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Old 03-11-2011, 06:19 PM   #1
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decline

My mother was diagnosed with alzheimers about a year ago; however my husband, children and I started to notice changes about 2 1/2 years ago. Today, we saw a new low. We took my mother out to dinner. She was trying to drink her nectar drink. There was a straw in her glass. She was holding the straw with one hand which resulted in the glass tilting at a precarious angle while holding a roll in the other hand. It was as if she forgot she was even holding the roll. I told her to put the roll down and hold the glass with her hand. She did not respond, even after I repeated the direction. I finally had to take the roll out of her hand so she would hold the glass. When we first sat down, she was holding the silverware in her hand while trying to open the menue with the other hand. I had to prompt her to put the silverware on the table. Again, is seemed that she forgot she had the silverware in her hand. I suspect that she is loosing the ability to carry out sequences necessary to complete tasks. Word finding difficulty and problem solving skills are also getting worse. [B]Is this typical in the progression of Alzheimers?[/B

]My mom is at an assisted living facility. The facility has 6 activities a day. Today, there was exercise class, trivia, bingo, book club meeting, wii golf, a violin concert and a movie. My mother does go to different activities and has friends there. The staff is very compasionate and the facility is very well maintained and looks more like a resort than a facility. Two geriatric nurses are on duty 24/7. They also have a memory unit, rehab center and nursing home so there is a continuim of services available when needed.

Do people find that activities and social envolvement available at an assisted living facility slows down the progression of alzheimers decline?

It was so upsetting to see the new low my mother hit today

 
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Old 03-12-2011, 03:23 AM   #2
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Re: decline

Can't speak to the assisted living complex, but I believe it probably helps. Certainly the familiarity of having routines and familiar people around is a good thing for her.

We had almost the same experiences with DH in a restaurant. At the time we guessed that DH wasn't able to understand our words to him anymore. As the stage progressed, we felt it was a combination of losing word-recognition (so he couldn't follow our verbal directions) and losing track of normal actions. It happened more frequently after the first incident, and over a period of weeks it became DH's new level of functioning. He started becoming lost with silverware and other objects, and had more "frozen moments."

In our case, the frozen moments and not knowing what to do next for normal activities led to the stage where DH was unable to dress himself without help, started eating with fingers and developed that vacant look that many posters report. This was also the stage when incontinence began. As you know, though, every patient is different and every stage progresses differently. Your Mom may not have another episode like this for weeks, or longer. We've only had one or two rapid declines during the last 9 years. In our family's experience, Alzheimers' more often eases you into each stage so you have time to adjust.

Last edited by Beginning; 03-12-2011 at 03:28 AM.

 
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Old 03-12-2011, 08:46 AM   #3
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Re: decline

I agree with everything Beginning said. Each does progress differently through the disease but there are also similarities. We have also had those moments with Mom and I believe there are several explanations. I do know that Mom's auditory perception was damaged early in her disease. She could hear you but didn't understand what she heard. "Put down the roll" may have been nothing more than gibberish when it registered in her brain. Then their is the problem of sequencing to accomplish a task. Put down the roll and pick up the glass is second nature to us but she was stuck in the process. Then there is the ability to know how to manipulate items. Mom also has a problem with starting task. She will look at a milk shake with a spoon in it but not know what to do with it. She may try to suck out of the spoon handle. She may try to drink from the side of the cup with the spoon in her way. But if I take the spoon, give her a couple of bites, she will eventually take the spoon and finish. All of these are very typical of the disease progression.

Yes, you do see a new behavior and then you may not see it for a while. Then it comes back more frequently until it is the new norm. I like what Beginning said about it showing itself and then giving you time to get used to the new norm.

It sounds like your Mom is in a wonderful place I do believe the activities make a huge different and the socialization is very important. Keeping them engaged does help. It may not significantly slow the progression but I do believe inactivity speeds the progression. The different activities tap different parts of the brain. Along with the socialization it does keep them in touch with their surroundings longer.

Mom has lost most of her speech and has great difficulty with auditory processing... but she will sing along with an old song saying each word clearly. Though she is incapable of "communication" the music reaches a place where she "remembers" and participates. Her smile is enough to say it is all worth while

Love, deb

 
Old 03-12-2011, 09:39 AM   #4
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Re: decline

Thank you for the responses. Another thing I have noticed is that at times, my mom looks like a deer in the headlights. I don't know if it is because she realizes that she is "kind of lost." The interesting thing is that she still does a suprisingly good job at covering. Of course, the fact that she is covering is becomming more and more obvious but it is interesting that she still does try to cover. I have also notice that when she is in the lobby sitting with a group of women, she often looks kind of lost. My husband and I have on several times said that "this is the new normal." My mom is using a walker, but still refuses to use it in her room. We have noticed that in the last few weeks, on three occassions, we had to grab her arm so she wouldn't fall backwards. She gets annoyed that we grabbed her and denies that she was falling. I don't know if she doesnt know that she almost fell or doesn't want to admit it

 
Old 03-12-2011, 10:01 AM   #5
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Re: decline

Quote:
Originally Posted by roxygirl1 View Post
My mother was diagnosed with alzheimers about a year ago; however my husband, children and I started to notice changes about 2 1/2 years ago. Today, we saw a new low. We took my mother out to dinner. She was trying to drink her nectar drink. There was a straw in her glass. She was holding the straw with one hand which resulted in the glass tilting at a precarious angle while holding a roll in the other hand. It was as if she forgot she was even holding the roll. I told her to put the roll down and hold the glass with her hand. She did not respond, even after I repeated the direction. I finally had to take the roll out of her hand so she would hold the glass. When we first sat down, she was holding the silverware in her hand while trying to open the menue with the other hand. I had to prompt her to put the silverware on the table. Again, is seemed that she forgot she had the silverware in her hand. I suspect that she is loosing the ability to carry out sequences necessary to complete tasks. Word finding difficulty and problem solving skills are also getting worse. [B]Is this typical in the progression of Alzheimers?[/B

]My mom is at an assisted living facility. The facility has 6 activities a day. Today, there was exercise class, trivia, bingo, book club meeting, wii golf, a violin concert and a movie. My mother does go to different activities and has friends there. The staff is very compasionate and the facility is very well maintained and looks more like a resort than a facility. Two geriatric nurses are on duty 24/7. They also have a memory unit, rehab center and nursing home so there is a continuim of services available when needed.

Do people find that activities and social envolvement available at an assisted living facility slows down the progression of alzheimers decline?

It was so upsetting to see the new low my mother hit today
It happens that we do see the first time when the elder declines. My father-in-law has had Alzheimer's for at least 7 years and we do see him declining every once in a while. It may happen at home or in the park - it goes with the action or the talk and etc. Fortunately we never had the situation when he literally goes like what your Mom did in the restaurant. One reason is that we always make sure he was cared for outside before he started going funny.
Back home he could often show it. e.g., he began to talk like a baby once in a while or began to tell me "wowowow" like a dog.... This means his speech is going downhill and he cannot really express.

The nursing home for memory impaired sometimes does make the elders better. I am not sure it delays the symptoms. But the peers can help motivating the elder to eat and play and etc. In my FIL's case, he was motivated to eat in the new home after he moved. He was literally eating one meal a day and was stopping eating back home last spring. The home also can offer him pureed food to make it easier to swallow.

It is surprsing and scary to see them decline but it does not happen everyday. It does slowly. To us, it is like every 6 months or so. Each hospitalization also makes him decline.

Regards,
NC

Last edited by ninamarc; 03-12-2011 at 10:30 AM.

 
Old 03-12-2011, 02:34 PM   #6
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Re: decline

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Originally Posted by roxygirl1 View Post
Thank you for the responses. Another thing I have noticed is that at times, my mom looks like a deer in the headlights. I don't know if it is because she realizes that she is "kind of lost." The interesting thing is that she still does a suprisingly good job at covering. Of course, the fact that she is covering is becomming more and more obvious but it is interesting that she still does try to cover. I have also notice that when she is in the lobby sitting with a group of women, she often looks kind of lost. My husband and I have on several times said that "this is the new normal." My mom is using a walker, but still refuses to use it in her room. We have noticed that in the last few weeks, on three occassions, we had to grab her arm so she wouldn't fall backwards. She gets annoyed that we grabbed her and denies that she was falling. I don't know if she doesnt know that she almost fell or doesn't want to admit it
The other thing I want to say is that the walker may be difficult for her to use. My FIL uses a cane. He tried a walker in late 2007 and he could not even drive it because he no longer can drive anymore (due to his lost memory on the road.) If your Mom has trouble using the walker, it may be that she begins having trouble to "drive". Either a cane or a wheelchair (the one that is light and has a seat) may be more useful to her. Anything that requires the elders to "drive" may only give them confusion.

Just my 2 cents.
NC

 
Old 03-12-2011, 03:53 PM   #7
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Re: decline

My mother showed signs of decline for about three years; however she had a mild stroke 1 12/ years ago. We convinced her to give up the keys after the stroke. Even before the stroke, we were getting more and more concerned about her ability to drive. She needs the walker due to balance issues. She is not happy about using a walker and would refuse to use a wheel chair.

 
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Old 03-12-2011, 04:04 PM   #8
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Re: decline

It is good that she gave up the keys Driving is an important issues with memory impairment. Not that they are unable to do the physical driving in an optimum situation but they don't have the good judgment to react in an emergency situation.

As for the walker. That is something they have to "learn" how to use. If they can not use it appropriately it is more dangerous than being without one. Because they don't have short term memory they have great difficulty learning how to use it. PT attempted four time to "teach" dad to use the walker and finally advised that he not use one. He went from walking to a wheel chair which is what most dementia patients do.

Love, deb

 
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Old 03-12-2011, 04:10 PM   #9
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Re: decline

She has been using the walker for about 16 months and so far, she is doing ok with it. I am sure tha as she continues to decline, her ability to use the walker will also change

 
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Old 03-12-2011, 07:08 PM   #10
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Re: decline

My mom had used her walker for about two and half years...she fought it but had to finally give in and use it...she did well learning how. But, speaking of declines, about a month ago, she finally stopped walking...just stopped..from one day to the next. Her walking had certainly slowed down but overnight it was gone. Not even able to stand. She is now full time in a wheel chair. She is unable to even help herself move from the chair to her bed or the toilet. We have to lift her always to move her. About the time she stopped walking we saw other things drift away. Her speech is declining along with a new issue called "pocketing". She is forgetting the sequence of eating. Bite, chew, swallow. She is forgetting the swallow part so she chews a bit and then "pockets" the food in the side of her mouth..
Not always, but sometimes.

She is completely dependent now. She has had this disease for over ten years and though it has been a slow progression it is now advancing faster day by day.

I also see the deer in the headlights look. Mom has it until her meds start taking effect. It seems to be a fear issue for my mom. I have to admit it is one that I hate...seing her afraid and unaware of what is happening around her.

Her residence sounds great. They need stimulation. A bored Alz. patient is not a good thing.

Love, Meg

 
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Old 03-12-2011, 07:13 PM   #11
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Re: decline

My mother still eats, but much more slowly than she used to. We notice that a lot of time, when she is engaged in any motor task, she sticks her tongue into the side of her mouth and the cheek bulges out. Does any else noticed this?

 
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Old 03-12-2011, 10:49 PM   #12
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Re: decline

I have not noticed Mom sticking her tongue into the side of her mouth. But I have watch children (and a few adults) do this when they are concentrating.

I have seen the pocketing. Actually Mom is infamous for pocketing her meds. That is why they are crushed or liquids now. One day in particular she pocked them in her cheek, ate breakfast, and handed the pills to me out of her mouth later in the morning. I would not have believed it except I was with her and watched when she picked them out of her mouth. When I was there Thursday she was walking around with a doughnut but not eating it. Later at supper, when I finally put a fork full of salad in her mouth... she picked out three orange seeds from her 3 PM snack. I wondered if she thought they were pills... or if she just didn't know how to get unwanted items that seemed hard out of her mouth.

So far I have not noticed problems with Mom's sequence of chew and swallow. What I have noticed is that she gets confused as to what to do with all the food and utensils. She will eat with her fingers, pick up a knife and eat with that for a while, then put her salad in her drink, stick potato chips in her pudding, then pick up a spoon and use it, and back to her fingers.

I actually had a lengthy discussion with the facility director lately about the dining room place settings at the table. They feel it is necessary to have a full place setting at each place. They have a fork, knife, spoon, napkin, and THREE glasses (then get water, juice, and milk at each meal) when they sit down. They get a salad bowl, a soup bowl, a dinner plate, dessert plate, and usually more utensils. Many times there are several plates and bowls sitting there at once. Mom just get confused and moves the food from one place to another not knowing which utensil to use.... and manages to get food in at least one of the glasses and some of her many drinks in her plates or bowls. I can give her a bowl and a spoon and she eats much better. So is it better to give them an elegant place setting or a functional one?

Roxy, I am glad you Mom has the walker and can use it. My Mom's gait has slowed dramatically and she has started to shuffle. She also leans to the right. It is almost like a meter to how tired she is. The more exhausted the more she leans. I guess if she got tired enough she would just fall over.

What I have noticed lately is that she seems to have lost the sequencing for sitting down. I know she doesn't understand auditory instructions so I will pull out a chair, pat the chair, sit down myself, or any other visual cue I can come up with. She just stands. There are times I feel like I am pushing her into a chair to get her to sit down. I ran into the same thing with her Thursday when I put her to bed.

Love, deb

 
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Old 03-13-2011, 05:59 AM   #13
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Re: decline

An occupational therapist I work with told me that she recently read a professional article which described using picture cues to help alzheimers patients carry out activities of daily living. It is an interesting idea

 
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Old 03-13-2011, 09:14 AM   #14
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Re: decline

I have actually used this a few times with success Roxie... to the point of writing words for Mom to read. Even though she can not communicate (find words to make coherent sentences or understand auditory input)... she can still read words and her visual input is much better.

When given a Camellia (Dad grew beautiful ones) she said "That's beautiful!". Comments about the same flower get no response. She read a card from my sister saying "Miss you, and would love to see you"... Mom's comment was "Come on!". That one made me laugh So when I had her at Urgent Care and she was getting squirmy from the wait, I pulled out a pad and wrote.. "Waiting for doctor"... to which she responded "I Know", and calmed down. I also noticed that when she because to lose her ability to put sentence together, she would start a statement and then finish it with words that were coming from her visual field. A fence, a door, a window.... they because the focus of her thoughts rather than what she wanted to say.

So I have noticed that the visual impacts her much more than the auditory and I do use that to help transfer ideas to her... and it works better than talking

Love, deb

 
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Old 03-13-2011, 10:08 AM   #15
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Re: decline

Quote:
Originally Posted by roxygirl1 View Post
My mother still eats, but much more slowly than she used to. We notice that a lot of time, when she is engaged in any motor task, she sticks her tongue into the side of her mouth and the cheek bulges out. Does any else noticed this?
My FIL has not done that but I can tell that this means she is making an effort to do so.... Does this any motor task mean walking or handling a cup of water and etc.? I can tell that my FIL goes very slowly if he is tired. He actually gets ****** off about any effort he needs to carry out. Everyone is different. In general, we take off the motor task from him and replace it with helps from the caregivers and better equipment. Try to take care of the person by taking off the burden.

Take care,
Nina

Last edited by ninamarc; 03-13-2011 at 10:09 AM.

 
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