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New territory with vascular dementia

1930strong
1930strong Member Posts: 1 Member
Hello! My mom just turned 96. As both my husband and I work full time (and all my siblings are out of the area), we helped mom sell her house two years ago to move to a brand new assisted living community in the same town, 8 minutes from our house. She had cognitive impairment, was forgetting her meds, not paying bills, left a burner on and thankfully didn’t start a fire, let her drivers license lapse and so was becoming socially isolated. She’s quite physically healthy and quite bright! She has done well at her new place, only needing med reminders, but in the last several months repeatedly forgets that her loved ones have passed away (my dad, my brother, her parents and siblings, etc). When she remembers or asks us if they have died, after 20-30 minutes of soothing assurances of the facts she gets it all straight again and is ok (and relieved). However, just recently she got it in her head that since my dad hadn’t “come home” that he must be somewhere having an affair, and of course this was devastating to her. Note: they were married 60 years. 6 kids, devout Catholics, and my dad was the absolute most wonderful, loyal husband, dad and family man. He died 15 years ago. She isn’t at the point where we can tell what I’ve heard is called a “therapeutic fib”; eg: “Dad ran to the store and he’ll be back shortly”. Instead, she understands the truth of the matter once explained, acknowledged that dad would never have cheated on her, and as a result feels she is losing her mind, not understanding why she can’t remember such significant events like my dad and brother passing from cancer or the fact that she constantly thinks my dad just died this week and we need to plan the funeral (until we explain it all for the 100th time and she gets relief from the confusion and anxiety). She is also recently thinking she’s only been at the community for a few days and is blown away when she finds out she’s been there two years. I’m looking for guidance from those with similar stories, wondering what comes next, if there is some kind of consistent timeline at this age, etc. She will be able to transition to the next care level, and then memory care if needed, but we don’t want to bump her “up” until appropriate. She still does everything on her own (bathe, dress, makeup, jewelry, etc., goes to many of the daily activities offered, happy hours, meals in the dining room, etc.) including cleaning the cat box at least half of the time! :-) I’m guessing the next phase will be complete memory loss? When we will then be using the therapeutic lies? Or no? It’s a terrible phase for her and pretty draining for me and the other siblings as she calls with the heartbreaking questions sometimes 2-3 times a day. I know others suffering so much more as caregivers and I salute you, but wanted to share in the chance someone else is experiencing a similar situation, thanks for reading!

Comments

  • SDianeL
    SDianeL Member Posts: 3,345
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    Member

    welcome. Sorry about your Mom. In my opinion your Mom should move to MC now. In AL they do not have 24/7 care, they are not trained on dementia caregiving and the facility is not locked and secure. She could leave. Her safety is the most important consideration not her happiness. By telling your Mom over and over about the deaths you are causing more anxiety and although she may finally agree and understand it’s temporary and she is having to relive the grief. I would try some therapeutic fibs. She is having delusions about your Dad. Ask her doctor for medications that will help with those and with her anxiety. I would let all calls go to voicemail and only call her once a day. Same for your siblings. Perhaps a schedule? I am attaching the staging tool that will help you see where she is and what to expect but everyone progresses differently so it’s impossible to know a timeline. https://static1.squarespace.com/static/6372d16ea4e02c7ce64425b7/t/63f7b80d80d8aa3e3aa4a47d/1677178894184/DBAT.pdf

  • H1235
    H1235 Member Posts: 2,058
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    Member

    Welcome. We usually say here it’s best to live in their world. You say she understands the truth of the matter once it’s explained, but that truth is still causing her stress. A therapeutic fib is not necessarily used because the person with dementia won’t understand or accept the truth, it’s used to avoid them suffering the loss of their lo or getting upset about something over and over and over. I would tell her a fib about your dad. If she doesn’t believe it try a different one until you find something that will give her some peace. Whatever story you tell her try adding in that he loves you and misses you, can’t wait to see you…. If she thinks she has just moved to the facility, let it be. There is no point in correcting her. If she asks how long she has been there again, tell her you can’t remember. If she remembers they have passed on her own and is concerned about funeral arrangements, I would try putting arrangements off til tomorrow or tell her everything is all taken care of and see if that works. Its really about finding a story they are able to accept and that gives them some comfort. Every person with dementia is different and you need to find something that will work for her. I would not correct her about anything unless it’s a safety issue. If she thinks the sky is green, if she doesn’t count the sibling that passed when asked how many children she has, if she somehow thinks she is living in a condo in Florida, just agree and move on. All this can make conversation difficult. You find there are so many things that can’t be brought up in conversation and the urge to correct is sometimes overwhelming. I will attach a link that I think gives a good explanation for using the therapeutic fib. I know nothing about the law firm that posted it. Mc is not just for people with total memory loss. It’s about safety. With an unlocked facility you are taking a chance that she will not try to leave. Mc also provides more care. Are you sure she is still brushing her teeth. It’s tough to really know. I know I made some big assumptions with these kinds of things. I hope something here helps.

    https://www.darpelelderlaw.com/therapeutic-fibs-and-dementia-a-compassionate-approach-rooted-in-love

Commonly Used Abbreviations


DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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