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Old 07-19-2012, 04:02 AM   #1
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MIL moved in with us

Hi, this is my first post and I am hoping for some input from more experienced than I ( although that would include almost everyone). My MIL has ALZ and moved in with us in December. She lived several states away and her doctor said it was too dangerous to let her live alone with her 2 dogs. We did not want to make her give up her dogs, although moving her out of her own house was horrible for her. We did keep a bunch of her stuff and set her up her own bedroom and a sitting room that we thought she would like. At first she was a little active and enjoyed reading and crocheting. Now she doesn't want to get showered or dressed at all. She really hates it when I wash her hair. My husband and I take total care of her with no help. The Dr. prescribed medicare to come out and help her exercise and shower, but that only lasted 3 weeks. Mom doesn't remember who those people are and it really upset her each time, so I decided to do these things myself, which she likes better. My own health is bad and so is my husbands. So my question is this. I love her and want to take care of her but it is extremely physically hard and painful for me. How do we know when it is time to put her in a nursing home? We don't want to. She loves living with us and if she has to give up her 2 dogs it will just kill her. She knows who her son is and she knows who I am, but won't read, or do any activities unless I strongly urge her and do them with her. She stares at TV but doesn't grasp what is going on. She also has a nervous hand twitch and is scratching at her face and arms until they bleed. When I see and stop her, she gets very aggitated. We can tell quite a difference in the last 7 months but don't know what to do. On one hand, I really don't want to move her out of our home because I'm afraid we will lose her far quicker. On the other hand, I wonder if we did move her into a nursing home would she get and enjoy activities with other people her own age, or would she keep herself isolated? I would sure appreciate any advise. We take her back to the doctor early August to be retested.

 
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Old 07-19-2012, 06:17 AM   #2
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Re: MIL moved in with us

Four, each of us has been where you are now and ask those same questions. I will tell you what I hears when I ask those same questions. If you are considering a care facility for your loved one then it is already time. We place our loved ones when WE are ready. They are past ready. We would all love to keep our loved one at home and sometimes that is possible... but sometimes that is not possible. Know you are responsible for providing your loved one with the best care possible. This does not mean necessarily doing it yourself. With your inabilities you are going to need additional help in the form of in home care givers or a facility.

Everything you described is typical dementia behavior. Normal daily task and things she has done all her life become difficult for her to do and she will stop doing them. It is common for her to withdraw. Showers can be a huge problems. There may also be episodes of wandering, incontinence, agitation, and paranoia. At some point she will eventually lose her connections with those she knows... and even her dogs.

First the shower. It is a daunting scary task for those with dementia. It involves being vulnerable (naked), uncomfortable (cold), and confused (multi step process). She may not understand what you want when you ask her to "take a shower". She may not remember how to do it. If you ask, NO! is probably what you will hear back. Look back and decide what time of day she usually took a shower. Was it first thing in the morning or when she went to bed? Go back to showering her at that time. Make sure the bathroom is warm, bordering on hot. Take it slow and make sure she understands what you are helping her do... one step at a time. "Let's take a shower" may not suffice as you take off her clothes. With Dad, I found it much easier to shower him just as he woke up, before he was dressed. That way I eliminated the undressing stage. Put a towel over her shoulders. This way she appears covered. You can even leave this towel in place and wash under it. Make sure the water is a comfortable temperature. Discomfort is a big deal whether it is from temperature of modesty. Let her help with as much as possible. Once in the shower let her feel the water with her hand before the body goes in. Use a hand held shower head to control where the water goes. Let her hold it if she will and can. Give her the soapy wash cloth and guide her hand, especially when washing the more sensitive areas. Take it slow as not to startle her. Hair can be a problems because it involves water in the face. Tilt her head back if possible and let most of the water roll off the back of her head. Put a wash cloth in her hand and guide it to her forehead to prevent water from running in her face. The more you can encourage her to participate, the better it will be. If the hair become the stumbling block, take her to a hair dresser once a week for a shampoo. Most of all take it slow and don't argue.

As for the moves, each move will be followed with a period of adjustment. You will be taking away what is familiar. You have to weigh this against the benefits.... to both you and her. Check out the available placements. Check out their ratings and deficiencies with state agencies. Visit multiple times, at different times of the day, and ask to just hang out in the area she will be in. Talk to other family members when the staff is not present. The parking lot is a great place to do this. Look past the decor to the staff. Notice how they treat the residents when they interact. Are there activities going on. Is it a lively active space. Check out meal time watching for those that need and receive assistance. Talk to the department managers and the care givers on the floor, not just the marketing specialist. You will know quickly if it is the right place for MIL.

Welcome to the board. I am so sorry that you are having to deal with this disease but know you are not alone. I am glad you found us and hope to hear more from you...

Love, deb

 
Old 07-19-2012, 06:40 AM   #3
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Re: MIL moved in with us

Dear Paws, I am sorry you and your husband are finding yourself in this situation, and also for your MIL. I just want to add my thoughts re dogs. Most people who haven't experience with pets will simply advise you to get rid of the dogs. I can tell you that it is not that simple, nor is it that monochromatic. Her dogs are a cocoon of warmth and emotional safety for your MIL. They don't judge her, they will always accept and be happy with her no matter what, and they don't tell her to do something she doesn't want. You are right in supposing that removing her dogs suddenly will be a very bad thing. This might have to wait until she needs to go to a 24/7 care facility. I am not sure I agree with Deb that she may forget or loose connection with her dogs. My hunch is the connection with her dogs will the one of the last things she will loose. It may well be that she will remember her dogs long after she has forgotten who you and her son are. (Caveat: I have no real experience with this part, but I do know the bond that my wife has with her dogs. The times of the worst confusion have always been the closest she clutches her dogs.). Be very gentle and careful when you need to rehome the dogs.

Last edited by Luau; 07-19-2012 at 07:18 AM.

 
Old 07-19-2012, 07:17 AM   #4
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Re: MIL moved in with us

I agree Luau and why I put the dogs last. She will remember that connection for the very reasons you stated but eventually she will lost that connection as well. Actually there are facilities that will accept pets for this reason. The one Mom is in allows residents to bring their pets as long as there is someone to take care of them. To that end there is an available pet sitter that comes in to feed, water, and walk the pets. One of our locked unit residents brought her little Maggie with her. Eventually the resident stopped paying attention to the puppy and the family took it back home. It is amazing how the pet bond can benefit a loved one... for all the right reasons.

Love, deb

 
Old 07-19-2012, 07:57 AM   #5
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Re: MIL moved in with us

Quote:
Originally Posted by Gabriel View Post
Four, each of us has been where you are now and ask those same questions. I will tell you what I hears when I ask those same questions. If you are considering a care facility for your loved one then it is already time. We place our loved ones when WE are ready. They are past ready. We would all love to keep our loved one at home and sometimes that is possible... but sometimes that is not possible. Know you are responsible for providing your loved one with the best care possible. This does not mean necessarily doing it yourself. With your inabilities you are going to need additional help in the form of in home care givers or a facility.

Everything you described is typical dementia behavior. Normal daily task and things she has done all her life become difficult for her to do and she will stop doing them. It is common for her to withdraw. Showers can be a huge problems. There may also be episodes of wandering, incontinence, agitation, and paranoia. At some point she will eventually lose her connections with those she knows... and even her dogs.

First the shower. It is a daunting scary task for those with dementia. It involves being vulnerable (naked), uncomfortable (cold), and confused (multi step process). She may not understand what you want when you ask her to "take a shower". She may not remember how to do it. If you ask, NO! is probably what you will hear back. Look back and decide what time of day she usually took a shower. Was it first thing in the morning or when she went to bed? Go back to showering her at that time. Make sure the bathroom is warm, bordering on hot. Take it slow and make sure she understands what you are helping her do... one step at a time. "Let's take a shower" may not suffice as you take off her clothes. With Dad, I found it much easier to shower him just as he woke up, before he was dressed. That way I eliminated the undressing stage. Put a towel over her shoulders. This way she appears covered. You can even leave this towel in place and wash under it. Make sure the water is a comfortable temperature. Discomfort is a big deal whether it is from temperature of modesty. Let her help with as much as possible. Once in the shower let her feel the water with her hand before the body goes in. Use a hand held shower head to control where the water goes. Let her hold it if she will and can. Give her the soapy wash cloth and guide her hand, especially when washing the more sensitive areas. Take it slow as not to startle her. Hair can be a problems because it involves water in the face. Tilt her head back if possible and let most of the water roll off the back of her head. Put a wash cloth in her hand and guide it to her forehead to prevent water from running in her face. The more you can encourage her to participate, the better it will be. If the hair become the stumbling block, take her to a hair dresser once a week for a shampoo. Most of all take it slow and don't argue.

As for the moves, each move will be followed with a period of adjustment. You will be taking away what is familiar. You have to weigh this against the benefits.... to both you and her. Check out the available placements. Check out their ratings and deficiencies with state agencies. Visit multiple times, at different times of the day, and ask to just hang out in the area she will be in. Talk to other family members when the staff is not present. The parking lot is a great place to do this. Look past the decor to the staff. Notice how they treat the residents when they interact. Are there activities going on. Is it a lively active space. Check out meal time watching for those that need and receive assistance. Talk to the department managers and the care givers on the floor, not just the marketing specialist. You will know quickly if it is the right place for MIL.

Welcome to the board. I am so sorry that you are having to deal with this disease but know you are not alone. I am glad you found us and hope to hear more from you...

Love, deb

 
Old 07-19-2012, 08:06 AM   #6
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Re: MIL moved in with us

We have 3 dogs of our own and have taken in her 2 dogs when she moved in with us. Yes it is hard and more trouble, but this beautiful lady has lost her home, changed states and only has her son and me left. I would never take away her two dogs. "Do onto others as you would have done unto you". Oh I forgot to mention: I would like to get rid of her giant 1989 Lincoln town car that takes up our whole driveway. But she still asks where it is and I take her to the window to show her it is safe in the driveway. I can't imagine how scared and confused she is, but I do know that despite my own medical condition (4 back surgeries and Ankolsing Spondylitis) that somehow, by the grace of God, we will see her through this. We will keep her home with us for as long as we are physically able. I am so glad I found this forum as I believe I have a lot to learn and, oh yeah, a lot to vent, so thank you all and God Bless each of you.

 
Old 07-19-2012, 08:14 AM   #7
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Re: MIL moved in with us

Thank you. I think as long as she seems happy to be with us, she will stay with us. But I am concerned that we are not physically able to give her the activities and excerises that she needs. Maybe I am keeping her with us to ease my conscience about being a bad christian by placing her in someone else's care. Now she sits in front of the tv most of the time except to go to the bathroom when we tell her, and the occasional trip to lunch or doctor's appointments. My other fear is that I saw my father's health decline badly when he was my mom's caregiver as she fought her battle with cancer and I just hope that my husband and I, who aren't in the best of health, can still have time for a life together when this chapter is finished.

 
Old 07-19-2012, 08:47 AM   #8
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Re: MIL moved in with us

Dear Paws,

It is very nice of you to move MIL to your own home. I think at this point, you can first consider hiring a part-time help so you two are not burned out. It helps if you know her MMSE level - the stage. It may be in moderate stage. Every patient forgets things differently. Naturally MIL hates water and does not want to take a shower - she would be afraid of water and the temp. So you have to gently guide her in the shower and get the water ready first. She likes routines, so stick to the routines. If you do it in the morning before she gets dressed, she may not reject it. Scratching a lot is nothing new for an AD (Alzheimer's disease) patient. She would be anxious since she loses some abilities so she would scratch. You simply cannot reason with her at all. She would never understand. Just distract her or take her to a park. If she is too anxious, she may need anti-depressant.

I understand that she needs her dogs. Wait until she forgets about her dogs, then get rid of them because 5 dogs will make your life harder. Taking care of an elderly with dementia is hard work and more pets would take up your time.

My late FIL had severe Alzheimer's. We waited until he forgot that it was his house where he stayed with home care caregivers part-time/full-time and 24/7. We actually exhaused the home care (too expensive) so we moved him to the nursing home near us in another state. His pets all died before his late wife died so we had no problem.
You probably should wait until she forgets more so she will not feel very bad in the nursing home. Yes, the nursing home can provide peers and activities but it depends on her personality - is she sociable or anti-social? My late FIL had the fantasy that he worked in the nursing home so it worked for him for almost 2 years until he died. He spent more time at home than the nursing home for his AD.

The question about when to send her to the NH depends on many factors. If you cannot do it anymore and you will get sick, then you need extra help such as part-time caregivers at home or a nursing home depending on her money situation. If you are sick, who will help MIL?

This is not about Christianity. Actually for God's love, it is best to find the best care for MIL. Going to a good nursing home is nothing wrong. Once you have exhausted home care, naturally nursing home is the next step.

Regards,
Nina

Last edited by ninamarc; 07-19-2012 at 08:52 AM.

 
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Old 07-19-2012, 09:03 AM   #9
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Re: MIL moved in with us

Four, my mom never forgot her dog Sam!!! When she was in the hospital we purchased a look a like stuffy and she dearly loved thar stuffy, a warning about that, when you do find one buy several, they always seamed to go for a walk on their own, and then my mom was really stressed in thinking that her little dog was lost. The stuff gave my mom comfort and she held onto him with a death grip, we even put a collar and lease on the stuffy..

Welcome to our place on the Internet.....and to planet Alzheimer.
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Old 07-19-2012, 06:22 PM   #10
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Re: MIL moved in with us

Four, we all wish that we could keep our loved one happily at home until the end. There are some that do. But you do have to assess your own situation and your MIL's situation as well. No, you do not want to destroy your own health and you have to determine MIL's need for entertainment and exercise that you may not be able to give her. If you decide to keep her at home for a while you will need to get somebody to help you.

Check as see if there is an adult day care in your area. Mom could go there for a half a day or all day five days a week. That would give you and hubby time for your life and a break from MIL. It would give MIL the socialization, stimulation, entertainment, and exercise you need. It is the best of both worlds. You can also hire a care giver for a few hours a day. Make it their responsibility to get her up, engaged, and moving for a while each day. Again it will give you some time to do the things you need to do. If she begins to wander at night, a night time care giver so you can get sleep would be wonderful. It is not good for her to sit in front of the TV all day but you can supply the socialization, entertainment, and exercise she needs at home. Just know you can reassess your situation at any time. A decision to keep Mom at home today does not mean you can not change your mind later. Please know that there is no guilt in placing MIL in a care facility if that is what you both need. Taking care of our loved ones does not mean doing it all ourselves.... it means having a care plan in place (whatever that may be) that gives our loved one the best care possible

Love, deb

 
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Old 07-20-2012, 06:12 AM   #11
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Re: MIL moved in with us

Indeed it is an issue how to entertain the elder at home. When my late FIL was at home, he was near lake Michigan. The caregiver brought him to the lake everyday. It was his habit to exercise everyday by the lakeshore so he enjoyed sitting there watching people. He was antisocial so he only watched people from afar. It depends on the person. My late FIL refused to go to any day center since he was antisocial and only wanted to work. The only reason it worked for him in the NH was that he thought he worked there in the NH. He had no hobby except writing research papers but he could not write anymore. So going to the lake was the routine.
You need to find out what MIL likes and do it accordingly to entertain or help her for her daily social life. She needs to go out for a while everyday.
Also, the NH would not be free like this. NH has outings once or twice a week and there are no one-on-one caregivers to take them out unless you pay personal caregivers to do so. NH is group care, not personal care and the family would miss the elders in the NH since you cannot live with the elder there. NH does have the minus and plus.
My late FIL had to go to the hospital a lot back home and he hated hospitalization. When he was in the NH, he never had to be hospitalized. So my personal feeling is that they need to go to the NH when they are very sick.

Take care,
Nina

 
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