My family member with dementia was at the time of placement reasonably ambulatory with cane or walker. Mentally engaged. Recognized family members and others routinely involved in her daily life (caregivers, neighbors, etc). She was moved to NH (3 weeks ago). I went to see her on a Friday, Tuesday went back to find her slumped in wheel chair, no longer walking, not engaged at all and did not appear to recognize or respond to me. She is and has been for years not able to articulate, so is non verbal so I cannot ask her about herself. I am concerned and frightened by the sudden change. My imagination and guilt for putting her there is running rampant. Is this sudden change a normal progression or could there be something more sinister to her decline?
Also, did the hospital staff complain that your family member was combative?
If so, they may be using "chemical contraints."....these are drugs that keep the patient submissive and often prevent movement.
https://nursinghomeabuseguide.com/abuse-injuries/elderly-restraints/chemical/
Here are a few paragraphs from the website:
"Chemical restraint is defined as the use of any type of drug to restrict an individual’s movement or freedom. Chemical restraint may be used solely for the purpose of sedating an individual. In most cases, chemical restraint typically refers to psychopharmacological drugs, such as sedatives and anti-anxiety medications.
It is illegal for nursing homes to administer chemical restraint to residents unless they are used to treat medical conditions or prevent residents from causing physical harm to themselves or other individuals. Federal and state laws aim to minimize the use of unnecessary drugs, especially chemical restraints.
Chemical Restraint Use
Chemical restraint use is highly controversial. In a nursing home setting, federal law strictly prohibits the use of chemical restraint for the sake of staff convenience, discipline, or other non-medical reasons.
It may only be used in instances where a patient’s behavior jeopardizes the safety of himself or herself, or the safety of other residents or staff members.
Even in these scenarios, the duration and nature of the chemical restraint must be outlined in the resident’s medical file.
It is important to note that there is no current drug that has received U.S. Food and Drug Administration (FDA) approval for use as a chemical restraint.
In fact, the FDA states that roughly 15,000 nursing home resident deaths each year result from unnecessary anti-psychotic use."
Pgross01 is referring to this sentence in the original post: "She is and has been for years not able to articulate, so is non verbal so I cannot ask her about herself."
The OP does describe that her mother engaged well until very recently, I agree with you, but evidently not by talking. There are other ways for a person to engage with others - smiling, reaching out to touch, stroking hands, just for example.
And the OP asks whether "this is normal progression." The OP does mean, is this normal progression of dementia - see her profile. It doesn't sound typical to me; but not because I'm assuming the lady doesn't have dementia at all. Where did you get the idea that if somebody recognises her family members she doesn't have dementia?
I would also suggest a geropsychiatrist. Or the doctor serving the facility could try a low-dose antidepressant. Depression is common in recently placed people and can look like a drastic decline in function. I'm sure you did everything possible before placing her and had no alternative. Home care is actually not safe in most cases of late stage dementia.
Dr. Gross
Call your local elder care center
people decline. It’s the issues that warranted full-time care, not the placement. Sheesh.
My great aunt, aged 96, in full possession of her mental faculties but physically too frail to live alone, was admitted "temporarily" to a nursing home. A few weeks later, she was not at all herself. Sleepy, not engaging when we visited her, no appetite, not much interest in her usual favourite drinks (Canada Dry ginger ale, e.g., had always been well-received before).
I tracked down the general practitioner who oversaw residents' medical care, and tentatively but in terms asked her whether my great aunt was being given any kind of sedation or similar to "help her settle in to the home's routine, perhaps," I think I said.
The GP was indignant. She would *never* countenance any such thing. She was appalled that I could even think it.
Well, I can't be sure and I never was sure, maybe auntie just perked up of her own accord and had been going through a rough patch for entirely different reasons; but following that conversation the next time we saw her and thereafter for two or more years she was back to normal.
So if I were you I would put the question to them. It will help if you are your family member's health proxy or at least have HIPAA authorisation, but you don't need either to express your concerns. Be as clear as you have been in your post about the Before and After picture, and ask if they can explain.
Even on returning home, it takes a few days to get back to their pre-hospitalization "normal" though never quite fully. I am FT caregiver, have been for 9 years, and dearly pray that I never am faced with the decision to have him in a nursing home.
I do recommend testing for UTI as well, as previously mentioned, as that definitely has a very negative impact overall. When my LO started talking nonsense I told doctor I thought he had a UTI though he'd never had one before. To which came the snot reply "are you in the medical field?" No I am not. "So do you have experience with this?" No I don't.... yet. "Well, he has dementia so....." I insisted that his urine be tested, and Dr. pushed back because it was tested on admission 48 hr. prior. I pushed back, demanded. Guess who called me that night with an apology and a much better attitude???? Caregivers know their LO. Yeah he has dementia and he can be cantankerous. But he has yet to talk nonsense albeit sometimes uses wrong word. But when he said he wanted me to take him to local police department and I enquired to reason... "so we could buy more room" huh, what?
Dementia and ALZ patients go through plateau periods, then step down. Sometimes the plateau is short lived, or longer than previous ones, that step down is barely perceptible, sometimes steep. Environment is key to both in many cases as are meds. All the best to you and please do not blame yourself. You have done the best you could, and can be pro-active in following some of suggestions posted here. God bless you.
Iit's easier to keep them like that then hearing them asking for help, ect.
I have Caregivers 24 7 stay with my 95 yr old Dad.
I had cameras installed so I can see how he's being treated.
You should deffiently direct your concerns and see what new meds were given and ask them not to be given.
A lot if times when the old person is uprooted from their home or wherever they were use to living and no longer familure with their surroundings, it can cause them to regress.
Two things: are drugs being administered and are any drugs new? If there is a new drugs in her regimen, it could have an adverse effect, and because she hasn't been in the SNF long, there's no understandable baseline for medical staff to draw from. I hate to say #2, but perhaps she is very depressed. She recognizes that she is in a care facility and she knows that her life has changed (likely forever).
I am so sorry.
Unfortunately, as it was for my husband, the majority of the declines were due to his Lewy body dementia and just part of his progression.
You must be gentle with yourself and realize that you're doing the best with what you have and know. You have no control over this nor did you cause it so you should not burden yourself with guilt. You're doing a great job.
Ask to see what meds she is on and check them against previously known meds.
Find out how they are ascertaining her wants and desires since she is non-verbal. Can she point? Nod? Can she pour her own water? Find out what sorts of things they are doing to make sure she stays hydrated.
Your job is to be her advocate and her voice. Attendance at care meetings is how you do this
This is very hard. I'm sorry you are going through this.
So in addition to the checkouts,
1) be sure to make time every few weeks to check her out - so to speak and get her a change of scenery - if not a home visit, even a McDonalds run works.
2) Check whether she is - or is supposed to be getting rehabilitative therapy.
3) Remember she's "in a new school" and still adjusting to the new people and places of the NH, or even new meds.
4) Share your concern with the NH staff so they can monitor.
If no medical reason seems to explain it, I have witnessed rapid cognitive decline due to a stressful situation or illness in NHs. You might want to take her for a home visit and see if she becomes more alert. It would at least give you a clue.