Questions for MIL’s neurologist

[Scuba]

Quote:

Originally Posted by robnplunder Awesome! Good job and best wishes.

Thank you very much!

[Teacher Terry]

That is great news. If it’s her idea then she will probably like it. I hope she can afford it.

[Bestwifeever]

For the OP--my good friend and her DH's doc are in tag team cahoots on who should be the bad guy for different things--the doc took on the drivers license issue by saying he was adjusting my friend's DH's medication so driving was not allowed until the meds stabilized, which was acceptable to my friend's DH (who would not be able to drive a car today and no longer wants to). Good luck to your MIL's children in figuring out what to do!

[robnplunder]

Dealing with dementia patient is one instance where lying is encouraged, even required.

[Scrapr]

Good job on the ALF front. The "kids" sat down with Mom & Dad and said pretty much you have to go to a facility. We suggested touring one.Dad was dead set against. The phrase feet first was uttered. Mom didn't say much, but a few minutes later they both come out of the bedroom w/coats on saying let's go. On the way back Mom got a call on her phone from a cousin. Mom said we found a new place! I think the trigger was that she did not have to cook anymore

[MissMolly]

Quote:

Originally Posted by Scuba We got a couple of breakthroughs today - MIL asked a close friend to tour the local ALF with her and she liked it! She taught first grade to some of the staff and she also knows some of the residents. Also she was excited that they would let her keep her cat. She asked DH and me to tour it with her when we are there next week, and also asked that I help her figure out if she can afford it. She does still really love her current home and isn’t necessarily ready to leave it right away, but she is at least open to the idea of moving. Thanks partly to advice from this forum and also from the ALZ Association, we got in touch with the nurse at her neurologist’s office and shared our concerns with detailed examples. We asked the nurse to confidentially share the information with the doc prior to the appointment, and suggested that anything he can do to get her to stop driving and encourage her to move into a safer environment would be very helpful. I feel so much better. This is a long way from being resolved, but at least things moved in a positive direction today. Hopefully BIL doesn’t derail this by continuing to assure her that she’s fine. I deeply appreciate all of the great advice and personal stories shared. MIL is one of the most important people in my life, and her safety and happiness are very high priorities for me. My parents are both deceased and I’ve never been in this position before so it really helps having advice from those who have walked in these shoes.

Not really wanting to burst your bubble, but we took our mom on a tour of Assisted Living places. She picked one out. We moved her in. They kicked her out before the end of the first month due to her aggressiveness towards the other residents (if someone was sitting at a table she wanted to sit at, she drug their chair with them sitting in it to another table, plus yelling, name calling, etc).

So we waited a few months. She again announces she wants to move into an Assisted Living place. We tour. We pick one. We move her in. She was kicked out in 2 weeks due to her unfiltered behavior (loud, obnoxious, hit people, would lay down on the floor right in front of the doors to the dining room to do exercises thus blocking the doors so nobody could enter/exit).

So then we try again with a 3rd place. The first two were large and very fancy upscale places. Since too many people seemed to be overwhelming for her, we then tried a small "group" type home. She only lasted 2 days before they called me. She went in the kitchen and was arguing with one of the staff who was trying to get her to leave the kitchen as she wasn't allowed in there. She grabbed a pan of grease and poured it on the stove thus setting the kitchen on fire (not to mention continuing aggressiveness and abrasiveness towards residents and staff alike).

Then she tells me she knows just what to do in the future to make sure she gets kicked out of places. And smirks at me. Keep in mind, nobody forced her to go to any of these. It was her choice.

We finally resorted to in-home aides for a few months but eventually they could no longer handle her either. She hit. She kicked. She called them horrible names that I cannot repeat. She would sit on the couch and chant "I want chocolate" for hours on end. Just try listening to someone say that to you 20 times in a row and then imagine it continuing for hours. By now, she basically no longer ambulatory and is incontinent.

She was admitted to a psychiatric hospital for a couple of weeks and then moved into another large, upscale place but was put on the skilled nursing level where they could better deal with her. She only lasted about 6 weeks before passing away.

[Teacher Terry]

I am surprised that they didn’t use drugs to calm your mom down.

[MissMolly]

Quote:

Originally Posted by Teacher Terry I am surprised that they didn’t use drugs to calm your mom down.

They finally did at the last place. The other places were Assisted Living, and even though we had her on medication to try to control some of her behavior she just had a stronger will then any medicine was going to conquer. You would have had to know my mother to understand. She was a force to be reckoned with

[Golden sunsets]

Quote:

Originally Posted by Patricia Lyn Dear OP, I feel so much for you and your family! I went through something similar with my mom. We ended up going and getting her from another state and moving her in with us until I could find suitable placement for her. It wasn’t easy. Family members were angry with us, she was angry, it was hard to find a good assisted living home for her. But we ended up finding a good place close to our house. As another poster said, sometimes you have to make unpopular decisions and you never really know if you could or should wait another 6 months, etc...But if it makes it easier, I believe there is no right or wrong in this situation. You just do the best you can and trust that you are looking out for her best interests.

Dear OP; The above comment is perhaps the most realistic option for you that will generate the best outcome for you and your MIL. I have gone through this with my Mom who now resides in a Memory Care facility. My Mom's decline has been fairly rapid. I would not let her drive again and given her memory issues, she is a danger to herself. Your BIL's reaction to his own mother would be the key that would drive me to relocate her to the area that you live in vs. the area she is in now.

[Teacher Terry]

I think the mom’s friends are in this community if I am not mixing up 2 similar threads.

[audreyh1]

Quote:

Originally Posted by MissMolly Not really wanting to burst your bubble, but we took our mom on a tour of Assisted Living places. She picked one out. We moved her in. They kicked her out before the end of the first month due to her aggressiveness towards the other residents (if someone was sitting at a table she wanted to sit at, she drug their chair with them sitting in it to another table, plus yelling, name calling, etc). So we waited a few months. She again announces she wants to move into an Assisted Living place. We tour. We pick one. We move her in. She was kicked out in 2 weeks due to her unfiltered behavior (loud, obnoxious, hit people, would lay down on the floor right in front of the doors to the dining room to do exercises thus blocking the doors so nobody could enter/exit). So then we try again with a 3rd place. The first two were large and very fancy upscale places. Since too many people seemed to be overwhelming for her, we then tried a small "group" type home. She only lasted 2 days before they called me. She went in the kitchen and was arguing with one of the staff who was trying to get her to leave the kitchen as she wasn't allowed in there. She grabbed a pan of grease and poured it on the stove thus setting the kitchen on fire (not to mention continuing aggressiveness and abrasiveness towards residents and staff alike). Then she tells me she knows just what to do in the future to make sure she gets kicked out of places. And smirks at me. Keep in mind, nobody forced her to go to any of these. It was her choice. We finally resorted to in-home aides for a few months but eventually they could no longer handle her either. She hit. She kicked. She called them horrible names that I cannot repeat. She would sit on the couch and chant "I want chocolate" for hours on end. Just try listening to someone say that to you 20 times in a row and then imagine it continuing for hours. By now, she basically no longer ambulatory and is incontinent. She was admitted to a psychiatric hospital for a couple of weeks and then moved into another large, upscale place but was put on the skilled nursing level where they could better deal with her. She only lasted about 6 weeks before passing away.

This is not a candidate for assisted living.

[MissMolly]

Quote:

Originally Posted by audreyh1 This is not a candidate for assisted living.

Up until this point she had been living on her own since my dad passed away in 2002. Where would you have started?

[KCGeezer]

You’ve gotten lots of good advice already Scuba. Listen to her friends and trust your own judgement. For what it’s worth here’s what my mom (and us) have been through. Sounds like we were more fortunate than some.

DF passed almost 30 years ago. DM did well in the house for a good 15 years after he was gone. We have a large family and she loved to have everyone over the holidays. With grab bars and the single story house she continued to do alright until about 10 years ago.

DS and I had been named executors years ago. DS took over paying bills when mom became embarrassed by the shakiness of her handwriting. Then we had to take away the car. Even though she only drove a mile or two away from the house she got lost coming home from church one day. Docs were onboard and that was finally accomplished. She groused about it for years. Made it another 4-5 years at the house with lots of family support.

When it became apparent that she wasn’t really safe by herself (a fall, bought a hospital bed because the guy who called was just so nice, lonely even though one of us stopped by almost every day) we convinced her to go look at independent living. Meals, laundry, activities, and staff could do bathing assistance if necessary. She was engaged giving things to kids and grandkids and a big garage sale but selling the house after 60 years there was tough. she adjusted to her apartment within a few months. Wonderful place close to 4 of the 6 kids that worked great until it didn’t. A couple of falls that she “didn’t know anything about”, then when she got in a delivery drivers van, “I was going to have him take me home”, we knew a more controlled environment was needed. Thankfully we took her to the lawyer and updated all the paperwork to current state regs while she could still fake her way through the competency questions but it was close. She made it almost 4 years in her apartment.

So now she’s been in memory care for about the last 6 months. That has been the easiest transition. We had it lined up and took her there after a short hospital stay saying the nurses just needed to help her get her mobility back. Smiles, jokes, and loves to have family visit although she forgets within 5-10 minutes that we were there. Once in a while she’ll surprise one of us by calling us by name. Some mild aggression towards staff and other residents started about 2 months ago so she’s now on happy pills at the gerontologist recommendation. Buspar and now Rispardal. They seem to help her sleep although DS has had to assist in calming her down a couple of times when the night nurse has called because mom has decided “she’s leaving now!”

The way I understand it it’s a roller coast down from this point. No way to foretell the plateaus, declines, or speed of progression. At 90 now, its all about keeping her safe, comfortable, and happy in the moment. Lately it’s been sorting and rearranging clothes, pictures, and what few Knick knacks she has in her room over and over over.

So do what you can for her Scuba but remember, it’s not her choice to go through this. My advice is to get ahead of it. There’s never a good time for difficult decisions.

[audreyh1]

Quote:

Originally Posted by MissMolly Up until this point she had been living on her own since my dad passed away in 2002. Where would you have started?

I suppose the aggressive behavior didn’t show up until you placed her in a group living situation?

[Teacher Terry]

My friend didn’t get aggressive until she was placed in a home. No choice as her husband died, no family left and her needs were beyond what we could handle. She was a sweet gentle person that totally changed. I really hope O die before this happens to me.

[MissMolly]

Not the hitting and kicking and name calling, but Mom was a force of nature. She had an overpowering personality and had always been very abrasive her entire life. Her sisters had severed all relationship with her years before all this. Her "friends" dropped her like a hot potato after Dad died, so it was apparent the only reasons those relationships existed was due to my Dad. My dad was very kind and soft spoken.

From my earliest memory I always thought she had a screw loose and that sentiment is shared by my 6 siblings. She always sought and demanded attention. At a family get-together she felt she wasn't getting enough attention so she climbed on a picnic table and began yelling (she was 78 at the time). At another family dinner she didn't like something someone said and spun a china plate across the room like Frisbee. It missed my sister-in-law but it hit a window breaking both the plate and the window. Just over-the-top stuff like this. She was always an extremely difficult person to be around.

So yes and no, but she had been that way all her life. I guess we had grown immune to her craziness over the years. It was just normal life with Mom.

[Scuba]

Quote:

Originally Posted by MissMolly Not really wanting to burst your bubble, but we took our mom on a tour of Assisted Living places. She picked one out. We moved her in. They kicked her out before the end of the first month due to her aggressiveness towards the other residents (if someone was sitting at a table she wanted to sit at, she drug their chair with them sitting in it to another table, plus yelling, name calling, etc). So we waited a few months. She again announces she wants to move into an Assisted Living place. We tour. We pick one. We move her in. She was kicked out in 2 weeks due to her unfiltered behavior (loud, obnoxious, hit people, would lay down on the floor right in front of the doors to the dining room to do exercises thus blocking the doors so nobody could enter/exit). So then we try again with a 3rd place. The first two were large and very fancy upscale places. Since too many people seemed to be overwhelming for her, we then tried a small "group" type home. She only lasted 2 days before they called me. She went in the kitchen and was arguing with one of the staff who was trying to get her to leave the kitchen as she wasn't allowed in there. She grabbed a pan of grease and poured it on the stove thus setting the kitchen on fire (not to mention continuing aggressiveness and abrasiveness towards residents and staff alike). Then she tells me she knows just what to do in the future to make sure she gets kicked out of places. And smirks at me. Keep in mind, nobody forced her to go to any of these. It was her choice. We finally resorted to in-home aides for a few months but eventually they could no longer handle her either. She hit. She kicked. She called them horrible names that I cannot repeat. She would sit on the couch and chant "I want chocolate" for hours on end. Just try listening to someone say that to you 20 times in a row and then imagine it continuing for hours. By now, she basically no longer ambulatory and is incontinent. She was admitted to a psychiatric hospital for a couple of weeks and then moved into another large, upscale place but was put on the skilled nursing level where they could better deal with her. She only lasted about 6 weeks before passing away.

So sorry. Sounds like a horrible experience. I doubt we will have similar issues with MIL. She’s very social, agreeable and fun-loving. Of course this could change as her disease progresses but so far we haven’t seen any decline in her desire to be pleasant to others.

[Scuba]

Quote:

Originally Posted by Golden sunsets Dear OP; The above comment is perhaps the most realistic option for you that will generate the best outcome for you and your MIL. I have gone through this with my Mom who now resides in a Memory Care facility. My Mom's decline has been fairly rapid. I would not let her drive again and given her memory issues, she is a danger to herself. Your BIL's reaction to his own mother would be the key that would drive me to relocate her to the area that you live in vs. the area she is in now.

We would not move her to us. I really think she’d rather die than leave her beloved little town where she’s lived for 50 years. She was a first grade teacher and has been a very active volunteer and community member. She has many friends, including four close friends who have been supporting her since her decline began (not financially but emotionally and also doing little things for her. Plus, any care facility will be thousands per month more expensive in So CA vs a rural area in GA.

We are not under the illusion that we could take care of her in our condo.

[Scuba]

Quote:

Originally Posted by Teacher Terry I think the mom’s friends are in this community if I am not mixing up 2 similar threads.

Yes, you are right.

[Scuba]

Quote:

Originally Posted by KCGeezer You’ve gotten lots of good advice already Scuba. Listen to her friends and trust your own judgement. For what it’s worth here’s what my mom (and us) have been through. Sounds like we were more fortunate than some. DF passed almost 30 years ago. DM did well in the house for a good 15 years after he was gone. We have a large family and she loved to have everyone over the holidays. With grab bars and the single story house she continued to do alright until about 10 years ago. DS and I had been named executors years ago. DS took over paying bills when mom became embarrassed by the shakiness of her handwriting. Then we had to take away the car. Even though she only drove a mile or two away from the house she got lost coming home from church one day. Docs were onboard and that was finally accomplished. She groused about it for years. Made it another 4-5 years at the house with lots of family support. When it became apparent that she wasn’t really safe by herself (a fall, bought a hospital bed because the guy who called was just so nice, lonely even though one of us stopped by almost every day) we convinced her to go look at independent living. Meals, laundry, activities, and staff could do bathing assistance if necessary. She was engaged giving things to kids and grandkids and a big garage sale but selling the house after 60 years there was tough. she adjusted to her apartment within a few months. Wonderful place close to 4 of the 6 kids that worked great until it didn’t. A couple of falls that she “didn’t know anything about”, then when she got in a delivery drivers van, “I was going to have him take me home”, we knew a more controlled environment was needed. Thankfully we took her to the lawyer and updated all the paperwork to current state regs while she could still fake her way through the competency questions but it was close. She made it almost 4 years in her apartment. So now she’s been in memory care for about the last 6 months. That has been the easiest transition. We had it lined up and took her there after a short hospital stay saying the nurses just needed to help her get her mobility back. Smiles, jokes, and loves to have family visit although she forgets within 5-10 minutes that we were there. Once in a while she’ll surprise one of us by calling us by name. Some mild aggression towards staff and other residents started about 2 months ago so she’s now on happy pills at the gerontologist recommendation. Buspar and now Rispardal. They seem to help her sleep although DS has had to assist in calming her down a couple of times when the night nurse has called because mom has decided “she’s leaving now!” The way I understand it it’s a roller coast down from this point. No way to foretell the plateaus, declines, or speed of progression. At 90 now, its all about keeping her safe, comfortable, and happy in the moment. Lately it’s been sorting and rearranging clothes, pictures, and what few Knick knacks she has in her room over and over over. So do what you can for her Scuba but remember, it’s not her choice to go through this. My advice is to get ahead of it. There’s never a good time for difficult decisions.

Thanks for sharing your story. I agree.