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mtbells Asked December 2018

My LO is 87 yrs old with some type of dementia. She fell and broke her ankle in 3 places and had to have surgery. Am I doing the right thing?

At the time she was living in an Assisted Living Facility and we have since moved her into our home (the facility is a major issue in itself but that is another topic). She requires 24/7 care now. We have a day sitter that stays with her while we work. We did see her on a weekly basis when she did not live with us. We got the phone calls with her crying - saying how lonely she was. Repetitive calls when we made plans because she couldn't remember what we had just told her etc. We knew she was getting was worse but she seemed ok, until I moved in with her. I would advise anyone who has a LO in a Assisted living facility - if they will let you stay overnight for a week to do it at least every 6 months, so that you know what is going on. It also gives you a chance to see how clean the place really is?? With so called light housekeeping twice a week? Our LO can put on the false front, whenever she is with anyone. Her Sunday School class does not think she has any problems.


So my questions are: she seems like she has gone downhill mentally, a lot. She is definitely a little passed the middle stage. Every day we remind her why she has a cast on. She cries whenever, for whatever reason, she is often confused about where she is. Sometimes she thinks it's her house or the facility. She stares off into space. She is no longer interested in reading the paper. Rarely plays on her ipad - solitaire. Definitely has good and bad days. Bad days she cries a lot, she is confused more than usual, looks depressed, is cold a lot (but she's will tell you she's hot natured) and shakes like crazy. We pull out the blankets and heating pad and give her something hot to drink before the shaking eases up.


She can walk with a walker but cries/whines every time because she's afraid she is going to fall. How well she does with the walking relates to her mental state. I make her walk (its not far) to the bathroom, supervised, and back to her chair. She has a bed sore that is healing because she is in it so much. I feel she needs to move and walk, for her mental health and muscle strength. At night I give her a break and let her sit on the walker and push her to bed.


Am I doing the right thing? Why is she shaking so much? Could it be Parkinsons? or is it all mental? She seems so much worse. Was she really this bad at the facility and we just didn't know? Am I being too hard on her? I am trying so hard to do the right thing. I have always felt their is a balance to helping or enabling. But with her, her age, and her mental state I am in new territory. I feel like I am dealing with a toddler. The pity crying gets on my nerves but I seem to do OK with everything else. Are we suppose to just let her stare into space? I am 2 months into this and everyday seems to be totally different. I just don't know.... for sure... between her mental state and the ankle.... I guess I just need some input or some assurance. I'm sorry this is so long. It's just hard to sum up something that seems to be so complex.

Isthisrealyreal Dec 2018
I completely understand that you have had a bad experience with an AL. No doubt there are really crummy ones that couldn't care less about the clients.

I think that it sounds like she may be beyond AL, she may need more care than they provide.

If she says it burns to pee, I would get some of those test strips you can check with at home. There are false negatives and false positives.

I am not in the medical field but I would get her a good probiotic, I use one that has a prebiotic as well, it really does make a difference in overall health. You would not give these with an antibiotic, wait 2 hours before giving. You will notice less stomach upset because the system has the bacteria it needs to do its thing.

I suppose it's a good thing she can take it off if she's to warm, can she put it back on? I have a hard time when the weather changes, to hot or to cold, makes me nutz.

You will get through this, it is a daily trial for all of you but if you and hubby decide together at what point things need to be implemented and what your long term plans are it is far easier.

Hugs!

SnoopyLove Dec 2018
I agree with the posters above that you need input from her doctor, or perhaps it's time for a geriatrician, a geriatric psychiatrist, a needs assessment from the county -- basically some outside input about what you are dealing with here.

I know what you mean about not being able to deal with pity crying. I hate pity crying, and I hate that I hate it. Luckily I don't encounter it with my father, but it would be so challenging for me if I did, and I think I would definitely seek out guidance from experts about why it's happening, what could alleviate it, and how to deal with and understand my own reactions to it, etc.

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cwillie Dec 2018
Your sentence "I have always felt their is a balance to helping or enabling" jumped out at me - it is enabling to do things for a competent person that they could/should do themselves, that doesn't apply to someone who is slowly dying from Alzheimer's.

Change is problematic for most people her age, add in dementia and it is many times more difficult. What are your long term plans? It looks as though she needs a higher level of care and will never return to her former AL, the sooner you start the process to find her permanent home the better for her and you. Residents of my mom's nursing home got walked regularly for PT if they were able and the opportunity to socialize and take part in daily activities (it is unrealistic to expect her to entertain herself at this point, she doesn't have the capacity).

As for the shaking, that could be a lot of things, have you asked her doctor?
mtbells Dec 2018
The enabling part - is when it comes to her doing things physically. She can walk but would prefer I leave a potty chair in the living room so that she doesn't have to move. I realize a part of it is fear but how else is she going to get strong enough to walk once the cast is off? I can play the mind games all day long but physically what is healthiest for her. She could walk fine before she broke her ankle. I try to engage her to read, color, etc. She tried to fill out Christmas cards and just started crying. She says she cant' do it (actually she says she'll do it later - but does not). I appreciate everyone's input. I am going to call her Dr.
Isthisrealyreal Dec 2018
I would rule out UTI first. That can look like decline.

She may actually be cold, if blankets and heating pad with warm drink stop the shivers. Inactive people get cold easy, blood flow keeps us warm and they don't have any, to speak of. I would try keeping her torso extra warm with layers, maybe a down vest, this helps keep extremities warm.

I would venture to say she is very scared and that is what the crying and whining is about. Broken bones are difficult at any age and worse for the elderly. Have you talked to her doctor about an antianxiety medication? A small dose could get her over the hump.

I hate to say it, but could she be beyond home care? Sometimes it takes a village and no home can provide that unless there are unlimited resources.

You have to consider every member of the house when making decisions to keep a senior at home.

I hope you find the answers to your situation.

Hugs!
mtbells Dec 2018
We have had bladder issues and we did see an urologist. She still says that it burns when she pees but she does not have an infection and she does completely empty her bladder according to the ultrasound. We have the daytime caregiver and my husband and I are the only ones at home with her. I will be calling her Dr and I will try to put a vest of some type on her. I have tried it in the past but she keeps going from one extreme to the other. I can put it on her and 30 minutes later she's taking it off. I do not want to put her in a nursing home until its absolutely necessary. The assisted living we had her in put a really bad taste in my mouth and I don't really trust that as an option after what we experienced.

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