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saintseal Asked December 2022

Is it good or bad to try to orient someone with dementia to the past they can't remember? Also, what to do regarding Christmas cards this year?

We moved my mom to Assisted Living Memory Care about six months ago now. We moved her to a first one that did not work out with problems at the place with the staff, cleanliness, and care (they were not showering her and doing her laundry (said they forgot) and basically not asking her what to eat and just giving her peanut butter and jelly sandwiches for every meal and needed daily monitoring by us. Also, the other people in the unit were much more advanced in dementia than our mom. So, we moved her to another place, and it is going much, much better with the staff at the new place. There are at least people in the new unit more her level - talking and mobile even if they are very confused. We would have moved her there originally but there was a waiting list.


 Anyway, when we set up the room, my sister put photos on the wall. Mom kept taking them off the wall. She even broke the glass in one (and somehow also broke her television and the glass on it!?). Sometimes she has fits of anger which I think I had learned at home to deescalate, so I'm not totally surprised by this. She can be totally great and very pleasant and chit chat too!


 To my question; I was wondering if it would be worthwhile to create a photo book with labeled pictures for a holiday gift to help to remind her of her past and her people. Right now, she does not seem to remember who her husband/our dad was. When I visited early this month, she did not know who I was. As I talked about in the other post, I spent six years taking care of her at home. In the mornings when she was at home, I would go through pictures and try to orient her to her family members and tell her stories of her past. I knew then that she was not clear on who I was some mornings when she woke up. An OT at the place suggest we label the pictures as to who they were, and we did that. But she moves them around and puts them away in drawers and such off the walls and tabletops.


 Do you think it is good to try to orient her to remember her past? And who people are? And her life before? Or just forget it? Sometimes she does remember things and it surprises us!


 She also traveled quite a bit with her job as a flight attendant and as I have been cleaning up the house, I found some memorabilia from her travels that she had set aside (probably to remember?). And I thought of creating a collage of it maybe with plexiglass ;-). But when I was there before, she is wanting to leave and is not always happy. She begged me to bring her to the airport and when her family calls, she asks the same. Would the travel stuff be good or bad? Would it trigger her to want to leave and be confusing? Or could it help to orient her to who she is and was?


 I guess I'm wondering is it good or bad to try to orient her to the past? Or just let go?


 Also, past years, I helped her to send Christmas cards. Basically I did them and she signed her name to the best of her ability. Mostly to people to send them to her and we would return one back as an activity and to orient her. People who are closer to her know about the move and her condition. But the less close people, when they send cards this year, I'm thinking I (not her) should communicate back to them about her condition and that she has moved so at least they have some information that she had not passed away. Is there a good way to communicate her condition to these more old and remote friends and family?


 Any thoughts on Christmas cards? On trying to get her to remember her past.


 She has declined so rapidly in the Assisted Living Memory Care and it is very sad to me. Many people said it would be better for her to have the interactions with the other people there instead of home alone with me. I suppose it is better (?) but, of course, I feel very sad. My sister says that I was her brain and she seemed more well than she was because the efforts I was putting into this at home and now family can see how much I was propping her up.


Any thoughts appreciated. Thank you.

Fawnby Dec 2022
Her decline is probably about the same in memory care as when she was home with you. The brain is doing what it's going to do no matter where she is, and that's the sad truth.

People seem to take comfort from the idea that this or that will revive the brain, but that can't happen because the disease is dementia, and the main result of all that effort is that caregivers get worn out. New brain cells don't just grow because the LO is playing bingo or making friends or looking at pictures from long ago. Dementia always wins.

There's no reason to burden yourself with guilt over any of the steps you've taken so far. Congratulate yourself for all you've done, for the good times you've made possible, and for sticking with it so long. I'm caregiver for my fourth dementia LO so far, and I understand your pain. But it is what it is. And dementia always wins.

Now let's all go drink some hot chocolate and try to have a guilt-free day.

Msblcb Dec 2022
I received some wonderful advice on this forum. I was trying to talk to my mom about memories and it seemed to upset her. I was told to stay in the moment. That is not easy but mom seemed to enjoy that more. It did not remind her of what she had lost.

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Msblcb Dec 2022
I placed my mom In May in an ALF. I placed many of her family photos in frames on the wall and used a Ptouch to let her know who they were and how they were related. (I used photos of her family when they were young). She referenced them often, but to be honest, I am not sure if they brought her pleasure or simply reminded her of her memory loss. But, she did speak of them often so I would count them as a positive for her.

I tried a memory box but she simply did not have an emotional connection or memory of many of the items.

In terms of cards, I saved every card she received over the years. I put those in a memory box and we would go through them. She loved the colors and textures of the cards. The names on the cards meant nothing to her. I sent cards on her behalf, with her signing them, but she did not understand the process or need. They may have been great for those that received them but not important to mom.

I placed her in the ALF after taking care of her for 5 years in my home. I was afraid for her safety and felt like she was isolated and needed the social interaction. While she did enjoy some of the activities, she was an introvert and did not make friends easily. She absolutely declined. While the staff tried, they simple could not care for mom like I would.

I will say that her familiarity with my home probably masked some of her confusion. When she was moved to the ALF, it was overwhelming at first but also made me much more aware of her true state of confusion. It was easy for her to hide her decline in my home where she could mask her confusion. I hope I am making sense.

My mom passed away in early November. We are not sure but think she may have had a stroke that caused her to lose her appetite and become so frail that she could not recover,

I would keep trying. My mom had a garden view in her room, I hung flowers outside, purchased small windmills so she would enjoy their color and movement. I purchased yarn for her to wrap in a ball, towels for her to fold, buttons for her to organized. Keep trying new ideas. It is often the small things that bring the most pleasure.

I wish you blessing on this journey. It is so difficult but I cherish those moments now.
saintseal Dec 2022
Thank you. I can relate so much to all you say. I think I need to let go of trying to make her remember and focus on the little things she enjoys now in the moment.
KNance72 Dec 2022
Let It go - the photographs , collage and Christmas cards That is In the Past instead try and reorient her to some group activities in her new home . Group activities , Bingo, coffee or tea - I think you are grieving because she has left her past behind so stay In the Moment with her . Merry Christmas .
saintseal Dec 2022
Thank you. So kind. :) I'm trying.
Anabanana Dec 2022
Last year I had my mother sign cards. She didn’t recognize where to sign. I had to place the pen in her hand, point and say “Here.” I wrote a letter on her behalf, explaining her decline and need for care, and tucked one in each card. I mailed these to her closest friends and key relatives to keep people in the loop.

All twelve recipients phoned me in January, appreciative of the news, however sad.

This year I will not ask her to sign. But I will write an update.

Something to consider about putting together a photo album. When my mother remembered everyone but was merely hazy with details, she appreciated it. Now that she thinks she’s random ages (typically 20, 44 or in her 70s - she is actually 97) she becomes combative or sad if the information presented conflicts with where she currently is in her broken brain. Examples: I am just some helpful old lady who visits and brings her mail when she thinks she is 44. When she thinks she is in her 70s, I am an old friend from her old neighbourhood. My husband once told her we were family, which set her off an hour long rant about how she just knew we weren’t. Proceed with caution.
saintseal Dec 2022
About a month into the new place my Mom would say "Please, please take me back to that place, the house. There was a girl there who helped me". I asked "Who is that girl" and she had to think awhile and said "She looked kind of like you" . Also, when asked her age she said "2, 4, 6?" Christmas cards where much like yours. Thank you your reply. :-)
Natasana Dec 2022
Regarding Christmas cards, the first Christmas after mom came to live with me I remember sending Christmas cards to her old neighbors so that they would know she had moved, where she was, the address and the phone number in case they wanted to contact her. Nothing was mentioned about her health status at all, and quite honestly they already knew about her dementia, having lived around her for years. Mom becomes so stressed and angry as holidays near because she can't find her address book and she doesn't have Christmas cards or stamps not to mention the whole process is way beyond her brain now. It just becomes a real source of agitation and confusion for her. This year I'll just buy a box of cards for the same five neighbors again. I do everything but sign the card. And mom has real mental difficulty with just signing the cards and doesnt understand what she's supposed to do. Last year it took her a couple days to sign the five. Mind you mom was worrying about Christmas cards in July. She had a fist full of coins and was adamant that we walk across the street to an imaginary store to buy cards. I just play it by ear.
saintseal Dec 2022
Thank you.
Fawnby Dec 2022
Do acquaintances really need to know anything about the health conditions of those who weren’t in the inner circle of friends? I think there’s no useful point in keeping them informed that, for instance, mom can’t walk or talk and lives in a care facility. Wouldn’t it be better if they remember her as the vibrant and beautiful person she always was? Isn’t it a violation of her privacy to reveal health issues that she wouldn’t care to share? I’m for letting communication dwindle rather than bring sadness to those who don’t know about her dire situation. I am interested to know how others feel about this.
saintseal Dec 2022
Yes, I can see now from your thoughtful reply and other responses that I should just let communication dwindle for those not in the inner circle.
MJ1929 Dec 2022
I made my mother a photo album of the pictures we displayed when my dad died. I don't think she looked at them once, and she forgot my dad within two months of his death. It broke my heart, but her brain was well and truly broken once and for all after her soulmate died, and she moved on to an imaginary husband.

She remembered certain people like her cousins, and it took a long time to realize she was remembering when they were all kids together, not as they were in the here and now. I found that pictures were no longer useful, and talking worked better. She also had vision problems, so that added to the picture problems.

As for the cards, I took over their Xmas list myself years before Dad died, but I didn't advertise that Mom was in a nursing home once that occurred. Only close people who'd know outside of the annual Christmas correspondence were told. I ended up corresponding with quite a few of my parents' friends and still get cards from some of them.

The two things my mother never forgot were her love of watching hummingbirds and her love of a good chile relleno. Everything else faded away.
saintseal Dec 2022
I appreciate your reply. I feel your points in letting go and being open to help a person appreciate small joys to them even in your personal sadness.
JoAnn29 Dec 2022
Mom got cards mostly from church people. She had a basket and I would line then up around the inside. They would disappear so not sure if she thru them away or other residents took them.

There comes a time when showing Mom a picture will not help her memory because its lost. Longtime memory dwindles down too. In my Moms instance, till she became like a child. Someone asked Mom about her kids one time. Indignantly Mom said "I don't have kids". At this point she never talked about Dad, I think in her mind she had never been married so had no kids.

I think your ideas are good ones but since she seems to taking pictures off the wall and destroying them, I would not go thru the trouble.

My Aunt had ALZ and was in a wheelchair. The common area was all decorated for Christmas. I took her down to look at the tree. I said "Nothing like your trees, huh" She said "no". Then I described how she had big real trees with bubble lights all over it with balls and lights.
saintseal Dec 2022
Thank you for your reply. I've decided not to go through with putting anything together with photos. Yes, things have disappeared from my Mom's room so there is that too.
Donttestme Dec 2022
You can try and orient her to the past if she seems to enjoy it. When it becomes a stressful thing, stop. Sadly, you just play it by ear, because as you noticed, she has good days and bad. So if it makes her happy to look at pics and hear you talk about them, do it. If she get aggravated or sad, don’t. You’ll find as her dementia progresses, she’ll be less and less responsive.

As for communicating with others, thats another play it by ear. For those she was very close with, I would tell them of her condition. For other who were merely acquaintances, I would just let it drop.

Can she participate in group dining or any activities in her assisted living place? That’s a good way to have her engage with others. With my husband, his so called friends all dwindled away. Any sort of communication became awkward and they didn’t know what to say to him.
saintseal Dec 2022
Yes, there are good days and bad. And yes, I see come her friends and family dwindling away because of awkwardness. I'm not sure she enjoys that I was doing all the 'remembering' people and your past -- she enjoys dogs and children and a little chit chat more than anything. It's me that needs to let go of trying to ramp her up on things.
Grandma1954 Dec 2022
When you show her pictures do the people have any meaning to her? If not then I would not bother with a photo album.
As far as Christmas cards go. It is up to you if you want to communicate with the senders. If you wish to tell them that mom enjoyed the card. If the cards are going to your house they may not know that mom is now in a Memory Care facility. You can give them the address if you wish. Most people that send out cards are doing so just because they have done it for so many years. If this is the only communication that mom has there is no response needed. If you wish to inform them of moms condition that is up to you.
saintseal Dec 2022
Yes, I think probably many cards are just coming from lists and doing it for years and no response is needed.
Luta65 Dec 2022
saintseal,

First, pls let me say that you are a golden daughter to have cared for your mom for 6 years at home and also that you reached the sensible place of knowing that you could no longer provide the 24/7 care she now needs.

Depending on the severity of her advancing dementia, you may start to see some improvement once she has adjusted to the new facility. You may want to do a bit of research on 'relocation trauma,' it's a very real syndrome and with multiple moves in a relatively short period of time, your mom is simply unable to process much right now. A good transition takes some 3 months for adjustment and this time only increases with moves, room changes and the broken brain.

It's likely that she's acting out because she can't process the thoughts and emotions that are evoked by what should be familiar faces and pictures. Give her some time to adjust to her surroundings before bringing new pictures and items in. Sometimes, less is better, esp while adjusting to a whole new environment.

I've learned to minimize the changes that I make to my Mom's room ( in a MC unit) and she has even thrown away some of my personal pictures that I brought for her and her reasons made no sense because there is no basis in reason. One pic from my parents' 30th anniversary (my copy, didn't have the stuff from their home yet) went missing and when I asked her, she said she didn't like how she looked in that one. She also removed some pics of Dad from the collages for the same reason. This was all well over a year ago and I hesitate to bring anything more in.

It may be helpful if you spend time with her around the facility, working to familiarize her with her surroundings, maybe some residents, and the steady, long term staffers. Allow her brain time to adjust to the new room and keep it basic; you can always reintroduce new stuff or things she's put away after she's more adjusted to her new setting.

The cards is a whole other issue for you to navigate, there truly is no 'best' way to stop sending cards. As long as people who care about her are informed that she's adjusting and in-care, that should be enough. Keeping in touch with people who are now peripheral to her life shouldn't be a priority and one can't expect the broken brain to remember when it's struggling to survive and know self from day to day.

I'm grateful that Mom's estate can afford the phone and cable because we talk almost every day. It took her a long time to adjust to the MC unit and that was with a lot of daily contact and freq visits. My expectations are lowered and that's the one constant: advancing dementia. I see in Mom a willfulness to forget the pain of her losses and I think that's one kindness of dementia, the increasing ability to forget all of life's losses.

I try to focus solely on happy memories and reinforcing who she is in my eyes and those of my family; she's often grateful to be reminded of the many beautiful family memories we made and the deep, abiding love her and Dad shared as well as her many life accomplishments. We say goodnight almost every evening and she loves it when I call her before I sing lullabyes (sp?) to my grandkids with her on speaker so she can listen in while they settle for sleep.

Maybe you can invest in a zoom device that staff could keep without access to password and later on, when your mom is better adjusted, keep in closer touch that way. It's a thought that I've had, but never any staff that I can rely on regularly for that type of 'face to face' contact.

Many on the site recommend youtube vids by Teepa Snow and her website and books on dementia. We learn as we go and take our cues from the responses of our LOs.

I wish you, your beloved mother and your family the best in what is an increasingly difficult process. Stay strong.
saintseal Dec 2022
Thank you for this thoughtful and sage advice and so much good information and suggestions. I will look up 'relocation trauma'. She has been in the current (new) place 5 months now.

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