She was able to live alone for about a year until, with her agreement, we moved her into assisted living. That was 2 1/2 years ago. In that time her short term loss has accelerated, now to the point that she cannot keep track of what we're talking about during a normal conversation. She's seen doctors on a regular basis since her stroke, never been diagnosed with alzheimer's but was on Aricept a couple of times (but the side effects weren't worth the supposed benefits.) I see her 2 - 3 times a week, and she always asks how my kids are doing, where are they, are they out of school (they both graduated from college years ago and moved out of state), what's new in my life, etc. etc. I know this is not uncommon in the elderly. But not long ago, she asked where her husband (my father) was, and I reminded her that he passed 17 years ago. She said, "Oh that's why he hasn't been around." The other day she said, "I know this will sound like a dumb question, but is my mother still alive?" So I reminded her when her mom passed, how old she was, and so on. But it's the lack of short-term memory that's so frustrating, for her and those around her. Again, I suppose this is not unusual, but during a typical hour-long visit, she might ask 10 - 15 times, When is Christmas? What are the plans? Do I need to do or bring anything? (as if.) And then ask randomly, again 10 -15 times, So what day is today? And what is the month? October? September? Oh, December? Have we had Christmas yet? What are the plans? Then again, What are your kids doing? Where they now? What's going on in your life? Sometimes I take the time to give her complete answers about my kids, their college years, current occupations and cities they live in. Other times I just breeze through short answers. She is unwilling or unable to do anything, like go to exercise class, try to read, etc. She picks up the TV remote when trying to answer the phone, randomly looks at a calendar/notebook/daily schedule that my sibs and I fill out for her, looking for information about -- for example -- what year her mother died. On that one, I had to say, "Mom, I don't think that notebook is going to say anything about when your mom died." She's mobile with a walker, but has a difficult time getting out of a chair (over weight, but who isn't?). She's getting assistance with dressing, showering, etc. She has not gone through any personality changes or mood swings. She still knows the names of her 6 kids and recognizes me when I arrive. She's able to laugh at her forgetfulness, or the lack of logic in her asking if her mother is still alive -- when you take the time to do some math with her (her mother would be like 140!) But again, it's the short term memory problem that's so frustrating. We've all accepted that she is incapable of forming new memories (and starting to lose some old ones; however, she can recite poems she learned in grade school). I try to just focus on the moment and enjoy the time together. But I find myself rambling on, trying to keep her mind engaged, see if anything I say will fill in some gaps or trigger any recollections of her own. Or I'll Google something we've been talking about or saw on TV and simply read from the search result. Add to both our knowledge base! I've to her read from old journals she kept, old letters to and from her sister that my aunt saved, my Dad's old WWII POW "memoirs" that I typed from pages of scribbled notes, watched re-runs of Ed Sullivan (Hey Mom, that's Jim Nabors. You remember him, right? No.) But whatever I do or whatever we talk about, she will have completely forgotten about it maybe 5 - 10 minutes later. I don't get angry, of course. It just all seems so pointless. I guess I have two questions. First, in the absence of things like personality changes or irrational mood swings, could this very severe and accelerating short term memory loss indicate alzheimer's? Second, is there anything I can do to make these visits more enjoyable, or maybe...I don't know...more meaningful? Any words of wisdom?
I was puzzled myself, looking back, that it wasn't until my mother's second stroke that anybody said the words "vascular dementia" to me - but it explained so much! Ask your mother's doctor if this is a possibility, and if so where you can find information and support for patients and families.
Your mom sounds lovely. I say that because you mentioned she was in an ALF. So she agreed to move without months and months of trauma and drama. Good for her and for you!
I know the forgetfulness is frustrating for you as it would be for most folks. It's difficult not to get impatient having to repeat yourself constantly. I agree that it doesn't sound like Alzheimer's. Alzheimer's is more insidious and life-shattering. Like mental illness on steroids. However it does sound like more than just mild cognitive decline (MCI). If a diagnosis is important to you take your mom to a geriatric psychiatrist or neurologist.
As for making your visits more enjoyable or meaningful, they ARE enjoyable and meaningful for your mom. True, she forgets what was said 5 minutes later but in the moment she's inquiring about your kids (as she remembers them), she's realizing her husband hasn't been around for years because he's dead (without going through the grieving process from square 1), and she wants to know if her own mom is still alive. Again, not falling apart emotionally when you tell her that her that her mom is not alive.
Your mom still has her social graces (which tells me right there it isn't Alzheimer's) and is interested in the goings-on of the family. You hit on the solution in your post. You have to stay in the moment. Literally. As maddening as it can be to repeat yourself over and over you're showing your mom kindness and respect and love by being in that moment with her. I know it isn't easy and it's exhausting but you're already doing the right thing.
Maybe old photos would entertain your mom (old photos are the go-to for people with dementia). Photos from her childhood if you have them or photos from your childhood. She may not remember the photos but talking about who's in the photo and what they were doing might capture your mom's interest for a short time. But if she continues to not remember photo after photo after photo it would be best to put them away so as not to frustrate her.
How about music? That's something you can do with your mom without having to talk. I once burned some CDs of Big Band music for some patients of mine and they loved it. Of course nowadays we don't have to burn CDs, we can just put the music on our phones. But maybe if you know of some music she'd enjoy or how about the soundtrack to a musical she's seen?
It's not necessary to see your mom with tricks up your sleeves to keep her entertained but these things might give you a break from the non-stop repeating and might be nice to whip out on occasion.
When doing some research (how I found this site), I did consider vascular dementia, as well as the possibility she's had subsequent small strokes that no one caught. Some of the symptoms don't seem to fit, but I'm going to do more research. She has been seen several times by at least one, possibly two neurologists. I can't say if they were geriatric neurologists, but that's how she got on Aricept. Both times she tried it, she got super depressed. With her declining mental and physical condition, there's always been elements of depression, and she's currently on Lexapro. But it was worse on Aricept. At that time she was still living alone, and during most visits she'd end up in long bouts of crying, with an inability to articulate why she was so (or more) depressed. I've never seen increased depression listed as a side effect, but from the perspective of her kids, she was not improving, there was a pretty clear connection to her depression and the Aricept.
I have worried about alzheimer's of course, but she's been seen by several docs, and she does get regular check ups. Mainly for blood pressure, cholesterol, thyroid, etc. And she hasn't shown any changes in her basic personality. She retains her sense of humor, doesn't complain about the caregivers or her treatment, and generally remembers close family -- although she can't remember who my sister's been married to for the last 30+ years, but part of that I believe is because they moved across state 6 or 7 months ago, and she's only seen him at big family gatherings.
So for now, I'm looking forward to finding a little free time to really read all the replies. I can tell there are many good ideas for coping, lowering or dealing with frustrations, activities I haven't thought of, and ways of adjusting my own attitude and expectations that will help.
Dad likes to reminisce and I often bring up topics to get the conversation going. He still reads his magazines and watches TV but I can tell he doesn’t do it as much as usual.
So I would guess your mom has vascular dementia. You said she has a hard time getting up...have you considered a recliner chair that raises her to standing? You could have Home Health assess her by bring in an OT or PT to see what can be done.
Alzheimer's is a slow and steady decline where as Vascular dementia can be steep dramatic declines. My Husband had both, slow steady declines then all of a sudden he would not be able to do a task he had done the day before. (He walked on a Sunday and Monday he could not/would not walk)
As far as the medications go. He had been on Aricept for quite a while. Later Namenda was added but that did not last long due to the side effects. I did not notice a decline when he went off Aricept but who knows what the decline would have been like without it all along.
Personally just from reading your post she sounds like she is doing a lot better than many. If she knows you and can ask about your kids and have a complete conversation you are lucky. (Does not matter if she forgets is in a few minutes) Conversation is the key. My Husband had been non-verbal for almost 8 years and it was frustrating for me and I can only imagine for him as well not being able to express frustrations as well as pain, hunger and other basic needs.
And...does she have a DNR or a POLST in place? If so make sure there is a copy with her at all times also post one in her apartment and keep one for anyone that takes her out.
Give her a hug for me.
I like the thought that she's happy when I visit, even if she won't remember it. if she's happy for that brief time, good enough. I also like the idea of getting her off cable. Although watching TV is about the only thing she can do, sometimes she gets the cable box and power to the TV out of sync, so there's just static. Then, the other day I stopped by and she had the TV on Channel 1127 -- there's definitely nothing on that station she watches. She's got dozens of recorded shows, however, because she obviously hits the record button while tying to do something else, turn the TV off I assume. Or the remote will just be missing, and she'll have no idea where it is (usually the bathroom). It does make me chuckle sometimes, and I can tease her a little -- but never to the point of making her feel bad. She does sometimes use humor as a way to cope, but I know there's deep frustration with her diminishing abilities. She frequently says, "I used to have a brain," and sadly, being in this condition was the biggest fear she had as she aged.
And thinking about things like misplacing the remote and her then pointing to some random object and asking if that's it, I'm wondering if her vision is getting worse. She also can't see her digital clock very well (it shows the time in big numbers, then day, date and month in smaller figures.) She often squints at it while asking what month it is. Getting her vision checked is something I could be proactive about and it might actually help her.
Also, a powered chair that would assist her in standing is a great idea that never occurred to me.
And of course, I'll continue to monitor how she's doing. Her beginning to lose longer-term memories is concerning.
Anyway, a lot of food for thought, and simply reading the perspectives of others who share similar experiences has been very beneficial.
I agree with bringing familiar music. Music was the last thing that mom remembered. She liked the old church hymns so I bought an Alan Jackson gospel CD and the staff and I played it repeatedly. Even when she had trouble finding and forming words, she could sing along. If I sang with her, she would sing harmony!
Mom had a lift chair, but couldn’t remember how to use it, or even that it was a lift chair. Maybe you could rent or borrow one to see if it works for your mom before investing in one for her.
It was hard sometimes not to lose patience with being asked the same thing over and over and her inability to solve any kind of problem. But mom never was hostile or paranoid or any of the behaviors that can show up with different kinds of dementia. I was blessed in that way. She lived in Independent Living until her death, with a LOT of help from me. She had her daily routine and as long as she kept that routine, she was OK.
"Dementia is not a specific disease. It's an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.
Dementia is often incorrectly referred to as "senility" or "senile dementia," which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging."
My understanding is that dementia is a term that one can liken to a large umbrella that covers a multitude of afflictions, with Alz being the most common and vascular as the second most common, as noted in the ALZ quote above. We did not have mom "evaluated" to determine the cause, mainly because there is not much one can do to treat any of these. She was over 90 and it is not likely to be the thyroid or vitamin issue. A few conditions have an underlying cause which CAN be treated, but in general dementia is not treatable. We attempted to maintain mom in her condo, but the aides hired (started with one hour daily, mostly to check on her and ensure she took her meds from a locked daily dispenser) only lasted a few months before she refused to let them in.
What you are describing is what we were seeing. Initially some difficulty doing "routine" things like paying bills, some repetition of questions or comments and so forth. Nothing to worry about too much. The car came up first, and we had to take it away before she injured herself or someone else. Unfortunately since she was living alone there were other issues that over time we could not witness. We did install cameras, partly to ensure no one took advantage of her, the aides were really there and partly to monitor her - one just inside, one outside and one in finished basement. Eventually she started the OCD behavior, mainly at night (sundowning) - initially this was a few repetitions and eventually became an hour to an hour and a half marathon checking the door lock, sidelights, dishwasher and LR over and over and over. The repetition of questions and comments became worse. It is so frustrating to have to keep answering/discussing the same things over and over. Grin and bear it! If it becomes too much for you, one thing that can work is redirection/refocus. This is like moving the needle on a record that is skipping. This is easier to do in person than over the phone, but generally if you can change their focus onto something else you might get some relief. Of course, it might mean repetition of something else! Getting her to focus on something that interests her and can keep her occupied, or going for a cup or tea or coffee can break the cycle, even if it is only for a short time.
We finally decided mom needed to be in a safer place. She was NOT amenable to moving in with any of us, wanted no part of people coming in AND was adamant that she was fine, independent and can cook (not), so she had no desire to move to AL of any kind (for years she would go to the free lunches and check these places out - now that we needed to go that route, nope! That refusal to move is what brought me here in the first place. You were lucky with mom agreeing to move!)
She managed to injure her shin and end up with an ulcer that delayed her move (literally days before we had the move planned and she could not tell anyone how this happened!), but she moved in early January this year. For the next 9 months she kept asking when she could go home to her condo. My younger brother would try to explain over and over why she could not. She would not accept his responses and would keep asking WHY. Typically she harped on him, not me (thankfully!) During visits, despite her really bad hearing (none in one ear, limited with hearing aid in the other), the repetitions of questions and comments continued. However, one day about 2 months ago, she asked if I could drop her off at her mother's on my way home. Ummm, not today mom, it is kind of late and it is not on my way. Maybe tomorrow. Okay. Her mother passed away almost 40 years ago! This is one topic that I felt was better to avoid the truth. Shortly after that query, she asked if I had a key to the place they had lived in before (not the condo). They sold that 23 years ago! Ummm, not with me - maybe at home, I'll check when I go home. Okay. Again, no need to try explaining. Her reality is changing, moving backwards in time as more and more short-term and more recent memories are lost. This is what you have to expect. At some point, home may be where the person grew up! People from the past may populate their "current" memories.
So, it does progress, there just is no timeline provided to us. It is kind of like how kids grow - some walk or talk earlier, some later, some roll over before you anticipate it, some don't, etc. In most cases, the end result is the same - kids grow up and become self-sufficient. People with dementia decline until they no longer know who we or they are and can no longer care for themselves. Each person and/or cause of the dementia has its own timeline, just like kids grow and learn at their own pace.
From what you have described, it certainly sounds like some kind of dementia rather than any age decline. It is not just brain glitches where you forgot where you left your keys or why you came into this room - THAT is normal. You could have her tested to determine what the underlying cause is, but why put her through that? It is what it is, and there is nothing really that you can do to stop it. What you are currently doing with her sounds great! The only recommendation I can suggest was noted above - learn how to redirect/refocus! You do not have to do it all the time now, but it does come in handy. Use it sparingly now and then, but as this progresses you will be more proficient at it AND thankful to have this "tool" to use! Sometimes it requires making little white lies too, but this is not done to be hurtful, but to avoid hurt! That was hardest for me, as I do not like being deceptive in any way, but it is what it is and sometimes works for the best.
Although a lift chair is an option, I have to agree with akdaughter. Would your mother know/remember that it is a lift chair and/or remember how to use it? Given that your mother is having issues with short term memory (troubles with TV/cable/remote, etc), it may be difficult or impossible for her to learn how to use this kind of chair. It seems like a huge expense to have as a chair (which is all it would be if she cannot operate it!) The rent/borrow option is something you could try, but I suspect it will still be a waste as she is not likely to be able to use it. Our mom asked for a walker, like the others in her MC place have. I brought the one she had for our dad. She does not use it, yet. Even though it is in her room now, she just walks by it and leaves the room. Thankfully we did not have to fork over money for it!!
So keep on with what you are doing - sounds like you have a good handle on it. Many of the suggestions here are good to keep in mind too. Best to have all the tools in your pocket for when they are needed!