AL made Dr. appointment for my 91 yr old mom because she wants to eat in her room, sleep all day & "refuses" to do everything. Any advice?
My mom has lived alone over 50 years, made all her own decisions without anyone to argue with her, and ate alone. Now 91, she is in IL/AL where all meals are in a dining room where everyone eats at round tables seating 6-8 people. The facility has a varied calendar of activities and entertainment, and a large gathering area to sit and watch people. Living here was her decision/choice and has been fine for just over one year until she fell on her face two months ago due to a UTI. Now she is in AL, has help throughout the day, and doesn't have to do anything herself. She has ALWAYS been obstinate, argumentative, and life-long chronically depressed. She now has early dementia ("people are stealing from me" when she forgets where she put things-usually in her pocket) and uses a walker. The AL just contacted me to say mom is now "refusing" to go to the dining room for any meals and sleeps all day. They independently contacted her Dr. who set up an appointment for her and for a psychiatrist, and called me to take her to this appointment which is scheduled for two days from now. I live over 1,000 miles away. In the last two years I have spent more time with my mom than I have in my own home with my own husband. I have only been home for 2 weeks from the last 3-week stay after her fall, and now I might have to go back. We are retired and are spending from our 401K accounts to travel back and forth. I have no solutions. My questions are, 1) why does a 91-year-old need a psychiatrist - how would that help her?; and 2) if she simply decides to eat in her room is that what they are calling "refusing" as in "she is refusing to do everything"? She is not refusing her meds and she has always lived alone so why would she suddenly want to join an active social schedule? I'm wondering if I should move her to a smaller facility like a Board and Care home, but she likes where she is at and she chose to live there vs other places we looked at. Maybe I don't even know what questions to ask the AL...
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Another wonderful source for information is Teepa Snow. Her (free) videos on dementia are brilliant. So helpful. Good luck.
The days your mom needs your help, you will still be able to have dinner with hubby & sleep in your own bed that night - even things like making an appointment at your dentist will become easier - when away from home there is so much down time with nothing to do but watch TV in a hotel room
For the last 6 months of her life my mom was a 4 minute drive down from 40 minutes - her dementia was such that she didn't know if I was there for 15 minutes or 2 hours - occationally I would run over for an extra visit after I put the dinner in the oven - at the end I would some days go more than once & just rub hand lotion on her hands as that soothed her but my stay would be about 30 minutes
Think about it & discuss with hubby - if you both decide start looking at what is near you for AL etc - by the way another advantage of being closer is that the NH won't know when you'll just drop in so she will have good care as 'eyes are watching' them all the time
I hear you on the psychiatrist but to tell the truth it's encouraging to hear they are that on top of things to be trying to get that going, for many residents these would be signs they might need some interventions and by the sounds of it many facilities don't think of much less arrange for this kind of assistance. That said it doesn't sound like that's necessarily what your mom needs, again she is behaving normally for her. You mention life long depression, is she on any meds for that? The doctor they made the appointment with, is it one she has known for a long time? If so I would hope that doctor knows this is normal for her, if not I guess they need the same conversation, sorry. I'm just curious, if you are her primary family and support what keeps her so far away? I mean if you don't have other family in her home town and you are considering a move anyway maybe moving her to a place closer to you would be helpful so you aren't making these trips because I'm not sure they are going to stop. It may settle down for a while but in my experience so far just when things are going along smoothly something happens needing a support trip. Just fair warning. Now again, if you can meet with the right people and get her care team all on board you are probably better off leaving things status quo if she's happy there, I was just thinking if you decide you want to move her.
Good luck!
With regards to your mom, having a psychiatry consult does no harm and may help better understand what is happening. Many AL facilities have their own psychiatrist and psychologist that will visit with a resident. Also many facilities also have regularly schedules trips to take residents for doctor's appointments, shopping, outings etc using their own driver/bus. So a doctor appointment can be scheduled with this in mind.
It may be less expensive to hire a home health aid/companion to help mom a few days a week especially on days when she needs to make appointment than for you to travel so often for non emergent reasons.
I speak from experience not living close to my mom in an AL facility, who is very needy, having severe anxiety and being alone for the first time in 60 years. She has been preferring to have breakfast in her room and does not like the regimented meal times and having difficulty interacting with others.
It is not easy to teach an old dog new tricks and many older folks are set in their ways. This does not mean they have dementia or are depressed.
As your mom gets older and possibly more feeble, some AL have dementia units (for a higher fee) and at some point if she needs more nursing care she may need transfer to a nursing or rehab facility.
My heart goes out. Good luck
Unless the AL has a strict policy about eating in their rooms - your mother should have the right to NOT socialize if she so chooses.
Explain to the AL Staff that if you must, you will seek legal counsel as your mother has her rights too.
It helped determine he no longer had the capacity to make his own decisions, for one. It helped determine the appropriate medication to treat his over the top anger, his depression, and some of his delusions.
It helped make the correct diagnoses of vascular dementia, delusions.
But he had those assessments in a geriatric psych floor in a hospital that took several days.
I had DPOA, and I live 900 miles away. I did not fly back for this, I waited until the results to determine the appropriate placement.
There are nursing services that transport patients, and I consulted with the nurses and doctors by phone.
I flew back afterwards to get things in order and make sure Dad was settled in his new environment.
I don’t know anything about Assisted Living, except we knew even before the evaluations that AL was voluntary and he was too stubborn and independent to stay if they said or did one thing he did not like. Like take a shower, or throw away old food, etc.
I hope you are able to explore other ways to get this done so you don’t have to spend your time and money until it is absolutely necessary.
In my mother's case, my siblings and I knew Mom better. She didn't have dementia like the nursing staff kept saying. She finally got a therapist that they wanted me to talk to to see what could be done. Turns out that I knew him. He agreed enthusiastically that Mom didn't have dementia - said "She's sharp as a tack". Nonetheless, the NH staff still wanted her on psych drugs because she was quarrelsome. She went downhill fast. In a fog most of the time. I keep thinking "if it were me"...no, no psychiatrist, no drugs. They need to find another way to deal with troubling behaviors. There is a video about how they handle dementia in a nursing home in Britain. They find out what the patients did for a living and try to recreate such things to give the patients a sense of being needed. I think nothing would have made my mother happier than baking or cooking. It might have made all the difference in the world if the patients could have done something like that together. But I digress...this is about AL - and I still would say "whatever makes her happy".
I have no idea why a Psychiatrist. Ask the doctor. I took Mom to a neurologist. Talk to the RN at the facility. Ask her why she felt the need to see a doctor. She and staff may have seen something you didn't.
The geriatric psychiatrist will look at her behaviors and meds to see if there is a different medication that may help with what may very well be depression.
She is in assisted living which does not include room service. In AL meals in the room, if permitted at all, would be an additional charge.
It sounds like they’re just doing CYA. My mother was in skilled nursing and she seldom joined in their activities unless she was forced. She had 9 out of 10 meals in her room and no one ever said a word. She just enjoyed her own company more than anyone else’s.
Before you run out there again and spend any more of your retirement fund, call a meeting and firmly but calmly explain to them that you are not “around the corner” and cannot keep dropping everything and putting your life on hold.