My oldest sis, 80 yrs old, widow, no kids, has been diagnosed w/dementia. We finally took her car from her. In her career, she was a supervisor & also the oldest in my family so has always been in charge. Now that she has memory issues, family has tried to help but she feels we're controlling her & she has lost her freedom/independence. She manages her meds/finances (barely), showers/dresses herself. We visited couple ALF, which is perfect for her but procrastinate on her decision. Had a trial 2 day a week w/caregiver, she let go. Currently, attempting a p/t companionship, cross our fingers it works. I'm trying to keep sane by keeping my distance cuz I want to avoid being mean to her.
ANY other ideas would be appreciated.
It is a tough situation, because we know that all choices are lost when intervention comes as a result of an ambulance ride to the ER.
It sounds like you are in those shoes, she won't do anything different until she no longer has a choice. You have to learn to choose your battles when dealing with this. Strength to you because it is difficult to wait and see.
With clients in your sister's position, when there are questions about her ability to manage but not as yet specific issues, our service might suggest 2 x 15 minute welfare checks daily. All that happens is that we smiley workers pop in, check that all is well, document medications (if any), nutrition and fluids, general appearance of the person (for example, whether she's wearing appropriate clothing), and report back any concerns.
This is a good way to get people used to accepting support because we don't meddle and we don't attempt to force anything on them that isn't part of their accustomed routine. They have a chance to get to know us and relax when they see that we aren't there to boss them around; and at the same time we can suggest small changes, such as pill minders and minor adaptations, which help to conserve and sustain their independence.
Your sister resents interference (I hope you've found alternative transport for her now that she doesn't have a car?), so the key thing is to keep intrusion to a minimum. The part-time companion might be a good approach, I hope it turns out well, only it's best if everyone's clear about expectations.
Once you satisfy the requirement, then you "just" need to become creative in how you get her the help. You can pick an AL facility that works for both of you. You can engage the staff on strategies to move her in. I've read on this forum how others use a "therapeutic fib" about a "crisis" in the home (gas leak, infestation, black mold, broken furnace, etc) and move her "temporarily" into the AL. If your PoA is legally active, she cannot "check herself out".
You seem to be afraid of her but this must change or you won't be able to act in her "best interests" as her dementia progresses. I wish you much courage and wisdom on this journey!
If her safety and/or comfortable day to day life is suffering, then you must get an assessment of cognitive status and ADL management skills, and base your decision making on that. Look for psychiatric/ neurological/cognitive practices for geriatric clients, and tell her that she needs to see someone or she could lose her insurance, or some other benefit that could jog her into cooperation.
Very VERY RARE is the needy dependent relative who happily embraces residential placement, but often the most reluctant become the most appreciative of living in a pleasant room, enjoying 3 meals a day, taking part in pleasant activities, and socializing with others, all in an AL or MC setting.
My VERY independent LO took about 6 months before settling in quite comfortably in a very well run AL about 10 minutes from my home.
Tragically, COVID ruined all of the good things in that life, but her life ( and mi e) would have been far worse if she hadn’t been where she was.
In your thinking about her care, replace the concept of “mean” with “beneficial, supportive, and caring”, because what you are considering on her behalf are definitely not “mean”.
Mom’s PoA is durable, but psychiatrist, neurologist and social worker need to cite her incapacity. Unfortunately, she will not return to her PCP, let alone following up with the neurologist and psych who diagnosed cognitive decline a couple years ago. Mercifully, I was able to have her driver’s license pulled almost a year ago.
Prayers to you and peace for us as we go forward.
I am getting 'me' time and am more relaxed.
thanks for your prayers and advice.
This has worked for my relative (mostly). Still has whittled down the visits, but just ok.
Try interchanging the word caregiver/companion with 'personal assistant' or something along the lines. Perhaps she may be more receptive to that title since it relates to what she did in her career?
One could argue that semantics won't change a spade from a spade in her eyes, but if your family and the caregiver agree to 'buy in' to that title, it could ease her mind in her perception of losing the most important thing to her- control.
I would challenge her a bit if she comes back and wants to let go the second caregiver. Keep asking questions. Ask for 1 positive or neutral feedback item for every negative one. Keep notes on what's working and what triggers may be.
You'll start to get an idea by elimination as well as begin to identify patterns of positive and negative characteristics which more often than not an agency can accommodate. (If they say they can't accommodate personality types, that is a lie they just don't want to - look elsewhere!)
ALSO - when family negotiation isn't enough, turn to a trusted authority figure like a physician. (ONLY IF SHE HAS A GOOD RELATIONSHIP WITH THEM AND TRUSTS THEM)
With a source of authority and their recommendation, you will have someone to revert to / throw under the bus rather than yourself or other siblings.
(You won't have the be the bad guy!)
Please keep using this forum - We want to hear your success and challenges all the same. Thank you for sharing!