best route to take as caregiver

CM9230

My mom has mild cognitive impairment; she has trouble with her short term memory however with some prompting she does remember. Her Nuero-psychologist mentioned some things for her to do to help avoid decline such as mental and physical exercises, social activities and change in diet. That being said I have recently purchase mental activities such as memory games/ jigsaw & other puzzles books/mandala art coloring books etc for her, we have scheduled time for her to start Aqua aerobics and I am training her on the things she should and should not indulge in her diet. I know this change is hard so I try and give her grace as it relates to what she eats however her I find she makes incorrect decisions in her diet and I am not sure if it is because she doesn’t remember she should have it or she makes a Conscious decision to enjoy something she knows is not good for her. Is there a way to determine between the two? Should I just take over the shopping and/or food preparation for her? I recognize shopping is apart of her getting out/independence. But I also recognize if I don’t help her now I may have to help her in the future due to mental decline. Please advise!!!! Thank you!

VLake

I'm the secondary caregiver and my mom is the primary for my dad. He does love his sweets, but so does my mom. As far as "incorrect decisions" for diet, both my parents have had a lifetime of choosing ice cream for dinner. It's not something that will just correct itself. Instead of trying to control that bad habit, my family cooks a lot and then gives the leftovers to my parents. Neither of my parents cook much anymore, not even my mother who does not have dementia, and so the leftovers at least provides yummy nutrition. They eat everything we send over there. Win win.

Cynbar

Remember that cognitive impairment is about much more than memory loss, it's also about loss of reasoning skills and executive function, the ability to make a plan and carry it out. Plus, you may have a lifetime of eating habits to change. I think all the doctors' suggestions are good ones, but keep them in moderation. Encourage her to do those things, but don't be so heavy handed that it becomes a barrier between you. And you probably need to consider, going forward, that she is losing her ability to make good decisions instead of consciously making bad ones.. If you want her to have just nutritious food in the house, you may need to buy it or order it online for her. And please keep an eye on what she is doing with it, eating it or letting it spoil, because impaired people tend to do what feels good to them ---- that broccoli you buy may not make the cut. Being a caregiver means always reassessing what our LOs can do in the moment. Good luck, this is a tough transition.

I also want to add that a lot of people do decline and progress into dementia, even when they are doing everything right. Unfortunately, it's not a case where you can guarantee she'll remain stable if you follow the suggestions to the letter. So, yes, continue to encourage her, but try to keep your expectations realistic re: what she can manage. She is so lucky to have you!

DrinaJGB

I believe that good nutrition helps tremendously. I always have healthy snacks in the house and DH eats them daily--yogurt with a banana and dollop of honey, carrots with organic humus, granola bars, graham crackers, walnuts, blueberries--and many kinds of herbal teas which DH makes for himself. I make sure to cook salmon weekly as well as many vegetables. I do not fry anything--only sautee in EVOO. Fresh tomatoes and avocados are always handy. Whole grain breads and cereals and oatmeal.

DH went to see his PCP this week and he was told that all of his labs were completely normal, and went on to tell him (after seeing his latest MRI)-that he had a mere 19% chance of surviving and yet here is is. After nearly a dozen years and a diagnosis of possible mixed dementia nearly 4 years ago there has been no downward spiral. His incontinence has improved to the point of no extra laundry loads any longer---a very long and slow process for many years now. I like to think that diet, exercise and brain puzzle workbooks (he hates electronics)-- as well as reading articles in architectural magazines and books have all helped him in this journey.

harshedbuzz

CM9230 wrote:

My mom has mild cognitive impairment; she has trouble with her short term memory however with some prompting she does remember.

It's hard to say. All too often, a clinician will diagnose MCI after an initial workup when the patient meets the criteria for dementia but they hold back pending a 6 or 12 month follow-up. Even if it is MCI, there is about a 25% change of progressing into dementia within 3 years.

Her Nuero-psychologist mentioned some things for her to do to help avoid decline such as mental and physical exercises, social activities and change in diet.

This would be best practices. And would benefit all elders. Many folks swear by this, but I personally have not seen much evidence that it makes a huge difference once a person is on the MCI/dementia trajectory.

That being said I have recently purchase mental activities such as memory games/ jigsaw & other puzzles books/mandala art coloring books etc for her, we have scheduled time for her to start Aqua aerobics and I am training her on the things she should and should not indulge in her diet.

My dad ate a remarkably healthy diet- fresh salads and fruit, whole grains and lean protein with a lot of fish. Nothing fried and no processed junk food. The man never snacked. But somewhere in the middle stages of the disease his palate did a 180 and he craved sauces, gravies, fast food and sweets to the exclusion his normal diet. My uncle encouraged my aunt, who was showing signs of dementia, to do puzzles and crosswords and do mall walking. When we cleaned out her house I found about 15 grocery sacks filled with NYT crossword puzzles; the older ones were mostly complete, but over time they were less completed, not even attempted and the newest 3 bags contained grids she'd cut out with no clues. Lets' just say, I do not consider this a success in her case. 

In the case of my friend's mom, she was the poster child for clean living- a crazy healthy diet- much of it from her own organic garden- and walking a couple miles daily. At 90, she took no medication for anything. Perhaps he lifestyle bought her more time without dementia, but eventually it won.

I know this change is hard so I try and give her grace as it relates to what she eats however her I find she makes incorrect decisions in her diet and I am not sure if it is because she doesn’t remember she should have it or she makes a Conscious decision to enjoy something she knows is not good for her.

This is tough. In addition to memory loss, dementia comes with a significant loss of executive function and reasoning skills early on. She may be past the point where she can think through the cause and effect of planning her menus and live in the moment eating what appeals.

Is there a way to determine between the two?

Have you asked her? Was she bought into "let's fight this thing together"? Or does she not understand she's had a cognitive shift?

Should I just take over the shopping and/or food preparation for her?

If you want to be certain she eats a certain way, it is probably best for you to supply meals ready to eat. Otherwise, she will buy and eat what is easy, on hand and perhaps unhealthy options that appeal to a changed palate.

Another piece you haven't addressed is her age and general health. The advice for a person in good health who has previously made good choices, is different than for an obese person with diabetes or CAD. I might allow an 80-something to eat what they like and make a different decision for someone 60.

I recognize shopping is apart of her getting out/independence.

True.

But I also recognize if I don’t help her now I may have to help her in the future due to mental decline. Please advise!!!! Thank you! 

IME, where minor cognitive decline progressed to full-blown ALZ or vascular dementia, it wasn't a scenario where you could invest in some hands-on preventative strategies proactively and avoid the roles of caregiver and advocate down the line. 

Most elderly require assistance at some point with aspects of their lives. 

Chipperj

Yes to food as medicine. Due to long term gut issues I slowly changed the way I eat. And it changed my life for the better. Now, I can put all I have learned to good use helping my mother. I am her sole caregiver. She is 94 and I am 65. Earlier this year my dear mother developed NPH, a severe memory illness. 

Our world was changed almost overnight. I have left my job and we now live on our SS checks. It isn't easy. None of it. The application for long term care services. The mountains of paperwork. All while keeping a close eye on my mother as she forgets she cannot stand without assistance.

I thought I had introduced myself before but if not my name is Chip. I live in central Florida. My goal is to keep Mom at home as long as possible. So, I am seeing that support isn't just helpful. To me it is vital if I am to stay in top shape. So, I need away time, exercise, sunshine, stimulating conversations, etc. 

Now we are into the 7th month since the diagnosis. I have learned a lot. I have a lot to learn. I am asking all of you for help.

Chip

Cynbar

This is an interesting thread. I know I believe in eating healthy, lots of fish and fresh vegetables and almost no processed foods. I bet a lot of us make those sensible choices for ourselves. But how much of this should we impose on a person with cognitive impairment, a lifetime of different food choices, and the inability to really understand why their diet has been changed? There is no manual, no one size fits all answer for this. I agree that there are probably different standards for a healthy person vs. someone who is obese with diabetes --- that is probably a starting point. And it's so hard to know if suddenly improving nutrition will slow dementia down, because every patient is different and we don't know what would have happened without the diet change. I guess, as with so many aspects of this dementia journey, the nutrition path will vary for many of us. But it is food for thought (the pun was intentional).....

DrinaJGB

Studies show that the American diet leads to inflammation, weight and pain. I for one choose not to inflict this on any of my family--least of all my DH with brain damage. Beside, I love cooking healthy foods and DH loves the meals I prepare so for us at least--it is a win-win.

Stuck in the middle

DrinaJGB wrote:

Studies show that the American diet leads to inflammation, weight and pain. I for one choose not to inflict this on any of my family--least of all my DH with brain damage. Beside, I love cooking healthy foods and DH loves the meals I prepare so for us at least--it is a win-win.

Lucky you!  I can't feed DW my "beans 'n greens" diet without sincere complaints of neglect and abuse.  I can nudge her, though.  Her burger can come with salad instead of fries, and her eggs come with fruit instead of hash browns.

DrinaJGB

Wow, SITM--I did say that "so for US at least it is a win-win".

  No call to get spikey. Gee whiz.

Stuck in the middle

Sorry, Drina, I didn't mean to sound spikey.  I sincerely meant he is fortunate to receive healthy meals lovingly prepared, and you are fortunate that he enjoys them.  I envy you a little, but I'm happy for you.

Thanks for calling me on it, so I could clarify.

DrinaJGB

No problem ,SITM--I can be the queen of spikey on some days --it comes with the territory.

mommyandme (m&m)

Dear Stuck,

I didn’t read spikey at all.  You’re genuine, straight forward and hilarious.  I enjoy your posts, “spikey” or not.  

Thanks for sharing, everyone! 

DrinaJGB

lol-m&m

Suzzin

My mom has for many years been a terrible/picky eater, and now she mostly exists on ice cream and gummie bears. She will refuse most other foods, or pick at it, so at this point I'm letting her enjoy what little happiness (and control) she gets in her day.

My dad will eat anything I make for him, he has expanded his taste buds as long as someone else does the work. Since he had to stop drinking he has developed a real sweet tooth, loves candy corn and m&ms. I keep a veggie tray fresh and stocked in the fridge, and bring it out every afternoon as our "regular" snack. As with my mom, I do what I can to make him happy. I think fighting over food would just cause all of us too much stress and besides, it's unwinnable! 

Jenlewis123

Hi I am new to this forum and really don’t even know where to begin. I am at a total lose on what to do to get my mother a diagnosis. I have suspected that she had the insets of dementia last year when her personality did a 360. But I was told by her doctor that she was fine, of course no testing was done or referral to a neurologist was given. So here we are again with another personality change but this time it comes with cognitive impairments, such are confusion, cognitive distortions, repetitive talk, hygiene issues, weight loss, not eating or drinking enough, suicidal ideation and attempts. My mom has been in and out of mental hospitals for the last three months and everytime she is discharged the treatment plan is to follow up with her primary doc to get an assessment done and referral to a neurologist. Problem is the longest my mom has been out of the hospital is today so far (24 hours) so I can never her get her to her appointment with her primary doctor because she is never out long enough. I just don’t know what to do

Rescue mom

Jenlewis, you will get more and better answers if you start your own thread with your question. Now you’re kind of hidden at the bottom of a different question. It’s easy, just click on the green box at the top of the list, a bit to right of center, that says “add topic,” or “new topic” something like that, and follow the prompts.

To the OP, already much good help here but I see big yellow flags from a line you had at the end, about wanting to do things now so you won’t be needed so much later….chances are very high that no matter what you do now, with dementia they get worse and you will still need to do more later. (I think someone above also referred to that.) Many people who ate very healthy, did puzzles etc., and exercised, still have terrible dementia.

There is nothing (barring a different health catastrophe) that will stop the disease from getting worse, although you may be able to slow it down or make things easier to handle, and sometimes meds can make bad behaviors more manageable.  just don’t  beat yourself up or feel like you could have been able to prevent it.

RanchersWife

Cutting way down on sugar and gluten healed my LO’s vowels and made digestive issues much more manageable. It took about a year into the pandemic (and me doing the shopping alone) before I realized that the food I was now buying her was much better for those issues than the cookies and sugar she was buying herself. She still gets some sugar and flour but things “work” better now.