Alzheimer Special Needs
One Week After The Move
One week ago, we moved Mom into an assisted living facility as a result of her increasing dementia. Nine years ago, a Doctor diagnosed Mom with the beginning stages of Alzheimer's. The transition has been difficult, but she seems to be adjusting to her new surroundings and new schedule.
The first few days of her move were chaotic. We took her out of her new surroundings to join the family for dinner. We ran errands for needed items. Not only did she have to move from her residence of eight years, but she had to adapt to an irregular schedule for a few days while we completed light and shower installations and hung pictures on her walls. She loved it, but we created confusion in her world. She did not sleep well for a few nights and it showed.
My brothers left town on Tuesday and Mom felt the loss. She was in her new location and felt the quietness surround her. Her new schedule was quite the opposite of her patterns before. Not an early riser or big breakfast eater, she had to be up by 7:00 a.m. to dress for breakfast. Meds are given at 8:00 a.m. and breakfast is shortly thereafter. Lunch is the big meal of the day and evening meals are a lighter fare served at 5:30 p.m. She was used to eating dinner later in the evening. Today she seems to be adjusting to the new hours. Her early bedtime of 10:00 p.m. lends itself to an early morning start.
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I walked into the apartment alone today as Mom was involved in an activity with other seniors. Entering her place, I noticed that all of her papers were neatly arrayed for her to see the activities of the day.She had her magnifying glass on the kitchen table along with a large activity schedule, notepad and pen. On her coffee table was the current newspaper used to keep track of the date. Her friends had sent greeting cards which sat stacked neatly on the corner of the coffee table. Her Bible sat close to her favorite chair in easy reach. Everything else was put away.
My Mom's previous home was decorated with plants, candles and lots of knick knacks. In the last few years, paper stacks had begun on shelves and dressers. Instead of reading the mail, she stacked it. The piles continued to grow until I sifted through each one, removing the junk mail and settting bills aside. It was an increasing headache to face the paper trail each time I visited.
My Mom no longer pays the bills. Except for cards and letters and an occasional magazine, there will be no paper for her to contend with. I am so glad that we kept things simple when we decorated her new place. The table space is convenient for today's necessary items. I am sure I will continue to find old dinner menus from the facility or outdated activity calendars, but the paper work has been greatly simplified in this move.
Because of the simple organization of her clothes, her assortment of eyedrops and other personal items, she is able to maintain her apartment. The bed was neatly made and the floors uncluttered. The staff cleaned her apartment on Wednesday and washed her clothes, returning them the next morning. As she returned the clothes items to the closets, some were misplaced, but easily rearranged.
To make things easy for her daily choices, we placed winter clothes together and summer clothes in a different closet. Pants are together, blouses are arranged together, etc. In the old apartment, her clothes were difficult for her to find. She would continually express a need to buy new clothes. We would find clothes "tucked away" that she had forgotten about.
Medications have become a big issue with Mom. She seems to forget that the medication aide administered the medication an hour after she has taken them. The medications have been placed in a security safe with a combination lock. Mom no longer has acess to any of the medications. It made her extremely angry when she wanted to take back control of the meds and was denied. Our new system includes a reminder, on a marker board on the refrigerator, noting the date and time that her meds were taken. This has seemed to alleviate some of the confusion that arises later in the evenings.
Developing A Social Life
It is very helpful for elderly people who live alone to participate in the daily activities around them. My Mom loves people and will introduce herself to a stranger with no hesitation. Her first few days in the new location were not typical. I could sense her holding back and wondered if she would attend the meals and join in a card game or watch a movie with the residents.
A couple of times, Mom shared that she had to get out and meet people or she would be a vegetable in no time. One day, as I disembarked from the elevator, I was surprised to see her in the beauty shop with her hair done. She found the shop on her own. Today she ventured down to the television area to watch a movie with others on the big screen. I am encouraged and hopeful that she will continue to get involved and meet others around her.
The Change of Responsibility
The progression of Alzheimer's seems to have taken away one life skill at a time. The first to go was Mom's ability to manage the checkbook. Keeping track of money became impossible. This was followed by the avoidance of paying the bills. Though the bills were not late, they bordered on it several times. Sorting the mail quickly became a problem. Unopened envelopes would be set aside and avoided.
Medications became overwhelming. Though she never overdosed, she did miss some morning pills. The worry about medications crept in and became consuming.
Caretakers, like myself, have many responsibilities. In addition to patient care we may be responsible for financial arrangements, purchases, medications, doctor visits, as well as future planning. Keeping the family informed of events and changes is important.
With all of the added responsibility comes the need and urgency to balance everything and stay healthy. I must continue to give attention to my own home, my marriage, and other responsibilities that were mine to begin with. After a couple of stressful weeks, I found myself with allergy symptoms and sinus pain. I took time to rest and recuperate. Thank goodness, my Mother is not demanding and understands that I do have other obligations too.
Schedules Are Important
My Mom has always been a night owl. I think she used to stay up after we had gone to bed to get things done around the house. That pattern stayed with her for years. Her sleep patterns are changing. I have noticed that Mom sleeps a lot more. She goes to bed early and wants to sleep late. Her facility serves breakfast at 8:00, thus her morning routine begins early. She will often nap during the day in her chair. When I visit her in the afternoon, she often looks like she has had a nap.
The regular schedule is very helpful to her. She is eating at regular hours and thus has more of a daily routine which helps with confusion.
The Continuing Grief Process
We are all going through a grief process. Wherever there is loss, we grieve. Many things have been lost. As Mom's memory fades, her independence diminishes. Her ability to communicate is affected and time and events are quickly lost. She has lost the ability to live in her cherished apartment with her dog and all of her friends. We are slowly losing the Mom we have known all of our lives. She will always be Mom, but the relationship is changing. She is becoming more childlike and we are becoming caretakers.
I heard someone tell a story recently. There was a woman who had Alzheimer's and lived in a nursing home. Her husband would drive over to eat lunch with her everyday even though she no longer recognized him. When asked why he continued to eat with her everyday, he replied, "She no longer knows who I am, but I KNOW WHO SHE IS!" Well said.
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