My 75-year-old mother lives with me. She has had two strokes. The only lasting damage seems to be a vascular dementia. However, the only things that my mother EVER has enjoyed is shopping, sleeping, eating, or watching TV. She does not cook anymore and will not try. She does not do puzzles or read. She gets virtually zero exercise. She does not pick up after herself or even get dressed daily. She barely comes out of her room and sleeps all day long. She is also very mean and has no boundaries within the house or with people. She has always expected people to do things for her. She complains about being "sick" constantly, and has gone to the hospital by ambulance on several occasions only to find nothing wrong with her (starting infrequently at age 33 and becoming far worse over the years.) She has been on anti-depressants for years and years. She complains, talks about people, insults, "tells on" people, all the time, and she is getting harder and harder to live with. She is never wrong and any disharmony in the household is blamed on everyone and anyone else. She would never accept outside help, nor would she join a senior center or accept counseling. Her only friends are relatives who are often occupied or limited by their own lives and/or health. Any offer to reunite with past friends is met with excuses and reasons not to go. Quite frankly, her demeanor has always been harsh or negative, and now it's coupled with her constant complaining, so people don't WANT to be around her, including me. Truly....she would accept NO PROFESSIONAL help. She would become angered and fly off the handle. She has no zest for life, and although fears death, seems only to be waiting to die. However, I should mention that she can put on somewhat of a phony/"crazy" show in front of others not close to her to give the impression that she is anything other than miserable.
No wonder Mom is depressed at her age. She's already had two strokes. She can no longer hop into a car and drive to the mall. She can no longer visit with girl friends. She basically has nothing to do, so gossiping is now her past-time. Where is your Dad, or has he and your Mom gone separate ways... that can be very heartbreaking, too. This isn't the retirement she suspected. I would be grumpy, too. Being "sick" gives her attention.
I would have Mom see her primary doctor, or go to urgent care, to have Mom checked for Urinary Tract Infections [UTI] as those can cause a person to misbehave, lose their filter, even become violent. This can be treated with antibiotics.
What was Mom's passions when she was younger? Doing volunteer work is the greatest pick-me-up if Mom is willing to do that. I know it would be a challenge, but give it a try.
The behavior you describe does not sound like typical depression to me. It sounds like she has some other mental health issues, perhaps in addition to depression. The first step in addressing that is obvious, but you can't get her to a doctor if she won't go.
Your question is what should you do with her. This may sound drastic, but what I think you should do is get her out of your house. You cannot control where she goes (unless you are guardian) but you can control who lives in your house. Since she has dementia she really shouldn't be living alone, so an apartment may not work. Maybe assisted living. Maybe memory care. Maybe a group home. Maybe a nursing home. Not your decision, but you could be thinking of possibilities to suggest.
Work with professionals to get her resettled elsewhere. I'd start by calling the Area Agency on Aging in your county. Explain that your mother, with vascular dementia, is living with you now but this cannot continue. Ask for a needs assessment for your mother, to establish what level of care she needs. Then discuss with them how to find a suitable residence for her. They can't force her to accept a particular place, either, but once she understands that she has to move, perhaps she will be more receptive.
The agency on aging varies from state to state. If yours cannot help with these things, they should be able to refer you to resources that can.
Another way to get professionals involved is to make an appointment for a needs assessment with your county's Human Services (welfare) department.
Be present during the needs assessment. The people who do them know that the person they are assessing lies or exaggerates or just doesn't remember accurately. But they have to write down the answers they are given. You can help that to be accurate. For example, my mother said, yes she could prepare her own meals. The daughter who was with her for the interview said, yes, Mom, but you can't get your own groceries, and don't use the stove. You can microwave things but it is getting harder and harder for you carry them to the table. Mom admitted that all that was true. She got Meals on Wheels. But if the social worker had had to take her at her word that she could prepare her own meals, that might not have happened.
Look into the eviction process in your location. Let us hope that it doesn't come to having the sheriff forcibly remove your mother, but having that option makes it clear that you are totally serious about this change. "Mom, it really isn't working for us to have you living here. I think you are not happy here, either. I will help you find another place to live if you would like help. But you must be out of here by the end of September."
If this solution is too drastic, then I think the alternative is to grin and bear it, and come here often to vent!
I'm very sorry to hear about everything you are dealing with. I know its frustrating and exhausting. My dad also suffered a stroke and I found it very difficult to cope with his negativity. I tried and tried to make him happy but nothing I seemed to do was ever right.
In hindsight, I do blame the vascular dementia, the side effects of the meds, the loss of his independence. It was just spiralling downwards. My dad has since passed and I do have terrible regrets about his care. For your mom, I wonder if maybe an assisted living or nursing home might give her more company during the day and more relief for you.
Thinking of you. I know its not easy.
Dad refused to see a Dr., although he was loosing weight, would take his meds only now and then, and showing signs of dementia. Did I mention he would take about 1/2 dose of insulin morning and night, but never would he check his sugar level? He fell a few times. I told him the next time he fell or had a medical issue, he was going to a NH, and that would always be met with "You better NEVER put me in a NH. I just walk out!"
Looking back, he always was Mr. Negative, always pointing out why something would not work, never on the positive side of things.
Anyway, his sugar bottomed out and wrecked the car [minor damage-no injuries], went to the ER and later his Dr, who recommended NH placement in a locked dementia unit. He is now doing well, just still pissed about "Who put me here? I'll knock them out!" That has been a little over a month ago, and slowly getting his meds straightened out. Things are looking better now.
1. She moved in with you? What happened to her home? Does sale of it pay for her needs? Will this provide for her in a home besides yours?
2. She flies off the handle at the mention of outside help. How far has a fit gotten? Was it life-threatening? Could she bar professional help from entering the house?
I agree with *Jeannegibbs* that you need to be present during an assessment, stating very plain truths. My parent had a whole group of us maintaining cleanliness, safety, ect, She thought (in her dementia) that she was doing it all. Not true. Say it -- gently.
She gets mad? How mad can she get? Life threatening to herself or others? If this is grumpiness, then treat it like a toddler and walk away.
Trips to hospital? Can you get a list of those trips? Showing reason, and outcome. Also look for "triggers." Too much tv show junk, a holiday or other significant occasion? Visitors?
With her being 75 years old, and if she is coddled in the health system she could live for many years -- physically ok enough, but mentally at risk. I "enabled" mine for 22 years to age 93, hoping she would "get happy and do things" but it did not happen. I lost a huge chunk of my life and opportunities.
Take a really realistic look at this. What are you going to gain? Family happiness? Money or property? Think again and do get some professional assessments involved, talk with financial planner for your parent and find her a nice senior community.
The "only"?
Imagine if you felt incredibly ill and incredibly tired every waking moment; that the gloss had come off everything you used to be interested in; and that everyone seemed to be carrying on as normal while you were drifting further and further away from your life. That's pretty much how your mother feels.
Your mentioning the meeting up with old friends made me smile at a memory. My mother's friend from her days in the army, so going back sixty years and more, also in her eighties, travelled alone for two hundred miles to come and see her. After dinner I settled B in mother's sitting room with the coffee tray then went back to the kitchen to find mother still firmly in her chair at the table. "B's waiting for you, aren't you going to join her?" "Do I have to?" "Yes, of course you do, she's come all this way to see you, you can't leave her sitting there by herself." "Well it's very trying!" snapped mother, and spent the rest of the evening in a grump.
The insults and rudeness, by the way, become more extreme because your mother's social filters are gone. Inhibition, which stops us telling people what we think of them when it would be hurtful or inappropriate, is a frontal lobe brain function; and it seems, from reading here about other people's elders too, that it's one of the first noticeable things that vascular dementia attacks.
Please don't think I don't sympathise with you. I've been through this and it is a black hole of negativity, almost as depressing for the caregiver as it is for the sufferer. But you can't restore your mother's brain, and she can't alter her behaviour either. There are techniques which will help you keep the stress under control. Other than that, it's a matter of judging whether you can learn to live with this in your home, or looking for a facility you trust to care for her well.
You do have an advantage I don't have. She lives with you, instead of you with her. That gives you a lot of leverage in getting her into a better living situation. I would go for it, because it can make life miserable. It would be better to live apart as daughter and mother than live together with resentment. The advice that others gave above is excellent. One thing that is good to remember is that you are as important as she is. You have the right to a good life. My mother started going downhill when she was 75 with what may be vascular dementia. She is 90 now and may live many more years.
A good friend of mine placed her mother who had dementia that eventually became severe in a small, private nursing home with only a few dozen rooms. She visited her weekly. Her mother lived with dementia for nearly 25 years and died at 100.
Now, this is very different from having a "houseguest" as it were. But your mother's refusal to do ANYTHING makes it very hard on YOU. And she can't see it, b/c depression sucks the light right out of a room.
So--either you continue to live with this mopey, angry person, or you don't. She really does NOT have the right to ruin your life. At this point (75 is still quite young!!) if she simply refuses ALL help offered and available, I'd be looking for somewhere to place her. You do not "owe" her anything but respect due an elder.
Yes, it is hard. Yes, she will be mad. But it's hard now and she's mad now. You are going to kill yourself caring for her and trying to get her to engage in life and she obviously doesn't want to. She'd probably be as miserable in one bedroom in a NH as she is at your home. She could certainly live 20 more years.
Sounds like you have a terribly difficult choice and I do not wish that on anyone. But, she isn't going to change, so you have to.
I had to laugh about mixing up the dog names. My mother mixed up the names of her seven kids. I apparently inherited the can't-remember-names gene. If that indicates dementia, then I come from a family filled with dementia!
The restaurant incident is very similar to my husband's melt-down day. We were at a local restaurant we've been to many times, with an adult daughter. We discussed what we would order. I reminded him of a choice he liked in the past and he said, yes, that is what he would order. When the waitress came he opened the menu at random and ordered something he had never liked before. (I think he was too embarrassed or worried to ask me what he had decided on.) When the waitress brought the little pot of hot water and a tea bag, he had no clue how to make tea! (He drank tea daily as long as I'd known him.) He was soon diagnosed with dementia.
So, yes, forgetting what she ordered COULD be a sign of dementia, but in itself doesn't really serve as good evidence. What other examples has your brother observed?
The saying is "Forget where the keys are? Old age. Forget what keys are for? Something else is going on."
Just one other comment here. Addressing your mother's pain with walking could be very important. Pain contributes to depression. It can be so distracting that you appear forgetful. I'm dealing with leg pain right now, and believe me, I am not at the top of my game! I am getting medical treatment. Pain is not caused by "old age."
I'm not surprised that she doesn't want to do much. People who have brain damage often can tell things are changing and they are scared and confused. I get why they don't want to leave the house. Not remembering things like how to open a car door or how to stir your coffee is embarrassing. Often the comfort of home is safer for them.
I'd read a lot about what she may be experiencing and find something that she might be able to handle with small steps. My LO would only do something, if I was right by her side. It still scared her though. She often felt that she was dreaming and things weren't real. I can see how that frightens people.
Blaming a dementia patient for their behavior, regardless of how odd we may consider it, isn't really helpful. They are disabled and need help and empathy.
Mental illness can be diagnosed and hopefully treated or at least controlled to a certain extent'
Once what you are doing becomes worse than what you have to do then is the time to take action. I would advise anyone never to make a promise that they will never put a loved one in a facility.
Jeannie Gibbs has weathered this storm for many years but there may come a time when Mom has to be taken kicking and screaming into a facility. It is very likely that any caregiver will get a serious illness like a stroke or cancer and the decision will be made for everyone. People who have had strokes frequently become depressed so that is always something to remember.
If you have a loved one who refuses to do OT and PT in the hospital may still be transferred to a N/H.BUT if they continue to refuse and show no improvement Medicare will refuse to continue to pay for the rehab and other arrangement will have to be made.
Frequent visits to an ER can be turned to the advantage of the loved one by refusing to take them home again. There shiould be a very good reason prepared in advance because the hospital staff will give you a very hard time and you may feel intimidated but pointing out the reasons someone can't live alone. A good example is someone who has had multiple falls and is not safe without a walker really can't and should not cook. It is very dangerous to try and take pan off the stove to drain the vegetable while using the walker with one hand. Likewise taking a shower or bath is fraught with danger.
Delta I don't think anyone was blaming you for complaining about behavior your mother can't help. Even with a past history of negativity once dementia enter the picture she really does not have control. be prepared this will only get worse