My mom has been in an ALF for 4 months and, as I have written, is a natural introvert. It has been very difficult to get her out of the room. She is going to a few activities but likes to eat in her room. The dining room gives her anxiety due to the noise and number of people. She is not a natural social person and the thought of chatting with the other residents just scares her.
I am noticing an increase of apathy and some signs of depression. During my visits I try to get her out of the room so she can interact and get more comfortable but it does not seem to be helping.
Should I consider a doctor’s visit for possible medication to help her? How do you know if this is a sign of the disease progression or a result of the new environment?
Should I give it more time since I know many patients take longer than 4 months to adjust?
Thanks, as usual, for your guidance.
”Differential diagnosis” is part of a good psychological or psychiatric or neuropsychiatric evaluation, and a good exam er will know what to look for.
As long as you’re supportive and affirming of her new residence you don’t need to be overly concerned about the specifics of your mother’s situation or how to address them.
In my LO’s case, we consulted a psychiatrist recommended by her facility because she was quite obviously intensely anxious and distressed early on, but with small doses of well chosen medication and some focused encouragement, she was enjoying her “hotel” by about 6 months there.
We received a document indicating that my LO has dementia after her eval was completed, and it turned out to be a HUGE help to support her POA.
Do your research with the social worker. You’ll feel better when you have at least a tentative plan.
I suggest you set up an in house doctor at the ALF and get them to call you after each visit with mom. That is THE most beneficial thing you can do is to have that direct line of contact with her health provider. And the meds can be ordered and delivered straight to the ALF once the provider orders them.
Good luck.
You say she is going to a few activities, that might be enough for her.
As an introvert myself, I can tell you what creates a situation of apathy and indifference..being forced into social engagement. It is exhausting and generally annoying being around people for very long.
The whole "lets go around the room and say a bit about ourselves" meet and greet...is the very definition of HELL for an introvert.
Are you an introvert? Do you understand how exhausting it is for people like your mom to socialize? She's going to activities. Just because she wants to eat her meals in peace in her room does not suggest that she needs medication. Introversion is not a mental illness.
Most introverts prefer to socialize one-on-one. Maybe she'll make a friend but that takes longer than 4 months. Ask the social director if there's another introverted woman who might be a good match for your mother. If so, ask her to arrange for the two ladies to have tea/coffee for two.
Perhaps she would also benefit from talking to someone who cares about her feelings. I'd get the pastor/chaplain to visit her.
That is part of this process. We can hope and want our LO to adjust in a way we think is good, appropriate or to meet their needs. But at the end of the day, they "adjust" their way. Letting go of our own wants or what we think is "an appropriate adjustment" is the hardest part.
In my mom's case, the facility has so many daily activities: group exercise class (one can do this from one's wheelchair as needed), a daily movie in a movie room, outings in to their beautiful gardens, a game room (lots of folks there all day), a library, "hallway bingo" (one only has to come to the door of their room to play with others in the same hallway, a beautiful dinning hall and one can get dinner from 5 to 7, NOT at a specified time).
My mom will have none of it. Instead for the last two years she eats all means in her bed in her room, won't get out of the bed unless necessary like when they take her for a shower. Will not leave the room for any reason, except for that 2 times a week shower. Won't engage with anyone other than the aides and medical staff there. Has the TV blaring 24/7 (she has a private room), the lights are out and the blinds are closed.
Yes, the psychiatrist on staff, psychologist, her geriatric MD, the social worker, all have tried. And yes, she is on two different Rx meds for depression and anxiety. So after 2 years of this it just is what it is.
So I have had to let go of any hope she might "adjust" in a way that she'd "make friends there" or "engage in activities." So she has adjusted and it is her way, not what I had hoped for. But I have accepted that.
This is a tough journey. Give yourself time to adjust too, you both are going through this in your own ways. And finding ways to let go of what you want for her "adjustment" may help you both in the long run. She has to adjust in her way with her care team, they are not new to this (they've seen it all before), and all you can do is let "the adjustment" whatever that may be happen in the time it takes to happen.
Maybe it is a depressing atmosphere that you don't see. Regarding her eating in her room, good for her, dining room could be a den of gossip with some residents smiling in other resident's faces and talking about them behind there back.
There was a tv show that mentioned this, where the woman smiled and talked to people that passed by her, then as soon as they were gone, she talked about them.
Bon Appetit!