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  • When it rains it pours!!!

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    Old 12-01-2009, 10:15 AM   #1
    jannar
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    When it rains it pours!!!

    All of you have been so helpful with your advice this past week. I am now facing another issue. You have given me good advice about not letting my 92 year old mother know that her husband is going into Hospice care and the end is near. Last night I received a call from the nursing staff at the assisted living facility. My mother has been battling a horrible yeast infection/bladder infection the past few weeks. The nursing staff have been helping take care of my mother's infection and things seemed to be going ok. There is a little store that carries everything from food to supplies located within the facility. Although my has Alzheimers, she is extremely mobile and walks almost every day around the lifelong care facility. Yesterday they called to let me know that my mother went to the store last week and purchased, vasoline, alcholol wipes and Colgate toothpaste. They discovered yesterday that she has been using all of these products on her bottom and then putting on her Depends. The nurse discovered that she was bleeding and called to let me know. I was upset because I felt they should have been monitoring her more closely. The Dr. is also upset. He has decided to move my mother into the health center that is attached while the staff there works with him to clear up this condition. The problem I have now is the health center is also where her husband is under Hospice care and she will have access to him. I'm pretty sure this move will also set her back. I know that Alzheimer's patients can use things in inappropriate ways--thus using toothpaste on her bottom. It sounds funny but is rather sad. As you can see, I'm dealing with a lot of different issues all at the same time and I'm more than 60 miles away. I'd appreciate any of your thoughts and suggestions as I move forth.

     
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    Old 12-01-2009, 10:31 AM   #2
    caringsister54
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    Re: When it rains it pours!!!

    First of all, your mother is free to walk around so its not truly a nursing home but more of an Assisted Living situation and there's no way you can blame the staff for not knowing what your mother was doing, its surprising how sneaky they can be.

    your mother was just trying to help herself and purchased the wrong things.

    Even if your mother is moved into the same facility that the husband is in is not necessarily saying they'll run into one another. Make sure everyone knows that is happening and insist that they keep the two of them apart at this time.

    Good luck.

    Caringsister54

     
    Old 12-01-2009, 11:33 AM   #3
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    Re: When it rains it pours!!!

    It's hard to blame an assisted living staff for what Mom does when they are not there. Mom and Dad were in Assisted Living and they are truly not set up for constant 24/7 monitoring. That is the job of the locked ALZ units and nursing homes. As for what you mom did... I am not surprised at all. They completely forget what to do with what they have at hand. If you Mom had not done this before, they didn't know to restrict what she was buying. It truly does sound like she is past AL.

    Mom came walking up so very proud of her "new energy drink" as she sipped at it. It was hand lotion. That same hand lotion because a dip for her chips and a topping for her peanuts. Gatorade has been used for spray starch. Toothpaste was used to fertilize the orchids along with Gatorade. Toothpaste was also used to polish the furniture and lipstick to clean the soles of her shoes. I won't tell you what she was doing with the little piles of poop last week!!! Just yesterday Mom poured coffee on her salad as a salad dressing. She said it was good. So what your mom did was so very typical.

    As for Mom and Step Dad in the same part of the facility... they don't necessarily have to see each other. I assume your Step Dad is bed bound and therefore in his room at all times. Your Mom may be out and about but doesn't have to be in the same area unless it is a really small area and even then a shut door should take care of the problem. It may take some planning and logistics with the staff but it's possible. If she should happen to "find" him then you will just have to deal with it as it comes but she does need the additional care to her bottom right now. Are there any more options for where to put him temporarily?

    You are right... when it rains it pours!

    Love, deb

     
    Old 12-01-2009, 02:42 PM   #4
    Martha H
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    Re: When it rains it pours!!!

    What a shock that phone call must have been. Toothpaste? Vaseline, so far no burning pain, But ALCOHOL?? It is surely amazing what can happen. And as the others said, the AL facility is not staffed to watch her 24 hours a day especially not in the bathroom .. no doubt she made her UTI worse, or caused it in the first place.

    Round the clock professional care is what they all need. I mentioned on another thread that the caregiver has nothing to lose but their pride...but of course NHs also cost an arm and a leg. It pretty well wiped out Mom's life savings. But by then, who cared? She got the 24/7 attention she needed, and when she was poor enough, Medicaid took over. I know I would have cracked up if it had been left up to me for even just 3 more months ...

    Love,

    Martha

     
    Old 12-01-2009, 06:53 PM   #5
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    Re: When it rains it pours!!!

    Deb, you bring up something interesting. You say Jan's mom sounds like she is past AL. My mom is like Jannar's. She walks all over the place. The staff and private aides all talk about how much she likes to get out of her apt. and walk around. They all adore her. They all say to leave her where she is (independent) as long as she is happy and not causing any problems..which she isn't. Though, at the moment, she isn't happy due to missing her late husband.

    But I wonder if there are guidelines as to when someone should be at an AL place or a nursing home or a locked unit. My mom can carry on a conversation but she cannot relate a story to us. She can get from here to there but loses her keys that are right in her hand. SHe has no short term memory. She has forgotten her husband is dead yet can shop and do lunch with the best of them. She has no idea how to handle money any longer but sure enjoys spending it! She doesn't know the difference between hand cream or dish soap if it is a pump bottle. If it's on her sink she'll use it for whatever purpose fits the moment. She knows what toothpaste is just doesn't remember to always use it. She can't find her nose in front of her face. She doesn't understand ice cream belongs in the freezer but can dial my number at a moment's notice. A lot of contradictions.

    Love, Meg

     
    Old 12-02-2009, 03:08 AM   #6
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    Re: When it rains it pours!!!

    Meg, I think it has to do with which parts of her brain are being attacked by plaques and tangles. That could be why AD doesn't always follow the same course. Some people lose the abiltiy to formulate a sentence, others are talkative right up to the end. My Mom lost her memory but her beavior never changed. She was always happy, always thanking the nurses for whatever they did for her, thanked visitrs for coming even when she had no idea who they were. She also had a lot of concern for others. When she saw a TV story about a little red headed girl who was burnt in a fire, she mistakenly thought it had been my brother's granddaughter, and when he came that day she very worriedly told him how awful it was that the little girl had been burnt. He tried and tried to clear up the misunderstanding, but she still thought it had been little A. Until a couple of hours later, when she forgot the whole incident.

    Mom never had a great affection for 'things' and never worried about other people taking anything, a common affliction, or about losing her home and furniture ... those things didn't matter. She loved being outdoors, and anyone who would take her in her wheelchair down the elevator and to to the gardens, was rewarded by her huge happy smile and thanks.

    If the staff at the AL think she is fine to stay there, then she probably is. When the time comes you will know, not doubt.

    Love,

    Martha

     
    Old 12-02-2009, 06:20 AM   #7
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    Re: When it rains it pours!!!

    It has been difficult for me to understand the progression of Alzheimers disease. It appears while there are some main characteristics, my mother does not fit the "norm". While my mother has lost her short term memory and is now starting to lose her long term memory, she is still fit and active. She was a Senior Olympian in five events (race walking being one of them)and still participates in a walking program that they have at AL. She doesn't know why she is walking anymore but she is walking. She has this routine of going for a walk after every meal. She mainly walks in one hallway where she goes back and forth between 30 and 60 minutes at a time. Walking has been so much a part of her life that if they were to put her in a locked up unit, she would probably die. That being said, her ability to walk around is also what has gotten her into trouble. For the most part, people would think she is "normal" if they would pass her in the hall. However lately, she has been going to the store that is within the facility and purchasing things that she now doesn't use appropriately. I have asked the facility to put an end to this and hopefully she won't be purchasing toothpaste, vasoline etc. to use on her infected bottom. There is a disagreement about where to best treat my mother for her infection. Yesterday the doctor wanted to move her to the health center for a few weeks. The AL staff convinced him that they could treat her at AL. He said he would give them two weeks to help clear up her bottom. I'm still waiting to see who wins. In the meantime, it is difficult to deal with a mother who is too physically functioning and yet doesn't have her mental capabilities to match.

    Last edited by jannar; 12-02-2009 at 06:21 AM.

     
    Old 12-02-2009, 08:53 AM   #8
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    Re: When it rains it pours!!!

    As long as she is not handicapped and wheelchair bound, your Mom can walk. Locked doesn't mean confined to a cell. It just means access to the outside world is blocked so they cannot wander out on the roads. They still have a common room, access to an inner courtyard, etc. Locked unit sound so scary - but it's not!

    love,
    Martha

    Last edited by Martha H; 12-02-2009 at 10:53 AM.

     
    Old 12-02-2009, 08:59 AM   #9
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    Re: When it rains it pours!!!

    Each of them are different and you are right Martha... it depends on where the plaques and tangles decide to concentrate. It also depends on the developed synapsis that they have to work with. There are many paths for an impulse to go through the brain. This disease takes them away one at a time... and for a while the brain just uses a different path. It may take them a little more time but they get there. Eventually all the paths shut down and that's when they lose an ability. That's why it seems to come and go for a while before it's gone. The brain is finding new paths that are already there if it can. The brain is really an amazing thing.

    As far as when to move them... that is something you have to decide from what you observe. It depends on your loved one and the caregivers, what can be done in each level, and what additional help is there. Some can stay in AL until the end. These are the happy ones that are cooperative and don't tend to create their own trouble. Some, like my Mom needed a locked facility sooner. Dad would have been happily sitting in AL still if it was not for Mom. Mom and Dad were also removed from the hub of activity in AL by being in the last room on the third floor. Therefore there was less attention, visits, contact, and Mom was was left to herself to get into whatever trouble she could find. Dad could be outside before anybody noticed he was missing. Having an emergency stairwell exit across from their room didn't help either.

    So you have to take everything into consideration and look at your individual situation with rational realistic logic rather than emotionally. In my situation with Mom's bad temperament agitating Dad, their location in the facility that didn't afford watching them closely, and a few failed attempts at changing things.... it was obvious to me that Mom and Dad had to be moved. It was a combination of Mom's and Dad's abilities, the facility, and many other things.

    If you Mom is dealing with her location ok, is happy for the most part, and the staff can effectively deal with situations as they arise then there is no reason to move her. But if she has more freedom than her cognition can handle and she's having difficulty functioning then move her. Incidents like buying items and using them improperly has to be addressed... because you Mom can't do any better. If the staff can stop her from buying the things she doesn't need and the apartment is stripped of items that might be misused then she may be ok. Just be aware that Mom won't get better... the situation has to change to suit her current abilities... there or somewhere else

    Jannar... My mom has always been very active and physically fit... and still is. She scoots around the facility with no problem and loves to walk... thought now it is wondering (one of the reasons she is in a locked unit). She has lost the ability to put together a complete sentence and does not understand most of what she hears... but she's the most ambulatory one on the floor. There is another resident there that only speaks in sounds similar to ba, ba, ba, ba... and she can almost outrun Mom. At least Mom still has words though she puts them together incorrectly. This disease takes what it wants when it wants to. It doesn't do it suddenly or all at once but bit by bit it comes and goes until it's gone.

    Also know that a UTI can and does affect their level of cognition so once that is all cleared up your Mom may do better.

    Love, Deb

    PS... I just saw what Martha wrote and she's absolutely right. Mom is a walker and she's in a locked unit and doing well. She walks a lot. There are two long halls she can navagate, a large dinning, living, and kitchen area, and a great enclosed outdoor garden area with a circular sidewalk. She's not confined except the doors to the outside world that she no longer understand anyway... are locked.

    Last edited by Gabriel; 12-02-2009 at 09:02 AM.

     
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