Difficult transition from AL to MC

MNPS

My mother started showing signs of dementia in fall 2018. My dad was in denial - but they finally got her an official diagnosis in January 2021, then my dad died in May 2021. So she has been in assisted living since right after his passing. She moved to MC in the same building in June of this year. This transition to MC has been really tough on her and I really don't know what to do. In AL she had a group of friends she would spend time with - but she started wandering the building constantly, riding the elevator up and down all day, showing up in people's rooms, etc.. She started getting aggressive with other residents and staff, so the facility said it was time for MC, so we moved her. We have a daily assistant come in from 8-12 to help her get dressed, make sure she eats breakfast and lunch, and try to keep her engaged in activities. The assistant can take her back to the AL side for activities with her friends, but I'm noticing a change in their notes. They say that mom has become irritated and restless, sometimes snapping at them. They'll take her to activities, but she won't stay more than a minute or two, then she wants to go back to check on her room, then when she gets back to the room, she wants to go back to the friends, and so on. Yesterday afternoon, my brother who lives nearby went to visit and he said that she kept asking him to take her with him, that she has nobody, that she's bored, etc. Taking her out just always seems to cause stress for her, so we avoid it, but I'm wondering if weekly outings would do her some good? Should we talk to a therapist or psychologist about getting her on some sort of medication? I feel terrible for her, I know the MC floor is not the most pleasant place - a lot of the other residents are much worse off than she is and not much to engage with. But the staff does try, they do a lot of coloring, they have different rooms with baby dolls, toy tools, flowers for arranging, etc. On the AL side she had her friend group and I think she mostly just listened to them talk and would occasionally engage. She has the assistant now, but then she has from lunch until dinner with "nothing to do" because she has to be back on MC floor when the assistant is gone. I wish we could justify having the assistant there all day, it's just so expensive as it is. I'm sure it's just the progression of the disease, but I wish there was some easy answer. This is probably more of a vent post, since there probably isn't much that can be done. Thoughts?

Marta

Absolutely you should consult her dementia provider about medication to reduce her irritability, since it is likely that she is miserable. I’m thinking of an SSRI like Zoloft or Lexapro. These are my go-to meds for patients similar to your Mom.

bjohnsen3869

My dad has been on Lexapro for about a year. Helped but now that he is in assisted living he is bored and constantly pacing around the room looking for stuff. Is there any other medication that will keep them from bouncing off the walls. When he lived with me I kept him occupied and/or engaged all day and he was great. I can’t sustain that for an extended period of time though because I have a 10 and 13 year old and 2 college aged kids. I’m getting discouraged because they aren’t taking care of him like I did.

MN Chickadee

This all sounds pretty normal. PWD have a hard time engaging in activities and can have a lot of apathy. Happiness can be elusive for a PWD no matter where they live. My mother wasn't happy in her home of 40 years nor was she happy after we moved her to MC. It's just part of the disease. My mom took a good 2-3 months to settle into MC so she may just need more time. Try to remember why you did this - to keep her safe and give her the structure and care she needs. You are doing what you have to and what you can with the information and resources available. This phase is very hard, I'm sorry you are going through it.

ESkayP

My mom moved into AL about a week ago, and I'm realizing now that she will likely need a higher level of care much sooner than I anticipated. I think Mom was using the familiarity of her house, her routine, and my support as a scaffold to hold her up. Now that she is in a new place, and I'm not there every day, she has shown significant regression in mood, initiation of activity, and communication. The staff is allowing Mom a transition phase of 30-60 days, but I have a feeling they already know that the progression of the disease is worse than I thought. I fear she will get used to her new apartment just in time for them to suggest MC. I'm afraid the second transition could be devastating. I appreciate you venting about this, though. As other commenters have stated, the restlessness, apathy, and irritation all seem to be par for the course. It's so hard when she doesn't behave like the woman I have always known.

MNPS

Thanks for the comments. She had an appointment with her doctor last week - I hadn't checked these comments, though we did discuss her change in mood with the doctor and we did ask about medication. The geriatrician said she would like to keep her off mood altering meds as long as possible, but to let her know if things get noticeably worse and she would revisit. The notes from the daily assistant basically indicate that mom's biggest source of frustration is the yelling of the other residents (the ones who are in much worse condition) on MC floor. Mom did always like the house to be quiet :0). It's like a stranger has taken over her body. My mom was so meek and mild, to hear that she's being aggressive is really bizarre. Will circle back with the doctor soon.

yarnball

I have made the decision that it is time for my mom, 87, to go to MC facility. She will hate me. I will find a way to deal with that and pray that it eventually passes.

Anonymousjpl123

@MNPS I wonder if she could visit her friends from the AL side - maybe do some activities? I know it is not easy, but could help her feel less isolated and ease the transition.

one other thought: are there quiet areas ij MC, rooms where she could find refuge and peace? In the MC section of my moms place there are sections where people are social, a few couches where people are more quiet and relaxing, and of course the tv area. Of someone wants action it’s there, but if they want quiet and relaxation it’s there too.

Maybe she can create an oasis somewhere - in her room or another part of the area? I know these are not earth shattering suggestions, but there’s no perfect answer. I hope things ease up a bit. Keep us posted.