Medical Forum / Diseases and Disorders / Alzheimer's / November 2004
First day of day care today
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Stephen B - 24 Nov 2004 01:10 GMT I enrolled my mother in an Adult Day Care program near home and today was her first day. My mother is physically very capable at 77, but the Alzheimer's has progressed to the point where she is unable to care for herself and is quite a burden on my 84 year old father, who is the primary caregiver. We decided on 2 days a week, Tuesdays ad Thursdays, and they pick her up an dbring her home. She is in utter denial of having a problem, and becomes agitated, angry and depressed all at once if there is a hint that she has a problem. In her world, the neighbor is in and out of her house and yard and messes everything up. The poor neighbor, who she doesn't speak to, is the focus of all blame. Her father, who has been deceased for over 50 years, is alive and well in her world, only missing. There are an amazing number of people living in the house. Outside and inside are interchangeable. An avid gardener for her entire life, she believes plastic and silk flowers are real, takes potted plants out of their pots and "replants" them in strange containers like baskets, and basically kills all plants with too much water or too much food. Currently, she is lamenting the loss of all of her plants to the ravages of the nasty neighbor, while the problem with the outdoor ones is that winter is coming. She is only visiting the house she has lived in for 53 years and her father, who has never lived in the US, has a house within walking distance, but he never visits and she is a prisoner, so she can't go where she wants when she wants. Never mind that I had to track her down one cold day last month when she bolted in her pajamas and bathrobe on a Saturday morning. She wears a tracking device, complements of the County Sheriff's department, so we feel safer about being able to locate her if she wanders, which is rare so far, fortunately. On the day I located her, the Sheriff's officer was on the way and the local police were already searching, I simply lucked out in finding her first. I am fortunate, or unfortunate as the case may be, to be living about 10 minutes away by car, so I see my parents daily to check on them each afternoon on the way home from work. Anyway, she was told that she was going to the Adult Day Care Center as a volunteer, and the Social worker was fine with that and the staff went along with this ruse. Apparently, she was asked to help a bit, but she still felt very bored and was angry that she had been made to go to this place. I spoke with the Social Worker who advised that she had a difficult morning, telling staff and others alike that she didn't belong there. In the afternoon she seemed to make friends with some people around her, but upon her arrival home she was clearly unhappy about the experience and stressed that she was very bored and that all they did was sit around. I know better than to believe her completely, but I do believe that she was bored if she was not actively involved in something almost constantly. She is not one to sit around, generally puttering around all day. (That would be cleaning up by emptying closets and drawers and moving things all over the house continually, driving my father nuts, of course. And in the yard endlessly moving things around, sweeping the driveway, lawn and garden with whatever is handy...) What are your experiences with dealing with the transition to Day Care? I really need this to work for both her and my father's sake. -steve
Evelyn Ruut - 24 Nov 2004 01:34 GMT >I enrolled my mother in an Adult Day Care program near home and today was >her [quoted text clipped - 79 lines] > to Day Care? I really need this to work for both her and my father's sake. > -steve in our case we told my mother in law that she had to go as therapy for a while "till she got better." there simply was no choice. i absolutely could not deal with having her into things here all day. i needed the break and she needed the stimulation. we made excuse after excuse, but when that bus came, she had to go on it. it wasn't mean, i believe that the reason she did so well was because of the stimulation of daycare. they did lots of wonderful things.
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Tumbleweed - 24 Nov 2004 01:43 GMT >I enrolled my mother in an Adult Day Care program near home and today was >her [quoted text clipped - 79 lines] > to Day Care? I really need this to work for both her and my father's sake. > -steve Stephen, this sounds exactly like my father, many of the same characteristics. He never settled into day care and after a couple or three years at it, causing a huge stress on my mother every single time he went (starting 1, and then 2 days/week) , he had to go into full time care because she simply couldnt cope any more. ]
Sorry to say this, but you are going to have to start looking for a home now, if she is in a position where she can wander out of the house, then ultimately the tracking device is just going to be a way of finding her body. What if she wanders off at 2am on a snowy day, or blunders about on the roads in the dark? A 24 year old person cant look after an Az patient 24x365, let alone an 84 year old one. A few years ago an Az sufferer wandered off in the middle of DFW airport. The were never seen again.If someone can vanish with all those people around and with secure doors and exits and so forth, how much easier when its just one 84 year old person looking after them.
One harsh fact of AZ is that you cant always have things work the way you want. You cant persuade an late stages Az patient of anything they dont want to hear. You may need it to work for you and your fathers sake, but from what you describe, its unlikely to. I would begin looking at homes now, it can take months to years to find a good one and then get your LO admitted. You dont want to be in a position of having to take the first thing that comes up when a crisis occurs with your father, which inevitably it will, either because he cant cope, or as a result of illness, however minor.And the stress on your father will undoubtedly make him more susceptible to illness.
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Stephen B - 24 Nov 2004 09:38 GMT >Sorry to say this, but you are going to have to start looking for a home >now, if she is in a position where she can wander out of the house, then [quoted text clipped - 6 lines] >exits and so forth, how much easier when its just one 84 year old person >looking after them. I rambled enough in my post that I didn't mention that I will be looking at a home within the next month or so. The Day Care facility is actually an offshoot from a Nursing Care facility and they have an Alzheimer's care unit. Day Care clients have preferential treatment on the waiting list. I am also looking at Potomac Group Homes. The cost of both is the issue, of course. My father is relaizing that he can't do it much longer, but he doesn't want to part with any of his money. I'm working on it. As for the wandering, the house is locked at night and she can't get out. Locks are up high. The problem is strictly daytime and only when my father forgets and "accuses" her of doing something, taking something, imagining things, etc. We are fortunate that she isn't a sundowner. She sleeps well through the night, usually going to bed early and getting up "late" morning. Thanks for your very valid concerns. It is way too hard on my father. It kills me for 1 hour daily! -steve
Feather Forestwalker - 24 Nov 2004 02:06 GMT > I enrolled my mother in an Adult Day Care program near home and today was her > first day. My mother is physically very capable at 77, but the Alzheimer's has [quoted text clipped - 41 lines] > to Day Care? I really need this to work for both her and my father's sake. > -steve Hi, Steve,
I told my client that I was taking her to the Adult Day Care Program as a volunteer, and that worked. Once in a while she tries to leave, but if I stay there with her, she's fine. Since I was hired to help with wandering and the like (and since she lives alone with Early-Onset AD at age 57), as well as with her morning and evening medications, she's had less tendencies to wander and less tendencies to get agitated and angry.
She won't ride the bus that will come and get her, she won't let me leave but for a moment. After lunch is when she wants to leave. So we generally do. Because she is still very active, she wants to "do things," and so, we have:
I've taken her out to the stables to feed carrots to the horses (she loves horses), and have taken her out to play tennis, as well. She loves the fresh air and sunshine, which we've been fortunate to have a lot of lately.
Because this is your mom, may I suggest getting a part time caregiver to come in and go with her to the program? Sometimes that helps to minimize the agitation.
Other caregivers (both children and hired help) drop their clients (or parents) off at the day program because they (the patients) are more used to being there.
However, there's one new client, whose husband has been bringing her, who simply will *not* stick around and tries to leave frequently. She's almost deaf, too, so it makes it hard to tell her that her husband will be back at 2 PM to pick her up. She wanders around and around the room, asking for him. . .but is easily distracted. That's what we have to do in the program, is distract the clients whenever they seem as if they are becoming agitated.
I wish you the best with your mom. Time will tell with regards to the continuance of the day program. I hope you can get her to continue.
Feather
Dennis P. Harris - 24 Nov 2004 03:27 GMT > She won't ride the bus that will come and get her, she won't let me > leave but for a moment. THEN SNEAK OUT. Seriously. She needs to get used to the idea that you're not going to be there while she's there, and that she needs to get involved with the group activities.
Feather Forestwalker - 24 Nov 2004 17:09 GMT >>She won't ride the bus that will come and get her, she won't let me >>leave but for a moment. > > THEN SNEAK OUT. Seriously. She needs to get used to the idea > that you're not going to be there while she's there, and that she > needs to get involved with the group activities. LOL....tried that; she *FOUND* me.
;)
Feather
Stephen B - 24 Nov 2004 09:41 GMT >I wish you the best with your mom. Time will tell with regards to the >continuance of the day program. I hope you can get her to continue. > >Feather Thanks for your feedback. I think we'll continue with the "helping" ruse. I think she will be okay as long as they can get her more involved and active. She can't leave the facility, by the way, as all doors are alarmed and or locked. -steve
Dennis P. Harris - 24 Nov 2004 03:24 GMT > Never mind that I had > to track her down one cold day last month when she bolted in her pajamas and [quoted text clipped - 3 lines] > Sheriff's officer was on the way and the local police were already searching, I > simply lucked out in finding her first. Sounds like it's time for your father to seriously think about placement, as much as neither of them may like it. If you don't do that soon, he will either collapse from fatigue or she will escape and you *won't* be lucky enough to find her.
Stephen B - 24 Nov 2004 09:42 GMT >> Never mind that I had >> to track her down one cold day last month when she bolted in her pajamas and [quoted text clipped - 8 lines] >do that soon, he will either collapse from fatigue or she will >escape and you *won't* be lucky enough to find her. I agree completely. Thanks for the feedback, Dennis. -steve
Rose - 27 Nov 2004 15:58 GMT Hi Stephen:
I don't want to say I think medication is the answer to everything, but I would like to share with you that my mother would not tolerate day care until her doctor put her on a low dose of Zyprexa. (Low doses of anti-psychotics like Zyprexa can be helpful in keeping elderly dementia patients calm without making them more confused, which anti-anxiety drugs can do.) Since being on that she's been happier, more reasonable, easier to manage and less totally dependent on my being with her every second. I was afraid it would make her a zombie but she's been able to take part in areas of life that she couldn't before, like going to a restaurant that's a little noisy.
May I also suggest trying a couple of different day care settings? The first one my mom tried had a lot of people and was pretty hectic, which got her agitated. I found a smaller, calmer one for her. It makes use of dogs and has a nice outdoor area where the clients can walk around.
Is she on Namenda? That medication can help with symptoms of moderate to severe dementia. Thanks to this drug combined with Aricept and Zyprexa my mom is doing much better than she would have been absent these medications.
Good luck!
___ "This is an impressive crowd, the haves and the have-mores. Some call you the elites. I call you my base." -- President George W. Bush
Stephen B - 28 Nov 2004 00:53 GMT >Hi Stephen: > [quoted text clipped - 16 lines] >severe dementia. Thanks to this drug combined with Aricept and Zyprexa my mom >is doing much better than she would have been absent these medications. Thanks for the comments and suggestions. I am planning to call the doctor next week to discuss medication as she has begun to get more anxious. She is currently on Reminyl and Paxil. I think a change is in order. I'll mention Zyprexa and also ask about Aricept and Namenda. The day care is not too hectic - there are about 30 people total there. They also have some outside space to go to, but the weather now is too cold for that, unfortunately. The current plan is to call her Tuesday morning to tell her that Emily (the social worker) called me to ask for her help that day. They will specifically address her needs with some craft project to "lead" other with. The social worker also suggested that they could make it more into a job, too, as that worked for a previous client with similar behavior patterns. They would give her a "paycheck" which I would "deposit" for her. I'd rather not go that route, but at least they are trying and willing to work things out with us. -steve
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