My mother lives independently, with an aide coming in 1-2 hours each day. Mom's mind is sharp but it's her emotional intelligence that seems to have worsened. It's not a dramatic change but an intensifying of a personality trait that she's had all along. I live five hours from her but my brother lives close by. Still, Mom contacts me first if there's a problem.
Last year my mother made the decision to stay in her free-standing condo home. At 93, she has lost many friends, but she did not want to go to an independent living facility. Now, her arthritis has made mobility difficult so she walks with a cane or walker. Her days are often long and lonely. When she decided to remain at home we discussed the down sides of diminishing social contact. We speak on the phone twice a day and I visit every couple of months...sooner if there's a problem.
I think part of her problem is that the time at home with little to do has allowed her worrying personality to worsen. She says she is not depressed. She doesn't socialize with her new neighbors, lovely people whom I've met and who offered Mom help if needed. My mother says she has nothing in common with her new neighbors because they are from a different, i.e. younger, generation and a different religion from hers.
Mom finally gave up her car last year. Her aide drives and takes her to doctors' appointments, shopping, etc. Mom's doctors tell her to move more but she refuses, saying it hurts and she's never exercised before and won't start now.
I know some of my mother's behaviors indicate depression but I don't think that's the main issue. She suffers far more from anxiety. She's philosophical about her situation but when we discuss my concerns about her anxiety, she tells me she can't help it. When I suggested that she speak to a counselor, I might as well have told her to fly to the moon.
Mom's financial situation is fine but she counts every penny, saying the Depression will always be with her. I have caught her eating spoiled food rather than throw anything away. Mom admits that having all this time on her hands leads her thoughts into dire directions. When her phone service was interrupted for a short time over the weekend she panicked because she felt totally isolated. She called on her cell phone, crying and hyperventilating, because her lifeline alert is tied to her landline, which wasn't working and her cell phone was running out of purchased time. Within the hour the landline service returned but my mother was an emotional wreck. We discussed what she could have done had the phone service not resumed. I added that it was not the phone problem but her panicked reaction to it that concerned me. I suggested she think about hiring a full time aide...she even knows a wonderful woman whom she could hire tomorrow...but Mom wants her privacy and doesn't want to spend the money.
My brother has many work and family problems of his own sh despite living close to our mother, he has little patience. Mom does not want to move in with me or anywhere nearby, where she feels she'd be even more isolated. I see her point but I don't know what more I can do. I've spoken to her doctors but there's just so much they can do. As I told my mother yesterday, I don't want her reaction to a minor problem to turn into a stroke or heart attack because her anxiety got the better of her. Is there anything else I can do?
Facilities vary from community to community, so take tours. Find one you like and take mom to eat lunch there without a lot of discussion ahead of time. "I found a nice place for us to eat today!" The site manager will help you set it up and may even eat with you and chat with your mom. They look like nice hotels these days.
Then you can walk/roll around the place and take it in. Some have Sunday brunches at a very reasonable rate.
Plant seeds so they can germinate!
I took my mom to eat lunch at the place we picked for her. We toured her around the place. She looked at a furnished model apartment. Then sort of asked/told her "wouldn't you like to live here?" That's when she got to pick which side of the hallway she wanted. Did the paperwork, wrote the rent check, and bam - deal done.
Don't offer choices that aren't negotiable. Do offer choices that will keep things moving in the right direction.
You know how much you can handle with continuous panic calls. Keep in mind that this is not only troubling to you, but it is horrible for her. Panic is very real. It's scary and debilitating. Obviously, she needs help. It's up to the adult child to protect the parent when it gets to this point. In some ways the roles do reverse. We must step up and make the more difficult and serious decisions. I would be hesitant to continue to allow her to live alone and suffer with the panic attacks. She may believe that she wants to stay in that environment, but a damaged mind would think that way. A reasonable person would not be thinking that way. That's what I would focus on.
My loved one was paying all her bills just months prior to requiring assisted living. Sometimes it happens that way. From my reading, isolation, anxiety, and depression can contribute to dementia.
She wants to live alone, deep down inside she is afraid of falling, forgetting to turn the stove off, etc.
Be aware that you are hearing about her friends' side of the story. When my mom lived an hour from me, in her big old suburban home, and three days in a row, I got a panicked phone call to "come quickly", I realized that we were in a non-sustainable situation. Mom couldn't stand having aides in the house, if it snowed, they couldn't get to her. She panicked if there was rain predicted.
Only you and your mom can work out what works to keep her calm. For my mom, no amount of reassurance, aide hours or even moving to a lovely independent living facility helped that. Only antidepressants and antianxiety meds did that. If one med doesn't work, you try another. Hope this works out well for you.
But her thinking process was changed, too complicated to go into here. She called me one day because "I'm almost out of shampoo". I'd bought her a quart botyle, so I couldn't see how she'd be close to finished with it. It was 3/4 full, and I realized that the SIZE of the bottle no longer entered into the ewustion, it was the proportion that was left.
In my book, unless someone has had a seversl hour battery of paper and pencil tests from a neuropsychologist and an hour of reaction time, perceptual and motor function tests from an associated neurologist, you can't tell much about a person's cognitive functioning, ie, their ability to reason and solve problems.
Doing a 15 question Mini Mental Exam tells you about memory, orientation to time, place and person, but very little about dementia.
If her anxiety can be treated with medication, maybe that will help her feel better and stop the panic attacks. Cymbalta worked great for my cousin.
Would she continue to have the panic attacks if she was not living alone? Maybe a trial relocation could address that.
My mother's doctors back home probably cost her many years of living by ignoring her symptoms and enabling her to ignore her symptoms too. Once you get to a certain point, there is no slowing things down or delaying the inevitable through diet, exercise, and social engagement.
If it is dementia, there is no explaining or reminding that will make it better or stop.
My mother's "won't do" turned into "can't do" very subtly at first, then very rapidly.
She continued to say she didn't want to do XYZ, when she either was afraid of doing it, or couldn't understand it anymore. Anybody who wasn't looking carefully would take her "I don't want to" at face value and move on without helping.
Many doctors will also diminish the symptoms of elderly female patients. This kind of discrimination is unconscious but it happens. Elderly women are completely invisible to a lot of doctors who don't want to deal with them. MDs aren't trained on geriatrics most of the time. My mother's urinary incontinence was totally dismissed by her GP who told her it's part of aging for women who had a baby. Sorry, but I was born C-section so that doesn't add up at all. He never referred to a urologist or a gynecology specialist for female incontinence. We will never know if there could have been any relief for her early on because of that.
I understand that, her doctors hsving told you that she's fine, you are trying to fit her dysfunction into boxes like "emotional intelligence " and the like. I did that too. But the truth is that her brain function has changed and you need to find her a doctor who can gelp you understand that, and what the safest, best response is.
Accept that change is inevitable, and our parents won't always ask for it or welcome it when they need it the most. This vision we have of never leaving home is very unlikely for a lot of people. We have to be open to do what the right thing is, even if it's different than the vision.
My mom started out exactly as you describe your mother, but I am 15+ years farther along than you guys are. I live in another state, 1800 miles away. She has been alone since 1986, had a major stroke in 89, and lives out in the country.
She was calling her brother in law next door at 2 a.m. to get the cat out from under the bed. Or to bring in extra large bags of cat food, so she could feed the "outside cats" that were more racoons and possums than cats. This evolved into her calling at all hours of the night complaining about men with red eyes staring in her window. This was sundowning, but we didn't know all of this strangeness was a blinking red light signaling change.
Sundowning turned into auditory and visual hallucinations any time of day or night. A few TIA strokes later and a doctor told her to quit driving, but she refused, not caring if she killed anybody. (Another big signal of cognitive change.)
She stopped eating fresh food, and probably should have died 10 times from food poisoning. She would be sick, but couldn't figure out why. (Must be stomach cancer....) She had her days & nights mixed up, was then missing doctor appointments. She had a ton of medication on auto-refill (19 Rx to be exact) that she wasn't supposed to take anymore, but it got mailed to her house anyway. For example, I counted 6 full, unopened bottles of Metoprolol when I cleaned out her house. She would take whatever, whenever, and on no discernible schedule. She should have died 10 more times from an overdose.
She could no longer handle anything that depended on following a process, such as doing laundry, preparing food, paying bills, arranging for home repairs. Her cover ups were genius though. Everybody bought into her stories that explained why the house was a hoarder mess, why it smelled like a corpse was rotting in there, etc. Why the trash was piled up.
I called social services on her to report a vulnerable adult, and they visited, but didn't find any need for services. I don't think they were looking or smelling for a need because it was a small rural county who had no budget to work with.
I realized that mom had been telling me the same story on the phone over & over for about two weeks straight about going to the doctor and being fine, no changes, then eating lunch at the local diner. Every other day for two weeks? Hmmm...
It all turned out to be a total lie.
I started intervening by having her mail forwarded to me for $1 on the USPS website.
That's how I found out she was in collections over $150 due on a fridge. Her 4th or 5th fridge in about as many years. I got the ugly bold truth by reading her mail. I saw her insurance statements about doctor visits paid, and put the dots together that it had actually been a long time since she was in the office. She had also stopped testing her blood sugar and taking her insulin.
Fast forward 3 years, and we moved her to our state, to a care campus near us that has continuum care coverage. Independent apartments all the way to hospice, where she is now.
I got her to a doctor who did an actual cognitive eval on her and found that she could no longer live independently. (I could have told him that, but having the doctor determine that is priceless.) He got her off a lot of meds, and sent her to PT for exercise.
Having mom in a continuum care place meant that when she needed Assisted Living (more help & services than Independent Living, but not 24/7 skilled nursing care) she was right there, on the wait list automatically. When she needed the nursing home care unit, it was a short hop down the hall, around some corners. Same for the locked dementia care unit where she will finish out her days in hospice.
Her entire time there she has had a visiting doctor, nurse, labwork, onsite PT, OT, dentist, dining room, meals included, and 24/7 oversight when that became necessary. When mom became a wandering/escape risk, they had a whole unit with secure doors where she could live, not just a locked room, and definitely no restraints (illegal).
I encourage you to get your mother to a geriatric physician who is trained to detect what is normal or not in the elderly, who won't dismiss your concerns, and who can guide you on this journey.
Tour some facilities near you to see what is available, should you need it. Be willing to do what must be done to keep mom safe and as well as possible. Simply embracing the fact that changes will come - and not on a convenient schedule - will help your stress levels a lot. We have to embrace that idea for our parents and help them through it. Come back here and ask any questions you have - we've seen & lived it all!
The Assisted Living facilities that I have seen have daily activities that promote movement, such as games, music and trips. The ladies gather to play cards and/or watch their favorite soaps. They get their hair done on site. They take trips for shopping. Some leave to attend church on Sundays and others attend the service that is held in the dining room. Maybe if she was able to observe the facilities and the residents, it might change her mind.
Independent Living, antidepressants, antianxiety meds and a good geriatric psychiatrist to prescribe them were immeasurably helpful.
I doubt if your mom is managing her bills correctly. Start helping her write the checks. Get online access and check on her account status. It may be time to think about getting her to sign a DPOA or seek Guardian status.