She’s been in a nursing facility because I had to call the police to find her pretty much incapacitated lying in her own feces and urine. Refusing to eat, or drink. She seemed to get better as occupational and physical therapy worked with her at a long term care facility. I trusted her enough to get her into an assisted living facility. She followed the rules for about a month and slid right back into her old ways. Assisted living is really for people who want to take care of themselves. She doesn’t. Period. She has been to the hospital for dehydration twice in 3 weeks. If it isn’t dementia what is it and how the heck do we fix it?
How did you place her? Do you have POA?
And I am surprised that during the time she has spent in the Skilled Nursing Facility and in rehab and in the AL facility that no one has given her a diagnosis of dementia.
Anyway....
With dementia she is not "REFUSING" to care for herself.
She can no longer care for herself.
Just like she did not "want" to become incapacitated, she did not "want" to be covered in her own fecal matter, her own urine. And she is not "refusing" to eat or drink. She maybe does not know the process to eat. If you think about it eating is complicated.
You have to cut your food up, or at least get cut food on your fork or spoon. (do you know what a spoon or fork is and how do you hold it?)
Now you have to get it to your mouth.
Now chew. this can be a confusing part.
Once you chew you have to swallow. (Pocketing is common with dementia so you have to make sure the mouth is clear)
Repeat these steps until the food is gone.
Many people with dementia need constant monitoring while eating. (Choking is common as is Aspiration that can lead to pneumonia)
Food has to go from "normal" food to cut up for them to minced to pureed. And liquids may have to be thickened
Eating and drinking is not an easy task when you have dementia.
And when someone can no longer feed themselves they must be fed.
Good luck to you.
She's elderly, she's declining, and she needs care. If she won't do physical therapy, it's likely because it's hard for her. Leave her alone and don't harp on her, but try to get her doctors to make an effort to figure out if she has something going on. Too many doctors write off their elderly patients and don't really care to try to diagnose an actual issue they might be able to treat.
The last thing you should do is blame her. As the others have said, no one sits in urine and feces by choice or stops eating out of spite. Until you can figure out what's going on, she needs the proper level of care, and perhaps she's beyond assisted living. Regardless of what happens, don't expect her to return to being fully functional as that rarely happens.
Did she make any friends at the assisted living facility?
What did she do earlier in her life? Can you help her find some volunteer opportunities in that area? Are animals allowed at the AL? Maybe she needs just something to do....someone who is counting on her to be present. Can she help with the meals? How about joining a church group or volunteer sorting food at a food bank?
- stroke
- kidney disease
- diabetes
- liver function problems
Any of these can mess with cognition.
Unable to self-care can be behaviour displayed in many mental illnesses - severe depression being a usual suspect.
Sitting unable to eat, drink, staying soiled seems almost catatonic behaviour to me. Seen this a few times.
A thorough neuro-psych evaluation may bring a diagnosis, get you a 'label'.
But not always. Sometimes no label happens, things just don't work & no-one know why. Not all things have cures.
If so, then you move from Curing to Coping. To finding accomodation for Mom that provides care at the high level she needs.
Has the AL place started bugging you about her? Have they said that they feel it might not be the best place for her? Are they calling you all the time?
Are you her POA/HCPOA?
you sent me a message and I can not reply to it for some reason so I am replying here to you.
There is a diagnosis called Failure To Thrive.
People who suffer from BiPolar have manic episodes. One day they will seem "normal" the next day shaving their hair off. Where I used to work we had a client that did that. Another time she gave away her furniture, another day all her food. Its not curable but it can be managed.
I am sorry if you feel like people are bullying you but you are asking a forum of mostly lay people to answer a question without any background. We answer from experience of being Caregivers and the info we are given. Sometimes there are assumptions because we don't have the whole story. We can only point you in the right direction to get help but we can't diagnose.
Start with diagnosis. There's no other way. Sure do wish you the best.