Rapid decline after move to assisted living?

Fardwarks

My mother (diagnosed with Alzheimer's at the beginning of this year) was moved by my dad to an assisted living facility on 6/20.  Prior to the move, she needed some assistance bathing & dressing, and was experiencing intermittent incontinence (mainly at night).  She also had a wandering episode and regular sleep disruptions and some hallucinations.  Dad (in his early 80s) was struggling to handle it. She was otherwise relatively coherent and would talk on the phone, could feed herself, get back and forth to the bathroom during the day, etc.

After the move, she was obviously upset for a few days, but then seemed to settle in a bit and was eating and drinking.  Then she completely stopped.  She began refusing to take medications, not getting out of bed, fighting staff on getting a bath and getting dressed, and began refusing most food/drink.  She stopped talking and responding to most people, except my dad, to whom she is particularly hostile (verbally).  She has been hospitalized three times (blood work normal, no sign of UTI) and kept overnight for IV fluids in the past month, but then released.  She was admitted again last night for observation. 

 I am here visiting now from out of state so this is a rushed message. Is this rapid decline after a move to AL normal?  I'm trying to help my dad with information on skilled nursing facilities, but of course most of what I am able to do is just relay information he's given to me.

Battlebuddie

  I’m sorry you are in this situation with your mom. 

     The symptoms you state are all of a serious nature. It would put your mom somewhere in Stage 6. Usually the end of stage 6 involves incontinence ( which you are beginning to see) . 

It sounds like she has taken a jump into stage 7. Patients move back and forth , in and out of stages so it might be that she will zig zag back to where she was , but maybe not. Placement of any kind can cause a progression.  

  If she continues in this behavior I think she would be eligible for Hospice , which would give you more eyes and ears on her. It certainly can’t hurt to have a consult to.   with them. Not eating or drinking is the big worry here. Hospice would address this and help you through it. 

  My loved one has been on Hospice for a year , so for dementia patients it isn’t always end of life care. They could stabilize her and she could “ graduate” from the program. 

   The illness is anything but “ normal” , so it’s always hard to advise , but these are my first thoughts. Others will come along with more thoughts too. Good luck  

Quilting brings calm

The symptoms you describe that occurred prior to placement in assisted living put her pretty far along on the dementia progression.  Either your Dad had been covering for her for quite some time prior to diagnosis ( that is called scaffolding) or she may have  a much more aggressive form of dementia rather than Alzheimer’s. Either way, she’s pretty far along and was probably  too far along for assisted living in the first place. It is true that changing the environment causes a temporary decline.  However it’s also true that the inevitable path that your mom is on means a decline too.  So it’s hard to say if she will improve back to the point she was the day she went in to assisted living or not.  Even if she  did, she’d be right back into this new stage before too long. 

I’m so sorry that your family has come into this at the stage your mom is in.  Some  of our loved ones got diagnosed much sooner so  we had time to adjust before this stage. I say some  because not all of us were ‘lucky’ enough for that,  you aren’t the first to be shell-shocked by their loved ones sudden decline being what got them diagnosed.