Being a carer

Scepticalscribe

macrumors Haswell
Scepticalscribe wrote: However, we found those health drinks - they came in a collection of cartons, either six pack, or a twelve pack, perhaps a 24 pack - to be excellent; off-hand, unfortunately, I cannot recall the brand name.

Two of them with which I am familiar (available in the US; I would guess also in the UK) are Ensure and Boost. Both are used in medical settings and are recommended for consumption by those who for whatever reasons need to add supplements to their meals or in some situations use them as meal substitutes.
Thank you, @Clix Pix for your timely post.

Very much appreciated.

Having read your post, (and thus, tweaked my memory), I'm actually pretty certain that Ensure was the one my mother was prescribed, and that she liked it (well, the vanilla version, at least - she didn't much care for the others and refused to take them).
 

Snow4maen

macrumors regular
Thank you.

As do I, but thank you.

This, I can well imagine.

In any case, some of the replies prompt a further response from me in the form of further advice:



1: Medical Stuff:

While a state funded public health care system is brilliant (and I am a huge fan of the NHS), one of the problems that we found - or, we experienced, - especially in the early days after my mother's diagnosis, was to find out what you were entitled to, and how to apply for it and access it. We were flying blind.

Sometimes, if public finances are somewhat straitened, it can then take a considerable length of time before you will be able to avail of those services.

My recommendation would be to make an appointment with your GP to talk about this; bring a pen and a note book, and write this stuff down. Bring a (trusted) friend, if necessary for support and to prompt you to ask stuff in case you forget.

Ask the GP what services exist - that you are entitled to access - in your local area for people with dementia, which are publicly funded, which are privately funded, and how the GP can support you in obtaining these services.

You won't know what is available until you ask (and then, find out): For us, "plugging ourselves into the system" (and that took a surprising amount of time) presented one of the greatest challenges when and while we were planning for our mother's care.

Supports exist, but you will not be able to access them until you apply (formally) for them, and you will not be able to apply for them, if you don't know about them.

Now, once we managed to obtain access to the system, the actual state supports that were provided were incredible, invaluable, and wonderful.



2: Food, etc:

We had the issue with dehydration, and refusing drinks, as well.

Initially, in the early days, (and this is almost hilarious to read in hindsight), my brothers and I were exchanging healthy organic recipes, trying to come up with meals that were both tasty and healthy.

Now, my mother had always had a very good appetite, and had always liked her food.

Two things changed after her diagnosis:

One, she became far more picky, and choosy and adamant re her food demands, and - like a child - began to refuse to eat her vegetables - instead exhibiting a marked preference for certain, specific foods.

This came about - I suspect - because, secondly, she developed a very sweet tooth, and showed a marked preference for sweet things.

A late development of a sweet tooth is one of the red flags (or diagnostic tools) for dementia: My mother, as it happened, had always throughout her life (and I am the same, now) - and this was also the case for the pair of us even as children - far preferred sour stuff - rhubarb, cooking apples, gooseberries - she adored gooseberries - and so on, to anything sweet; personally, I love lemons, and the entire citrus family.

However, the sudden onset of the sort of palate whereby one wants - for example - ice cream, apple tart, almond croissants, cakes, - (especially in a person who used to disdain that sort of food prior to her diagnosis) - in my mother's case, her sweet tooth kicked in around six months after her diagnosis - along with the sort of stubborn character that a strong willed child may express - means that the diet of the person you are caring for will change radically.

Many people with dementia lose their appetite.

We decided - after a while - that it was stupid (on our part) to fight this battle; stratospheric blood pressure and cardiac problems took second place to caring for someone with dementia.

In other words, (and the GP confirmed this), the key thing was to get her to want to eat, (rather than trying to persuade her to eat a healthy and nourishing diet), and that meant giving her what she wanted to eat.

Thus, her diet comprised cakes, almond croissants, (sometimes, almond and chocolate croissants - all bought in the French bakery), apple tart, rice pudding with tinned fruit, sausages (she loved sausages), chicken wings (she loved chicken wings), chips, (what our Transatlantic Cousins describe French fries), or roasted potatoes (yes, she loved roast potatoes), and so on; we gave her what she wanted to eat, rather than what we thought she should be eating.

Now, that battle - that lesson - took a while to learn (well, we lost that battle), as we simply decided that it was more important that she eat something - anything, as long as she wanted to eat it - rather than insisting that she eat a diet that was healthy. The carer was exceptionally good (and patient - I wasn't that patient) at persuading my mother to eat a few mouthfuls of something a little healthy.

But, that - the healthy stuff - also had to be sweet in taste; thus, carrots and parsnips pureed - with lots of butter, or sweetcorn - worked, whereas healthy greens were disdained and rejected.


3: Liquids:

Dehydration was an issue for us, as well.

My mother, - who had always been exceptionally well hydrated, unlike many of her generation - she was one of the first people I knew who regularly drank plenty of liquids, including water, during the day - developed a dislike of water, as her dementia became more marked, and her sweet tooth became more pronounced - and her tea had to be sweetened in order to persuade her to drink it.

This we addressed by seeking out and sourcing out sweet fruit juices (for example, I managed to find some Italian peach juice, in an excellent Italian deli - standard orange and apple juice were too acidic for her, and she didn't care for them), as well as the sort of tasty "health drinks" (consumed from a small carton, with a straw, or poured into a glass) that you find (these came with a prescription, but ask the GP or the pharmacist for advice) in a pharmacy.

Those health drinks supply some nutritional needs for people who have lost their appetite on account of ill-health, and - if memory serves - they came in chocolate, strawberry, and vanilla flavours.

In any case, I recall that my mother liked only the vanilla, and threw a wobbly whenever it wasn't available, refusing to accept any (lesser) substitutes.

However, we found those health drinks - they came in a collection of cartons, either six pack, or a twelve pack, perhaps a 24 pack - to be excellent; off-hand, unfortunately, I cannot recall the brand name.



4: Do (Play, watch, Listen to) Whatever She Likes:

Harry Potter is an excellent idea.

As @Apple fanboy has already mentioned, for my mother, it was ABBA; we had their greatest hits playing on a more or less continual loop - she loved it, couldn't hear it often enough (which is why she heard it all day, and, had forgotten that she had just heard it), and would proceed to try to conduct the music, or (when she was more mobile), dance to it, or, have "Mr Monkey" dance to it.

Actually, I must admit that I am profoundly grateful to ABBA, for, simply pressing "play" on the CD player and starting the CD (Dancing Queen was the first track, Waterloo the last) would serve to put her in a good mood, and they gave my mother many happy hours during the time she suffered from the condition of dementia.


Once again, the very best of luck and remember to try to be kind to yourself and forgive yourself when you fall short of the demands and standards you try to hold yourself to.

Thanks so much for this, very good of you. I appreciate it, I can take some solace in that you’ve had a very similar situation.

I can relate to everything you are saying! Yes we’ve got fussy eating, and very little drinking. We do have pretty good care here, our doctors have been very good with mum, if I call them in the morning and I am worried about her, very often they come out to see her then or in the afternoon, I’ve lost track of how often I’ve needed this. Mum has pretty severe mobility issues, she can only just make it around the house, and to the toilet. She’s been house bound for years, hasn’t really gone out. And because I’m worried she may have a fall or get in trouble, I’m not getting out much either. And keeping very strange hours.

Mum will have a cup of tea in the morning, whenever that is, it’s currently coming up for 11:30pm!, she may then have a coffee, but often not. I’ve tried to encourage her to drink some juice, but so far that’s been refused, she will accept a glass of milk, but I can’t make her drink it. I encourage her, remind her, but it’s just gets ignored. I mentioned to the carer the other day she is still not drinking enough, when the carer left she got upset and accused me of talking her down all the time, then went off to her room and shut the door and didn’t want anything to do with me! So no drinks!

We are in contact with a mobility team, who have been good, but all the aids they have given mum, she has rejected them. It’s impossible to make mum do anything other than what she wants.

And the fussy eating! So far each day for a long time it’s been roast potatoes. I’ve offered all sorts, but no, she won’t eat them. Its roast potatoes or nothing. She also went through a period of being crazy for sweets, some days all she would eat were sweets. And yes I agree, it’s better to eat something rather than nothing, I mean realistically, you won’t get her to do anything she does not want to. And that may apply to getting in an ambulance, the last time I had to call one, she was stuck in A&E all night, and she didn’t like it. Mum is her own worst enemy. I can try with good intentions to help her, but she will only do what she wants.

Mum’s never been into music, which is strange as I love it. Neither of my parents were into music or creative stuff, not sure what happened to me, but I think I have more fun! It’s the Harry Potter for mum, but last night at some point she tried to put a film on, and now there are discs missing, and in the wrong order, all sorts. Don’t know how that happened. I’ve looked through them to try and organise them, but I’m sure there is at least one film missing.

And yes, the liquid food drinks. They would be great but I’ve tried about three. Yes we tried ensure, the carers got mum some, but she tried it and does not like it, so won’t have it. I was paying for the expensive Huel drink as I thought that would be better, it’s quite tasty. But no, that got rejected. You can only do your best, I can’t make mum accept something, or drink or eat.

I have bought some fizzy effervescent multi vitamins, you just drop the tablet in a glass of water and give it a minute. So far she seem’s to accept that. She needs it on such a restricted diet, but I worry about iron, women need more iron than men if I recall correctly, and a diet of ice cream cones and roast potatoes probably won’t give her much iron. And the iron fortified foods, she won’t eat. Bread, chips, cereal, etc.

The past few days she’s been doing a lot of sleeping in her chair, which is ok, but when she is sleeping she’s not drinking, and she’s asleep a lot. I just made her a cup of tea and she’s fallen asleep watching the film. It will probably get cold.

It’s very difficult to see mum like this, or anyone. And it never ceases to amaze me how wrong health can go, we all go by relatively well and ignorant of how bad it can get. Until we get ill, and sometimes it can be a shock! So many people now are dealing with cancer, more than ever before, I think treatment is better now, but that doesn’t make it easier.

I had an acute psychotic breakdown, and clinical depression, leading to a suicide attempt and a month in a mental hospital, didn’t expect that really, had no idea I could get so unwell.

It makes me think, if today you are well, appreciate it. You are not guaranteed your health.

P.S. I should mention, so far we've not had the terrible mood swings or aggression. Thank God. That would be hard. Mum remains a very lovely person, just a very poorly one.
 

Clix Pix

macrumors Core
Miss AFB was on Ensure when she was loosing weight in hospital for a while.
Yes, it is used in eating disorder treatment programs -- usually as a mandatory supplement to a meal when the patient has not completed the meal -- and it is also utilized in other medical settings such as when someone is recovering from an illness or surgery, and it is used with the elderly, especially those who are in the throes of dementia.

Both Ensure and Boost are readily available over-the-counter (OTC) in pharmacies and grocery stores in the US.
 

Bodhitree

macrumors 68000
Yes, my stepfather luckily was not that fussy over food, in the evenings we would roll him in his wheelchair up to the dinner table and he would happily tuck into whatever we had prepared, ranging from pasta to baked cod in onions and tomatoes.

But he would be a bit fussy over breakfast, he always wanted toast with grilled cheese, and over drinks we would try and keep it varied, tea or bouillon or pear juice. He would refuse any pills, but effervescent vitamin tablets were a good find for us as well.

One good tip, when selecting care worker agencies make sure they get on well with your general practitioner. We had a bit of a conflict, with as a result that our GP didn’t visit us for about a year.
 

Snow4maen

macrumors regular
So apologies for the Bible bashing, I respect all opinions/faiths. But if I couldn't lean on my faith with all this, I wouldn't make it....


Screenshot 2024-05-01 at 08.08.25.png
 

Snow4maen

macrumors regular
I'm not (remotely) religious, but - in such situations (and I have walked that walk in my worn suede shoes, both blue and brown), all I can say is you reach out for whatever works for you when seeking succour and support.
Sure, it’s all about what works. I had a hard time when I was young, all rather negative. I needed to find something truly good as I was feeling pretty cynical, and I needed hope. I found both in my belief of God and my faith. But of course it’s not without its issues. Whatever works, right? I mean God gets me out of bed in the morning. I find it helpful. But I’m very liberal. I believe good is always rewarded, even if you are not a person of faith.
 

Snow4maen

macrumors regular
So a bit of an update...Over the past couple of weeks, and especially the past few days mum's gone very much downhill. Very confused, very deluded. Hardly drinking or eating. I try to get her to do it. Yesterday she lost her remote control for her TV in her bedroom. I looked, I turned the mattress and bedding over, all sorts, I can't find it. So now she can't watch TV in her room, which is quite a problem. This morning, I got up and I go into the lounge and I can't find the remote for the TV in the lounge either, and yep I have looked well. It's gone. So now we have no TV. I have recently phoned the doctors and told then how she is, and they have referred her to the memory clinic. Not sure that is enough, but I can't call them today as it's Saturday..will try on Monday...this is all a bit crazy!!!!
 

Apple fanboy

macrumors Ivy Bridge
So a bit of an update...Over the past couple of weeks, and especially the past few days mum's gone very much downhill. Very confused, very deluded. Hardly drinking or eating. I try to get her to do it. Yesterday she lost her remote control for her TV in her bedroom. I looked, I turned the mattress and bedding over, all sorts, I can't find it. So now she can't watch TV in her room, which is quite a problem. This morning, I got up and I go into the lounge and I can't find the remote for the TV in the lounge either, and yep I have looked well. It's gone. So now we have no TV. I have recently phoned the doctors and told then how she is, and they have referred her to the memory clinic. Not sure that is enough, but I can't call them today as it's Saturday..will try on Monday...this is all a bit crazy!!!!
Not much help with the dementia, but you can buy those universal remotes. I have one on my TV in the bedroom as the power button stopped working on the original. Then stick an air tag on the back of it.
 

Snow4maen

macrumors regular
Not much help with the dementia, but you can buy those universal remotes. I have one on my TV in the bedroom as the power button stopped working on the original. Then stick an air tag on the back of it.
Thanks for this! I just managed to find a replacement for our Sony Bravia, was careful to check the model number, got it on Amazon, arrives tomorrow. I'll look into the air tag and keeping it safe now. The trouble is she's up all night when I am trying to get what little sleep I can and she needs the TV, this is when the remote disappears, so I can't put it away over night to keep it safe. Will look into the air tags...
 

Scepticalscribe

macrumors Haswell
So a bit of an update...Over the past couple of weeks, and especially the past few days mum's gone very much downhill. Very confused, very deluded. Hardly drinking or eating. I try to get her to do it. Yesterday she lost her remote control for her TV in her bedroom. I looked, I turned the mattress and bedding over, all sorts, I can't find it. So now she can't watch TV in her room, which is quite a problem. This morning, I got up and I go into the lounge and I can't find the remote for the TV in the lounge either, and yep I have looked well. It's gone. So now we have no TV. I have recently phoned the doctors and told then how she is, and they have referred her to the memory clinic. Not sure that is enough, but I can't call them today as it's Saturday..will try on Monday...this is all a bit crazy!!!!
My commiserations.

This is all very difficult.

Re remotes, might I suggest that, from now on, - and even thinking of doing this will bring you agony, you may even hate yourself, (well, I did, at times), because taking such a decision, means recognising that each and every such step marks a further (formal) step in marking your mother's decline with the condition of dementia that is claiming her, and a further deterioration in the degree of independence and control over her life that she can be permitted as her condition progresses - you don't leave them in her hands, that you control the use of, and the access to, the TV remote controls.
 

Scepticalscribe

macrumors Haswell
Thanks for this! I just managed to find a replacement for our Sony Bravia, was careful to check the model number, got it on Amazon, arrives tomorrow. I'll look into the air tag and keeping it safe now. The trouble is she's up all night when I am trying to get what little sleep I can and she needs the TV, this is when the remote disappears, so I can't put it away over night to keep it safe. Will look into the air tags...
Ah, my sympathies.

This isn't easy.

This - the "being up all night" - when standard sleep patterns are disrupted - and the individual with dementia is up all night (and often, insanely energetic at the same time), is known as "sun downing" in any of the formal literature.

I suggest that you read up on it.

Two things are worth noting re "sun-downing".

Firstly, it is exhausting - utterly exhausting, and soul-destroying - for the carer, and is very frustrating, and - above all - this is one the issues that can give rise to, or lead to, carer burn out.

And, it is not predictable: With us, we never worked out any sort of predictive pattern - we never knew when a night of madly energetic roaming and wandering would take place.

Worse, secondly, this is when the notorious nocturnal 'wandering" or "roaming" can start to take place.

And, unfortunately, sometimes, this roaming is no longer confined to wandering wildly around the house (or flat, apartment, whatever form the actual domestic dwelling takes).

Sometimes, they can break out (yes, break out) of a locked house and hit the streets, and will (initially, at least) be weirdly energetic and focussed (and, paradoxically, strangely steady on their feet, even if they have a history of falls, and falling, otherwise).

You will have heard tales of how people with dementia can sometimes be found miles away from, or kms away from, their home, and, when discovered, will be in a bewildered state, remembering nothing of how they got to where they were found, and nothing of their activities the previous night.

For us, (and we were very fortunate), this happened only once; at the time in question, I was working abroad, and was away, and one of my brothers had come down for the week-end to put up, and decorate, the Christmas tree.

He, my mother and the carer had all retired to bed, and, sometime after midnight, they were awakened by the sound of the front door (which was solidly locked) crashing open; they leaped out of their respective beds, checked my mother's room to find her bed empty, threw on some clothes and charged out of the house to find a small (and very determined) figure trotting down the street with surprising speed, and extraordinary focus.

They ran after her, caught up with her, and were able to persuade her to return home.

My recollection is that these episodes of sundowning (and nocturnal roaming) tended to occur roughly fortnightly, but with no predictability within that: In other words, it could happen two out of three nights, and then not for another ten days or so.

She never remembered anything of what she had done at night, and was appalled (in the relatively early days, when she still retained some mental capacity) to learn what she had done.

If memory serves, this stage lasted around two years, at least, it did for us.


Now, my recommendations (and remember, I have been there, have done that, and have bought and worn that particular life experience t-shirt), would be as follows:


1: Get a baby (alert) monitor and have one in your mother's room, its twin wherever you are.


This will allow you to hear her breathe, will let you know if she is in any trouble, and will alert you if she is no longer in her room.


2: Now is the time for a bit of Mother-proofing of your house or home: The principles are the same as child-proofing a house, and every bit as heart-breaking.

This includes controlling (and/or limiting) access to stuff such as TV remotes, and anything important or potentially dangerous: Stuff such as TV remotes.

Guard all house keys with your life, and make a few copies - have one on you at all times, and give one (or two) to trusted friends/neighbours.

Your mother will manage to lose them, and will do so at the most inconvenient time possible.

I have known cases where neighbours/friends needed to get into a house when one of the inhabitants, residents, had a fall, or accident, etc.

Turn the switch controlling the electricity to the oven off at night, every night. Someone with dementia cannot be trusted around cookers or fires.


3: If possible, get her some sort of identity bracelet, or necklace, or something that she can wear with her name, phone number (your phone number) and address in case she somehow breaks out and goes wandering and doesn't remember who she is, or where she lives, when someone finds her. (This didn't work for us; however, we were able to have someone - ourselves, and/or the carer, - with her 24 hours a day).


4: Ask your GP to prescribe some sort of sleeping tablet for her, anything to try to regularise or develop a sleeping routine for her. (We had difficulties with this).


Again, may I wish you the very best of luck with what is - I've been there - an exceptionally challenging situation; remember to be kind to yourself, and to forgive yourself. Your mother is lucky to have you.
 
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Snow4maen

macrumors regular
Ah, my sympathies.

This isn't easy.

This - the "being up all night" - when standard sleep patterns are disrupted - and the individual with dementia is up all night (and often, insanely energetic at the same time), is known as "sun downing" in any of the formal literature.

I suggest that you read up on it.

Two things are worth noting re "sun-downing".

Firstly, it is exhausting - utterly exhausting, and soul-destroying - for the carer, and is very frustrating, and - above all - this is one the issues that can give rise to, or lead to, carer burn out.

And, it is not predictable: With us, we never worked out any sort of predictive pattern - we never knew when a night of madly energetic roaming and wandering would take place.

Worse, secondly, this is when the notorious nocturnal 'wandering" or "roaming" can start to take place.

And, unfortunately, sometimes, this roaming is no longer confined to wandering wildly around the house (or flat, apartment, whatever form the actual domestic dwelling takes).

Sometimes, they can break out (yes, break out) of a locked house and hit the streets, and will (initially, at least) be weirdly energetic and focussed (and, paradoxically, strangely steady on their feet, even if they have a history of falls, and falling, otherwise).

You will have heard tales of how people with dementia can sometimes be found miles away from, or kms away from, their home, and, when discovered, will be in a bewildered state, remembering nothing of how they got to where they were found, and nothing of their activities the previous night.

For us, (and we were very fortunate), this happened only once; at the time in question, I was working abroad, and was away, and one of my brothers had come down for the week-end to put up, and decorate, the Christmas tree.

He, my mother and the carer had all retired to bed, and, sometime after midnight, they were awakened by the sound of the front door (which was solidly locked) crashing open; they leaped out of their respective beds, checked my mother's room to find her bed empty, threw on some clothes and charged out of the house to find a small (and very determined) figure trotting down the street with great conviction.

They ran after her, caught up with her, and were able to persuade her to return home.

My recollection is that these episodes of sundowning (and nocturnal roaming) tended to occur roughly fortnightly, but with no predictability within that: In other words, it could happen two out of three nights, and then not for another ten days or so.

She never remembered anything of what she had done at night, and was appalled (in the relatively early days, when she still retained some mental capacity) to learn what she had done.

If memory serves, this stage lasted around two years, at least, it did for us.


Now, my recommendations (and remember, I have been there, have done that, and have bought and worn that particular life experience t-shirt), would be as follows:


1: Get a baby (alert) monitor and have one in your mother's room, its twin wherever you are.


This will allow you to hear her breathe, will let you know if she is in any trouble, and will alert you if she is no longer in her room.


2: Now is the time for a bit of Mother-proofing of your house or home: The principles are the same as child-proofing a house, and every bit as heart-breaking.

This includes controlling (and/or limiting) access to stuff such as TV remotes, and anything important or potentially dangerous: Stuff such as TV remotes.

Guard all house keys with your life, and make a few copies - have one on you at all times, and give one (or two) to trusted friends/neighbours.

Your mother will manage to lose them, and will do so at the most inconvenient time possible.

I have known cases where neighbours/friends needed to get into a house when one of the inhabitants, residents, had a fall, or accident, etc.

Turn the switch controlling the electricity to the oven off at night, every night. Someone with dementia cannot be trusted around cookers or fires.


3: If possible, get her some sort of identity bracelet, or necklace, or something that she can wear with her name, phone number (your phone number) and address in case she somehow breaks out and goes wandering and doesn't remember who she is, or where she lives, when someone finds her. (This didn't work for us; however, we were able to have someone - ourselves, and/or the carer, - with her 24 hours a day).


4: Ask your GP to prescribe some sort of sleeping tablet for her, anything to try to regularise or develop a sleeping routine for her. (We had difficulties with this).


Again, may I wish you the very best of luck with what is - I've been there - an exceptionally challenging situation; remember to be kind to yourself, and to forgive yourself. Your mother is lucky to have you.
Thanks so much for this!

Some great points here, I literally just removed the back door and front door keys and put them somewhere safe. And turned the cooker off at the main switch. I feel stupid for not thinking of this before!

The trouble with the remote controls is, while I’m up during the day I largely have control of them, it’s me that selects the films for her to watch as she can’t handle this. But at some point I need to go to bed, I don’t get much sleep, but I badly need it. It’s becoming more difficult now as she is up most of the night and often comes into my room and asks questions! If I were to take the remotes off her, all the time she is awake during the night, she wouldn’t be able to use the TV. And the TV is all she has, she does nothing but watch it. While she’s on her own, she struggles with this, but manages to get a channel. If I took them off her she’d be up all night with no entertainment, which I would feel bad about.

Unfortunately it’s during the night that the remotes go missing! But I don’t want to leave her without her TV.

Yes I could speak to the doctor about a sleeping pill.

We had a really super chap, Oliver, come over today from the out of hours service as I was so worried about how little fluid mum is taking on. No matter how often I prompt or remind her about drinking, and she always has a drink. She just ignores me. He was very thorough and helpful, but on checking her kidney function noted that it has been in decline for some time. I asked if that was due to lack of fluids and he said it was. We both explained how important drinking is to her as if she does not improve she may end up on dialysis. But when I prompt her to drink, it either gets ignored, or she complains saying she’s had plenty. Which of course she hasn’t.

I mean, she also has COPD, which is quite advanced, and could get into respiratory trouble at any time. And she has glaucoma, has had for years, it’s being treated, but she can’t travel so can’t get it checked. She has very bad mobility problems.

Poor mum is falling apart, it’s not just the dementia, which is bad enough. I’m just doing damage reduction here. Trying to protect her as much as I can, but she is her own worst enemy, she’s never listened to anyone else in her life, and the dementia has just made her even more stubborn.

I can only do my best, but she is only going one way and it’s nearly impossible to help her.

The delusions are pretty full on now. She imagines the bungalow is full of strangers. You can’t tell her it is just us two. She keeps saying she wants to go home, we are home, but she can’t accept that.

So I’m not sure which health issue is going to be an emergency first? The respiratory problems? The possibly advancing glaucoma, which can get nasty. Or the dementia?

I’ve had great support where we live from the doctors surgery, which is still under a lot of pressure. And even our struggling chemist have been good. In our area we have a great out of hours service, which we are lucky to have. And those who I have spoken to numerous times at 111 have been great. But none of this can take the problems away.

I hear glaucoma can get quite painful if it gets bad. But mum can’t manage to get in and out of cars, her legs and knees don’t work well. And the only person who could drive has a car that sits too low for her to get into, even in a friends larger SUV style car, she can’t manage to get in and out of it, we did try. Then there is the confusion, if she did go for an appointment she likely would talk nonsense. I don’t drive as I can’t afford it, and I stopped driving a long time ago and lost confidence, I get very anxious driving and I get confused due to my problems, I just can’t manage it.

It is all very difficult, I can only do my best.
 

Scepticalscribe

macrumors Haswell
Re the TV, my suggestion is not that you leave her without the TV, but that you (and this is heart-breaking) take certain specific steps which will have the effect of curtailing her independence, or autonomy, or choice.

It is heart-breaking because you will want to try to ensure that she remains as autonomous, as independent, as in charge of her life as possible, yet the very nature of this condition ensures that these are the very areas which must be curtailed in order to give her the best chance of some sort of quality of life.

In other words, select a channel for her to watch (check what is on), but keep control of the remotes (otherwise, they will go missing in the maddest of places).

The keys and oven (cooker) advice comes from personal experience, and no, you are not remotely stupid for not having thought about it until now. We never thought about these things (either) until we had to.

One night, I had to physically stop my mother from trying to start cooking dinner (and she never much cared for cooking) at 3 a.m.

And seriously, you do not want her to manage to lose, or misplace, the house keys.

Trust me, this is something you do not wish to experience. And, if it does happen, as is the mad way of the world, it will happen at the worst possible time, and on the most inconvenient day possible. You do not want to have to think about breaking into your own house.

Get copies of the keys cut, and give some to trusted friends/neighbours.

In fact, we even had one of those 'outside safes' installed, (with a code), attached to the house wall outside the back door, where we placed an emergency spare set of house keys.
 

Scepticalscribe

macrumors Haswell
And the coming into your room and asking questions - not least when you are poleaxed and exhausted and foggy with sleep deprivation.

Yes, yes, yes, yes.

Once, when I was away, my mother - at 6 a.m. one summer's morning, - went into my brother, fully dressed and proceeded to wake him up and demanded to be taken to church.

Not only was this utterly surreal, it was also insanely ironical, as my mother was an ardent feminist, and not remotely religious (she had strong views on organised religion and the position of women).

This is an exhausting stage.

When she deteriorates further, while her physical care needs increase, the stress (and exhaustion) associated with this stage will (fortunately) have become a receding memory.
 

Scepticalscribe

macrumors Haswell
Actually, much modern car design is something of a bug-bear of mine, as we also had these issues (just being able to get into SUVs can present a significant challenge for smaller women, it does for me - and not just those suffering from dementia - to enter), and some cars are far too low to be able to enter and exit them with any degree of ease, especially if your knees are wonky, and or you are unsteady on your feet.

And aesthetically, to my mind, they are ugly as well.
 

Scepticalscribe

macrumors Haswell
Re appointments, (medical or otherwise), from now on, - given her confusion - you (or someone competent) must always accompany her; she will not be capable of advocating for her own care needs, articulating what she wants, and nor will she be capable of understanding (let alone remembering) what is going on.

You will need to be there, and you will need to take notes, and ask questions.
 

Snow4maen

macrumors regular
Re appointments, (medical or otherwise), from now on, - given her confusion - you (or someone competent) must always accompany her; she will not be capable of advocating for her own care needs, articulating what she wants, and nor will she be capable of understanding (let alone remembering) what is going on.

You will need to be there, and you will need to take notes, and ask questions.
Yes this has been the case for a long time now. I am the one who calls the doctor out, and explains in as much detail as possible what I can, as best I can. Including general observations, like temperature, blood oxygen, pulse, and blood pressure, which surprisingly for mum are all kinda ok for a 76 year old with her conditions. I have been her advocate for years. But we can’t get out to distant appointments, we are in a large rural area, and not only can I not drive, but mum can’t be transported either.
 

Snow4maen

macrumors regular
Actually, much modern car design is something of a bug-bear of mine, as we also had these issues (just being able to get into SUVs can present a significant challenge for smaller women, it does for me - and not just those suffering from dementia - to enter), and some cars are far too low to be able to enter and exit them with any degree of ease, especially if your knees are wonky, and or you are unsteady on your feet.

And aesthetically, to my mind, they are ugly as well.
Same here, SUV’s are ugly. My father worked for Volvo cars, I always had an affinity for them, they were significantly safer than any other car. Not sure about nowadays mind. I used to own and old style Volvo estate car back when I did drive. Had a bad rear end collision out on a country road one day, the only reason we didn’t end up seriously hurt was that Volvo estate. It took minimal damage, the car that hit us was written off, it was totally knackered! We checked on the driver and got help, and thanks to my trusty Volvo, proceeded off to the main town for a job interview!!

And now I see Volvo have gone with fashion, and I seem to recall they announced the Volvo estate is no more, to be replaced by the SUV style. Very sad.
 

Scepticalscribe

macrumors Haswell
Same here, SUV’s are ugly. My father worked for Volvo cars, I always had an affinity for them, they were significantly safer than any other car. Not sure about nowadays mind. I used to own and old style Volvo estate car back when I did drive. Had a bad rear end collision out on a country road one day, the only reason we didn’t end up seriously hurt was that Volvo estate. It took minimal damage, the car that hit us was written off, it was totally knackered! We checked on the driver and got help, and thanks to my trusty Volvo, proceeded off to the main town for a job interview!!

And now I see Volvo have gone with fashion, and I seem to recall they announced the Volvo estate is no more, to be replaced by the SUV style. Very sad.
I love Volvos - my brother used to drive one - terrific cars, well designed, comfortable and safe.

I used to love Saab for the same reasons.
 

Snow4maen

macrumors regular
And the coming into your room and asking questions - not least when you are poleaxed and exhausted and foggy with sleep deprivation.

Yes, yes, yes, yes.

Once, when I was away, my mother - at 6 a.m. one summer's morning, - went into my brother, fully dressed and proceeded to wake him up and demanded to be taken to church.

Not only was this utterly surreal, it was also insanely ironical, as my mother was an ardent feminist, and not remotely religious (she had strong views on organised religion and the position of women).

This is an exhausting stage.

When she deteriorates further, while her physical care needs increase, the stress (and exhaustion) associated with this stage will (fortunately) have become a receding memory.
I sometimes wonder if I should lock my door, but then it may distress her if she can’t get in. I’d rather reassure her.

Yes religion, all religion, has its problems. I know for the Catholics they don’t allow female Priests. But I am Church of England, and our priest/vicar is a woman, who I very much respect. And she baptised me. My father was pretty awful, I was brought up by my mother. I’ve always gotten on better with women than men, when I was young all my friends were girls. I’m not very ‘laddy’ not that there is a problem with that, but rather than go to the gym or play sport, I would prefer to listen to music, or read a book.

I would be offended if my church didn’t value women equally, and I do think it does. We have female Bishops too. But there are many other issues I struggle with. Christians tend to be a bit prudish about sex, remember lust is supposed to be a sin! And I know people who are quite homophobic. I can’t abide this.

You can’t have it both ways. If God is really omniscient, then with full knowledge and deliberation He has brought gay and lesbian people into existence. A bunch of blokes wrote the Bible, not God. Who are they to call Gods creation sinful?

Love is love.

I lived with a lesbian friend at university. She trusted me, and never told anyone about her sexuality. We lived together for about a year, and that she trusted me with something so personal as a heterosexual male, well. I was very moved by her confidence in me. I’ll never be homophobic.

I don’t exactly toe the line as such, I’m a very strange Christian. I do not want to get married, and do not want to be a parent. And I do not see women as just breeding machines. But having said that, I have no problem with someone who wants to get married, have kids, and be a housewife! The important point is to have freedom of choice.
 

Scepticalscribe

macrumors Haswell
Yes this has been the case for a long time now. I am the one who calls the doctor out, and explains in as much detail as possible what I can, as best I can. Including general observations, like temperature, blood oxygen, pulse, and blood pressure, which surprisingly for mum are all kinda ok for a 76 year old with her conditions. I have been her advocate for years. But we can’t get out to distant appointments, we are in a large rural area, and not only can I not drive, but mum can’t be transported either.
Yes, in rural areas transport can be an issue, and the limitations of (reduced) public transport, and the horrid nature of much modern car design mean that getting places - such as to medical appointments - can be a real challenge.

When (or if) anyone asks "what can I do?", car rides to appointments (in a car that is accessible) is a favour that can (and ought to) be asked, or requested.

If you have any friends with the sort of car that one can get into, now is the time to call on them.

In fact, this is something that my mother used to do for quite a few of her friends, as she drove, and always had her own car, whereas some of her female friends did not.

The onset of dementia meant that she herself took the decision to forego driving, (her GP, for reasons of autonomy, independence, self-respect, urged her to try to continue driving for a little longer) and I suspect that this - and admitting this, accepting this - was one of the biggest blows that she suffered after her diagnosis, as she understood that she was deteriorating and that her further decline was inevitable.
 

Clix Pix

macrumors Core
I really hate to bring this up, but......OP, given both her cognitive decline and her various physical issues it seems to me that your mother has now gone beyond the point where you alone can care for her. Is there not some way you could have someone come into your home regularly, either during the day or the night in order to provide support to you with hands-on assistance and care of your mother? Is there not some social services agency which would be able to work with you? This would give you some respite, some relief, so that you would be able to get some much-needed rest and/or attend to other things, deal with the other usual responsibilities of life...
 
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