As I wrote earlier in Sentinel Event – The Crisis that Changed Everything, mom had been to the emergency room with dehydration and hallucinations which led to the recommendation that mom and dad immediately move to an assisted living facility (ALF). In fact, mom had more health issues than I was aware of at that time as her kidney blood tests were also abnormal when she was in the emergency room. At that time, the doctor attributed it to her dehydration, but looking back, I can see it was an early clue about the problems to come.
In addition, in the weeks between mom’s hospitalization and the move into assisted living, my father’s last surviving brother passed away. Now dad was the only survivor from his large family and mom was the only one left in her family as well. (I didn’t know whether to tell dad or not due to the stress of the move. After a few days, I told him and mom too.) Mom started to dwell on the fact that she was the last survivor in her generation quite a bit in our phone conversations.
When they moved into the Gardens, mom was suffering from dementia and decreased vision and dad had early Alzheimer’s . Everyone was very nice, but the staff were insistent about washing all of mom and dad’s (supposedly clean) clothing right away and giving mom and dad showers. Their clothing had food stains on them and dad’s jacket was smelly. The marketing people seemed overly concerned with how things looked. I thought they should just chill out a little and let mom and dad settle in. Mom was having a hard enough time with the transition without extra pressure about their grooming!
I was also frustrated to learn how much the marketing director was involved in determining what clothing and furniture mom and dad could bring in and wear. I felt that it was not appropriate for the marketing director to be involved in this. I did not object to the nursing staff and aides working with mom and dad to assure proper clothing and bathing.
Every morning the aides laid out clean appropriate clothing for mom and dad when they helped them bathe and dress. After breakfast, mom would change to the same clothing she had worn the day before. She had her favorites and wanted to stick with them. It became a battle of wills between mom and the staff at the Gardens.
At the same time, mom was still having some hallucinations. One day on the telephone she told me she had to wait for Essie to take her to the doctor’s office. That didn’t seem likely now that she was in the ALF. I found out there was no appointment with the doctor and mom had just dreamed it up. She didn’t want to go to bingo or any activities because of this imaginary medical appointment.
In their first 2 weeks in the assisted living facility, before I arrived to help them move into their permanent Mom apartment unit, mom was still telephoning me several times a day with contradictory requests and statements. During one call she requested that JL and I bring her “home” and not sell her things, and then she insisted that I not come there at all. She was calling my son at his home with these requests as well. I was really tired before I even got there to help with the move.
The home health nurse, BJ, visited mom and dad in their assisted living facility as part of her follow up with their doctor. She also called me and said that she thought they looked wonderful – much better than 2 weeks before. She said mom was wearing lipstick and dad walked and talked more than he had for months. She did note though that mom wanted to go “home”. BJ reminded mom that they had considered the northern city where their permanent house was and the southern city where their mobile home was and decided they couldn’t spend a full year in the northern climate. Dad agreed that it was too cold up north, so mom then said yes, it was better to be where they were.
When I arrived and helped them move the rest of their clothing and furniture from their mobile home, I also went shopping for new clothing for both mom and dad. JL and I bought some new chairs and beds also as the old ones wouldn’t pass the “smell test” for the facility. I was frustrated at all the requirements that seemed to pop up after they moved in although I had to agree that mom and dad didn’t smell clean and fresh. I just had too much to do in that one week to get enough shopping done.
After I got home, I kept in touch with mom on an almost daily basis. Slowly she adjusted to life at the Gardens. She started to take part in bingo and other activities. Dad liked to go to yard sales and thrift stores and it turned out that once a month they had a “thrift store” right there in one of the units at the Gardens. They sold donated items and crafts residents had made. Mom and dad both liked to go to that thrift store too.
Dad was more talkative and aware in assisted living also. He discussed his medications with the nurse and was aware of most of the medications he was taking. I think he wasn’t getting all of his medications as prescribed before as mom kept getting confused counting them out. Now that a nursing staff was in charge of his medications, he was doing much better.
Mom still had appointments with several physicians in the community. I arranged with a home health care service to have a nurse accompany her to all her appointments. The Gardens provided transportation but they did not send anyone with the resident. Since mom didn’t have a clue about why she was there and what was done or not done (short term memory was almost totally gone by then), I wanted another person to fill me in on what had transpired. I also wanted that nurse companion to be with mom in the waiting room and the doctor’s office to help mom remember why she was there.
Mom and dad had always had a good sense of humor. Mom was funniest when she talked about the meals they had at the Gardens. They had assigned seats and always sat with the same couple. She didn’t know the woman’s name, but they both referred to the wife as “the lady who talks too much”. Dad didn’t hear that well either, and by this point neither did mom. The husband was also talkative, but not as much as his wife.
For awhile, things seemed to be settling down with mom and dad. Finally they were getting regular meals, medical appointments and medications. Within 6 weeks of moving in, mom had completely forgotten about their mobile home and no longer asked any questions about it. Dad all of a sudden remembered his tool shed and the things that were in it. He asked what happened to it and was upset to learn I had given his tools away. After a few days he mellowed about that, but it surprised me that he even remembered to ask. He had Alzheimer’s for years whereas mom’s dementia was more recent.
For a short time, it seemed as if their lives calmed down but then mom’s dementia started to rapidly worsen again.