What do you do when an alzheimer's patient starts hitting during moments of rage?
My mother is the primary caregiver to my step-father that is in late stages Alzheimers. We believe he is in stage 6. He is beginning to have difficulty with balance, walking and forming complete sentences or thoughts. We already have to remind who we are sometimes and he only talks about things that happened 30+ years ago.
Now we all completely understand that alzheimer patients basically turn into children. But even attempting to get him to take a shower is a huge task! If we say/ask him to do something like take a shower, without hugging on him, showing complete affection, he gets mad and rips, tears his clothes off. Throws things etc! This is starting to happen with other every daily routines. We HAVE to be as completely nice as we can most possibly be or he snaps into a rage! And this is really hard to do, especially when he has never been that nice of a person to begin with.. Now he is either overly nice, which is weird or he is the same mean person he always has been.
Okay, my mother has been really trying. She goes to support groups, etc but it is beginning to be too much for her to handle. Seems that she has just had enough and truthfully, I can not blame her. I've helped over the past few years and it is more than I can handle. Also something neither of us are trained to do.
I'm not sure of where to turn for help.. I had a social worker come but that only lasted a couple of weeks. After the social worker realized that my mother drives and they are not home bound, that ended. AND made my mothers car insurance go up!?!
I've looked into in-home care, assisted living, nursing home care, etc but that cost an arm and a leg! Its WAY more than they can afford! I even looked into continuing care communities, so my mother can have her independence and my step-father can get the care he needs but that is too expensive as well. I have seen a few communities that they can afford but they always have what is called "gross income restrictions". Unfortunately their gross and net income is two drastically different figures! Due to the cost of their medications, premiums, life insurance policies etc etc..
I've even looked into assistance with the VA but.. yup another but, he didn't serve during a war. he served right in-between the Korean and Vietnam war. So the housing assistance program isn't an option.
And from what I have read, Medicare won't cover any housing until he becomes, well basically a vegetable. Though, years ago, my father signed in his living will not to keep him alive with machines etc.
As of now, we have moved my parents into a straight-up, gated senior apartment community that is close to us. There is no assistance for care, can not afford those, but at least there is a sense of security. Which we as family, do help on a daily basis so my mother can have a break, etc.
Guess what my question is, how do middle class senior citizens with a disability get assistance especially when one is becoming violent?
What do you do when an alzheimer's patient starts hitting during moments of rage?
My mother is the primary caregiver to my step-father that is in late stages Alzheimers. We believe he is in stage 6. He is beginning to have difficulty with balance, walking and forming complete sentences or thoughts. We already have to remind who we are sometimes and he only talks about things that happened 30+ years ago.
Now we all completely understand that alzheimer patients basically turn into children. But even attempting to get him to take a shower is a huge task! If we say/ask him to do something like take a shower, without hugging on him, showing complete affection, he gets mad and rips, tears his clothes off. Throws things etc! This is starting to happen with other every daily routines. We HAVE to be as completely nice as we can most possibly be or he snaps into a rage! And this is really hard to do, especially when he has never been that nice of a person to begin with.. Now he is either overly nice, which is weird or he is the same mean person he always has been.
Okay, my mother has been really trying. She goes to support groups, etc but it is beginning to be too much for her to handle. Seems that she has just had enough and truthfully, I can not blame her. I've helped over the past few years and it is more than I can handle. Also something neither of us are trained to do.
I'm not sure of where to turn for help.. I had a social worker come but that only lasted a couple of weeks. After the social worker realized that my mother drives and they are not home bound, that ended. AND made my mothers car insurance go up!?!
I've looked into in-home care, assisted living, nursing home care, etc but that cost an arm and a leg! Its WAY more than they can afford! I even looked into continuing care communities, so my mother can have her independence and my step-father can get the care he needs but that is too expensive as well. I have seen a few communities that they can afford but they always have what is called "gross income restrictions". Unfortunately their gross and net income is two drastically different figures! Due to the cost of their medications, premiums, life insurance policies etc etc..
I've even looked into assistance with the VA but.. yup another but, he didn't serve during a war. he served right in-between the Korean and Vietnam war. So the housing assistance program isn't an option.
And from what I have read, Medicare won't cover any housing until he becomes, well basically a vegetable. Though, years ago, my father signed in his living will not to keep him alive with machines etc.
As of now, we have moved my parents into a straight-up, gated senior apartment community that is close to us. There is no assistance for care, can not afford those, but at least there is a sense of security. Which we as family, do help on a daily basis so my mother can have a break, etc.
Guess what my question is, how do middle class senior citizens with a disability get assistance especially when one is becoming violent?
Unless there is a lot of money in his name, I am going to offer the solution. Hopefully, there is just their home and pension or social security, and not big savings account.
Its time to face the hard truth (and protect your mother and save everyone else's sanity). He CAN go to a nursing home under "custodial care". And it works best if you DON'T have money. Talk to his doctor, he needs a 3 day stay in the hospital to re-activate his 90 days of medicare paid nursing home. Once in the nursing home, work with the placement consellor about switching him to custodial care when the Medicare days run out. They will (not you, you just sign papers) help you apply for Medicaid (in california its MediCal). Medicaid pays for his entire stay for the rest of his life in a nursing home. If anyone tells you that can't happen, contact me and I will explain it better. But I have been a director of assisted living communities for almost 20 years, I live and breathe this stuff. The other thing you should do right now is get him on Hospice. Again, most people will say that can't be. It can. Most doctors don't understand hospice. they all think its for pain management in the last days of life. Not so. And late stage alzheimer's is a quailifing diagnosis. Hospice is completely covered by Medicare. And they provide nurses, aides, social workers, even doctors if your doctor doesn't want to do it. Hospice basically says its for someone with 6 months or less to live. But nobody can accurately say when someone will die. So Medicare has criteria, but the hospice knows how to do it. But pick a good hospice. Vitas is in a lot of states they are pretty good, there are others, ask around. good luck. Donahue Vanderhider, MSG (Gerontologist) p.s. if there is a lot of savings, buy your mom a car cash (doesn't matter if she drives)who's to say you can't driver her in her car, pay insurance for the year in advance, and get some nice furniture for the house before you send him to the hospital. Do not just take it out of the bank or give it to the kids, medicare has a "lookback" of 3 years and they will catch it and deny you. So use it on real expenses and do it before the hospitalization. (Man, somebody should pay me for this stuff) : )
Unless there is a lot of money in his name, I am going to offer the solution. Hopefully, there is just their home and pension or social security, and not big savings account.
Its time to face the hard truth (and protect your mother and save everyone else's sanity). He CAN go to a nursing home under "custodial care". And it works best if you DON'T have money. Talk to his doctor, he needs a 3 day stay in the hospital to re-activate his 90 days of medicare paid nursing home. Once in the nursing home, work with the placement consellor about switching him to custodial care when the Medicare days run out. They will (not you, you just sign papers) help you apply for Medicaid (in california its MediCal). Medicaid pays for his entire stay for the rest of his life in a nursing home. If anyone tells you that can't happen, contact me and I will explain it better. But I have been a director of assisted living communities for almost 20 years, I live and breathe this stuff. The other thing you should do right now is get him on Hospice. Again, most people will say that can't be. It can. Most doctors don't understand hospice. they all think its for pain management in the last days of life. Not so. And late stage alzheimer's is a quailifing diagnosis. Hospice is completely covered by Medicare. And they provide nurses, aides, social workers, even doctors if your doctor doesn't want to do it. Hospice basically says its for someone with 6 months or less to live. But nobody can accurately say when someone will die. So Medicare has criteria, but the hospice knows how to do it. But pick a good hospice. Vitas is in a lot of states they are pretty good, there are others, ask around. good luck. Donahue Vanderhider, MSG (Gerontologist) p.s. if there is a lot of savings, buy your mom a car cash (doesn't matter if she drives)who's to say you can't driver her in her car, pay insurance for the year in advance, and get some nice furniture for the house before you send him to the hospital. Do not just take it out of the bank or give it to the kids, medicare has a "lookback" of 3 years and they will catch it and deny you. So use it on real expenses and do it before the hospitalization. (Man, somebody should pay me for this stuff) : )
Thank-you Donahueg for your reply and information!
When I had a social worker coming by to visit them, this has been within the past few weeks. I talked with her about hospice care, which she did say that Medicare would cover it. She talked with me about Medicaid too and I told her that after I looked at Medicaid online, my parents exceed the min gross income to qualify for Medicaid. She just said "hmm.." as in Oh well.. Of course she just left us high and dry after that, when she found out my mother drives.. But am I missing something? does the social worker not fully understand Medicaid either? Is there a way around this?
Now, my step-father does have a small federal pension, SS and my mother receives SSI. They have no more than $1000+/- in their savings account. The only thing that they have, that they outright own is her car (its been paid-off for yrs) and furniture. And as I said in my first post, their gross income and net income is two drastically different figures (a $38,000/yr DIFFERENCE!) after medications, premiums, life insurance, etc. They are only left with roughly $24,000/yr to pay for rent, food, gas, etc. In other words, no, my parents most certainly, do not have a lot of money! In the past few months, they have also filed and completed the chapter 7 process, foreclosed on their house and then we moved them close to family (in the senior apt community).
Additional, my parents have also kept their very expensive BCBS standard 105 plan (no long-term care). Mainly to help with cost of medications. Did look into medicare part D but broken down, there wasn't any difference. But I've also tried to see, if by chance, their BCBS plan would cover part of nursing home care. Unfortunately, it does not or so the benefit booklet and BCBS customer service says...
Okay, he does have his first appt with his new psychiatrist coming up in 11 days. I will make sure that my mother lets them know that he has started hitting her again and I'll have her ask about the custodial care. Hopefully the new doctor will at least suggest the custodial care or something of the sorts. I really hope so because my mother and I, are really getting at our wits ends. Every where we have turned, I get the "no" answer.
Also, if you believe that I've completely missed something with Medicaid and the income limits. Please Please PLEASE let me know! I will forever be grateful!! And I can only wish that I could pay you for the info but I've been unemployed the past few years due to taking care of my parents, dealing with doctors, the attorney, the move, etc. It has certainly been a full time job being POA! Thankfully I have a wonderful, understanding, caring husband or there would have been no way I could have done it all! Of course we're living off of pennies but we're making the best of it.
Again, thank-you so much for your reply and the information!! I'm truly TRULY grateful!!!
Thank-you Donahueg for your reply and information!
When I had a social worker coming by to visit them, this has been within the past few weeks. I talked with her about hospice care, which she did say that Medicare would cover it. She talked with me about Medicaid too and I told her that after I looked at Medicaid online, my parents exceed the min gross income to qualify for Medicaid. She just said "hmm.." as in Oh well.. Of course she just left us high and dry after that, when she found out my mother drives.. But am I missing something? does the social worker not fully understand Medicaid either? Is there a way around this?
Now, my step-father does have a small federal pension, SS and my mother receives SSI. They have no more than $1000+/- in their savings account. The only thing that they have, that they outright own is her car (its been paid-off for yrs) and furniture. And as I said in my first post, their gross income and net income is two drastically different figures (a $38,000/yr DIFFERENCE!) after medications, premiums, life insurance, etc. They are only left with roughly $24,000/yr to pay for rent, food, gas, etc. In other words, no, my parents most certainly, do not have a lot of money! In the past few months, they have also filed and completed the chapter 7 process, foreclosed on their house and then we moved them close to family (in the senior apt community).
Additional, my parents have also kept their very expensive BCBS standard 105 plan (no long-term care). Mainly to help with cost of medications. Did look into medicare part D but broken down, there wasn't any difference. But I've also tried to see, if by chance, their BCBS plan would cover part of nursing home care. Unfortunately, it does not or so the benefit booklet and BCBS customer service says...
Okay, he does have his first appt with his new psychiatrist coming up in 11 days. I will make sure that my mother lets them know that he has started hitting her again and I'll have her ask about the custodial care. Hopefully the new doctor will at least suggest the custodial care or something of the sorts. I really hope so because my mother and I, are really getting at our wits ends. Every where we have turned, I get the "no" answer.
Also, if you believe that I've completely missed something with Medicaid and the income limits. Please Please PLEASE let me know! I will forever be grateful!! And I can only wish that I could pay you for the info but I've been unemployed the past few years due to taking care of my parents, dealing with doctors, the attorney, the move, etc. It has certainly been a full time job being POA! Thankfully I have a wonderful, understanding, caring husband or there would have been no way I could have done it all! Of course we're living off of pennies but we're making the best of it.
Again, thank-you so much for your reply and the information!! I'm truly TRULY grateful!!!
best bet is to find an elderlaw or estate attoney that can tell you how do properly get rid of their excess funds. At some point,the last step will be to pay it to the nursing home for custodial care until HE runs out (start unmingling their funds so, things are either in his name or hers) when his extra funds run out, then Meidcaid will take over. Feel free to turn that car in and get a new one, feel free to buy new furniture or remodel something in the home. (check with the attorney on this) Basically when DAD is broke, and all there is is his monthly income then he will qualify for Medicaid and all the good stuff that provides. And don't worry, they do not count the house as an asset nor will they make them sell their house. Basically, you need a the RIGHT lawyer to tell you whats fair game in spending money and whats not. But beware, attorneys are notoriously uniformed ans B.S.ers - get one that has recommendations and one that knows eldelaw. Contact your local Alzheimers Association for recommendations if you like.
best bet is to find an elderlaw or estate attoney that can tell you how do properly get rid of their excess funds. At some point,the last step will be to pay it to the nursing home for custodial care until HE runs out (start unmingling their funds so, things are either in his name or hers) when his extra funds run out, then Meidcaid will take over. Feel free to turn that car in and get a new one, feel free to buy new furniture or remodel something in the home. (check with the attorney on this) Basically when DAD is broke, and all there is is his monthly income then he will qualify for Medicaid and all the good stuff that provides. And don't worry, they do not count the house as an asset nor will they make them sell their house. Basically, you need a the RIGHT lawyer to tell you whats fair game in spending money and whats not. But beware, attorneys are notoriously uniformed ans B.S.ers - get one that has recommendations and one that knows eldelaw. Contact your local Alzheimers Association for recommendations if you like.
You go to an elder attorney and they will put real estate in one irrevocable trust and the other assets in another irrevocable trust. Irrevocable is the key....once that your father is qualified for Medicaid, the government cannot take either trust before or after his death. It is totally legal. But also remember that an attorney can easily charge $10K to do this. So if your parents can't afford that, then apply for Medicaid for your father. Talk to Health Advocates at the hospital they can help you with the application.
Meanwhile, you will still need to plan and pay for a funeral, which also can be put into irrevocable trusts through the mortuary.
You go to an elder attorney and they will put real estate in one irrevocable trust and the other assets in another irrevocable trust. Irrevocable is the key....once that your father is qualified for Medicaid, the government cannot take either trust before or after his death. It is totally legal. But also remember that an attorney can easily charge $10K to do this. So if your parents can't afford that, then apply for Medicaid for your father. Talk to Health Advocates at the hospital they can help you with the application.
Meanwhile, you will still need to plan and pay for a funeral, which also can be put into irrevocable trusts through the mortuary.
And by the way....if your father is hitting your mother, you don't wait for a doctors appointment. You call 911 and have the police order the 3 day hospital stay/evaluation. Besides the new doctor may just prescribe strongs drugs and send him home. You need the 3 day evaluation.
You mentioned "...Now he is either overly nice, which is weird or he is the same mean person he always has been.
BOTH behaviors are NEW. Alzheimers is brain damage. And whether or not a person was mean in their life, this is completely different. The mean person that he always has been is gone. So this mean could escalate where the old mean never did...to dangerous levels of violence.
And by the way....if your father is hitting your mother, you don't wait for a doctors appointment. You call 911 and have the police order the 3 day hospital stay/evaluation. Besides the new doctor may just prescribe strongs drugs and send him home. You need the 3 day evaluation.
You mentioned "...Now he is either overly nice, which is weird or he is the same mean person he always has been.
BOTH behaviors are NEW. Alzheimers is brain damage. And whether or not a person was mean in their life, this is completely different. The mean person that he always has been is gone. So this mean could escalate where the old mean never did...to dangerous levels of violence.
In dealing with my FIL we found that going for custodial care can be a real challenge. It involves court items and they have to come and interview or at least check out the person. In my situation the custodial care was more of a hassle than a benefit. I guess what I am saying is check out any type of decision totally before taking it. And by the way - - when they look at your income I think there is always a place to write in any 'special circumstances' perhaps you could indicate their prescription and insurance costs there. Good Luck.
In dealing with my FIL we found that going for custodial care can be a real challenge. It involves court items and they have to come and interview or at least check out the person. In my situation the custodial care was more of a hassle than a benefit. I guess what I am saying is check out any type of decision totally before taking it. And by the way - - when they look at your income I think there is always a place to write in any 'special circumstances' perhaps you could indicate their prescription and insurance costs there. Good Luck.
From my experience, AnitaP is exactly right. you can call the police, and in most jurisdictions they have the right to place a person on an involuntary hold (or as it is often referred: a 72 hour hold). It will depend on the responding officers,so they need to be told about the diagnosis, the alzheimer's and your fears that he will continue to be violent.
About custodial care...I am not talking about a conservatorship, which is a court order that puts one person in charge of another person. I am referring to the clinical term for placing someone into a long-term care environment (nursing home). In order for Medicaid to pay for it. The maximum stay you can get in a nursing home (without extremely unique circumstances) is 90 days from Medicare. But if you have someone with late stage alzheimer's and they need to be in nursing home, effectively for the rest of their life,they have to start paying themselves. Then when the person runs out of money, they (or someone on their behalf) applies for Medicaid, and Medicaid will take over and pay. And that long-term nursing home placement paid by Medicaid is often called "custodial care".
Finally regarding what you do with your dad's money to speed up the process of him qualifing for Medicaid, You should talk to an expert. And elderlaw attorney, or a financial consultant that works with older people. Even some of the larger care management companies will be able to provide you with the right expenses.
From my experience, AnitaP is exactly right. you can call the police, and in most jurisdictions they have the right to place a person on an involuntary hold (or as it is often referred: a 72 hour hold). It will depend on the responding officers,so they need to be told about the diagnosis, the alzheimer's and your fears that he will continue to be violent.
About custodial care...I am not talking about a conservatorship, which is a court order that puts one person in charge of another person. I am referring to the clinical term for placing someone into a long-term care environment (nursing home). In order for Medicaid to pay for it. The maximum stay you can get in a nursing home (without extremely unique circumstances) is 90 days from Medicare. But if you have someone with late stage alzheimer's and they need to be in nursing home, effectively for the rest of their life,they have to start paying themselves. Then when the person runs out of money, they (or someone on their behalf) applies for Medicaid, and Medicaid will take over and pay. And that long-term nursing home placement paid by Medicaid is often called "custodial care".
Finally regarding what you do with your dad's money to speed up the process of him qualifing for Medicaid, You should talk to an expert. And elderlaw attorney, or a financial consultant that works with older people. Even some of the larger care management companies will be able to provide you with the right expenses.
we experience this with my dad a few years ago. the result was he was put on Aricept and Lexipro by his primary care doctor. I was afraid for my mother's safety with dad acting like he was (yelling, hitting, hair pulling, etc.) Subsequently he calmed down IMMENSELY, and both my mother and I feel the combination of these two medications has been a godsend. Please if you put your father in a facility do consider the medications anyway; it's very hard in a facility to manage these kinds of issues and you don't want your father endangering anyone else with his behavior. Good luck to you and your mom.
we experience this with my dad a few years ago. the result was he was put on Aricept and Lexipro by his primary care doctor. I was afraid for my mother's safety with dad acting like he was (yelling, hitting, hair pulling, etc.) Subsequently he calmed down IMMENSELY, and both my mother and I feel the combination of these two medications has been a godsend. Please if you put your father in a facility do consider the medications anyway; it's very hard in a facility to manage these kinds of issues and you don't want your father endangering anyone else with his behavior. Good luck to you and your mom.
DONAHUEG, I am an only child and I have a unique issue. Dad passed away 3 years ago and the house went to mom. I am disabled (SSIDB) and have been living in the house for 7 years. That was before dad died and mom had a stroke at the same time. She is now in the nursing home for stroke induced dementia after I cared for her at home for 2 years. She was fighting me. My name is not on the house and mom has money so far for her care. My question is when she goes on medicade will they take the house from me and make me move because I am not on the deed. The elder attorneys here are not good and I am in a small town. I can't travel to see one. I asked and was told there is a state recovery act that allows them to put a lien on the home so that when mom passes away I will be forced to sell the home and pay them. It is too late to put my name on it or the govt would think I was hiding money. I am her POA. That is all. I have been using some of her money for her care because meds,personal items, clothing etc are not included in home costs on private pay. There was also some large home repairs that had to be made because of possible safety issues...leaking roof and kitchen, flooded basement,broken steps, etc. I want to stay in the home when she runs out of cash and take over taxes, upkeep etc but not if they are going to take it. I can keep it as is. Can they take the home?
DONAHUEG, I am an only child and I have a unique issue. Dad passed away 3 years ago and the house went to mom. I am disabled (SSIDB) and have been living in the house for 7 years. That was before dad died and mom had a stroke at the same time. She is now in the nursing home for stroke induced dementia after I cared for her at home for 2 years. She was fighting me. My name is not on the house and mom has money so far for her care. My question is when she goes on medicade will they take the house from me and make me move because I am not on the deed. The elder attorneys here are not good and I am in a small town. I can't travel to see one. I asked and was told there is a state recovery act that allows them to put a lien on the home so that when mom passes away I will be forced to sell the home and pay them. It is too late to put my name on it or the govt would think I was hiding money. I am her POA. That is all. I have been using some of her money for her care because meds,personal items, clothing etc are not included in home costs on private pay. There was also some large home repairs that had to be made because of possible safety issues...leaking roof and kitchen, flooded basement,broken steps, etc. I want to stay in the home when she runs out of cash and take over taxes, upkeep etc but not if they are going to take it. I can keep it as is. Can they take the home?
I'm sorry you and your family are going through this. Physical aggression is hard on everyone. Our home care agency trains family caregivers and our professional caregivers in three basic strategies to manage challenging behaviors in Alzheimer’s patients--prevention, redirection, and retreat.
The first strategy is prevention. With this, you try to determine what is triggering the aggressive behavior and then take steps to avoid that in the future. Make sure your step father is not tired, hungry, thirsty, needing to use the restroom, in pain, or overstimulated. For prevention, make sure he is getting enough sleep and a chance to rest and take naps during the day; make sure he is getting enough to eat (finger foods as snacks throughout the day can help); monitor his fluid intake and make sure he is drinking at least six glasses of water per day; take him to the toilet every two hours; for pain, two tylenol four times per day for a week can sometimes make a dramatic difference (check with his doctor first); make sure the environment is quiet and calm (if the TV is always on, turn it off).
The second strategy is redirection. With redirection, you want to: 1) Distract your step father from what is upsetting him 2) Focus his attention on an enjoyable activity 3) Address his underlying needs (e.g., hunger, thirst, or frustration)
The third strategy is retreat. Apologize to your step father for upsetting him and leave the room. If you’re in imminent danger of being hit, retreat immediately without trying to redirect. Come back five minutes later with a smile on your face and try again.
Keep in mind that at this point, your step father is severely brain damaged, so the world is an unfamiliar, scary place to him. He may not understand language or the purpose of routine activities, and he may be unable to communicate to you what is making him angry. And his frustration at being unable to understand or communicate could be contributing to his aggression. When you communicate with him, you need to speak slowly, using simple words and short sentences. Help him understand by using visual cues (pointing and gesturing help).
Shower time can be particularly hard for an advanced Alzheimer's patient because he may not remember the purpose of showering, he may not have the cognitive ability to know what to do in the shower, and the water may scare him (particularly water on his face). He may also have trouble knowing how to unbutton his shirt or understand why you are trying to take his shirt off of him.
Some tips on helping the shower go more smoothly are: 1) Choose a time of day when he’s on his best behavior. 2) Do something he enjoys and that is relaxing for him before the shower. 3) Prepare the bathroom in advance (e.g., gather towels, wash cloths, soap, shampoo; make sure the water is warm; make sure the bathroom is not cold). 4) Give simple one-step instructions on what you want him to do and demonstrate with gestures; if he needs help unbuttoning his shirt, help him unbutton, but tell him what you’re going to do before you do it. 5) Tone of voice and body language on your part are very important; speak softly and smile. 6) Privacy is important, so don’t make him walk a long distance naked; undress near the bathroom or have a robe ready. It may also help to let him wear a towel around his waist while he’s in the shower to cover his private parts. 7) If he has poor balance, you should be using a shower chair; the best is a transfer bench that let’s him sit on the chair outside of the tub and then swing his legs over the tub while sitting. 8) Let him test the temperature of the water with his hand before getting in the shower. 9) In the shower, give one-step instructions and gesture (take the wash cloth, wash your arm, now wash the other arm). 10) If he can’t bathe himself, you might try a hand-on-hand gesture where you let him hold the wash cloth while you move his hand. If you need to bathe him yourself, it can help to let him hold your wrist, so he feels like he is in control; in fact, he may think it is his hand washing him. 11) Start by washing the parts of the body that are least bothersome for him first, like his back. Save washing the his hair and his private parts for the end because those areas have the most potential for trouble. When washing his hair, take care to keep the water off of his face; many Alzheimer’s patients find this frightening. 12) If showers are too hard, you may want to give him a bed bath instead with no-rinse soap and shampoo. You can even wash part of his body one day and another part the next day.
I hope this helps. Good luck. Jim
I'm sorry you and your family are going through this. Physical aggression is hard on everyone. Our home care agency trains family caregivers and our professional caregivers in three basic strategies to manage challenging behaviors in Alzheimer’s patients--prevention, redirection, and retreat.
The first strategy is prevention. With this, you try to determine what is triggering the aggressive behavior and then take steps to avoid that in the future. Make sure your step father is not tired, hungry, thirsty, needing to use the restroom, in pain, or overstimulated. For prevention, make sure he is getting enough sleep and a chance to rest and take naps during the day; make sure he is getting enough to eat (finger foods as snacks throughout the day can help); monitor his fluid intake and make sure he is drinking at least six glasses of water per day; take him to the toilet every two hours; for pain, two tylenol four times per day for a week can sometimes make a dramatic difference (check with his doctor first); make sure the environment is quiet and calm (if the TV is always on, turn it off).
The second strategy is redirection. With redirection, you want to: 1) Distract your step father from what is upsetting him 2) Focus his attention on an enjoyable activity 3) Address his underlying needs (e.g., hunger, thirst, or frustration)
The third strategy is retreat. Apologize to your step father for upsetting him and leave the room. If you’re in imminent danger of being hit, retreat immediately without trying to redirect. Come back five minutes later with a smile on your face and try again.
Keep in mind that at this point, your step father is severely brain damaged, so the world is an unfamiliar, scary place to him. He may not understand language or the purpose of routine activities, and he may be unable to communicate to you what is making him angry. And his frustration at being unable to understand or communicate could be contributing to his aggression. When you communicate with him, you need to speak slowly, using simple words and short sentences. Help him understand by using visual cues (pointing and gesturing help).
Shower time can be particularly hard for an advanced Alzheimer's patient because he may not remember the purpose of showering, he may not have the cognitive ability to know what to do in the shower, and the water may scare him (particularly water on his face). He may also have trouble knowing how to unbutton his shirt or understand why you are trying to take his shirt off of him.
Some tips on helping the shower go more smoothly are: 1) Choose a time of day when he’s on his best behavior. 2) Do something he enjoys and that is relaxing for him before the shower. 3) Prepare the bathroom in advance (e.g., gather towels, wash cloths, soap, shampoo; make sure the water is warm; make sure the bathroom is not cold). 4) Give simple one-step instructions on what you want him to do and demonstrate with gestures; if he needs help unbuttoning his shirt, help him unbutton, but tell him what you’re going to do before you do it. 5) Tone of voice and body language on your part are very important; speak softly and smile. 6) Privacy is important, so don’t make him walk a long distance naked; undress near the bathroom or have a robe ready. It may also help to let him wear a towel around his waist while he’s in the shower to cover his private parts. 7) If he has poor balance, you should be using a shower chair; the best is a transfer bench that let’s him sit on the chair outside of the tub and then swing his legs over the tub while sitting. 8) Let him test the temperature of the water with his hand before getting in the shower. 9) In the shower, give one-step instructions and gesture (take the wash cloth, wash your arm, now wash the other arm). 10) If he can’t bathe himself, you might try a hand-on-hand gesture where you let him hold the wash cloth while you move his hand. If you need to bathe him yourself, it can help to let him hold your wrist, so he feels like he is in control; in fact, he may think it is his hand washing him. 11) Start by washing the parts of the body that are least bothersome for him first, like his back. Save washing the his hair and his private parts for the end because those areas have the most potential for trouble. When washing his hair, take care to keep the water off of his face; many Alzheimer’s patients find this frightening. 12) If showers are too hard, you may want to give him a bed bath instead with no-rinse soap and shampoo. You can even wash part of his body one day and another part the next day.
I hope this helps. Good luck. Jim
Here's a good interview on the use of antipsychotic drugs to manage aggressive behavior in Alzheimer's patients (they work in 1 out of 8 patients). http://www.sfgate.com/cgi-bin/blogs/kalw/detail?entry_id=63353
Here's a good interview on the use of antipsychotic drugs to manage aggressive behavior in Alzheimer's patients (they work in 1 out of 8 patients). http://www.sfgate.com/cgi-bin/blogs/kalw/detail?entry_id=63353
to bunkie10, you really should try posting your question as a "new topic" or "new post" (whatever they call it on this forum). This way more people will see your question and it will increase your chances of getting a reliable answer. As far as I know - they cannot take or even put a lein on your mother's house. A house is not calculated by Medicare or Medicaid as income. (that would be pretty lame if they forced every senior citizen to sell their home in order to get care). But this is not my field of expertise,you still need talk to a professional. Try asking via email to the alzheimer's association. I am sure they will come up in a google search.
As far as putting the house in your name, I think it is reasonable for an only child to put their only parent's home in their name. And I would do it a.s.a.p. I don't think anyone is going to think ill of you, and even with the the "look-back" period, you should be ok. Just remember that by assuming the house, you may face property taxes and the like. Of course, after its in your name you can sell it and put the money in a trust fund for yourself (or just take a nice vacation). But don't sell it while its in your mom's name. Because then you will end up having to spend it all on the nursing home before you can get the medicaid. come by my blot at easycaregiving.com and sign up on my email list.
to bunkie10, you really should try posting your question as a "new topic" or "new post" (whatever they call it on this forum). This way more people will see your question and it will increase your chances of getting a reliable answer. As far as I know - they cannot take or even put a lein on your mother's house. A house is not calculated by Medicare or Medicaid as income. (that would be pretty lame if they forced every senior citizen to sell their home in order to get care). But this is not my field of expertise,you still need talk to a professional. Try asking via email to the alzheimer's association. I am sure they will come up in a google search.
As far as putting the house in your name, I think it is reasonable for an only child to put their only parent's home in their name. And I would do it a.s.a.p. I don't think anyone is going to think ill of you, and even with the the "look-back" period, you should be ok. Just remember that by assuming the house, you may face property taxes and the like. Of course, after its in your name you can sell it and put the money in a trust fund for yourself (or just take a nice vacation). But don't sell it while its in your mom's name. Because then you will end up having to spend it all on the nursing home before you can get the medicaid. come by my blot at easycaregiving.com and sign up on my email list.
Thank-you to all for the information and advice! To date, we have talked with the Adult Protection Services (they really gave no help at all), Center on Aging, in contact with a "better" social worker (to help with applying for medicaid, respite care, etc) and have gotten a doctor to increase his anxiety medication. & he's already on Aricept but not Lexipro. We'll ask the new doctor about that one.
Things have gotten better but we will still need to take everything one day at a time. Really, I believe the episodes were brought on by my parents being in a new environment (they moved about a month & 1/2 ago). A move is stressful enough for any and everyone but for an alzheimer's patient, guess it's x100.
Also, my parents can not afford to hire an elderlaw attorney. They filed chapter 7 and their house was foreclosed on, both completed around the end of 2009. What income they do have coming in, goes to paying medicare, insurance, life insurance, MEDICATIONS, rent, food, etc. All of which makes their income a month-to-month basis. Which is why we are going the route of working with the Center on Aging and a social worker. Both, thankfully, are offering various assistance options.
Again, thank-you to all for sharing your information and advice!!! Here's to tomorrow being a better day!!!
Thank-you to all for the information and advice! To date, we have talked with the Adult Protection Services (they really gave no help at all), Center on Aging, in contact with a "better" social worker (to help with applying for medicaid, respite care, etc) and have gotten a doctor to increase his anxiety medication. & he's already on Aricept but not Lexipro. We'll ask the new doctor about that one.
Things have gotten better but we will still need to take everything one day at a time. Really, I believe the episodes were brought on by my parents being in a new environment (they moved about a month & 1/2 ago). A move is stressful enough for any and everyone but for an alzheimer's patient, guess it's x100.
Also, my parents can not afford to hire an elderlaw attorney. They filed chapter 7 and their house was foreclosed on, both completed around the end of 2009. What income they do have coming in, goes to paying medicare, insurance, life insurance, MEDICATIONS, rent, food, etc. All of which makes their income a month-to-month basis. Which is why we are going the route of working with the Center on Aging and a social worker. Both, thankfully, are offering various assistance options.
Again, thank-you to all for sharing your information and advice!!! Here's to tomorrow being a better day!!!
Hey, keep that positive attitude up. It can be hard, but you seem to holding up. Thats the spirit. By the way, the best insurance you can have is Medicare as a primary and Medicaid as a secondary. We call it Medi-Medi, and in my business the two combined cover just about everything. I am going to assume your parents have the Medicaid, because they are broke - thats actually not a bad thing. It they don't have, try to get it. Unless you live in a very small town, every city has non-profit agencies that will try to help you. Even so, you can go down to the social security office and ask for a Medicaid application and they will be happy to help you.
Hey, keep that positive attitude up. It can be hard, but you seem to holding up. Thats the spirit. By the way, the best insurance you can have is Medicare as a primary and Medicaid as a secondary. We call it Medi-Medi, and in my business the two combined cover just about everything. I am going to assume your parents have the Medicaid, because they are broke - thats actually not a bad thing. It they don't have, try to get it. Unless you live in a very small town, every city has non-profit agencies that will try to help you. Even so, you can go down to the social security office and ask for a Medicaid application and they will be happy to help you.
Sad to say my mom died with Alzheimer's almost a year ago. I moved from out of state to live and care for her = to the end. It was a 9+ years major event that changed the trajectory of life. And I am grateful for the experience. HOWEVER, if I knew then what I know now I would not have been so distressed by those early-stage behavior.
She did hit (me and the nurses) and said truly mean things that broke my heart - all the more so because I knew she was not in control of her faculties it mad me so sad. She also, once told folks at a car rental place that she didn't know me and my sister and that we had kidnapped her. It's funny now...but at the time I was shocked to think that she had these thoughts going around in her head. On times when I'd take her for a nice long ride around the community where she spent all of her 90+ years and returned to the home where she'd spent the last 40+ years, she would refuse to get out of the car because she didn't recognize the house ... OR ME! She would also lock her bedroom door and stay up all night rearranging the furniture in her room. I forced the door one night to find that the mattress and box springs were standing on the sides against the wall, the bed was stripped and her bags were packed. One of the earliest and definitive experiences that told me that she indeed had Alzheimers, was the 8 gallons of black berries that I left on the stove cooking for us to make homemade jelly. I ran to the store to get more canning jars - took about 30 minutes --- and when I returned the hot boiling pots of jelly had been washedup and put away. Yet the berries were no place to be found - and she couldn't tell me what happened to them. Eventually I found them stored in various cupboards and cabinets. With all this carrying on, I was also worried that she would get up and walk away from the house and become lost in the woods nearby. Not to mention the hallucinations at night...she kept seeing strangers standing at her windows and was constantly being visited by 'bad babies' that would get in her bed and kick and cry and not let her get any rest. My Mom gave birth to and raised 13 children. I guess she had many 'bad babies in the bed' experiences that were coming back to her.
Putting her in a nursing home was not an option - only because I knew that how she felt about nursing homes as she'd been caregiver to her sister and had to have her removed from one because of mistreatment. Also, I could not bear the thought of having her being cared or not being cared for by strangers. She being elderly African American from another era, she did not trust whites and felt they had mal intentions. Most of the homes were ran and staffed by whites. She and I were pretty much living below the poverty level. But I was committed to stay with her to the end - even if she didn't know who I was or even who she was. I felt I owed her the right to live out her life with dignity of being surrounded by familiar things and people who loved her....no matter what.
So I kept her at home. But I contacted her doctor for a prescription that would treat her hyper condition (we'd tried several of the AZ drugs with bad effect). He prescribed Seroquel. And it literally saved our lives. I know it's not for everybody. But it worked for mom. It toned down her behavior, made her calmer. It started as a sleep aid to help her sleep through the night - and it worked. I loved the medication because in the morning Mom would be herself. Not a drugged out zombie. She continued on the drug for about 4 years. She died suddenly last July. I think her heart just gave out. Don't know if Seroquel had anything to do with that. But I will say this...AZ patients are living in a strange world that they don't understand themselves. Those who care for them - and about them must move into their world - as best they can. Realize that these people's minds and abilities are unraveling before your eyes and they are distressed by the inability to make sense of their state and their world. Slow everything down and try to live in the moment with them. Ask their doctor for a mild drugs that will ease their anxieties, hallucinations, and calm their nerves.
I know my mom - as she was - would never had hit me (as an adult) or anyone else. Nor would she had said mean things to me or us. But as she broke down...she couldn't help it.
Sadly, as I recall, this period didn't last more than a year or so. It stopped when I got her on a 1 a day dose of seroquel. Good luck.
Sad to say my mom died with Alzheimer's almost a year ago. I moved from out of state to live and care for her = to the end. It was a 9+ years major event that changed the trajectory of life. And I am grateful for the experience. HOWEVER, if I knew then what I know now I would not have been so distressed by those early-stage behavior.
She did hit (me and the nurses) and said truly mean things that broke my heart - all the more so because I knew she was not in control of her faculties it mad me so sad. She also, once told folks at a car rental place that she didn't know me and my sister and that we had kidnapped her. It's funny now...but at the time I was shocked to think that she had these thoughts going around in her head. On times when I'd take her for a nice long ride around the community where she spent all of her 90+ years and returned to the home where she'd spent the last 40+ years, she would refuse to get out of the car because she didn't recognize the house ... OR ME! She would also lock her bedroom door and stay up all night rearranging the furniture in her room. I forced the door one night to find that the mattress and box springs were standing on the sides against the wall, the bed was stripped and her bags were packed. One of the earliest and definitive experiences that told me that she indeed had Alzheimers, was the 8 gallons of black berries that I left on the stove cooking for us to make homemade jelly. I ran to the store to get more canning jars - took about 30 minutes --- and when I returned the hot boiling pots of jelly had been washedup and put away. Yet the berries were no place to be found - and she couldn't tell me what happened to them. Eventually I found them stored in various cupboards and cabinets. With all this carrying on, I was also worried that she would get up and walk away from the house and become lost in the woods nearby. Not to mention the hallucinations at night...she kept seeing strangers standing at her windows and was constantly being visited by 'bad babies' that would get in her bed and kick and cry and not let her get any rest. My Mom gave birth to and raised 13 children. I guess she had many 'bad babies in the bed' experiences that were coming back to her.
Putting her in a nursing home was not an option - only because I knew that how she felt about nursing homes as she'd been caregiver to her sister and had to have her removed from one because of mistreatment. Also, I could not bear the thought of having her being cared or not being cared for by strangers. She being elderly African American from another era, she did not trust whites and felt they had mal intentions. Most of the homes were ran and staffed by whites. She and I were pretty much living below the poverty level. But I was committed to stay with her to the end - even if she didn't know who I was or even who she was. I felt I owed her the right to live out her life with dignity of being surrounded by familiar things and people who loved her....no matter what.
So I kept her at home. But I contacted her doctor for a prescription that would treat her hyper condition (we'd tried several of the AZ drugs with bad effect). He prescribed Seroquel. And it literally saved our lives. I know it's not for everybody. But it worked for mom. It toned down her behavior, made her calmer. It started as a sleep aid to help her sleep through the night - and it worked. I loved the medication because in the morning Mom would be herself. Not a drugged out zombie. She continued on the drug for about 4 years. She died suddenly last July. I think her heart just gave out. Don't know if Seroquel had anything to do with that. But I will say this...AZ patients are living in a strange world that they don't understand themselves. Those who care for them - and about them must move into their world - as best they can. Realize that these people's minds and abilities are unraveling before your eyes and they are distressed by the inability to make sense of their state and their world. Slow everything down and try to live in the moment with them. Ask their doctor for a mild drugs that will ease their anxieties, hallucinations, and calm their nerves.
I know my mom - as she was - would never had hit me (as an adult) or anyone else. Nor would she had said mean things to me or us. But as she broke down...she couldn't help it.
Sadly, as I recall, this period didn't last more than a year or so. It stopped when I got her on a 1 a day dose of seroquel. Good luck.
Carolyn- I'm sorry that you and anyone had to go through that. It is a VERY difficult to watch this disease progress, difficult to maintain it, tolerate and cope with. I give you BIG kudos for all that you did for your mother!!!
So, today my step-father had his doctor appt with his new doctor and he actually put him on Seroquel. This is the first that we have heard of it and I really REALLY hope that it has the same effect on him, that it did on your mother. I truly hope so because I can not handle nor tolerate seeing the bruising on my mother again! We will do everything we can to make sure it doesn't happen again but we are not with them 24/7 and if this happens over & over again, regardless of how many medications we try. We may have no choice but to put him in a home. Well, that is, if we can figure out how to pay for it & or "if" we can get them on Medicaid. Even though, I know he doesn't want it and I know my mother does not either but I can not and will not risk him actually causing harm to my mother.. My little mama is only 5 ft tall and 100 lbs. We are working on finding some sort of hospice care to come in, adult day care and various other assistance but even with that, that still leaves a certain amount of time that she is alone with him and that's the time we have to worry about. Though, one way or another, we'll figure all of this out. Just hope it is sooner than later!
Donahueg- both my parents have Medicare but neither have Medicaid. I have a feeling we are going to have a hard time getting them approved, since their gross income exceeds the min requirement. As I have said, their gross and net income is two drastically different figures. And no one EVER considers the net income when applying for anything! We're gonna try though! And I, we, are trying to stay positive. It's not always easy but we're trying..
Carolyn- I'm sorry that you and anyone had to go through that. It is a VERY difficult to watch this disease progress, difficult to maintain it, tolerate and cope with. I give you BIG kudos for all that you did for your mother!!!
So, today my step-father had his doctor appt with his new doctor and he actually put him on Seroquel. This is the first that we have heard of it and I really REALLY hope that it has the same effect on him, that it did on your mother. I truly hope so because I can not handle nor tolerate seeing the bruising on my mother again! We will do everything we can to make sure it doesn't happen again but we are not with them 24/7 and if this happens over & over again, regardless of how many medications we try. We may have no choice but to put him in a home. Well, that is, if we can figure out how to pay for it & or "if" we can get them on Medicaid. Even though, I know he doesn't want it and I know my mother does not either but I can not and will not risk him actually causing harm to my mother.. My little mama is only 5 ft tall and 100 lbs. We are working on finding some sort of hospice care to come in, adult day care and various other assistance but even with that, that still leaves a certain amount of time that she is alone with him and that's the time we have to worry about. Though, one way or another, we'll figure all of this out. Just hope it is sooner than later!
Donahueg- both my parents have Medicare but neither have Medicaid. I have a feeling we are going to have a hard time getting them approved, since their gross income exceeds the min requirement. As I have said, their gross and net income is two drastically different figures. And no one EVER considers the net income when applying for anything! We're gonna try though! And I, we, are trying to stay positive. It's not always easy but we're trying..
My father has Alzheimer's and the rest of my family has brainwashed him into insanely thinking that we have caused the Alzheimer's effect and he has completely written us out of his will, meaning that we got nothing to remember him by whe he dies (he was a Vietnam War Veteran). I wish you the best in your situation and may god be with you because he will be the only one left in the end. When in doubt, look to the man in the mirror and the man upstairs and they will lead you into righteousness. Please don't allow yourself to be driven insane becuase of this becuase it has already happened to me and I am abusing drugs because of it and you SURELY do not want to go down the road I am on right now. I say this in all seriousness. MAY GOD BE WITH YOU. MAY GOD BLESS YOU.
My father has Alzheimer's and the rest of my family has brainwashed him into insanely thinking that we have caused the Alzheimer's effect and he has completely written us out of his will, meaning that we got nothing to remember him by whe he dies (he was a Vietnam War Veteran). I wish you the best in your situation and may god be with you because he will be the only one left in the end. When in doubt, look to the man in the mirror and the man upstairs and they will lead you into righteousness. Please don't allow yourself to be driven insane becuase of this becuase it has already happened to me and I am abusing drugs because of it and you SURELY do not want to go down the road I am on right now. I say this in all seriousness. MAY GOD BE WITH YOU. MAY GOD BLESS YOU.
Guess I didn't read the original message thoroughly. I didn't remember that your Mom and Dad are living on their own - together. I don't recall if you stated your mother's age - but I'm presuming that she's 'up there.' If so, she shouldn't be trying to handle home care of your father alone. It's just too tough a job for one elder person to care for another....my mother cared for our Dad who died of emphysema. We were so focused on his needs that we barely noticed that she had started slipping away. Family members, need to have a serious talk about someone moving in with them.
I hope the Seroquel works for him. Caution - there are ongoing warning against giving this drug to Alzheimer's patients mainly because it was originally approved for treatment of bipolar disorder - not treatment of patients with dementia. And has not been researched or tested for this use with Alzheimer's patients. I asked my mother's RN why not...obviously this drug has been given to AZ patients for many years. She said she didn't know. I think no one wants to take responsibility for tracking the results of usage of this drug for uses not approved. So our loved ones get to be test animals...without anyone tracking the long term results. What a waste. So even if it does work, be vigilant to any side effects. The worst for my mother - which took a while for me figure out, was as the dosage was upped, she slept too many hours...which caused her to miss meals and to lose weight.
Now that I've scared you - (smile) - I was like you, between a rock and a hard place. My only other option was to place Mom in a nursing home, turn over her Soc Sec income and assets to them - which is about what would have been required. By the way, I did have hospice care for her for about 3 months. But the service that I used was more interested in running up as many hours of billable services as possible - and not much interested in giving my mom, or me (her caregiver) any respite. It took a few months for me to catch on. After two or 3 months of visits from various and sundry of their 'specialists' - that included Social Workers, Chaplains, physical therapists, etc. Some weeks I had 2 or 3 of these folks drop in for multiple visits. The two services that I really needed and cared about getting (1) Help with her personal care (bath/bathroom/grooming) and (2) "sitters' that could relieve me at home so I could run errands outside of the house, didn't work out.
1) Nursing Aids - they were understaffed with nursing aids (who performed the feeding, grooming, etc) She could only see my mother very early in the early morning - (about 8 am). This was before my mother would wake up from her Seroquel aided sleep. (Also, in the later years, I started to let her stay up as late as she wanted...she just never wanted to go to bed at night. I being a night owl, I didn't really mind....because she could sleep late in the morning. My mother was nice person when she woke up on her own, but when she was awakened - for the purpose of having strangers poke and prod at her she would get angry and very uncooperative...this is when the hitting came in. I wanted them to come around 12 or 1 PM, after she'd awaked on her own, sat on the potty, and had her breakfast.
But they couldn't work it out. So I figured, since I was doing everything else for her, including successfully treating her bed sore anyway, there was no point in disrupting my mother's peaceful sleep to have a Nursing Aid give her a bath and change her clothes and diaper. In time, I got to be good at all these task. Didn't mind doing them either. Also, when I finally got a copy of the statement showing what they were billing medicare, I could see what was driving their endless services - except those that we needed. The one thing that I needed most and was desperate to have, was home sitters. MEDICARE DOES NOT COVER SITTERS!!!. I would gladly join a mob to march on Washington to kick the asses of whomever made the decision that Sitters should be excluded from Medicare coverage. Since the family caregivers are saving the state/fed zillions in nursing home fees by caring for their loved ones at home, the least they could do is provide some type of stipend to the family care givers to help them keep body and soul together...and if they will not cover sitters, they should at least reimburse or provide funds to the family to ease the stress on the one or two family members who are actually doing the work.
When I complained about this to the home care service that I signed on after kicking the hospice people out (they were charging about $1000 a month for each of their so called specialists who dropped in on short notice once or twice a month for a few minutes and did very little that was beneficial to my mother. All those visits by strangers actually was the source of great irritation to her. So I took her off the hospice plan. Since Mom had a series of bed sores on her tailbone area, I was able to get the doctor to order home care ... in order to have the bed sores treated.
They were scammers too, to some degree. I was working very had at helping Mom's sores heal using the bandaging system that they had provided. It took a visit from my younger brother who saw the bed sores and the type of bandages that were being used, and told me that Mom's sores would never heal unless we got her up out of the bed to sit up most of the day - to take the pressure off the bony tail bone area...and also the sores needed to breath...so I used sterile gauze and neosporine and got her out of the bed for most of the day to sit in her big padded rocking chair. Not only did her bed sores heal..but her attitude improved....she was no longer the quiet human blob that stayed in bed all day. I also cut back on the Seroquel (we had got up to 3 a day... because patients become desensitized to them after a while. But mom had lost considerable weight from the point of first taking the Seroquel. So a little bit of the drug can go a long way.
Even thought I had an RN coming 3 times a week for the last two-three years of her life, and I'd mentioned my concern about her weight more than once, the prime RN told me that mom's weight of less than 100 pounds was normal for a woman of her age (90+). When I came to my senses, and reallized this weighing less than 100 pounds is not normal weight for any adult. I took her word for it - until it was almost too late. I worked like the devil to help Mom put weight on again. I don't know if the RN was just stupid or just thought I was. When she died she was barely over 100.
If your loved one is sleeping more than 10 hours, you need to cut back on any sleeping aid that is causing them to sleep too long, get bed sores because they miss too many meals.
To keep spirits up and bodily functions working, get your loved one up every day - even if they fall sleep in their big chair - it's better than letting them lay in bed all day. Watch the temptation to go to a liquid diet when the loved one seems to not want to eat. Maybe what's needed is a change in menu. Instead of soups, etc. I eventually got out the blender and took to pureeing the food she'd like to eat in the past after she got to the point where she could no longer chew/swallow well. I pureed the cornbread, black eyed peas, fried chicken, mashed potatoes, sweet potatoes, etc. so she could enjoy the taste of food that she'd always eaten and liked.
I also made her super rich milk shakes with instant breakfast, chocolate syrup, wheat germ and bananas, I also baked spice apples to go in her breakfast oatmeal. When she could no longer walk, I sat her in her wheel chair and pushed her - like a swing --- she'd glide so far then use her own legs to propel herself back to me. We'd keep that up for about a half hour at a time. It gave her something physical to do, and I think it did remind her of being pushed in a swing - when she was young. She enjoyed it.
Believe me, in 9 long years, I had about every experience you can think of. But I wished I'd known the things I learned near the end, from the beginning. Be patient. If your loved one is like my Mom, he/she will exhibit noticeable behavioral changes every 6-8 month. Around 3 year before her death, Mom had a minor stroke, that left her speech very garbled....the AZ made it impossible for a speech therapist to accomplish much in the way of rehab. So spend as much time as you can talking to them while you can. Take lots of photos and if possible video tape them talking about their life.
In the end, it comes down to Just BEING with your loved ones. Sometimes, I'd just sit near Mom and hold her hand as we watched old black and white movies on TV. She enjoyed having her long wavy hair brushed. So I took my time each morning with made a big deal of brushing and braiding her hair. I took a lot of photos of her during the years...at the different seasons and would email updates to family members with photos every few months.
As someone said, don't let it make you crazy. I started a non profit (to preserve my old high school bldg and history) which gave me something positive to focus on that had a 'future' beyond my mother's eventual demise. The monthly meetings, and ongoing planning of various fundraisers, kept me sane and living a fulfilling life. It was something I could throw my positive passion and energies into...I did not want to allow myself to get bogged down in a big hole of depression. I walked a lot on the highway near our house. I took lots of photos of the small wild flowers and critters that I discovered with the changing of the season. A stray BC mixed pup showed up at my Mom's house about the time I moved in. Mom had encouraged me to 'just feed him.' Well Buddy is a big, old shaggy mess today. But he has been a great companion for all these years. Now we are both old and creaky, but still taking our daily walks.
AZ is hell for all concerned. My intention was to give my mom, a loving companion to walk with her the last mile of her confusing days. I thought that abandoning her in her hour of greatest need to be cared for by strangers would have been the opposite expression of the love that I felt for her. Obviously everyone has to do what they feel is right. My reality test was: "What can you live with." I could not live with the idea of her dying alone in a strange place, possibly mistreated, and leaving this world feeling unloved and unwanted. I was but a few inches from her when she slipped away, and yet, I feel sad that my arms were not wrapped around her shoulders at the moment of her departure. But that I can live with.
Follow your heart.
Guess I didn't read the original message thoroughly. I didn't remember that your Mom and Dad are living on their own - together. I don't recall if you stated your mother's age - but I'm presuming that she's 'up there.' If so, she shouldn't be trying to handle home care of your father alone. It's just too tough a job for one elder person to care for another....my mother cared for our Dad who died of emphysema. We were so focused on his needs that we barely noticed that she had started slipping away. Family members, need to have a serious talk about someone moving in with them.
I hope the Seroquel works for him. Caution - there are ongoing warning against giving this drug to Alzheimer's patients mainly because it was originally approved for treatment of bipolar disorder - not treatment of patients with dementia. And has not been researched or tested for this use with Alzheimer's patients. I asked my mother's RN why not...obviously this drug has been given to AZ patients for many years. She said she didn't know. I think no one wants to take responsibility for tracking the results of usage of this drug for uses not approved. So our loved ones get to be test animals...without anyone tracking the long term results. What a waste. So even if it does work, be vigilant to any side effects. The worst for my mother - which took a while for me figure out, was as the dosage was upped, she slept too many hours...which caused her to miss meals and to lose weight.
Now that I've scared you - (smile) - I was like you, between a rock and a hard place. My only other option was to place Mom in a nursing home, turn over her Soc Sec income and assets to them - which is about what would have been required. By the way, I did have hospice care for her for about 3 months. But the service that I used was more interested in running up as many hours of billable services as possible - and not much interested in giving my mom, or me (her caregiver) any respite. It took a few months for me to catch on. After two or 3 months of visits from various and sundry of their 'specialists' - that included Social Workers, Chaplains, physical therapists, etc. Some weeks I had 2 or 3 of these folks drop in for multiple visits. The two services that I really needed and cared about getting (1) Help with her personal care (bath/bathroom/grooming) and (2) "sitters' that could relieve me at home so I could run errands outside of the house, didn't work out.
1) Nursing Aids - they were understaffed with nursing aids (who performed the feeding, grooming, etc) She could only see my mother very early in the early morning - (about 8 am). This was before my mother would wake up from her Seroquel aided sleep. (Also, in the later years, I started to let her stay up as late as she wanted...she just never wanted to go to bed at night. I being a night owl, I didn't really mind....because she could sleep late in the morning. My mother was nice person when she woke up on her own, but when she was awakened - for the purpose of having strangers poke and prod at her she would get angry and very uncooperative...this is when the hitting came in. I wanted them to come around 12 or 1 PM, after she'd awaked on her own, sat on the potty, and had her breakfast.
But they couldn't work it out. So I figured, since I was doing everything else for her, including successfully treating her bed sore anyway, there was no point in disrupting my mother's peaceful sleep to have a Nursing Aid give her a bath and change her clothes and diaper. In time, I got to be good at all these task. Didn't mind doing them either. Also, when I finally got a copy of the statement showing what they were billing medicare, I could see what was driving their endless services - except those that we needed. The one thing that I needed most and was desperate to have, was home sitters. MEDICARE DOES NOT COVER SITTERS!!!. I would gladly join a mob to march on Washington to kick the asses of whomever made the decision that Sitters should be excluded from Medicare coverage. Since the family caregivers are saving the state/fed zillions in nursing home fees by caring for their loved ones at home, the least they could do is provide some type of stipend to the family care givers to help them keep body and soul together...and if they will not cover sitters, they should at least reimburse or provide funds to the family to ease the stress on the one or two family members who are actually doing the work.
When I complained about this to the home care service that I signed on after kicking the hospice people out (they were charging about $1000 a month for each of their so called specialists who dropped in on short notice once or twice a month for a few minutes and did very little that was beneficial to my mother. All those visits by strangers actually was the source of great irritation to her. So I took her off the hospice plan. Since Mom had a series of bed sores on her tailbone area, I was able to get the doctor to order home care ... in order to have the bed sores treated.
They were scammers too, to some degree. I was working very had at helping Mom's sores heal using the bandaging system that they had provided. It took a visit from my younger brother who saw the bed sores and the type of bandages that were being used, and told me that Mom's sores would never heal unless we got her up out of the bed to sit up most of the day - to take the pressure off the bony tail bone area...and also the sores needed to breath...so I used sterile gauze and neosporine and got her out of the bed for most of the day to sit in her big padded rocking chair. Not only did her bed sores heal..but her attitude improved....she was no longer the quiet human blob that stayed in bed all day. I also cut back on the Seroquel (we had got up to 3 a day... because patients become desensitized to them after a while. But mom had lost considerable weight from the point of first taking the Seroquel. So a little bit of the drug can go a long way.
Even thought I had an RN coming 3 times a week for the last two-three years of her life, and I'd mentioned my concern about her weight more than once, the prime RN told me that mom's weight of less than 100 pounds was normal for a woman of her age (90+). When I came to my senses, and reallized this weighing less than 100 pounds is not normal weight for any adult. I took her word for it - until it was almost too late. I worked like the devil to help Mom put weight on again. I don't know if the RN was just stupid or just thought I was. When she died she was barely over 100.
If your loved one is sleeping more than 10 hours, you need to cut back on any sleeping aid that is causing them to sleep too long, get bed sores because they miss too many meals.
To keep spirits up and bodily functions working, get your loved one up every day - even if they fall sleep in their big chair - it's better than letting them lay in bed all day. Watch the temptation to go to a liquid diet when the loved one seems to not want to eat. Maybe what's needed is a change in menu. Instead of soups, etc. I eventually got out the blender and took to pureeing the food she'd like to eat in the past after she got to the point where she could no longer chew/swallow well. I pureed the cornbread, black eyed peas, fried chicken, mashed potatoes, sweet potatoes, etc. so she could enjoy the taste of food that she'd always eaten and liked.
I also made her super rich milk shakes with instant breakfast, chocolate syrup, wheat germ and bananas, I also baked spice apples to go in her breakfast oatmeal. When she could no longer walk, I sat her in her wheel chair and pushed her - like a swing --- she'd glide so far then use her own legs to propel herself back to me. We'd keep that up for about a half hour at a time. It gave her something physical to do, and I think it did remind her of being pushed in a swing - when she was young. She enjoyed it.
Believe me, in 9 long years, I had about every experience you can think of. But I wished I'd known the things I learned near the end, from the beginning. Be patient. If your loved one is like my Mom, he/she will exhibit noticeable behavioral changes every 6-8 month. Around 3 year before her death, Mom had a minor stroke, that left her speech very garbled....the AZ made it impossible for a speech therapist to accomplish much in the way of rehab. So spend as much time as you can talking to them while you can. Take lots of photos and if possible video tape them talking about their life.
In the end, it comes down to Just BEING with your loved ones. Sometimes, I'd just sit near Mom and hold her hand as we watched old black and white movies on TV. She enjoyed having her long wavy hair brushed. So I took my time each morning with made a big deal of brushing and braiding her hair. I took a lot of photos of her during the years...at the different seasons and would email updates to family members with photos every few months.
As someone said, don't let it make you crazy. I started a non profit (to preserve my old high school bldg and history) which gave me something positive to focus on that had a 'future' beyond my mother's eventual demise. The monthly meetings, and ongoing planning of various fundraisers, kept me sane and living a fulfilling life. It was something I could throw my positive passion and energies into...I did not want to allow myself to get bogged down in a big hole of depression. I walked a lot on the highway near our house. I took lots of photos of the small wild flowers and critters that I discovered with the changing of the season. A stray BC mixed pup showed up at my Mom's house about the time I moved in. Mom had encouraged me to 'just feed him.' Well Buddy is a big, old shaggy mess today. But he has been a great companion for all these years. Now we are both old and creaky, but still taking our daily walks.
AZ is hell for all concerned. My intention was to give my mom, a loving companion to walk with her the last mile of her confusing days. I thought that abandoning her in her hour of greatest need to be cared for by strangers would have been the opposite expression of the love that I felt for her. Obviously everyone has to do what they feel is right. My reality test was: "What can you live with." I could not live with the idea of her dying alone in a strange place, possibly mistreated, and leaving this world feeling unloved and unwanted. I was but a few inches from her when she slipped away, and yet, I feel sad that my arms were not wrapped around her shoulders at the moment of her departure. But that I can live with.
Follow your heart.
Where do you turn when they try to kill you with a garden rake. and drinking excessive alcohol with there medication. who do i contact ? This is serious. Please help.
Where do you turn when they try to kill you with a garden rake. and drinking excessive alcohol with there medication. who do i contact ? This is serious. Please help.
Hi Raybiden, Thank you for your question. I'm sorry to hear about your situation. One article one Caring.com suggests that you report dangerous behaviors to your loved one's doctor, as medication can sometimes help. The doctor may also have some information on other useful resources.
Read the full article here: http://www.caring.com/symptoms/alzheimers-symptoms/engaging-in-aggressive-behavior.
Take care, Emily | Community Manager
Hi Raybiden, Thank you for your question. I'm sorry to hear about your situation. One article one Caring.com suggests that you report dangerous behaviors to your loved one's doctor, as medication can sometimes help. The doctor may also have some information on other useful resources.
Read the full article here: http://www.caring.com/symptoms/alzheimers-symptoms/engaging-in-aggressive-behavior.
Take care, Emily | Community Manager
Jim,I enjoyed reading your informtion. Thanks Sandy
Jim,I enjoyed reading your informtion. Thanks Sandy