Getting Stressed

Paula1968

I am in the process of moving my parents to AL. My mom is in a care facility until we can get them into their apartment. She had a fall on Thanksgiving and had to have hip surgery 4 days later. Since her fall the dementia has gotten worse and they will not let her come home until we get them moved into AL. I have explained to her what is going on for the last two weeks. Today she got angry with me because she thinks I am keeping things from her. For the last 3 days I have told her what is happening and she doesn't remember. I got frustrated with her today and started to cry. I know that it is part of the progression. How do you deal with this. I don't want to be mad at my mom. This progression came on fast and hard. She was okay before she had her surgery but she got post op delirium and has gotten worse since. I have been living with my dad since Thanksgiving while working and trying to take care of my husband who lives at our home. I am just at my ropes end. I love my parents very much and I don't want our relationship to falter because of what is happening.

M1

Hi Paula, it's great that you're getting them moved. Unfortunately dementia does change our relationships, I suspect you are grieving the fact that you can no longer communicate with your mother like you used to. It will be easier if you give up those expectations-i wouldn't tell her too much about the move because she likely can't process it, and that is what is frustrating you. There's a saying on these boards to give the answer that provides the most comfort. We all learn to use fiblets/benign lies, but it does change the communication.

LicketyGlitz

I'll tack onto M1's good advice by suggesting a trip to the geriatric psych doctor for your mom, they may be able to recommend a medication that will help your mom a little bit with frustration, not cure by any means, but help.We had a geri psych doctor for the majority of my mom's dementia journey and they were extremely helpful!

I also starting taking a low-dose antidepressant while caregiving for my mom and that helped as well as making sure I incorporated some self-care into my caregiver world (usually a night with girlfriends and a glass of wine when I could get out... or Zoom with them).

And Paula, any big adjustment in a dementia person's world is going to send the progression zooming ahead. It's always a shock the first time and then I learned to anticipate that things were gonna get cray-cray for awhile if there were any big changes, or illness. I put on extra patience for those days/weeks. Sometimes it helped, sometimes it didn't.

harshedbuzz

Paula1968 wrote:

I am in the process of moving my parents to AL. My mom is in a care facility until we can get them into their apartment. She had a fall on Thanksgiving and had to have hip surgery 4 days later. Since her fall the dementia has gotten worse and they will not let her come home until we get them moved into AL.

What kind of AL did you select? Is it a hospitality model AL that provides meals and minimal assistance with meds, showers and maybe weekly housekeeping? Or is a high acuity AL for MC with dementia informed staff-training and activities? If it's the latter, your dad will be doing most of her hands-on care as traditional AL is set up more for people with stamina and mobility issues.

Another issue many families who opt for AL run into is that a PWD who has more than they mildest of symptoms can be excluded or even bullied by other AL-residents who haven't had a cognitive shift. This happened to an aunt who was placed in AL when her DD could no longer emotionally handle the burden of her care. My cousin is deaf and had difficulty communicating how bad things had become at home.

Unless your dad also has dementia, a MCF wouldn't be an ideal fit. You may be at an impasse where one level of care is not appropriate for both parents. 

 I have explained to her what is going on for the last two weeks. Today she got angry with me because she thinks I am keeping things from her. For the last 3 days I have told her what is happening and she doesn't remember.

With dementia, people rapidly lose empathy, short-term memory and higher order thinking skills needed for reasoning. Rule number one is that you don't try to reason with a PWD. Best to stop talking about the move at all and don't try to get her permission, buy-in or blessing. Just move her when new apartment is ready. I would use medical transport and explain the move as a "nicer apartment for seniors where she'll be spoiled by not having to cook and clean". 

Many become paranoid and suspicious of the very people who love them and are trying to help them. My dad was ghastly around this. Medication did help to a minor degree, but in the middle stages of the disease he was constantly accusing my mom and I of all manner of horrible things. I never had an issue with taking it to heart and could easily let it roll of my back, but a lot of people really struggle. 

Dad used to accuse me of somehow robbing him of the same $350K (he lost day-trading earlier in the disease)- sometimes I sold his house for less than it was worth because I am stupid, sometimes I got into his bank accounts and stole the money. Someone here suggested apologizing and promising not to ever do it again. I thought they were nuts, but I tried it and it worked beautifully- apologize and then redirect with another topic or sweet treat for the win. 

I got frustrated with her today and started to cry. I know that it is part of the progression. How do you deal with this. I don't want to be mad at my mom.

This might help-

12 pt Understanding the Dementia Experience (dementiacarestrategies.com)

It's OK to get mad. Not at your mom, but at the situation in which you find yourself and also at the disease. This group helped me a lot. I also got a lot out of a local IRL support group. My mom struggled more and longer, so we got her a psychiatrist, medication and some talk therapy as well. 

This progression came on fast and hard. She was okay before she had her surgery but she got post op delirium and has gotten worse since.

We had this with my aunt who was bullied in AL. She had vascular dementia which tends to progress in steps/plateaus anyway, but the trauma or the hip, surgery and SNF for rehab was like dementia on steroids. She was so out of it, the family had to stay with her 24/7 in the SNF because she wouldn't/couldn't recall the injury and wanted to walk unassisted. She never got out of the SNF, but your mom might regain some cognition once she's settle "home" with your dad.

I have been living with my dad since Thanksgiving while working and trying to take care of my husband who lives at our home. I am just at my ropes end. I love my parents very much and I don't want our relationship to falter because of what is happening.

It's hard. It sounds like your mom is at a point where the relationship you enjoyed previously is no longer possible. Perhaps you can build a new bond with the person she is now. I have a dear friend who cared for her former spitfire of a mom at home. We used to meet for lunch and trade dementia war stories when our parents were both still alive. She explained the shift like this "I feel like my mom is gone.  There's a little old lady at my house that we take care of and she's nice enough- but she's not my mom". 

Wishing you some peace when the placement happens.