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How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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This is my second answer for this question. There are several answers stating that she should be on hospice. Hospice will maintain PICC lines, GI tubes, pain medication, etc. They can come to your home. Godismystrength, see if hospice could be right for you if they come to your home. My husband's doctor mentioned several different agencies we could use that would do it that way.
Mom has it too for the last few years. She now takes glucerna on her gtube. She will now be prone to pneumonia or silent aspiration. Her doctor advised us to put her on hospice but I refused to. It is hard to take care of her but our love for her takes precedence over that. We put transderm scop patches on her to make her saliva thick and swab her every now and then. It will not eliminate the chances of her having silent aspiration but it will decrease it at least.
My mom is 93 and has normal pressure hydrocephalus which causes dementia. She was "pocketing" food, liquid, saliva in her mouth which would end up drooling out of the corners of her mouth. She had speech therapy which consisted of muscle stim and exercise as they lose muscle strength and forget to swallow. Until I experienced this, I had never heard of it before. Mom is still drooling so we have to put ointment in the corners of her mouth so they will not get infected. Plus, she now aspirates so is on pureed food that she hates. If I give her medication, I must touch the side of her cheeks and remind her to swallow. That helps. Until I experienced this, I had never heard of it. And now, eating is one of her few enjoyments but she can only have food that is pureed. They say she just forgets to swallow - she can swallow but forgets. Good luck.
First consult with her doctor about the nighttime difficulty with swallowing. Also my dad gets confused more in the evening, so your mom might not be able to say why she is refusing her meds. See if the evening meds can be crushed (MD or pharmacist) I give Dad his evening meds with his dinner. They can make him dizzy, and pee, so this seems like a good time.
Give her a warm herbal tea, maybe with lemon grass in it (Lemon Zinger by Stash). That would cleanse her mouth, and make sure the pills are not too large or weirdly shaped. See if the evening meds can be crushed into a jello pudding?
I'm wondering how she does with her meals? If she can swallow her food fine, it likely not a true structural wallowing problem. If it's only in the evening, could meds taken earlier in the day be making her too sedated to swallow at the later time.
It is possible for dementia to actually make someone forget to swallow their own secretions. And of course, Alzheimers does progress to the point that they are not able to swallow. This can be first evident with choking on food. But when it gets bad, they no longer choke, just aspirate, because they lose their gag reflex.
Your mother needs to be evaluated by a doctor or speech pathologist for swallowing difficulty. She may also have strep throat or another infection that causes painful swallowing. Contact her doctor/case worker to set up an appointment. If she is severe enough for injectables or IV meds, you need to go that route.
If there is no physiological/medical reason for her problem, it may just be part of dementia. If it only happens at bedtime, there may be a perceived power struggle or just disgust with the taste. Ask for help from her nurse, caseworker, etc. They probably have seen this before and will have suggestions.
Swab out the excess saliva. Do not attempt to give pills, she cannot swallow. Ask for injectable drugs or IV drugs. If you don't have Hospice, you need them now. Call them.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Godismystrength, see if hospice could be right for you if they come to your home. My husband's doctor mentioned several different agencies we could use that would do it that way.
It will not eliminate the chances of her having silent aspiration but it will decrease it at least.
Give her a warm herbal tea, maybe with lemon grass in it (Lemon Zinger by Stash). That would cleanse her mouth, and make sure the pills are not too large or weirdly shaped. See if the evening meds can be crushed into a jello pudding?
It is possible for dementia to actually make someone forget to swallow their own secretions. And of course, Alzheimers does progress to the point that they are not able to swallow. This can be first evident with choking on food. But when it gets bad, they no longer choke, just aspirate, because they lose their gag reflex.
She definitely needs a swallowing evaluation.
If there is no physiological/medical reason for her problem, it may just be part of dementia. If it only happens at bedtime, there may be a perceived power struggle or just disgust with the taste. Ask for help from her nurse, caseworker, etc. They probably have seen this before and will have suggestions.