My ninety year old mother has recently moved to assisted living in our community. She has insisted on living in her own home since she started with memory and thinking issues (about 10 year ago). For the last 6 years, I have been retired and majorly in charge of her life and home and cat. I have employed part time caregiver help the last 3 years. She has gotten worse in spite of all help. I also feel she is depressed. We tried meds and she can't tolerate them. Two months ago she suggested going to a local AL because her good friend was moving there. I jumped on the opportunity and pushed forward with plans. Within 3 days she forgot she initiated it and starting saying I was putting her there. Still I persevered. She moved in and even though her friend was there for her, she became enraged with her situation. Never acting out to the staff but saying to her friends that I wanted her money and her home, calling my lawyer to change her will and making every person in our small family cringe. I employed a geriatric manager to help me and to evaluate her. He confirmed her drs diagnosis and started making care suggestions. She continued to escalate, won't participate in activities, call my daughters demanding visits, calls her friends insisting that they visit. She has walked to her home (short walk) and smashed out a window to gain access to her sunroom and is generally out of control. I can't not be in her presence because she gets in a rage saying I ruined her life and she wishes me dead. I am horrified and she keeps making vague suicide threats to the staff of the AL. She insists that I hire staff around the clock and keep her in her home. Reasons I don't think its a good idea are lack of in home caregivers in my area, it would use up her money too fast ( my FIL is 98) and last but not least, in home health care is unreliable and would demand my daily involvement and I can't do it any longer. I am 66 and have been caregiving for my various family members for 13 years. What feedback can you give me for my decisions? I see many examples on the site of people who are giving up their whole lives for a family member, but I can't do it. I am thoroughy burned out. I can't give everything to my mother and have nothing left for my husband, children and grandchildren or me..
My mom was paranoid and could be physical when she was upset to start with pre-dementia, but once she moved into the moderately severe stage, the paranoia and combativeness was through the roof. Everyone was an imposter, out to kill her, take all her money (ha ha ha), especially me - her only child and the only human on this planet with any interest in her wellbeing.
Seroquel worked OK for a while, but she had a couple suicidal threat incidents, a blackout, and an epic psychotic break for the record books, and a few catatonic episodes that scared the staff pretty well. She ended up in a geriatric psych unit for 5 days, and came out to a super secure memory care unit where she can't get outside. And a much calmer experience on Risperidone.
This is not to say mom is sedated, because she is not. She can still hurt nurses who are trying to do her cares, and she does fight them from time to time. It's a fine line between chemical restraint and being able to do the cares without injury to anybody. Mom's dosages is on that fine edge, so we just punt and pray. The facility always goes with the lowest dosage possible and the state health department audits this very frequently.
Nobody wants to go into long term care. Nobody wants to put someone in long term care, but we have to live in the real world where none of us are super hero. A lot of us have life obligations to deal with, like paying bills, keeping our jobs, clothing and feeding our family. That stuff doesn't dry up & blow away because mom needs care.
A lot of the time, the elder will accept care better from people who are not family. People who look like medical authorities because they are in doctor & nurse's clothes, while we are not.
I can't physically handle my mother. There's that consideration. Who provides care if I put my back out trying to shift her? I already have a permanently messed up shoulder from mover her and her stuff before.
Being in a care facility means the loved one is in a place purpose built to handle literally anything that can happen. My house is not that place. Neither was mom's house.
Sometimes there are very strong advantages to going into care outside the home. You will discover people who are resolutely in one camp or another - home care vs. center care. It was the same debate when my kids were little - home care vs. daycare. Each family has to figure out what the right answer is for them, look at the pros & cons, and come up with a workable solution. Then plan ahead for changes!
Your mother is so obsessed and determined to go home. It does seem that doctors could find some medication that will help dampen the obsession. If that one thing could be eased, then she might be able to enter her new life more peacefully. She might even enjoy it. I would encourage her doctor to work with a geriatric psychiatrist to see if they can find something that helps. I suspect your mother is afraid of her new surroundings and it is triggering the rage and desire to go back to where she feels safe. If she could feel safe at the AL, it would be ideal.