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She has a caregiver daily for 4 hours. She lives in her own house. No family live near her.

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TigerKim,

As previously suggested, she needs an evaluation done by a Geriatrician or Neurologist.

Keep in mind that Moms safety is paramount! If she is forgetting things like the stove etc... you may need to increase the hours of the caregiver or consider a retirement community.

Get your ducks in a row now!
Make sure Mom has a POA(financial & medical).

Theses are tough conversations to have with our elderly LOs, but it's important to have them before Mom is no longer able to decide for herself.

In the interim, I had a little success using big posters (in important places)with reminders for my Aunt with Alzheimer's. Sadly, she eventually forgot to read them.

Best wishes
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I am a caretaker for my husband and I have done multi-tasking jobs for most of my working career so when I left the work force, I knew that with an inoperable brain tumor that was found in the late 70's or early 80's, I would have to keep my mind as sharp as possible. The seizures I had and take meds for daily, have caused some memory loss but, my dr. said he saw nothing during all the years of visits that would lead him to believe I was having memory problems. He told me to keep doing the crosswords and mind games I do every night. But, in December of 2018, I went in for a colonoscopy and had to have emergency surgery to repair a tear and also they found a mass in my colon. That required surgery as soon as the first one had began to heal. So, 2 days after Christmas, I was back in the hospital while most of my colon was removed and they found a 2nd mass in it that was cancer. The point I am making is that it was my 13th surgery during my lifetime and none had given me trouble before but, the last 2 have left me with anesthesia induced short term memory problems. I walk into the room for a specific item I need and have to stand and think what it was. I get tired and I start to stutter and can't get the words out straight. I know what I want to say but, I can't say it!! I thought it would get better and I still do the word games. 16 each night in the hopes I do not lapse further. I am supposed to have my knee replaced but, I am holding out until I can't take the pain any longer. I know what will happen if I am put under again. And there will be nobody to take care of my husband who has been diagnosed with dementia and onset alzheimers. He is on 4 medications for it and will not fill them or take them unless I remind him.
If your relative is suffering from memory loss due to the anesthesia, I seriously doubt it will get better. I pray it does and wish they could find a reason for it messing with our minds.
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Imho, without knowing what things she needs to recall, that is a difficult question to answer.
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Has your mother received a full cognitive evaluation with a neurologist? A thorough evaIuation might reveal the underlying cause for her diminished memory. If dementia is involved there may not be a lot that you can do when cognitive impairment is the issue. However, there are a few medications that may slow the progression. You might ask her PCP to refer her to a provider specializing in elderly memory issues. A specialist may be able to offer a treatment plan to optimize her health in many areas including her memory.
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Your mother may or may not have dementia that was accelerated by the stress of surgery and anesthesia. You don’t need a doctor’s diagnosis to determine the danger of her situation. If your mother were to fall and no one was there, it could be hours before she was found. This situation is not going to get better, she needs far more help and supervision than four hours per day. Even if you lived an hour away and visited her every day it would not be sufficient to keep her safe. My recommendation is to move her to a facility near you as soon as possible and put her house up for sale. You will never regret doing the right thing for her. I believe any intervention/evaluation by a social worker or elder welfare check would find her situation to be neglectful and you could be held liable. When I placed my mother in an assisted living facility post surgery I was living 6 hours away. Many of her neighbors were snowbirds and weren’t aware of her medical situation nor that she was temporarily moved. One of them reported her for an elder welfare check. I was contacted asking where she was since the social worker was obligated by law to SEE my mother within 24 hours. Had I left her home alone I could have been convicted of neglect. Providing a 24 hour access to care living situation is not only imperative for your mother but a legal obligation for you. I know my response is frank, it is meant to be, not to offend but to hopefully open your eyes to the urgency of need. It is not easy but can and should be done immediately.
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Not to be a 'downer" here but if the surgery was in October chances are this is as good as it is gonna get.
She needs more than 4 hours of supervision.
If she decided to go for a walk at 9PM would she know how to get back home? If there was a fire in her home would she know to call 911, would she know how to get out of the house/would she know that she needs to get out of the house?
It truly does not sound like your mom is safe by herself.
Might be time to look into Assisted Living or Memory Care. (if her memory is improving AL would probably be alright but MC would be the best option)
Your other option is someone there all day and if possible video cameras at night if the option of having someone there all night is not an option.
Contact Local Area Agency on Aging they may have suggestions for you.
I would also contact the doctor and make sure her doctor is aware of the fact that she has some anesthesia related cognition problems.
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Alexa would be perfect if she is able to have Internet access.
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What does she need to remember?

You're talking about a person whose cognitive skills are currently so impaired that she can neither write nor use voice-activated electronic devices. She has caregivers with her for four hours each day, and presumably these people support her food, fluids, medication and personal care.

So what does your mother have to remember that is essential, and can't wait until - God willing - she recovers from her recent surgery?

Or to ask the same question from the other end, so to speak - what is she forgetting that is actually a problem?
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TigerKim, it is not uncommon that patients with dementia, especially LBD, react strongly to medications. Sometimes they have the opposite of the intended effect. Surgery with anesthesia would definitely affect a patient with dementia. It has been my experience that, once the decline sets in, they never go back to a previous, higher level of functioning. They may have "moments" which are bright and hopeful. Then the fog moves back in. I say this not to depress you but to see each moment as "this is the best they will ever be" so you can breathe it in, memorize it and appreciate it. It's not perfect nor is it ideal but it is the best it will ever be. Hugs to you!
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Oh I forgot to add that if it's in the early stages, there are cognitive meds that can help put off advancing dementia for a while. I think the ones my mom took were aricept & namenda. Good luck!
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Sounds like it’s time to increase the home caregiver hours to maybe 6 hrs, her most active day time period. Also I would consider unplugging the oven/stove & just having her use a toaster oven that automatically shuts off & a microwave. You should get a few cameras on the doors & garage doors so you can view if they are locked up & night and can call & remind her if not. Eventually she’ll need longer & longer home care. She can’t drive if she’s forgetful too so the aide will need to take her to the store. Then she can move in with a relative in time ❤️
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If mom's cognitive function was fine before surgery then ask the surgeon's office or her primary care doctor what could be the cause and if you can expect her to revert back to cognitive level. The first priority for anyone living alone is their safety - impaired judgement increases risk of a fall etc.
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INatalie cameras in all rooms. I had Nest Cameras installed in my 96 yr old Dad's home.
Eany installation and your loved one can be watched 24 7 from your computer or cell phone. You can even talk thru it.
A real comfort to be able to see and hear what's going on 24 7.
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Doesn’t sound like she’s safe ..
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I am not certain what you mean by "how to remember things". Are you meaning such things as what to shop for, the day the garbage cans go out, or other "things". I think if your questions means things that simple, perhaps a list to the caregiver who comes is more appropriate.
I think you do know, however, without support in the area, that soon care placement will be needed. You are making calls daily, and that is great, but what happens when/if they aren't answered. A wellness check will only be possible for a limited amount of time.
Sure do wish you good luck.
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This isn't a total solution, but she likely needs more interaction than just 4 hours daily.    Do you call her daily?  

I second the recommendation to contact the AZ Assn.
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TigerKim Dec 2020
I do call her daily and my sister-in-law calls her daily, too. I will follow-up with the AZ Assn. Thank you for your response.
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There comes a time there really is not anything you can do to help them remember. They will even forget in the same minute of a reminder. Mom needs 24/7 care at this point. When last did you visit? It is time so you can see first hand what is going on. Not a couple of days, but a couple of weeks.

Read everything you can about dementia and you will soon realize she cannot and must not remain in her home as much as she is.
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TigerKim Dec 2020
I last visited in November. I had also visited in September. She had surgery in October and post-anesthesia from the surgery we have really seen the memory loss. She hasn’t been diagnosed with dementia but maybe getting her diagnosed is the next step. Just hoping that she will return to her normal level of functioning before we have to take more serious steps.
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Since you listed your question under the Alzheimer's and dementia category, I have a question. Are you expecting your mother to live alone in her own home, with dementia, for 20 hours a day? If so, that's a dangerous and unrealistic expectation, especially at 93 years old! My mother is 94 next month, with dementia, and lives in a Memory Care Assisted Living community. There is nothing I can give her to help her remember things.....even her Alzheimer's clock which tells her the day, date, time and whether it's day or night doesn't help because she doesnt remember to look at it. Same thing with the dry erase board on her wall to remind her.....it doesn't work. 24/7 caregivers is what works to remind her it's time to eat, bathe, take her meds 5x a day or whatever. She can usually use the phone, not always.....but frequently loses her phone book with numbers or punches the numbers in wrong and frustrates herself something fierce. As time goes on, things only get worse so they become literally incapable of learning new things or retaining info that's told to them. It's all part of a brain that's broken and no longer functioning properly.

Go to Alzheimers.org for more info and an 800 # for help and resources to guide you. They deal with both Alzheimer's and dementia. Good luck!
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TigerKim Dec 2020
Thank you for your response. I only posted in this category because I thought I would find good resources for memory here. She has not been diagnosed with either Alzheimer’s nor dementia. She was fine until she had surgery requiring anesthesia in October. Still trying to figure out if she will return to her normal level of functioning or if this memory loss is more permanent. I will check out Alzheimer’s.org. Thank you.
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