Mom with dementia

I can attest to what Victoria2020 said about the reminder tools not working for very long. They only worked for about 4 months with my mother. She's been living alone and I visit 2 times per week to check on her. At this point she can't remember to take meds, eat, drink, bathe, etc. without my prompting and/or insisting. When I visited yesterday, the smoke alarm was chirping loudly. I asked her what that noise was and she didn't know. She also didn't know how long it had been chirping. I explained to her that the chirping was coming from the smoke alarm and that it needed attention. For the next 20 minutes while we were waiting for maintenance to come fix it, she asked me 4 or 5 times about the noise. That confirmed what I had already decided - that the move to memory care at the end of this month is absolutely necessary for her health and safety. She won't like it one bit, but I don't see any other viable option since she has loudly and repeatedly refused to accept/tolerate paid help at home.

Hi conmel99,

Since you're saying this seems like a very sudden change it might be a good thing to get her to her doctor and checked for a UTI.

Because the disease takes away immediate memories first, the things that work best are usually things that the person has always done. If she doesn't check a calendar every day for a to-do list, she won't remember now to start using one. It sounds like she's not safe to be at home alone if it's just her.

A lot of people here have a story about their come-to-Jesus dementia moment when they understood how compromised their loved one was. It takes so long to realize how far along they are because they can still do things like carry on a coherent conversation, so they sound ok, but they aren't.

@conmel99

Anytime a PWD seems to have progressed from one stage to another, it is prudent to check for something like a UTI. Such infections can be silent as in "no symptoms" and wreak cognitive havoc in the elderly even without dementia.

That said, sometimes it's hard to recognize subtle changes in cognition if your visits are typically several hours during the day rather than several days of 24/7 during which you might see a very different level of function. I have a friend who was a devoted daughter who saw her mom daily collecting her around 1pm and spending the afternoon and evening together until she brought mom home around 8pm. She knew mom was having a cognitive shift and thought she was proactive in moving mom into her home but discovered after living with her 24/7 and prepping her mom's place for sale just how lucky she'd been in avoiding a disaster. Ironically, because I didn't see my dad as often and had to stay over when I did, I had a clearer picture of dad's deficits than my friend did.

People often ask about medication management and the short answer is that sometimes an electronic pill dispenser can be effective for a short time for some PWD but at the end of the day there is no substitute for human supervision. Forgetting meds is more of an IADL than an ADL like dressing/bathing. Thinks of ADLs as those skills we learned as young children- bathing, dressing, self-feeding; IADLs are more of the "adulting" skills we learn as teens and young adults like driving, paying bills, handling emergencies. I trusted my kid to handle his own showers by the time he was 6-ish but I dispensed his meds myself until he was in high school.

It might be better, if she can afford it, to bring in a home health aide to supervise meds daily if you or your brother can't make certain she's doing this properly. I have heard of some folks using FaceTime to make sure their cooperative parent takes their meds in the early stages which worked so long as the parents remembered how to use their smartphone.

Regardless, this is a wakeup call to put together a Plan B with your brother for future care as she will need 24/7 care fairly soon. The link below is a checklist of symptoms and stage in which they typically happen. Most folks straddle stages at times IME.

Tam-Cummings-LLC-Handouts.pdf (tala.org)

HB