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How do you convince someone to go into assisted living if they don't want to go? My grandmother hasn't been officially diagnosed with Alzheimer's, but everyone, including the doctor, agrees she has dementia. The doctor wanted to refer her to the senior behavioral psychiatric evaluation center, but she won't go. The doctor strongly encouraged her to go to assisted living, but she refuses. My parents are at their wits end. She is making my mom physically sick because of stress. My grandmother is verbally abusive to them and makes the most outrageous accusations against people. My father gets frustrated and won't have anything to do with her for days at a time. My parents can't get any help from anyone else in the family. I live 45 minutes away and do what I can, but she has another son who lives 10 minutes away. He won't do anything for her unless her checkbook is wide open. My grandmother has recently started experiencing memory loss. She hallucinates and gets confused easily. The doctor said she is malnourished. She won't eat. If we take her a meal, she accuses us of trying to poison her. We tried to get her set up on mobile meals but they said she doesn't qualify. She won't cook for herself mainly because of her arthiritis, but also because she has no appetite and she's afraid the squirrel will "jump out and bite her" if she goes into the kitchen. She believes the squirrel got into her refrigerator and urinated in her milk. She didn't know and drank and the milk, and she thinks that is the reason her stomach has been cramping. This squirrel has been living in her house for two years. It steals her food. We have had numerous extermination and pest control companies out and no one can find anything. Animal control didn't find anything. People come into her house while she's gone and move the furniture around. People steal pictures off the wall. If she misplaces something, someone surely stole it. Then, if she finds it a couple of days later, someone in the family deliberately hid it to piss her off. If she goes anywhere, she tries to stuff everything she owns in her purse because she's afraid it will get stolen. She made my mom carry her teeth! I'm afraid for my grandmother living by herself. She wants to move in with my parents, but they refuse, and I can't blame them.
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I KNEW there was something I forgot here! AK you have got to tell dad he cant do that! OMG my poor MIL goes through this and lemme tell you scared aint exactly what Id label her in these moments its more like terrified  I have never seen anyone be so genuinely terrified in my life but the first time was a wake up call for me and yelling is the very LAST thing I would have done. I take her directly near whatever it is she is hallucinating over (I have no idea how to explain this any other way) but to give you the back story... APS came to my home on a report of abuse (supposedly I was beating my 83 year old MIL! Im still thinking of devious ways to pay back the idiot who called that false claim in  ) Anyhow because of that visit she went into a tailspin and started down that horrid path...she thought there were holes in the walls with eyes in them watching her (not even my husband could coax her out of her safety zone...could be cause he was pretty much reacting in a manner quite like your dad) I had to physically go over all the walls in the upstairs running my hands over them to calm her down while speaking to her in a calm manner. Just because we dont see it doesnt mean its not real to them  Its the same thing with auditory hallucinations...we dont hear it but they sure as heck do. Heres a little exercise to play with dad next time he has a moment like this... Does he believe in God or Jesus? Well, hes not visible to anyone yet you believe hes real.... same thing. ********************************************** Well, butter my butt and call me a biscuit. |
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What is the brother's problem? SOMEONE should always have DPOA for situations precisely like this!! What bothers me is how much their mother is SUFFERING while they are all playing ostrich!!
Managing people who have delusions & hallucinations is not easy. It's always best to orient the person whenever possible, but in your gramma's case, she isn't buying, so why try to force her to accept what she cannot comprehend as reality? It's a losing proposition to try and convince someone that what they see is not real, especially when they see it over and over and over... Yelling at her is simply cruel. While I understand the frustration he feels, he is taking it out on a person who cannot help their behavior! Just because she has periods of seeming lucidity does NOT mean she is, in any way shape nor form, competent to care for herself! As for her "squirrel bites," she may simply be bumping into things... The skin of elderly folks becomes very thin and easy to tear & bruise. Could these be insect bites of some kind that she is scratching? Fleas, mites, bedbugs, etc. all can cause irritating bites that people can scratch into terrible looking wounds... With MRSA infections so rampant these days, those "bites" present more than a casual issue with her. Keep trying to get through to her children, dear. Sometimes we can be awful stubborn and slow on the uptake when we should be listening to the wisdom of a fresher set of eyes and point of view. "She ain't heavy; she's my mother." Mom got her wings 11/18/2008 |
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Ok, now go with that thought for a moment hun. SOMETIMES she is lucid....what about the other part of the time she is not? Do you see where Im going with this train of thought? Ok now relay this to your mom and dad. Sometimes we have to find a way to explain a situation in a manner that makes a person really think outside their comfort zone for them to "get it" Sometimes its a word sometimes its a phrase sometimes its a stranger that finally says that "perfect" word or phrase for them to finally get it. People that suffer from this disease can be oriented at times but its the other 95% of the time that causes the trouble and undoes all the progress one thinks they have made. If you crack a vase sure you can glue it back together, turn it a little so the fracture doesnt show, but the crack is always there. It never goes away. ********************************************** Well, butter my butt and call me a biscuit. |
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I had a long talk with my mom lastnight. Your advice has been very elightening for me, especially the part about how my grandmother can no longer be held accountable for her behavior, and when you said my parents cannot continue trying to reason with her. I explained to my mom that she and my dad are expecting too much from my grandmother. They haven't grasped three things yet: They think my grandmother can still be held accountable for her actions because she's lucid at certain moments. They don't understand the role of parent and child has to be reversed. They are trying to reason with her as though she were a normal person. My mom says my dad's brother won't let them get power of attorney. I told her if the doctor wants to take this far enough I don't know that he could stop them. I told my mom they could probably "invent" a reason for my grandmother to go in the hospital to have some tests done for Alzheimer's. She will never agree to be evaluated by the psychiatrist at the senior behavioral center. My father hasn't had a personal appointment with my grandma's doctor, but he called her and they were e-mailing back and forth for a while. Now, he's so fed up he doesn't want to do anything. My parents are sticking their heads in the sand and have temporarily given up. The hateful message my grandmother left on the answering machine yesterday was the straw that broke the camel's back. My mom retired a few months ago, but now, she's considering going back to work so she will have an excuse not to take care of my grandmother! I hadn't considered the self-injury idea. You mentioned the bruises she thinks are squirrel bites could be something she's doing to herself. I don't know. Any food that doesn't have to be refrigerated is kept in the microwave because if she leaves anything out, the squirrel will eat it. There is now a padlock on her microwave! The registers and vents are covered with aluminum foil because that must be where the squirrel gets in. A paper bag is wrapped around the kitchen faucet with tape because the squirrel also comes up through the faucet. She washes dishes in the bathroom! The squirrel also clears out the caller ID because it doesn't want her to know when people called her. The professional decorators are still coming every night to move the furniture around while she's asleep. She says they've got no right to do that in her house. I go along with it and tell her maybe they're trying to arrange the furniture so that she doesn't fall. My parents don't play into it. I've read you're supposed to go along with their delusions and hallucinations because you'll never be able to convince them it's not real. My dad gets angry and tells her none of it's real. He told her she was sick in the head, and she told him he was sick in the head, too. He tried to explain to her what Alzheimer's is, and she said he's the one who has Alzheimer's. |
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Oh geeze AK Ditto to what MB just stated what is wrong with this doc that she has to speak about cognitive decline IN FRONT of your grandmother?!
Goes to show you how much the medical community at large knows about AD...absolutely nothing past "lets medicate them with Aricept"...yeah that'll work  I guess its true what they say "ignorance is bliss" In one respect I can understand your parents behavior with your gran this disease is frustrating on a good day nevermind a bad one but they need to be educated on how to effectively deal with her on a level she can understand because she just can not process information in a rational manner anymore. Being embarrassed by a person who is cognitively challenged proves there is little understanding about this disease. If aunt wants an active roll with her mom then tell her if shes embarrassed there are "business cards" she can have made up that do the explaining for her "My loved one has AD please be patient with her" Please refer one or both of your parents here because I highly doubt anyone around them including grans PCP can give advice on how to deal with this disease properly. As to why gran hoards her things when she leaves her home sweetie, this is a common behavior for sufferers of AD. Her squirrel bites that might be something like what my MIL does, its self harm tendencies which if Im getting a good glimpse into your grans behaviors by what your saying here she most likely has Psychosis brought on by AD or maybe she was a long time sufferer and now that AD is a factor the psychosis is exacerbated to an even higher degree . This is one of the main problems with my MIL who benefited by a drug regiment greatly but let me also say this was NOT an easy task as many here can testify to. Honey if you think your parents are frustrated now you shoulda seen me! But with the help of these same people here Im sane today because of them ********************************************** Well, butter my butt and call me a biscuit. |
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AK, what I am hearing here is that your parents have not caught on to the fact that you cannot relate to people with cognitive disorders the same way you did when they were 39! THey are still relating to her in a parent/child fashion and that ain't gonna cut the mustard. The doc is EXPLAINING instead of making statements ("I am ordering home health for you;" "You must hire an aide to help you"). Discussing her cognitive issues with her is not realistic. That's like asking the inmates of the asylum how to run things! Society bends over backwards to preserve patient choice, but we have to be realistic about how *competent* folks are to make choices! Framing questions for her to choose between two or three things, any of which will be acceptable is one technique. "Mom, would you like for our friend to help you or would you rather hire an aide through an agency?"
The problem lies as much with your parents as it does with your grandmother. Your gramma cannot help her behavior - her brain is impaired. Your parents are choosing not to make changes in how they are relating to her! This is one of those mountain & Mohammed situations - the mountain ain't gonna come to Mohammed, so Mohammed must go to the mountain. Until your parents accept that THEY have to change their behavior and their approach toward Gramma, everything will remain the same until a crisis forces everyone's hands. No change means no change. Discussing with Gramma her residential situation, bizarre habits, delusions, etc. is futile! The doc may be taking the "normal" approach because she is documenting your Gramma's functional inability to care for herself, but your parents are expecting behavior from her that she cannot deliver on!! I hope that your parents, aunt, etc. will speak to a social worker who is knowledgeable in eldercare affairs. The doctor should be able to refer them to someone. They need some education about elderly people with cognitive disabilities so that they can make good decisions about how to best approach your gramma's care. Making an appointment with Gramma's doc for discussion of your Gramma's condition without her presence is the best action, especially since the doc just got a good demonstration of how "out there" Gramma's brain has become. Please feel free to invite your parents to ECO! Many of us here have "walked the walk" they are on with your Gramma and can offer suggestions to them based on the circumstances of their situation, but if they aren't "computer savvy," hopefully we can arm you with suggestions for them!  "She ain't heavy; she's my mother." Mom got her wings 11/18/2008 |
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My parents are so fed up that they have decided to stick their heads in the sand and do nothing for a while. They offered to pay a trusted friend of my grandmother to be her live-in caregiver. She refused. My dad called her up and said it's the smartest decision she ever made in her life. He's so mean sometimes! Yesterday my aunt took my grandma to the doctor for a flu shot and to discuss a few of her strange behaviors. My grandmother showed the doctor "squirrel bites" on her arms. The doctor said those were bruises. No one knows how they got there. She told the doctor the squirrel must be male because it bites her "you know where" while she's asleep at night. The doctor once again said she wanted to refer her to be evaluated at the senior behavioral psychiatric center. My grandmother again refused. The doctor brought up assisted living again, and my grandmother said she's not going because she won't be able to take her furniture and most of her belongs, and she's not leaving her good furniture behind for the squirrel to eat up and people to steal. My aunt brought up how my grandma calls everyone constantly, leaving nasty, hateful messages on people's answering machines. She gets bored and calls us to tell us it's raining. The doctor told her it was unncessary to call people all day long about trivial matters. My grandma said, "Well, fine, I just won't call anybody anymore, and you all can wonder if I'm dead or alive!" She couldn't get a flu shot because they were out of them. After her appointment was over my aunt and grandma went to the front desk to make an appointment for her to get a flu shot. The receptionist said they weren't taking appointments for flu shots because they aren't sure when the vaccines are going to arrive. My grandmother got upset and asked if she would be able to get a flu shot. The receptionist told her that because she's a high-risk patient, her name should be on the list, and that they would call her when the vaccines come in. My grandmother yelled, "Well, am I on the list or not?" The receptionist tried to explain to her again that because she's in a high-risk group that her name should be on the list. Then, my grandmother and aunt went to the mall. My grandmother stuffs everything into her purse because she's afraid it will get stolen if she leaves it at the house. When she was paying for something, it took her forever to find her wallet. She apologized to the cashier and said she couldn't find her wallet because she has to take everything with her because her grandson has been breaking into her house. Why did the cashier need to know that? If I had a grandson, I would be embarrased to death to tell someone I dont' even know that he breaks into my house! |
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Ah.....Ok that'll do a crown...now Iv always been wantin one of those things for my head...might even do my hair up just so....but I gotta die ta get it?!.....Eh somethin ta look forward to I guess   I guess Ill hang onto mine then ********************************************** Well, butter my butt and call me a biscuit. |
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I think we wear it into heaven to identify us as an elite group, and exchange it for a crown. |
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Uh Torp WTH do we do with the nauseating color tshirt is what I wanna know I tried to give it to Salvation army but they refused it too ********************************************** Well, butter my butt and call me a biscuit. |
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Hee hee go figure we start talkin about MOW's and I just saw the billing today for the first time its $55 for the month and its based on income of the person so there you go I learned something new today yippee for me **chuckle**
You know hun even if gran is going to be mad at your mom and dad or that money grubbin uncle of yours is gonna be mad (in the grand scheme of things does it really matter if he gets mad anyhow? Naaaa) Honestly shes not going to remember it anyhow this is a short term problem for a long term situation so my advice is to get the atty or go the route Torp suggests and have a SW go and visit gran to make a recommendation and if shes really "allergic" to all meds then they need to know this since it causes a greater problem with controlling behaviors in the long term ********************************************** Well, butter my butt and call me a biscuit. |
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Wow. I sure understand. But it's a lot like having teenaged kids in that sometimes you have to do what is in their best interest and let them be angry with you for a while. And it does sound a bit like, at least at the moment, grandma may need more support than typically available in assisted living. BUT with proper treatment and medication, she may be stabilized enough to qualify for the less restrictive assisted living later. My MIL had to spend some time in the nursing home, but improved enough to graduate to assisted living for about a year or so. In fact, knowing that the possibility was there made her cooperate much better with the therapy and medical treatment. She wanted to get OUT of the nursing area so worked hard! I'm so very sorry. I know hard hard this all is. Most of us have been there, done that, gotten the t-shirt and hated the color. An attorney may be a good place to start. Or you might look into finding an elder social worker. Where I live, there are United Way nonprofits who can send a social worker out to evaluate grandma and made suggestions about available services. |
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Crazy. I've driven a MOW route, and we had quite a number of clients who lived in really big, nice houses. Some of them don't qualify for the free meals, but the service didn't cost much. As I recall, at the time it was about $2.50 a day. Some voluntarily gave even more and took the excess as a charitable contribution on their taxes. The delivery itself was free. I was a volunteer and used my own automobile and gasoline.
It wasn't only about getting them fed, but having someone physically check in on them every day. I once found one of my regulars on the floor of his bedroom where he'd fallen and laid all night. He couldn't reach the phone. But I heard him calling when I knocked, peeked in the window and saw him, and called 911. I had lots of stories like that. One lady never could remember how to operate her can opener, so when I delivered her meal I always fed her cat too. LOL |
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In our area, mobile meals is only for low-income people. I thought it was for both the needy and elderly. Even after the doctor's office called them, they won't accept her. So, we've started looking into other options. I know a lot of the hallucinations, verbal abuse, and accusations would go away if she could be medicated. But, she is allergic to every medication known to mankind. Thanks for your advice. My parents are seriously considering talking to an attorney. They just aren't sure they can bring themselves to do it. They're afraid my grandmother would never forgive them. My dad's brother is against it because if she goes into a nursing home or assisted living, he knows he will never get another dime out of her. He refuses to help her or have anything to do with her unless her checkbook is wide open. I didn't think my grandma was bad enough to go into a nursing home, but I've been doing some more research, and I think she might be beyond needing assisted living. |
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WHAT?! Seriously? What does she have to do to qualify there??? Im serious, I have patients on MOW who ambulate are alert/variable, can cook for themselves but choose not to so Id be asking these folks what bug crawled up their butt that they would refuse a person with Dementia who could most likely start a fire if they tried to cook a meal Sorry that just fries me Anyhow welcome in AK glad to have you MB is absolutely right ALF's wouldnt take her how she is now so take the advice given about getting her into a hospital by telling her its a routine test. I went through much the same with my MIL, I never told her what she would go in for I would always say its a routine checkup nothing more and I NEVER let a doctor talk in front of her EVER thats just cruel so make sure nothing about her "condition" is ever said while she is in the room. I feel for your mom and dad hun but they need to not take anything she says seriously this is a person who is no longer in control of her faculties...she can not be held accountable for her "behavior" any longer. Tell mom and dad when she gets bad they need to walk out of the room and let her settle down Id be asking her PCP if Ativan (AKA Lorazepam) is a good med for her if its this bad. Please ask, if its not there are alternatives. Again welcome in and tell Mom to give us a looksee hun theres a lot of good info here she could implement into her cg routine with mom ********************************************** Well, butter my butt and call me a biscuit. |
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I'm so sorry. Sadly, what you are going through isn't that uncommon.
Mom's Buddy has given some good advice. You might ask her doctor what he thinks about getting APS involved because what he tells them will have an impact on what they decide. Does he think grandma is bad enough that a judge might give someone guardianship? Unfortunately, sometimes you have to wait until there is an incident (a fall or some other medical emergency), then get things done while they are in the hospital. |
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Senior Member |
Welcome, AK. Glad you found your way here. First, does anyone have your grandmother's DPOA? To make decisions for her, a health care proxy or DPOA is needed.
Your mom and the doctor COULD do some conniving to get her into the hospital overnight for something OTHER than a psych test - most older folks will go for bloodwork, X-rays, CT scans, ANYTHING but a psychiatric evaluation because that just doesn't compute for them!! They are from a generation that doesn't believe in psychiatry, first; secondly, they are already worried in their own private thoughts that they may be "losing it." Once she is in-hospital, it would be easier to evaluate her and document her behavior so that there would be documented reasons to slide her into the behavioral unit for more testing and evaluation. The doctor might be able to prescribe some meds for her that will help soothe her long enough to get her to agree to an evaluation. Please understand that with the paranoia and delusions she is experiencing that she may not qualify for many assisted living places because those are mainly for people who simply need assistance but who are not struggling with cognitive or behavioral problems. Sometimes people respond better to authority figures than they do their family or friends. The doctor MIGHT be an ally here if he/she will tell her that she simply has to have assistance because she is not able to take good enough care of herself because of her arthritis and "nerves," not to mention that she needs someone there with her all the time so they can catch that danged squirrel!! If push comes to shove, your parents may have to get Adult Protection Services involved if they can demonstrate that your gramma is a danger to herself or to others. Often, they can get folks to do things that family cannot... Do be sure to document, document, document and check on her frequently. Sooner or later, she will have to allow herself to be helped or the Adult Protection folks will see that she does. Worst case scenario, especially if none of her children has her DPOA or Health Care Proxy (which could be invoked if doctors sign a certification that she cannot care for herself properly), is that your parents will have to go to court to gain legal custody of her. Depending on what state you live in and how strictly folks enforce her personal rights, it could be relatively painless or it could be very difficult... Good luck! Please update us when you have time! "She ain't heavy; she's my mother." Mom got her wings 11/18/2008 |
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