can and even more than most people would. The social atmosphere, plus the absence of the family dynamic (considering her past behavior) may have a positive effect on her. She could be suffering from depression, as well. I do know this - when my mother-in-law moved into a local nursing home she totally turned around, and she did thrive. She loved it.
Good luck. I know it's a hard decision. But you deserve a life, too. And she may do better in a group setting.
Carol

Marcella59 May 2011
My mother was acting the same way. Have little routines for her. This keeps her feeling safe. Also, speak slow and in a soothing tone. Sometimes a nursing home can turn them around and sometimes they get worse. Try some interaction with the family maybe Bingo. This way she will start to feel that she fits in. I ask her input about things. This makes her feel important. You sound like a fantastic daughter.

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debmcd1256 May 2011
You seem to have a very good perspective of what is going on. That is often hard to do in these situaitons. I am in a situation with alot of similarities. I think one of the first things is for her to be evaluated for depression. When my mom first came to live with me I noticed alot of the same things you described. Her neurologist insisted she be evaluated by a geriactric psychiatrist. The outcome was the she was severely depressed, even suicidal. With minimum meds and some counseling sessions she is much better now. The other side is if this is a progression of her dementia. That sort of progression might indicate Alzheimer's. Has that ever been a discussion? I do think you owe it to everyone including yourself to look at the facility. While you may be quite able to provide the physical care, it can become a real burden. I am 3 1/2 years into this and while I really want my mom cared for I have missed alot in the last years. I always know that I can handle a day at a time but as they have added up, I resent the cost. You need to look at the big picture, 6months/5 years. I hope you find some answers.

careshare May 2011
Snooky, My father had frontal temporal lobe dementia and lost interest in everything, lost his ability to recall words and so he couldn't communicate well. Incontinence, apathy and weakness was the first stage. (Although he didn't have any paranoia)
I think your mom could definitely use an antidepressant. It might take a little time to find one that works without side effects.
I think it would be helpful for her to go to Assisted Living or NH, however, please don't regret your decision if she doesn't thrive, it could very well just be the progression of her disease.

yellowfeever May 2011
I too have similar situation with my mom. Mom does take antidepressants. However, being with my mother for the last 2yrs I notice more and more the dementia progression. I feel bad saying this but she has returned to infant like state. I do EVERYTHING for her now. She can barely walk or feed herself and is incontientent the whole way around. I was told about Dementia Hospice and failure to thrive. I did some research on the web about the criteria and right now my mother fits it. Hospice states that they must have 6 months or less to live. If I wouldn't be here with mom she wouldn't make it a month or at least 2. Her doctor however won't sign off on the evaluation for the Hospice though but thats another story.
Anyways, if your mom fits the criteria for dementia hospice she would have access to nurses and aides that will come to the house. If you still want to keep her at home. They will make her comfortable. Medicare will pay for it if she qualifies. I read on the internet that alot of people are unaware including drs that you can get Hospice if you have Dementia. Maybe with some research that could be an option for your mom as long as you can get her doctor on same page.
My heart breaks for my mom, even though we was never close. No matter what happened in the past I am her daughter and she is my mother. Its up to me to be her advocate and get her the best care I can. I haven't made peace yet with the thought of moving her to a nursing home. I want mom to stay here as long as she is medically able, but the days are getting harder.
I hope you get some good suggestions that will work for you and her. Good luck!!

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