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Diagnosis at this time I would think is quite critical.
Just my opinion as an RN.
Your choices of care are likely better decided by you given you know your elder better than we do by a long shot. Nothing in this realm is fail-safe. We all make the best choices we are able.
I can see her go out and check her mail when caregiver is not there. I can zoom in and look at her swollen ankles. She takes her phone with her when she goes out the door with her walker. I do not have cameras in the house, as I felt it was just against her privacy. I want her to have someone come daily, but she gets really upset about that idea and fights me.
When I say she has sundowners let me state, she has never been diagnosed. But, when the day comes to an end she forgets what you tell her and will ask 10 minutes the same thing again. She can get angry real fast, but she has always been like that. I have watched several YouTube videos of bad case sundowners, and that is not her.
I do like all your ideas. And yes, I will be making a trip up there to observe how much decline for myself.
Her hearing and eyesight is bad and getting worse. She finally stopped driving and we got the car sold. That took 2 years to get her to agree to stop driving. I think, she scared herself running over a curb. We had several fights over her giving up driving over the the last two years.
Recently, she has admitted to me that she went to bed leaving the lights on, and she never does that which makes me believe she is aware of her memory failing. I agree, my biggest concern is her falling and nobody there. She does not cook other than microwaved, and I order her DoorDash hot meals when she wants me to, She can’t stand Meals on Wheels anymore.
She will not wear her neck alert device because it inadvertently goes off, and she does not know it until the first responders are in her house. And she is shocked and little freaked out to see several firemen in her house. I have a Texas DNR form in her house with Huge Black Letters DNR over the Manila envelope taped to the wall.
Caregiver said her memory about past events from years past is crystal clear! It is just her short term memory at the end of the day. I asked her “experienced” care aid, if it was time to get her to memory care, and she didn’t think she was at that point just yet.
It has taken her aide weeks to get into her bathroom to clean it because my Mom would not let ANYONE into her bathroom to clean. Finally, the aid has been able to get clean her bathroom! Her aid is concerned about her, and if I could not reach my Mom by phone, the aid lives 8 minutes away. She is willing to come more days a week, but my Mom refuses more days!
My Mom has a temper and will not hold back tearing my a** up, if she thinks I’m pushing her when she is not ready for memory care. I don’t have the skill to deal with her when she is difficult and has no empathy for anyone but herself. I get emotionally wore out and takes me back to her abuse growing up affecting me for days being overwhelmed.
And if all she's wanting to eat is biscuits and gravy, let her eat them as it's better than nothing.
It may be time to bring hospice on board now, but they will not allow her to live by herself but will require that someone be with her 24/7, so you may have to get her placed in a memory care facility first.
Hospice should be able to help you find the right facility for your mother.
It is not uncommon for someone with sundowners to leave the house at night. I couldn't imagine if your Mom's caregiver checked in on her the next day and found she was not in the house.
It is time for your Mom to move to Memory Care where the facility makes sure no one in Memory Care is able to go out the front door without being with a relative or Staff. And at night, the main doors are locked for the residents safety.
Good luck.
The not eating is normal and I am WITH her on the bisquits and gravy. That's my style. And agree she shouldn't be forced to eat anything she doesn't like or more than she wants. But in general as we age we take in less food and we sleep more, and it can come gradually at first, but often toward the end of its being safe it can come exponentially quickly.
You mother is at 95 in her home. She has someone checking on her now three times a week, but to be honest the time has come for daily checks of some kind from some one and a plan with someone with keys who can make entry to check. You are approaching the time when there WILL be a phone call either from hospital ("We have your Mom with us") as I did with my bro, or from a neighbor ("The mail is just sitting"). I think you recognize this.
There's no easy decision here. More and more (and of course at 82 why WOULDN'T I think this way) I tend to think those lucky enough to live at home and die at home should be ALLOWED TO. What is another year in a nursing home compared to the final exit feet first out our own door. HOWEVER, being on the floor with a busted hip for two days? Nope. Not good and you would beat yourself up on that one the rest of your life. Also, just a fall and lying on the floor for 6-8 hours can in the fragile elderly cause a bedsore of necrotic issue that goes to the bone, causes sepsis and death.
I think you are looking at some tough decisions. I would be you already know that.