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My mom has been in a nursing home for over 4 yrs. she has dementia and recently has not been able to figure out how to eat her breakfast. Once out of bed and into her wheelchair the breakfast is delivered to her room. ( My mom WILL NOT EVER go to the dining room). Once the meal is delivered the staff leaves the room. My mom sits there for hours crying and trying to figure out how to eat. My sister and I both have witnessed this happening and have started going to the NH before breakfast to help her. Her dementia is terrible in the morning so breakfast and rising is very difficult. While this everyday appearance by my sister and I is working (we stay 2 hrs min) we are finding we cannot keep it up everyday of our lives. The nursing staff will not help her eat breakfast. If she wants their help she must go to the dining room. What shall we do? We are getting worn out.

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Is she in a nursing home or assisted living/memory care?

Anyway, I'm beginning to dislike these 'skilled nursing facilities'. My mother is in a so called Medicare Five Star Rated facility. While I like the various entertainment, the CNA's, the aides, etc., I'm not too fond of the RNs (of which there is one at each station doing paperwork, it seems). Don't even try to ask THEM a question. I always go over their head to the social worker who then goes to the RN's. Also, you need to call the doctor to get the RN's to do anything, there are so many rules and regulations as to why they can't do things on their own. Quite frankly, I don't blame them, everyone is suing today.

Something needs to change because the largest group of people are starting to get old and that's me, and probably a majority of you guys out there, who are baby boomers. It somehow always falls to us to exact change.
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In my Mother's NH in Illinois, I know they do not allow anyone to eat in their room, on a continuous basis, due to the possibility of choking. I do believe that your mom is in the wrong facility, if she needs help with eating and won't go to the dining room. They do feed patients, but they are all at one table.

My MIL is in assisted living in AZ. No one can eat meals in their room, there.

I would hire a private person to feed her in the mornings, I think.
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Re-check her night time medication. See the nursing notes. Ask the doctor, can they give her night meds earlier? More water. Has she been a morning person all her life, or is this new to her. I like the idea of a later breakfast. Are they allowed coffee? Give that, then the meal later. Have the doctor order the nurses to ambulate her early, before breakfast, if she walks. I sincerely hope her needs can be accommodated, not everyone can fit into the Nh schedule. I fully understand why she won't go to the dining room.. Please take care of this special lady as you find some relief for a difficult circumstance. Can you change your visiting schedule, sometimes go together with your sister to make it more pleasant.
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It should not matter whether she is in assisted living or a nursing home. They have a responsibility to see that she is fed even if they have to do it. When my father was in a nursing home, as long as my mom was there, they expected her to feed him. This is normal but my mother is not. My mom quit going during lunch time so they had to feed him. My father was brought out to the dining area in a wheel chair, he could not feel himself. This is unacceptable to me. This is what you are paying for regardless of family dynamics that prevent a family member from doing it.

My mother is now in a memory care facility. She can still feed herself. There are other who cannot. Some family members will come to spend the time and feed them, others cannot because of working. There is one man who cannot feed himself and I have seen the staff (with gloves on) hand feed him because this man will not sit down. He is on the move all the time, pacing, walking.
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If she needs help eating they need to help her. This is not OK. People can have trouble eating for cognitive reasons not just physical ones and that should not allow them to assume she "could if only she wanted to" so we can leave her hungry. Uh-uh. Contact the ombudsman.

BTW - Just because she does not fit the cookie cutter mold of sundowning instead of not being a morning person....- well, is there some med they are giving at night, maybe in too high of a dose for her, that is leaving her confused in the AMs?? This ought to be reviewed.
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Could she drink a Boost or Ensure for breakfast? Maybe try something like that...
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First, forget trying to figure out the whys. She is behaving this way because the poor dear has dementia. Don't worry about other motivation.

Second, I assume your goal is to have her transition gently into her day and eat breakfast without being upset. Might she do better eating breakfast later? Would the staff have more time to help if she isn't doing it during normal breakfast times?

It sounds like your presence is a comfort to her and you are willing to do this, but not on an every-day schedule. Is that right? How many days would be reasonable? I like cwillie's suggestion of hiring someone else to come in and help on the other days.

Thirdly, have you had a conference with the staff? Perhaps at the next Care Plan meeting, or a special conference just for this topic. Approach it as "one of your residents has a problem related to her dementia. How can we work together to solve it?" They may have some suggestions. Don't be accusatory or demanding. This problem is a result of the dementia and is nobody's fault. Do they have a dementia wing and are they more flexible with their scheduling and one-on-one help there? (Even if they have such a unit it may or may not address this kind of issue.)

Alos, at my mother's NH there really is a desire to provide each resident with quality care. They do listen to family. They have constraints with staffing but they are good at brainstorming and trying to work around obstacles. If you haven't already had discussion about this, with at least DON and Social Worker, I'd start there.

Lastly, it sounds like Mom is especially anxious in the mornings. Perhaps an anti-anxiety med would help. If she is already taking something, perhaps a change in the timing or dose would help. Drugs don't solve everything, but they are worth at least considering.

Your dear mother is very fortunate to have two advocates working on her behalf. I hope you come to some comfortable resolution. Do let us know how this works out. We learn from each other, and we care!
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I agree with all that has been said.....the nursing home has their rules. My mom will not go to the dining room. She has never gone to the dining room, always eaten in her room. Since about a month or so ago she has been crying and unable to gather her senses enough to figure out how to feed herself in the morning. We wonder if it is due to medications, dementia, or even acting (on my mom's part) as a means to get attention. Since we have witnessed her confusion so severe in the morning and clearing after the day starts (she's even happy throughout the day now that we are coming every morning) we believe it has to be dementia and mornings. We have checked her meds to make sure she isn't getting something that makes her drowsy, she is not. We are a little shocked HOW CONFUSED she is in the morning.......and then becomes clearer later in the day. However, she still has dementia, so the clear.....turns to confusion.....turns to clear. It is a baffling and clever disease as you said freqflyer. I think we are either going to have to hire someone to help her if we are unable to come every morning. My sister and I agree that we have seen tremendous improvement in the rest of her day if we are there to get it started on the right path. It was painful to watch her cry in confusion and frustration and not eat breakfast and then here come the meds and the staff is pushing her to eat so they can give her meds. Even the staff salutes us in getting my mom's day off right.......makes their job easier. While I think the dining room would be better because there is staff to assist with eating, we DO NOT have that luxury. She WILL NOT go to the dining room. I thought about forcing her..............but...........I don't want to be anywhere around when that event takes place! The reason my mom doesn't like to go in the dining room is complicated: She has never been a social person, very, very private. She also will not leave the room unless she is 100% dressed and her hair is perfect. THEN, after all that she cannot eat around people, especially old, sick, slobbering, coughing, confused, comatose people. Even though my mom has dementia, she fights it, she fights to stay alert, pretty, witty, and proud. She basically is unreasonable. It is impossible for anyone to be all those things........did I tell you she is also OCD, perfectionist. It's a difficult situation. I appreciate all of your comments. :-)
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Nora789, what does the nursing/aide staff say in regard to your Mom and her breakfast?.... are there days that you nor your sister cannot come in the morning to help her out? What does your Mom do, does she eventually eat breakfast on her own? I just wonder if your Mom is doing this to get attention from you and your sister, her way of going on strike hoping that you would take her home. Dementia can also be a clever disease.

And as Babalou had asked above, why doesn't your Mom want to go to the dining room?
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Why won't she go to the dining room?
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Is this a nursing home or assisted living?? Usually they are more helpful than that in a nursing home, but usually residents don't have the option to eat in their rooms either unless they are temporarily ill.
Would they provide someone to feed her for a fee? Or could you afford to hire someone to come in to help her in the mornings on the days you can't be there? I know it seems that you are paying more than enough already, but you really can't expect to get preferential treatment without paying for it, imagine if they had everyone wanting room service?
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