Advice request for what and how to keep tabs on mother in law with early memory loss living alone

Mike Son-in-law

My mother-in-law is beginning to enter the early stages of dementia. She seems fine on her own now, but she lives an hour away and we struggle to know when she will not be able to live on her own. We act too soon, she loses independence, too late, she could get hurt. This is our first time dealing with this and we are interested in learning what other folks that are going or gone through this have found to work well.
So much to learn… a few questions if you can share:
1. What was your aging loved one's situation and what were the biggest safety risks you recommend that we should be on the lookout for?
2. Any subtle signs that we might be missing that are hard to observe from a distance on calls or short visits?
3. What was your strategy for extending your loved one's time living independently for as long as safely possible?
4. Did you try any useful technology to help check up on loved one or help keep them safe living independently? How did it go and how did your loved one respond to the device or the intrusiveness?
5. What was the final thing that triggered you to transition to something like visiting home care, assisted living, or something else?
Any advice is appreciated as we begin this journey,

M1

Welcome to the forum. Big early risks for someone living alone are scammers and financial mixups. Does one of you hold power of attorney for her for finances and medical care? If not, this is best addressed early while she can still consent, and a certified elder law attorney can also help with long-term financial planning for eventual assisted living or memory care.

Sometimes a prolonged visit over a few days can help identify how she is really functioning-can she cook? shop? Do laundry? Is there expired food in the fridge? Can she take her own meds? Are bills being paid? In a general sense, be aware that all of us tend to overestimate our LO's abilities. Also familiarize yourself with anosognosia-she is likely not going to recognize her deficits and is unlikely to agree willingly to changes in her living situation.

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harshedbuzz

@Mike Son-in-law

Hi and welcome. I am sorry for your reason to join us but glad you found your way here.

My folks were spending summers 4 hours away by car and winters a couple hours away by plane when dad developed dementia. Mom was in denial and fought me initially getting a diagnosis and taking steps to keep them safe in the moment and going forward.

I have a dear friend whose mom developed dementia around the same time my dad did. We used to get together monthly to compare notes on this ghastly experience. Her mom lived less than 0.25miles away and the spent a lot of time together. Friend would collect mom after her part time teaching position, they'd run errands or do chores together, have dinner and then watch a little TV before mom went home for the night. When friend's mom progressed to a point her house was sold and they moved her in, my friend was gobsmacked at how poorly her mom functioned through a 24-hour day. There were expired foods in the pantry, things stored in odd places, mom wasn't eating breakfast and wandered the house much of the night. Because my folks didn't live within day-trip range, I stayed with them for a couple days at a time when I visited which gave me a much better sense of what was actually going on which is ironic as she was the more caring and engaged daughter.

Two caveats in assessing a PWD who doesn't live with you. Firstly, many will have a condition known as sundowning. This is when they slip from their baseline ability to function into a more impaired state. usually this happens in late afternoon or evening, hence the name. A person who still seems OK much of the time might be hallucinating or overcome with delusions and do really dangerous things. Just before my dad was diagnosed he was having auditory hallucinations and would look for people in the house. The second things to be aware of is showtiming. This is when a PWD in the early or middle stages can pull it together for a short period of time and appear to function at a higher level than they actually do. This is exhausting for the PWD and they can't sustain it for long. This is why I suggest a visit of a couple days. If you typically arrive mid-morning and leave to be home before dark, you could miss MIL at her neediest.

While visiting, you can check the house and car for evidence that she's not functioning well. Clutter and hoarding, dents and scrapes on the car, an empty fridge or one filled with spoiled food, dust in the shower/tub because she's not bathing, etc.

Watch the money. The elderly are singled out for scams and it is so easy for a PWD to be trapped by a bad actor on the phone, snail mail, or via email. Unsavory family members can be an issue if you have any. And PWD can get into the weeds financially without help. Spending beyond their means, making generous donations to legit and imaginary charities, and mishandling investments. My own dad day-traded away $360K in the early stages of dementia and after he died in 2018 I discovered he had no less than 5 internet security suites on auto-renew. He last owned a computer in 2010.

In your shoes, I would get the legal paperwork in order and become familiar with her assets-- what kind, where and how much. If she doesn't have considerable wealth, you'll want to learn about qualifying for Medicaid should she need that down the line. A CELA is the best option for this.

National Elder Law Foundation (nelf.org)

I would also get your plan B in order. Talk with your wife about expectations going forward. Will you become her hands-on caregivers in your home? Will you need to make changes to the house to make that doable-- a full bath with a walk-in shower and bedroom on the first floor, a ramp into the house. Or does a MCF make better sense for your family? You might want to tour now to get a sense of what is available in your community. It almost always makes the most sense for the PWD to move near their POA and primary caregiver. What are the costs? Does the facility accept Medicaid if she runs out of funds? Is there a waiting list? It's also a good idea to check out SNFs in your area. With age and dementia, the likelihood of needing rehab after a hospitalization is pretty high and it is useful to know which SNF you'd want her transported to.

HB

saldoodle

To answer the technology question...A couple of things that have been great from afar:

I have found it exceptionally helpful to have access to my mother's Google account (email and calendar in particular). As things got harder for her I stayed on top of appointments, etc and would call to remind her. I also started noticing when she started buying stuff that made no sense or when she accidentally signed up for a subscription instead of a single order of something.

Additionally I use Life360 so I can tell where she is and what charge her phone is at (in case I need to remind her to plug it in). I get alerts when she leaves the house and returns. And if she were to get turned around she can call me and I can literally see where she is on a map and redirect her.

I got a sensor system (not a camera) from Sentinaire that allows me to "see" my mom moving around in her home... But it's only as a stick figure so she still feels she has her privacy. The neat thing about this sensor is if she falls it sends me an automatic alert.

I've also gotten TeamViewer on our phones and computers so I can access hers when needed (only if she gives permission).

Lastly I have access to get back account app. I did this after visiting her and finding she hasn't opened 4 months of mail and she had overdraft notifications in that pile!

Key at this point is letting them know you want to be a support, not controlling them and that these items help allow that.

Good luck! It's a true challenge to balance safety, respect, and privacy with our need to help. Reminding them your goal is to keep them as independent as long as possible only can help.

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