Mother has forgotten how to speak English in memory care. Any suggestions?

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Mother has forgotten how to speak English in memory care. Any suggestions?

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My mother is a very healthy 98-year-old who has been living with me for many years. The past two years have been so difficult, her dementia became violent and she hallucinated that the sitter and myself were trying to kill her. She no longer recognized me. She wanted to move back to her native country of France. I actually took her there to visit for 6 weeks and I almost lost my mind. She did not recognize the place or the family and screamed for the police to get her out of there. She refused to eat what I prepared because she thought it was poisoned. We came back home in what I can describe as the most difficult flight of my life and all she has been asking for is to go somewhere else where there are people her age.

I found a beautiful Memory Care a few minutes from my house and got on the waiting list. It took 3 months and every day she would pack her bags to go there. Finally we moved her in and once she was there she wanted to leave and go back home (meaning France). It has been three weeks and it's been a very rough start. The first night, the nurses aide came to change her and my mother refused. The aide got very rough with her and forced her on the bed and forcefully changed her. Thankfully I have cameras and was able to see this and report it immediately. She was fired on the spot.

Now my mother gets aggressive and screams and kicks any time someone wants to change her, put her in bed, etc. She has "forgotten" to speak English and only speaks French to the helpers and to the other patients. She says she does not understand English at all. We have lived in the US for 50 years, she spoke English all that time. She is on Seroquel and an anti anxiety med.

I am at a loss of what to do. I visit her every day, bring her gifts, nothing works. Surprisingly, she now recognizes me as her daughter. I am considering bringing her back home with me but I am afraid she will do the same here. Any suggestions?

Alzheimer's & Dementia Communication & Language Memory Care

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Has she been checked for a UTI? Often changes in behavior are the only symptom and elderly women get them A LOT. Start there, if you haven't already. After that I'd ask the doc about medication adjustment.

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Thank you for your response, she has been checked and no UTi. Her meds have been adjusted twice since she is there so it could be that she needs more time...

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This doesn’t sound like a uti as much as her longstanding dementia. Op, it got bad enough so you had to place her, and now it’s worse. Many mcs tell los to not visit initially so that the elder adjusts.

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Thank you for your response, this facility encourages visits as much as possible. It could be that I am there too much and she needs some distance from me to adjust. I agree with you that it is the dementia working on her.

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Please don’t bring her back to your home until you have given her a much longer chance to orient herself to her current surroundings.

None of the behaviors you’ve described are surprising, and none of your efforts to comfort her or please her are unexpected in your position as a loving and devoted daughter.

Unfortunately you mother may have arrived at the point in her progressive neurological deterioration that none of your good ideas can make ongoing sense to her.

Three weeks is actually a VERY BRIEF span of time to expect even limited adjustment to a totally new environment. When my LO entered a very good local MC, we were thrilled when after about 6 months she began to respond positively to her new lifestyle.

Unless the staff has encouraged you to do so, you may be visiting too much (and worrying too much and empathizing too much), for her welfare AND YOURS.

Part of the adjustment to residential life is for the resident to slowly realize that caregivers are there to HELP THEM. If a caregiver/relative is too often present, you can see how that process can take longer.

Obviously you and she are both still dealing with the horrible, DEPLORABLE experience with the banished aide, but assuming her current care is acceptable, she will hopefully move forward.

The bilingual issue is interesting. As long as she has some comprehension of what’s said to her AND a willingness to communicate in some way to express her needs, it may not be too important at this point.

You have attempted to move Heaven and Earth (literally!) to do your best for her. Now give her some time to just observe and become accustomed to her routine, BY HERSELF.

Your concerns about bringing her home (another MAJOR CHANGE) are fully justified. Her “illness” is progressive. Change can exacerbate her struggles.

You may want to enquire whether there is a psychiatrist on staff at her MC. A small dose of medication may be helpful. It was a Godsend for my sweet LO.

Hugs and hopes that you and she find a good balance at some point in the not too distant future.

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Thank you for your very caring response. I am dealing with the guilt of putting my mother in MC and your words help immensely. I will take your advice and try to distance myself a bit (it's going to be hard) but you are right, she needs to know that the caregivers in this new home are there to help.

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There is nothing you can do to improve her condition. It's not uncommon that people with dementia who speak English as a second language, will forget it and only leave intact the original native language. The brain functions can be compared with an onion because it has many layers. The outside layers are the first ones to go. Then layer after layer from the outside in. A second language is an outside layer. The native language is a deep layer. All learned knowledge including social appropriate behavior are outside layers. The core of the onion contains only animal instincts for survival, aggression and sexual. That's why some people with dementia can become sexually obsessed. Not because they really want sex and are able to perform. It's only the raw animal instinct, devoid of any physiological or emotional inolvement. It's not real sex, it's only the primitive automatic manifestation of the reproduction instinct. It never involves the rest of the body, it's totally automatic and unconscious.

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Wow! I have never heard such a clear and descriptive explanation of this. Thank you, I will keep the onion and layers in mind.

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As TChamp said, people suffering from Dementia will revert back to their first language. Mom had an Italian lady in her NH. Her family owned a restaurant for years so she knew English but she only spoke Italian.

You need to give your Mom some time to adjust. I see nothing wrong with showing up sometime during the day but don't stay for long. Get her out in the Common area where there are other people. Let the staff do for Mom.

I would not bring her home. Stop feeling guilty about something you have no control over. You will enjoy her more if you're not doing the constant caring. France is not going to happen. That is not your fault. Your Mom is 98! The mind and body have to give out at some point. Look at the years you had together.

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Thank you, your kind words mean a lot!

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Retired ESL teacher here. My mother is also in Memory Care.

T Champ is correct, regarding the language and brain layers. If you think of that onion being eaten away from the outside in, you can get an even clearer picture of what is happening.

At my mother's MC, there are MANY Hispanic people there. Most were truly bilingual before dementia, but who now only speak English. In Florida, luckily for them, we have many caregivers who are bilingual.

It might be interesting to know if your mom has any "receptive" English left. Like if a caregiver asks her a question, can she indicate a preference? Like, Mrs. Smith, would you like an apple, or an orange?"

If not, can the caregivers use more objects, or picture cards to show her the choices that she may have to make?

As an ESL teacher, I had many sets of cards that would have a representation of an object or an idea. You could make or buy some.

Here are some body part cards that you could print. I'm thinking that you mom might be able to point to something that is hurting her, for example.

https://en.islcollective.com/english-esl-worksheets/search/flashcards?vocabulary=body-parts&student-type=elementary-school

Here are some from Amazon that you can buy:
https://www.amazon.com/eeBoo-French-Flash-Cards/dp/B07F6XHY4F/ref=sr_1_1?crid=20BV1MLBLB4VO&keywords=flash+cards+food+french&qid=1651076668&sprefix=flashcards+food+french%2Caps%2C81&sr=8-1

I've even made Powerpoint slides and posted them on walls for new speakers of English.

Feel free to send me a personal message, if you need more ideas.

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Thank you so much for your advice. I can see you were a great caring teacher. I will look into getting the flashcards.

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This is an additional note about my comparison of the brain damage caused by dementia with peeling an onion from the outside in. Recent memory is the outermost layer, therefore, it's the first to go. The memory occupies all the layers of the onion, from the most recent to the earlier and oldest life experiences, always in the direction from the outside in. People with dementia may lose all the memory related to their adult life, but have vivid recollections of their childhood experiences. Practically at the end, they have reached the mental state of a new born baby, in which only basic instincts remain. They become totally helpless, can't eat on their own, and are bowel and bladder incontinent. They have completed a reverse journey of their lives. From that point, they are ready to return to wherever they came from.

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I just got back from my mother's MC where she was having a meltdown and of course, all in French and no one understood why she was crying. I thought of the onion and it helped me understand it better and calm her down.
Thanks!

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This can also be manifestation of stroke affecting the language centers in a way that spares first language. I have seen this many times with left brain stroke specifically. There is also a phenomenon of "chronic stroke" that doesn't show abrupt changes, but is a manifestion of inadequate blood flow to part of the brain. These are conditions that can be managed, but at Mom's advanced age aggressive treatment is not usually worth the effort.

A practical suggestion is an interpreter. Any health care facility has access to this, and it is usually required by law. This can be a speaker phone or iPad connection to an interpreter who will interpret anything said in both directions. There is usually a charge for this, but it is reasonable for short amounts of time. You might also find someone in the community willing to do this or a bright teenager willing to help for community service hours.

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What if you tried skipping a day visiting her, just as an experiment? Advise her caregivers of what you are doing and ask them to pay attention to how it affects her, and then discuss with them when you return. Seems low-risk, and you might learn something from it.

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I hope the Memory Care has an Activities Manager or Organiser who is creative.
Yes to flash cards & printed commonly used words in French for the care staff to see. They will soon get used to using those familiar words to communicate to your Mother for bathe, dinner etc.

While it is very common for people to revert to their original language, it seems that aggressive incident may have sparked a fear reaction & more sudden loss of English. I am so sorry that happened.

Having some French books, films, being 'culturely inclusive' should be the aim for any Memory Care for all their residents.

Another angle I have heard of, is to have a someone visit from a local community group. I had heard a local Polish Club would send two ladies as volunteers to meet any new Polish resident & staff - as another resource. While not medically endorced translators, having visitors that speak your language for a friendly chat was wonderful & brightened a newcomer's day. Is there a local French Community Club/Group at all?

I hope your Mother settles in & can feel at ease very soon. (((Hugs)))

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hmmm. I can imagine 2 scenarios going on here. Either, like my dad, she is forgetting the English language, in that instance it helps to say the French or English word to have her understand. Maybe the staff can have a list of basic French words to use.
I found some great shows and German music on tv that bring him back in time in Austria and lets him be in his world. It brings him joy most days and others he is now to the point he falls asleep in front of the tv or he doesn't understand what is going on anymore to enjoy the show either in English or German. Cooking shows, polka dancing from Tirol showing the town and people dressed in their traditional clothing , etc is good.
If you don't speak French I am happy to find something that maybe will work, my French is rusty, lol.
Happy shows that do not involve people also change the mood, like funny baby/dog videos, etc
Or
It is a way to control the situation and have you feel like you need to have her move home because only you can understand her. Does she speak English to you on the phone or in person and then talk to others in French or appear to not respond to them speaking in French?
As a side note, my dad reacted very badly to Xarelto he went off the wall and was very reactive to anything we would do. It was a nightmare. He also went through a time in which he would fight changing clothes or getting ready for bed, but now he has advanced and doesn't have the sense or energy to do that anymore.
I also have much more luck if I stop and tell him the next step (I mean every minute step) in anything we do, make sure his hearing aids are working and have enough light around him. I move VERY slowly from task to task or movement around him.
Be mindful of your face because they can lash out at any time and knock teeth out.
ok, here we go, one last thought. She may be feeling very horrible due to the change in surroundings. Is she using the bathroom like normal? The change may make her hold back or forget her bowel movements. When he needs to go, sometimes we have to sit with him and tell him to go because it can be days with his bowels and he is very "full" in his abdomen.

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Hi and thank you for your suggestions. I didn't add the fact that my mother has Macular Degeneration so she can't see well and television is of no interest to her. I have convinced the nurse that she needs to take her anti anxiety meds (they hesitated because it can be a fall risk) and it has helped. However now she sleeps too much. I have a list of French words and phrases on her wall so now the helpers are trying to talk to her but her attention span is almost zero. I am also French and we spoke mostly French at home so when I visit and talk to her, there is no problem. But I cannot be there all the time, that's why she is in a MC unit. I guess it will be a learning experience until she adapts or I find a plan B.

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Just a wild thought here...
Contact the local High School or Community College. the department that teach languages might have a student or two that would love to practice their French.

As to your mom's agitation, can you talk to the director or the nurse and see if they can not medicate her prior to changing her? I can totally understand how frightened she must be after being forcibly changed. (thank goodness you witnessed this and reported it)

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I'm sorry this has all happened. First, I would not bring her back home with you without having a clear plan for the future. Second, have you talked to her doctor about the aggressiveness? Does he have any ideas? I wouldn't worry about her sleeping, I suspect her behavior is tiring her out. Think toddler tantrums and the aftermath. They go to sleep too.

Just so you know, I don't have personal experience with what you are dealing with. However, I have travelled to other countries and know there are some very subtle differences on how people interact with each other. I think you were on the right track when you visited France. However, your Mom might be too acclimated to the American version of France. Are there any Memory Care facilities anywhere in the US, in a French-American environment? I suspect what could be triggering a lot of the aggression is her lack of security, with her illness and mental state, and also the way she is being treated; it is just not close enough to the respect and empathy that she expects. An acquaintance ended up putting her mother in a facility in Japan because the way that they treated the people in assisted living in Japan, was more aligned to what her Mom expected. Her mother lived the first 18 years of her life in Japan. She needed the Japanese "structure" once dementia took hold. 2 years later and her Mom is thriving.

I have been told that it takes a minimum of 6 weeks before one can get an indication of whether the AL facility is compatible with an elder. That's with people who hear and think and have grown up speaking US English in America.

I feel for you. Please take care of yourself. Keep on observing and changing and trying. Flash cards are okay, however, as good as the facility is, finding a facility has care givers that speak French, even if it is not native, might bring your Mom more peace.

I wish you a lot of luck.

P.S. Dementia is weird in that some new experiences are kept and others just pass through. Because your Mom had a bad experience at that facility, she may never ever feel safe again there. I've been told that bad experiences are stronger memories and therefore are more likely to be retained and used as reference.

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Not sure I understand what you mean moving LO to another country where the caregivers speak the language. Then they are completely removed from family and moved to another country? Is that what you are suggesting?

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Newer laws require there to be an interpreter when providing medical care or social services to the public. Not sure how that plays out or is interpreted when providing day-to-day care.

Even dementia patients have rights to communicate.

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Please address her issues with her doctor. She may have any of a number of causes to create this difficulty: infections, poor oxygenation, poor sleep, chemical imbalances in her blood.... just to name a few. Have her primary care doctor get those types of medical problems addressed first. If she checks out as fine medically, then ask for referrals to neurology and geriatric psychiatry. She may have poor circulation to parts of her brain that deal with memory, impulse control and decision-making that might be able to treat by a neurologist. Lastly, the geriatric psychiatrist is the expert on medications to help with her behavior problems. Be aware it can take weeks to any psychiatric medication to reach effective levels and each person needs to have his/her medications fine-tuned to the optimal combination.

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Mkaposch1: This is so difficult, but you have a great heart. Don’t give up trying to help your mom.

I am caring for my bride of 31 years. The day she goes to Memory Care will be the hardest day of my life. But once I place her I know bringing her home would be a very unwise choice. I would suggest you not bring your mom home. It will make your life even tougher for both of you.

I’m sure you visit with the neurologist but you may ask him/her if meds need to be adjusted. Care for one living with this wretched disease is nothing short of an arduous journey. It is a moving target. Therefore meds need frequent adjustments.

Besides Seroquel there is Trazodone, Memantine, and a host of other pharmaceuticals that can help calm your mom. When my wife gets too agitated, which is rarely, I have to administer Haldol.

I hated using meds. I felt guilty for doing so. But at times it is the only way possible to get her to a place of rest and peacefulness. And I don’t mean for me, but for her as well. No one wants to live in torment and fear as your mom does when she needs changing. It’s scary to her. So meds can definitely help.

One more thing. If you or your mother can afford it, consider having a caregiver from an outside agency come to spend a few hours a day with your mom. Maybe you can ask agencies if anyone speaks French. If someone visits her daily at the MC facility she would get used to them and maybe they could help change her when necessary.

Praying for wisdom and peace for you!

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Be careful with Haldol. Read up on the side affects. That is what they give them in nursing homes. I will not allow them to give my mom haldol.

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The language issue is not uncommon with people with dementia. A friend of mine said the same about his mother whose first language was Chinese. When she was in her late stage, she could only speak Chinese.

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I wonder if some simple French songs, children's songs or the like, played softly might be helpful. Or language tapes with simple French phrases, just some familiar background noise for her in her room might be soothing. If they have a tv in her room someone might be able to channel French childrens' shows, soothing, and very young, for her. Sort of a French Mr. Roberts if there is such a thing. We have a big country next door with a huge French population, although truth is the people from France might not recognize that French, you might want European French shows. I bet You Tube has them and some tech oriented high school kid could probably put it on her room tv in a heart beat. Just a random thought. Experimenting can be helpful.

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The behaviors that you describe are common with people who have dementia, such as losing the ability to remember speech, aggressiveness, wanting to go "home" which is symbolic and means wanting to go back to a time when she was independent and could do things for herself. She will go through phases, and her memory and physical condition may decline further. Unless you are prepared to learn alot about dementia, spend 24/7 caring for her, and hiring aides to help, it would not be advisable to bring her to your house. Speak to the management staff at her facility about the issues you are noticing. In general, they are experts (except for the nurse you reported) and can tell you what to expect and how they handle different behaviors. Some facilities have support groups where family members of residents can share questions and experiences. My mother who also had advanced dementia "forgot" how to walk eventually and had to be tranported by wheel chair everywhere. Even though she was small and only weighed 90 lbs, it took two aides to lift her from the bed to the wheel chair safely. Eventually she also forgot how to speak and how to feed herself and had to be fed. In time, your mother should get used to the staff there and will allow them to change her, bathe her, etc. without a fuss. Sometimes it's just a matter of leaving the room and waiting a few minutes, then coming back to do what needs to be done. Change is difficult for older people, especially people with dementia. It will take some time for her to be accustomed to her new surroundings and the staff and other residents. Not remembering English will make things more difficult for her. All the best to you both.

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You’ve had such a hard road, and my heart goes out to you.
If your current neurologist cannot adjust her meds appropriately, then find a second opinion.
I wouldn’t bring her back home unless you have a team of helpers to assist you.

Supporting you in spirit~

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I’m not a doctor but to me meds are not always the answer. Try getting her someone who speaks French that is willing to help her transition slowly to speak English. Stop taking her on the trips she’s not mentally ready. Caregiver could speak French make sure she’s not signing her life away. Also, French counselor use the money for that. Check on the meds it maybe to much for her. Her fond memories are leading her to France try pull out picks maybe u can go over memory lane.

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It seems to me bc ppl get older and revert back to childhood or other doesn’t mean they need meds. They just need more communication. As we get older everyone else is and or dying or going about there way and it’s less ppl for the older folks to chat with. Find others in the neighborhood whose a guardian of there parent maybe you all can go to the park or restaurant meet up snd chat

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Here is a useful video that shows what to do for your loved-one when they want to "go home."

This lady's videos are very helpful:

https://youtu.be/r5Mj6yzVo_U

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A person with dementia often goes back to speaking their native language even if they haven't spoken it in decades. I had a care client who came to the when she was a teenager. She spoke perfect English, no accent. As her dementia got worse she reverted back to speaking Italian. Her family was lucky to get an Italian-speaking caregiver. My client was living in her childhood. She was an orphan who grew up in a school/convent run by an order of Catholic nuns. She thought I was one of the sisters who took care of her. That was fine with me. Your mother wanting to go home could mean different things. She may want to "go home" to a different time in her life like childhood or youth. She could mean her home at your house. It won't make any difference where she's taken.
Do not take her back to live at your house. Please don't do it. You will be sorry you did. Stop visiting her every day too. In fact, don't visit her for a few weeks. She has to get acclimated to her new surroundings. She also has to get used to being taken care of by people who aren't you. As for the aide who 'got rough' with her when it was time for a diaper change, your mother is aggressive. In such a case the facility should have sent two aides to get it done. Or had one of the nurses on duty get up and go with the aide. The facility instead fires the aide for what was their mistake in the first place.
Let your mother get used to her new place and the new people caring for her. Don't visit for a while. Call her daily and request that a staff member communicate with you daily or every other day during the time you're not visiting to keep you updated. Give it while. Your mother will adapt.

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Aide's mistake (worse, actually, but mistake will do). If you're faced with a situation outside your competencies you do not proceed, you get help. I hope they fired her through a window.

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My mom is also starting to forget English. She has gone back to her native language. This is common with dementia as they revert backwards. I finally put my mom in a nice memory care facility and sometimes she doesn’t speak English and she is hard of hearing, so not fun for the aides or nurses, or her for that matter. They do have a translation service that they use at the facility so that helps.
As for the aggressive behavior, my mom had become extremely aggressive towards me at home, that is the reason I agreed to place her in memory care. What I have learned since then is her aggressive, and paranoid behavior was a reaction from her seizure meds (keppra). You may want to read up on her meds and check what the side affects are. Since my mom was transitioned to a different seizure medication her behavior is much better. I wish I had known that before, I would have kept her at home with me, Good luck.

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Sedation and placement in Memory Care...........there's nothing for you to do, except to get on with your life. Maybe take a break and just FaceTime for a while.

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Bringing her back home is the absolute worst thing you could do. It sounds like she would be a danger to herself and others.

Stop visiting so often or she'll never adjust.

Good on you for being so proactive to install those cameras.

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I understand that mother’s sight is poor, but perhaps it would help to make some very clear cards that carers can show her to let her know what’s going to happen. A bed (perhaps someone getting into it), a shower etc. It might go with the words you have pasted up. It must be frightening when people start moving your body and you don’t understand.

It’s a big help if the ‘right’ language is available, but sometimes it isn’t. Remember that a very very small number of Navaho speakers were actually used in WWII as an alternative to code, because no-ne else could speak the language except this tiny group of older people. Where I am, the local language groups usually have a club (often with fantastic food), and some of them actually operate a NH. Mostly the bigger groups, like Greek and Italian, but if you could find a French club they might have some good suggestions. Older people losing their most recent language is very common, you might find that Alliance Francaise have ways to cope in your area. The last poster I suggested this to, went out and found Finnish speakers in Melbourne! Don’t give up!

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mkaposch1: Perhaps your mother still has that scary episode of the forceful aide in her mind. You should definitely not bring her home.

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First of all, I want to thank everyone who sent messages and ideas. I am overwhelmed by the love and support I received from you! I have used some of your helpful suggestions already. I have had to travel for work for a week so I call my mother at a specific time to talk with her. She seems to be doing ok but still asks when I am coming to take her home. We live in New Orleans and you would think there are a lot of people who speak French here but it’s not the case at all. Not one caregiver who speaks the language. I will keep looking and trying all the things you all have suggested. Many thanks.

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Please call Visiting Angels in New Orleans.........you might get a French speaking aid!

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Mother has forgotten how to speak English in memory care. Any suggestions?

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