My Alzheimer's mom is abusive - is it time for a nursing home?
I am the caregiver of my 94 yo mother who has Alzheimer's.She has been with me and my family for the past 5 years. I am also her power of attorney.In the last few weeks she has gotten progressively worse. She is verbally and physically abusive. She is starting to wonder. She does not always realize where she is. She is also sun downing now.I am torn between a nursing home and bringing someone into my home. I have five children and I am now leaning towards a nursing home as she is abusive to my younger kids(6 and 13yo).She is yelling and screaming most of the night so even with someone in the house we would still be awaken.
I don't know how to start this process. Can I take her to the hospital and ask for a 72 hour hold? Can ask her primary care doc to have her admitted for a mental status change? My mother has a $3100.00/month income with her retirement and social security. She has a house and property. Will we have to sell it if we put her in a home? We live in Washington, DC. We are now at our wits' end and I have no idea where to start. I do not want her to hurt us or herself. Please advise.
You have several questions, so let's start with the one which asks if you should move mom, an Alzheimer's patient from your house to a nursing home. The most important consideration you raised is that she is abusive to you and to your kids. This is a very valid reason to place her in a nursing home. Though nursing homes have sometimes gotten a bad rap, it is important to recognize that they have licensed and presumably skilled staff in place 24/7 to deal with the issues you describe.
However, it is important to remember that they have to cope with her behavior problems also, and I urge you to get a medical evaluation from a gero-psychiatrist or a neurologist to determine whether any new strategies, including medications can help with her abusive conduct. There is also research which suggests that good and consistent behavioral approaches to managing this kind of conduct do work and can be put in place in a nursing home more readily than at home because they have staff around the clock.
The next step is to do your research. If you think your mom qualifies for Medicaid, you will need the advice of an elder law attorney who knows this area of the law in your state to advise you. If you think she can qualify in the future, perhaps after property is transferred or sold, you still need expert legal advice to make this happen. If she does not qualify, people generally sell property to move the family member toward qualifying for Medicaid. Otherwise, you pay out of pocket unless she has long term care insurance. (Most people don't).
The next move on your part is to research nursing homes in the area that specialize in handling residents with Alzheimer's Disease and other dementias. Look for "memory care" in the description of what the facility has to offer. Visit unannounced. Talk to other family members who have residents in a facility you are considering. Decide based on what seems to offer mom the most protection and care that she can afford.
Another important factor to look at is your sense of guilt. It happens to almost everyone who has to place a loved one in a care facility. It's not ideal, but neither is having Alzheimer's. No one can help what has happened, but you can help what you are doing about it and how you relieve yourself and your family of a burden that may be beyond your ability to safely manage at home. Not everyone can deal with the burden and the stress, and it's okay if you can't keep her at home. What you can do is to monitor her every day by visiting, watching over her to see that she remains safe, attend meetings about her care, demand accountability from all staff in a polite way and stay in communication with her doctor.
It is not likely that if you take her to a hospital and ask for a 72 hour hold that they will do this. She is not "mentally ill". Rather, she has a progressive illness that affects her behavior, and it has a physical cause. If you are leaning toward a nursing home, listen to your own wisdom in making that decision. It's perfectly okay and appropriate to make a decision based on what is good for you and for your whole family. Five years is a long time to be a primary caregiver. Follow your leanings and do all you can to keep watching over your mom. You are a loving daughter. Placing her does not take away from that at all.
Please really think over taking your mom to a nursing home. My mother became abusive during a 6 month stint. They dropped her, over medicated to the point of not waking up for days at a time, left her food in front of her for up to 7 hours when I would come in to find it. I could go on and on.
What helped my mom was the pill form of pot MARINOL. It has calmed her down alot but is not perfect.
I all so found a wonderful care giver to help me. This all so made a Hugh change for the better. I went through alot of people to find her.
My mom has been home now since Jan. It's very hard but so much better.
In addition to exploring medication, you might want to check local private nursing homes and day care centers to see if any of the have a "sundowners club". They will keep your loved one overnight as if it were daycare and keep them doing activities all night.
If none of them have it , suggest that they start one. It can be a lifesaver and you can get your sleep.
I'm the oldest of 5 and only one lives out-of-state. We finally hired a "private" home services agency at a lower cost than a facility. Our mom has had sundowners for months now, but the caregivers have to stay up with her and near her at all times.
It does take all the income she has to do this, but so far we have not had to resort to a nursing home facility. The agency we hired is not "health care", but a private individual owning a home care business with experience in this field. They are licensed and bonded, but again, not professionals. We have been fortunate to keep her in her own home, but not oblivious to the fact the "facility care" is inevitable before it's all over. We tried the family member idea living with my mom free-of-charge, but it was too much and unrealistic for one person to manage . Three people rotate to take care of my mom now. This is not an "answer", but someone who knows what you're going through.
I too have faced a similar situation with my 84 year-old mom who has Alzheimers. I thought at one point to place my mom in a facility, but decided against it after much thought. It is a very difficult matter to handled, but I pray daily for strength. It is only my 25 year-old daughter and I taking care of my mom. It is hard, very hard, but we are getting it done through the help of the Good Lord. It has been only He who has given us the strength to do it and we're at the point now where we don't think about it. We just do what needs to be done and move on. Mom was a very good mother/grandmother/person and not once did she give up on any of us and we are determined not to give up on her no matter what. We are in it for the long run. Just look to the Hills for whence cometh your help. Your help comes from the Lord who puts no more on you than you can bear.
I have been taking care of my wife for over 5 years since she was first diagnosed with alzheimers and parkinsins, she is now starting to experience sundowners. She has long term care insurance but I have decided that I can still take care of her and she will be more comfortable living in a place where everything is familiar to her. Its really tough being a caregiver, but with God's help I will manage to take care of her, we've been together over 51 years....
Wow,been married for 51 years. God bless all spouses and caregivers that truly know the meaning of commitment. Alzheimers disease sadly robs our loved ones, and takes their personality to a lost land. We have only their spirit and memories left to help us carry on. Please remember while being so responsible for caring for your spouse, that you also take care of yourself. Reaching out here at caring.com is a good place to start.
Dr. Mikol Davis
Please get your mother into her doctor for a check-up; simple infections like urninary tract can cause the aggression; and I echo the Dr's advice to have your mom seen by a neurologist. We didn't do this in the beginning and my mother's primary care didn't offer/suggest; it was a mistake in retrospect and hindered my mother receivinbg more accurate, better care; also a neurologist can better prescribe medication that can help with the agression (if not caused by infection or other identifiable cause)as well as the sundowning; after my mom was finally seen by a neurologist, we began to try different medications (my mother has vascular dementia)and finally found the one that helped her agression but allowed her to be fully participatory (the medication is Depakote that finally did the trick--at a very low dosage too); I have heard from others and thru this web site that melatonin has proved to be very effective for sundowning;but be sure to check for contraindications as it can interfere with some medications; but most of all, any change in behavior should be followed up with a doctors visit and a trip to a neurologist to rule out a small stroke or onset of other neurological disorders;
We placed mom in a home as my father could not give the consistency needed to keep my mom feeling secure--such as meals always at the same time each day, activities planned, and bedtime rituals, which go a long way to managing aggression and sundowning; myself and other siblings live out of town and for now this was the best solution for us.
We placed my Mom in a memory care unit about three years ago. i feel it was the best thing for her and my family. She had NPH and lewy body dementia. She has hallucinations and behavioral issues at times. She is incontinent and was difficult to manage in my home. In the facility they address her medical, emotional and social concerns. I urge people to go to a geriantologist and not a primary doctor. You need someone who specializes in eldercare. Medications and treatments are very different for the elderly. I visit my Mom daily and remain a constant advocate for her. BUT my health and family were in jeopardy when I was trying to do it all myself. I do not believe my Mom would want me to give up all of that to care for her. I do not feel guilty about my decision... i feel I am doing what is best for my Mom.
My mom went into a psych ward after my dad died because of abusive behavior accompanied by a nervous break down. The psychiatrist got her properly medicated and she is home and happy with her caregiver. It has been 5 months now and she is having really good comfortable days at home.
Anytime someone becomes physically abusive, or bullies children, even if it is caused by dementia, they need to be removed from the home. Especially if there are children in the home. If medication takes care of the aggressiveness, the person can come back to the home.
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