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I got a ride to visit Mom for the first time since I broke my ankle. I brought her snacks and ensure, milk, etc, as well as clean clothes. I brought my new puppy hoping that would make her smile, peak her interest a little. It didn't. Its been 4 weeks and I can see a big change in her. A good change is the Zoloft appears to be working and she doesn't seem quite so negative, argumentative, or depressed. I found no obsessive notes all over her room like we have seen for the past 2 years. Somehow, she didn't seem as unhappy, but somehow she seems resigned, maybe giving up. Maybe without the obsessions she is facing reality?
She looks terrible, as if she has aged years and acts very tired. She hasn't had her hair done in weeks because she says she doesn't feel well. She said if she doesn't go down for meals they bring them up. It appeared she couldn't hear well out of her new hearing aids. The more I thought about it, the more I believe it wasn't her hearing but more her inability to follow and comprehend what she was hearing. She seemed a little "out of it". A few days ago she called me and my sister, perfectly able to hear on the phone, but the last 3 weeks she has called several times a day and says "I can't hear a thing" and then hung up. What changed, we don't know.
She kept lying down and sitting up, and I only stayed 45 minutes because she seemed exhausted and I noticed she has tremors that are worse. She said her ribs hurt. I asked if she had fallen and she said yes, then she said no. I told her I would talk to the nurse so they can take her to the doctor since I can't drive with my broken ankle. She freaked out, her usual self of refusing any help, saying "they will all come up here and try to take care of me".

We are paying $4200 a month for her to be taken care of, and she isn't getting much of anything because she hides in her room and won't let anyone know her needs. Its her stupid stupid pride and yet she goes around wearing filthy clothes and doesn't shower. I found a stinky used depends in the night stand and dirty dishes under the sink, a huge pile of dirty clothes in the closet (so here I am still washing and ironing her clothes? ) and if the surface looks ok, that's as far as the AL goes? They don't check around, they don't check and clean her hearing aids? They tell me she is ok, but we suspect it is because she lies and pretends she is fine so they will leave her alone, and probably they think we are the problem thinking she isn't fine. I thought this was a great place at first, but I beginning to think they really don't observe her because they know she won't let them help her or maybe at 100, she is just allowed to survive however she chooses. There is no use telling them her ribs hurt or that she might have fallen because she has already rejected their request she use a walker 1) she will lie and tell them they don't hurt any more and refuse to go to the doctor 2) if they took her to the doctor, what could he do - pain pills? any instructions she wouldn't follow and they can't make her 3) she has cried wolf for the past 20 years, we have no idea when she does or doesn't have a serious pain. She has never had even a headache so the slightest splinter she makes a big deal. One minute she says something is wrong, the next she denies it.

But, somehow, something doesn't seem right with her, a change that feels like an omen, and I wonder if she is just letting go at this point. At 100, its possible. I simply don't know if there is anything more I can do or what I can ask them to do in my absence. Maybe AL is just a glorified expensive babysitter unless the person actually lets them help. One good thing, the zoloft at least has relieved some of her anxiety and obsessions so she isn't so unhappy. Maybe I have to just leave it at that.

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If she's stable on a current dose why would you have the doctor lower it and go backwards? I say leave well enough alone. Side effects are not guaranteed to happen. If they do, then work with the doctor to adjust.

My mom has behaved like your describe your mom for years. Years and years and years. It's not the end. It's partly dementia, depression, and possibly other problems.

It was around this point my mom had to leave her apartment and move into the skilled nursing/24-7 unit. Her cognitive ability was just too far gone to remain safely independent.
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AmyGrace: Thinking of you today. Peace and Blessings to You and Mom.
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She's only been on the Zoloft for 6 weeks. Actually she is much better as far as her negativity, depression, verbal aggression and obsessions. I could ask the doctor to cut it back now that she is calmer.
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I know people who have taken Zoloft and you may want to check this out, because the people I knew on it had problems with it causing them to feel spacey and even depressed - the very thing they were taking it for. If it turns out to be the Zoloft, perhaps they could at least cut her dosage down.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842121/
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COULDITBEME: Yes, my mother cries when she doesn't get her way, just like a little girl, and she can turn it off fast. She also answers the phone in a voice that sounds like she is on her deathbed. Then she says she doesn't feel well (naturally at 100, but we have heard this for 10 years, and she still has no health problems). Two minutes later she starts talking in a normal voice. She is little girl, helpless victim manipulative. I think that is how she controlled my stepfather because he was a bully.
You are doing the right thing, just walking away when your mother misbehaves. I've found there is no arguing with a person with dementia. When Mom gets argumentative and difficult, I leave. I noticed that for the past 3 years, its impossible to hurt her feelings because she doesn't remember on thing that happened 10 minutes ago, sometimes 5 minutes ago. That's probably why she only looks at magazines, because she doesn't remember what she read by the time she reaches the end of a paragraph.
I hope you get your wish that you can keep her home, but know that the dementia is very slow progression unless they have a physical event. Dementia patients can live a long time. Mom has been sliding for 10 years and even now, she would know if she was put in a mental hospital.
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she sounds like my dad. He is only 81 but he started this behavior about 10 years ago. Basically he just sits and watches TV all day for 10 to 12 hours a day. He has no interest in anything although he used to. if we try to get him to go somewhere or get involved in something he just says not interested. I think you are doing the best you can with your mom and although her behavior is strange to you she is never going to change. You do have the right to call though assisted living all the time especially if you are paying them that much money and they are not taking care of her basic needs. I hope things work out okay for you
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A memory test was done (I can't remember what it is called) . No blood test were done. Due to past history (with the same Doctor 13yrs). She is Geriatrician and Internal Medicine. She has been a great Doctor to Mom and has no problem doing whatever is necessary to help her. So, I guess she dropped the ball on the test. She reviewed and removed 2 meds that had side affects that would make dementia worse. I just didn't know what test can be done to help diagnose dementia/Alzheimer. I have an appt. to see Doc for me and about Mom. I go without her so I can inform Doc. I am still searching for all the info I can get. She started on Aricept (generic) last week of April. Doc wanted to try for 3 wks to see if there is any improvement and if she can tolerate the meds. I didn't tell Mom she is taking that. So far, no difference in anything. Your description of your Mom is almost exactly like mine. Does your Mom cry at nothing and especially if she doesn't get her way? Mom drives me insane with that. Since I had lumbar spine surgery in Jan and I live in Chronic Pain complicated by other medical problems, I am working on financial ability to hire a little help with personal hygiene and some respite. Hopefully, Mom's check will be a portion of that cost. Hoping. I am the eldest of 4. My sister is 2 yrs younger than me. She says she is not able to take care of Mom. Well, what about me? (pout moment). That is another post. I am walking away when she starts her stuff. I go to my room and my dog stays with me. It would be cheaper to keep Mom at home than the NH. I am hoping I can hang in long enough for Mom not to know what is going on then I can admit to NH without feeling so bad. Happy Mother's Day to you. Thanks so much. I read your post and learn from them. Keep it up.
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ITCOULDBEME: I'm not sure there is one best answer since dementia is so diverse in its behaviors, except that it is difficult. Its dealing with an adult who still has adult skills and language ability but acts like a child. Unlike a child, they do not learn, do not grow up but deteriorate and you can't reason with them. Its hard to get your mind around it. Your mother is a lot younger - maybe you need a second diagnosis to make sure it isn't something that can be treated? Mom's lousy doctor threw Alzheimers at us and we will never know for sure since she wasn't tested for it. It doesn't matter at 100. It is what it is. You don't say if you are going to put her in AL or try to take care of her yourself. (I tried living with mine about 25 years ago and my sister tried long before that. Mom carries around a dark raincloud which she enjoys sharing, and with no interests of her own and seeing the glass half empty, she consumed and smothered every part of our lives in negativity. And yet, she presented a sweet, little girl, nice person to others. We just can't live with her.) At least in IL (and now in AL) she is with people her own age and shared experiences. We could never trust her not to do dangerous things like climbing stairs with a cane, standing on a chair, etc. so she is safer where she is. Some of us on this forum can be full time caregivers, some can't for whatever reason. Know that caregiving can affect your health so whatever you decide, do not feel guilty because you need to live your life. Love her, make sure she gets what she needs but it doesn't all have to come from you. As far as dealing with her - Don't let her rope you into endless arguments because she will not remember, and you can't reason with dementia patients. An important thing to know is that daughters seem to get the brunt of it, we become THEIR mommy and they often take it out on us and can be very different people around others.
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AMY GRACE: Your Mom sounds like my Mom in a lot of ways especially the last statement you made to Garden. Mom is 77. This Jan she was diagnosed with Alzheimers. The doctor calls it Alzheimers one time and dementia the next. I am so tired and confused. I don't know which way to go. She was put on Aricept 2 wks ago. I can't see a change. My question to you is do you have any experience that you would share with me regarding this sad adventure? She has high b/p controlled, high cholesterol on meds, osteoarthritis on meds , hypothyroid on meds, and Alzheimer/dementia on meds now. Anything will be appreciated. I noticed your experiences and appreciate your post. Thanks and God's Blessings to You and Your Mom.
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Boy AmyGrace, my heart goes out to you. And your mom. It sounds like you and your sister have tried your best to make your mom's life a good one in her present condition. You can only do so much...hugs.
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Garden: Mom has had no short term memory for at least 6 years and she has been this way all along. Something sticks in her head and she obsesses. Most of what she sees and hears is forgotten in a couple of minutes. They have lovely music activities which she goes to for about 10 minutes before her attention span wanders. She has never been interested in music although we have tried. Most of Mom's problem stems from the fact that she has no interests or hobbies and never did. (she has always been strange that way - her only interest is how she looks and family) Actually, I brought my new puppy when I visited her. She hardly paid attention to her, didn't even pet her. I have two mini poodles and often brought my older one to visit when she was in IL. She showed little or no interest. We have always decorated her room and before that, her apartment. Little by little she takes everything down and stuffs it in a drawer. Sadly, even when younger Mom was incapable of real enjoyment of most things the rest of us find wonderful - a good meal, a nice shower, music, art, hobbies. She just sits and thinks about things to worry about. Its very sad.
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Are there any music or pet therapy activities in the facility? If not, ask the director or administrator about that and if they can get some started. Bring a CD player or radio, something easy to operate, and play music that your mother liked while you're there.

These are things that can be done in her room, unless the facility has activities that are musically oriented.

At 100, she may in fact be thinking that enough is enough, but there may be something like a furry little dog or music that could bring her out of the slump, if that's what it is.

It's also possible that the change is just too much for her - especially with your physical limitations so she's feeling lost without her usual supports.
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Sigh.....poor Mom. Her dementia is so awful (but I am glad she is not aware of it) Yesterday she called me five times asking about my broken hip and whether my sister broke hers. She has no memory of me being there on Sunday (with my boot and knee walker). She has a new "obsessive thought" going through her head and I have to keep re-assuring her I have not broken my hip, only my ankle. I had written her a note about my ankle, but when she read it to me, she added broken ankle and hip. Three calls within 15 minutes, obviously each time not remembering she just called. Its so sad.
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Blannie you have my sympathy! My sister and I spent 8 years doing just what you are doing - giving assisted living to Mom while she was in IL. The last two years were awful as her dementia got worse and worse. She was living on ensure, yogurt, soup broth and sweets. Other residents were looking after her because she was confused a lot. She hid things too (especially milk of magnesia) and I did almost 80% of the care. No one in the family would agree with me to move her to AL, but finally I convinced the doctor at her annual to diagnose her and based on that, the IL refused to renew her lease. Otherwise she would still be there! I hope I have given you an "out" if you need one to move her!
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My first guess is that she has gastritis or GERD possibly as a medication side effect and can't put it ont words other than "my ribs hurt." Have her take the Zoloft with food and get her some Zantac (ranitidine) 75 BID to go with it - its OTC and worth a try. Yes, in AL they do let them refuse quite a bit of care, but maybe if she feels better she will start letting them help more.
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AmyGrace your mom reminds me of my 95-year old mom. Only mine's in independent living. As a friend told me, "No, your mom is in assisted living and you're providing the assisted part." True! My mom is almost a hermit and happy about that. I shower her, bring her food (she no longer goes down for meals), books, take her to the doc etc. She's stubborn like your mom and doesn't want any help from outside. She has been known to hide things and she certainly lies about how she's doing if anyone asks. She's now taking naps, so I think, like your mom, she's winding down. She's also frail and is ready to go (as she's told me 5,000 times). Hugs...it's tough being caregivers to these stubborn old gals!
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No countrymouse, neither of us can get Mom to the doctor now. I can't drive or walk more than a few steps and sis is having surgery tomorrow. The facility could "accompany" her, but the "aides" are not committed or observant enough and could not represent a family member at the doctor's office. As you said, the AL's hands are tied because she does not want help. She can get up and dressed, make her bed, put on makeup, get herself something from the fridge, get herself down to meals (when she feels like it). She hasn't showered or bathed in years and refuses to take one - and the AL won't force her as long as she doesn't smell. Basically, as long as she can get around like that they don't need to spend a lot of time with her. They do make sure she gets at least 2 meals, but they can't force her to eat. She lies like a pro, puts on an act and that is what they see. Its sad because life could be easier for her, she could be getting more help if she asked for it. But she is the most stubborn person I have ever known my whole life, and she isn't going to change. We have decided to let her determine her own fate at this point. She is 100 years old and very frail, but yet strong. Unless she is physically ill with something that can be treated with antibiotics that the AL can dole out, she will not cooperate or let herself be helped. Perhaps she has given up and unconsciously wants to die, and if that is her wish, she has the right to make that decision.
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AmyGrace, on behalf of your mother you are entitled to be a hundred quid a day's worth of pest. Remember that, and call away.

There are two sides to this story. Side One: your mother appears to be fine and declines offers of help: the AL staff's hands are tied. Side Two: What part of the word 'Assisted' are they having difficulty with? Where is the default help with activities of daily living, including washing, dressing and generally coping?

Most of all, in that useful four week break - just about the perfect interval for you to have stepped back so that you can see the wood for the trees - you have observed a noticeable but hard-to-define ***change*** in your mother. Can you or your sister or both together get her PCP/GP to visit her, with you present to assist with hearing and communication? If it were me I'd want her checked out. It could be nothing, or nothing anyone can do anything about anyway, but at least you'll have a ruled out a few of the usual suspects
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Thanks Jessie. I guess I have to do that. I feel like I am calling them about stuff all the time (things we expected that should be doing or noticing) and I don't want to be a pest. Just in case, I'll bring up a hamper and put a big sign on it "HAMPER" and hope that Mom will use it. (Probably not since she ignored the hamper at IL and threw her clothes on the closet floor then also.) My mother is one odd duck!
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AmyGrace, I don't have any answers. I just wanted to give you a big hug. She is 100, so it may be the end is soon. We never know. The only thing I can think to do is to tell the staff where to look to get the dirty clothes and dishes. Sometimes we just have to work with where they are.
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