Hi Lisa, and welcome to forum. Can you tell us a bit more about your Mom and about you? Does your Mom live with you, or you with her? How old is your Mom? What conditions does your Mom have that may contribute to her current actions? Is she well physically, but mentally has severe diagnosed dementia? Is your Mom exhibiting behavior that is different from how she "has always been?" You do indicate that she was this way even "when well". But you also say there is a problem with combativeness. It sounds as though Mom may now need 24/7 care and placement lest you sacrifice your entire life to her remaining years. I look forward to having you answer a few questions for us that might help us to answer YOU, but from what little you tell us I think you are looking at need for placement. There is no arguing or curing dementia, no reasoning with it. I am wishing you the best.
If your Mom has severe dementia, there is not much she can do. She can no longer remember how to do things she previously did or the ability to learn new things. If by combative you mean if you try to change her or u give a sponge bath she fights you, they get like this. They don't want to be touched.
In the last two weeks before Mom passed, she started humming to the point she was upsetting other residents because she got louder every day. Then she closed her eyes not to open them again. But she was responsive. Then it was she would not get out of bed. Not being able to swallow was the next thing. She was in transition. Hospice was called in and she passed 6 days later.
Maybe its time to have Mom evaluated for Hospice and some meds to keep her calm.
Your mom needs Skilled Nursing care, it sounds like, if she's bedbound with severe dementia. She also needs medication to help her with the agitation and combative behavior you say she's displaying. Call her doctor for meds and as far as "finding care" goes, that depends if you have to apply for Medicaid for long term care in a SNF, or if she has funds to self pay, or you want in home help? Without giving lots more details, it's impossible to answer your question properly.
Not entirely sure of your situation and this is not a fun or easy journey.
Not sure if you are caring for her at her home, your home or what all is involved at this point? But as others have said if she has "severe dementia," she needs to be in a skilled nursing home facility which has memory care where they have staff who are trained to handle the care in a safe way.
Trying to urge, insist or cajole dementia patients in the severe or end stages of the disease (if that indeed is where your mom is on this trajectory) to engage in activities or get out of bed is really NOT possible. Dementia causes the brain to not function properly, with more and more decline in all abilities. Some folks just assume that dementia causes memory loss; but all brain functions are lost over time. Remembering how to do an activity can be lost along with loss of interest.
It is virtually impossible to handle this care at home and certainly not solo 24/7. I tried for several years solo, caring for my mom in my house and lost my mind and my life and she was mid stage. She has been at a great nursing home for 2 years now and that is will she will remain. It is sad, but it had to be.
In terms of finding a facility, first I hope you have the paperwork in place. Do you have a durable financial POA, a medical POA and an Advanced Directive? Hope so. If your mom has a dementia diagnosis it may be hard now to execute this paperwork and seeking to become her legal guardian may be the only option. Hope you also have established access to all her accounts on-line so that as part of any application processes for a nursing home and likely Medicaid coverage, you can handle all the paperwork (there is a lot).
You might find it helpful to seek the advice and help of an elder care attorney licensed in your State, and one familiar with your State's Medicaid rules for long term nursing care. Each State's Medicaid program is slightly different. Most elder care lawyers who help folks get qualified for Medicaid long term nursing home coverage also know the best facilities and may have advice about how to get a bed at those facilities. Often going in private pay first as a sweetener, is helpful.
Your area agency on aging can also be helpful with advice about facilities to check out. And do go visit them. You will want a Medicare and Medicaid qualified facility (as w/both BOTH your State Medicaid and the USG through Medicare regulate such facilities and thereby the facility is required to many more things than those facilities not so qualified.)
Most states have lists of quality facilities and various publications -- such as US News and other pubs -- rank them, Medicare ranks them as well. You'll want to check out all the ratings and rankings: staff to resident ratios, quality measures, the percentage of residents and staff fully vaccinated for COVID, reports of problems; and pick the best ones and go see them.
Getting a bed can take time and again, going in as private pay for a half year or so can help! The monthly rate where we live on the east coast in an urban area is about $14-$15K a month; if your mom has the funds to pay for 6 months out of pocket or longer; facilities like that. Some non-profit religious-run facilities that are also Medicaid and Medicare qualified, "like a donation." NOT THAT they will say that out loud; but it is part of "sweetening the deal" to get your LO into a good facility (something like $25K).
She may be finding it difficult to do things. Personality changes are also common. They may be partly from frustration at not being able to understand and do things. Try to find people who know how to handle clients with dementia and all of its stages. A memory care facility may be best. All the best to you and your mother.
Dimetia cause a loss . Of Ability. To communicate. I watched a movie about a woman's decline with Alzheimer's and she refused to transfer would sit. On her butt without moving. Turns. Out she had pain. Caused her to refuse movement. She was not able to tell anyone she was in. Paim. much like infant . U have to see doc for. or explain.
Please consider making an appointment for yourself with a Geriatric Psychiatrist and make a plan to bring Mom to the second appointment; he/she can write prescriptions that may help.
An occupational therapist may have some great activities. Call A Place for Mom or the Care Advisor here (on the right) and ask about an appropriate placement that offers an activities director.
Is your Mother living with you? If so it would help to take her to a day facility with experts who can engage your Mother. My Mother doesn’t have dementia but they have a memory care facility and all the caregivers in their wing are trained to deal with memory care residents. They engage them in many ways to include outings, art therapy etc.
The most important part is to identify the underlying cause for the behavior. Sometimes they are just hungry, or thirsty, or in pain but don’t know how to communicate it due to their dementia. other causes can be fatigue, frustration, general physical discomfort from arthritis, physical needs, such as needing to use the restroom.
Recently there has been a lot of study on music therapies for dementia: Select music that’s familiar and enjoyable to your loved one. If possible, let them pick the music. Play music from a source that doesn't have commercials; the interruption of an ad can lead to confusion. Choose music that aligns with a desired mood. For example, soothing music can establish a calm environment, while a faster-paced song from a loved one’s youth may boost their spirit and remind them of happy memories. Encourage your loved one to dance, clap, or sing along. Don’t use music as a background filler during meal time, and eliminate competing noises by shutting windows and turning off the television. Too much noise can be overwhelming or distracting.
You can also ask for a personal caregiver to come to your home and assist you with taking care of her. For more information and resources on dementia care and senior care in general you can visit: https://www.brightstarcare.com/lake-forest-irvine
Does your Mom live with you, or you with her?
How old is your Mom?
What conditions does your Mom have that may contribute to her current actions? Is she well physically, but mentally has severe diagnosed dementia?
Is your Mom exhibiting behavior that is different from how she "has always been?" You do indicate that she was this way even "when well". But you also say there is a problem with combativeness.
It sounds as though Mom may now need 24/7 care and placement lest you sacrifice your entire life to her remaining years. I look forward to having you answer a few questions for us that might help us to answer YOU, but from what little you tell us I think you are looking at need for placement. There is no arguing or curing dementia, no reasoning with it. I am wishing you the best.
In the last two weeks before Mom passed, she started humming to the point she was upsetting other residents because she got louder every day. Then she closed her eyes not to open them again. But she was responsive. Then it was she would not get out of bed. Not being able to swallow was the next thing. She was in transition. Hospice was called in and she passed 6 days later.
Maybe its time to have Mom evaluated for Hospice and some meds to keep her calm.
Not sure if you are caring for her at her home, your home or what all is involved at this point? But as others have said if she has "severe dementia," she needs to be in a skilled nursing home facility which has memory care where they have staff who are trained to handle the care in a safe way.
Trying to urge, insist or cajole dementia patients in the severe or end stages of the disease (if that indeed is where your mom is on this trajectory) to engage in activities or get out of bed is really NOT possible. Dementia causes the brain to not function properly, with more and more decline in all abilities. Some folks just assume that dementia causes memory loss; but all brain functions are lost over time. Remembering how to do an activity can be lost along with loss of interest.
It is virtually impossible to handle this care at home and certainly not solo 24/7. I tried for several years solo, caring for my mom in my house and lost my mind and my life and she was mid stage. She has been at a great nursing home for 2 years now and that is will she will remain. It is sad, but it had to be.
In terms of finding a facility, first I hope you have the paperwork in place. Do you have a durable financial POA, a medical POA and an Advanced Directive? Hope so. If your mom has a dementia diagnosis it may be hard now to execute this paperwork and seeking to become her legal guardian may be the only option. Hope you also have established access to all her accounts on-line so that as part of any application processes for a nursing home and likely Medicaid coverage, you can handle all the paperwork (there is a lot).
You might find it helpful to seek the advice and help of an elder care attorney licensed in your State, and one familiar with your State's Medicaid rules for long term nursing care. Each State's Medicaid program is slightly different. Most elder care lawyers who help folks get qualified for Medicaid long term nursing home coverage also know the best facilities and may have advice about how to get a bed at those facilities. Often going in private pay first as a sweetener, is helpful.
Your area agency on aging can also be helpful with advice about facilities to check out. And do go visit them. You will want a Medicare and Medicaid qualified facility (as w/both BOTH your State Medicaid and the USG through Medicare regulate such facilities and thereby the facility is required to many more things than those facilities not so qualified.)
Most states have lists of quality facilities and various publications -- such as US News and other pubs -- rank them, Medicare ranks them as well. You'll want to check out all the ratings and rankings: staff to resident ratios, quality measures, the percentage of residents and staff fully vaccinated for COVID, reports of problems; and pick the best ones and go see them.
Getting a bed can take time and again, going in as private pay for a half year or so can help! The monthly rate where we live on the east coast in an urban area is about $14-$15K a month; if your mom has the funds to pay for 6 months out of pocket or longer; facilities like that. Some non-profit religious-run facilities that are also Medicaid and Medicare qualified, "like a donation." NOT THAT they will say that out loud; but it is part of "sweetening the deal" to get your LO into a good facility (something like $25K).
Here are some sources to check out facilities
https://data.cms.gov/covid-19/covid-19-nursing-home-data
For my state, but bet yours has similar site: https://healthcarequality.mhcc.maryland.gov/
https://www.medicare.gov/care-compare/results?searchType=NursingHome&page=1&city=New%20York&state=NY&zipcode=&radius=25&sort=closest&tealiumEventAction=Result%20Page%20-%20Search&tealiumSearchLocation=search%20bar
https://health.usnews.com/best-nursing-homes
https://www.newsweek.com/rankings/americas-best-nursing-homes-2023
Doc prescribed pain. Med . Woman. Would transfr
An occupational therapist may have some great activities. Call A Place for Mom or the Care Advisor here (on the right) and ask about an appropriate placement that offers an activities director.
Recently there has been a lot of study on music therapies for dementia:
Select music that’s familiar and enjoyable to your loved one. If possible, let them pick the music. Play music from a source that doesn't have commercials; the interruption of an ad can lead to confusion. Choose music that aligns with a desired mood. For example, soothing music can establish a calm environment, while a faster-paced song from a loved one’s youth may boost their spirit and remind them of happy memories. Encourage your loved one to dance, clap, or sing along. Don’t use music as a background filler during meal time, and eliminate competing noises by shutting windows and turning off the television. Too much noise can be overwhelming or distracting.
You can also ask for a personal caregiver to come to your home and assist you with taking care of her. For more information and resources on dementia care and senior care in general you can visit:
https://www.brightstarcare.com/lake-forest-irvine
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