Dementia, Care Giving, Elderly Parent, and When More Is Too Much

March 15, 2012

in BLOGS,General

 
Healthy care giving for an elderly parent with dementia is now a common occurrence as our parents are living longer.  The challenge of needing to take over the health care of an aging, elderly parent is a huge responsibility we are honored to fulfill.  However we do have to learn when more is too much?
 
Mom Moon has been in a long term health care facility for over 3 ½ years since falling and breaking her hip. When she entered the health care facility for rehab and to learn to walk again, we were determined she would be able to come home and once again be able to walk with her blue “Cadillac” walker.
 
Dementia, at the various levels, is one of the most difficult symptoms of care giving to come to grip with for the elderly parent.  The good part of Mom Moon’s dementia was that she could not remember all the pain of breaking her hip, 2 bouts of pneumonia, and a very serious C-def infection. The bad part about the dementia was that she could not remember to set goals to learn to walk again. The challenge for us was finally accepting the fact that the dementia would not allow her to remember to work toward walking again. We learned that more physical therapy was good as far as exercise and flexibility.   However we had to accept the fact that more therapy was too much and that she was not going to be able to walk safely again even with her blue “Cadillac” walker.
 
The first 3 to 4 months Mom was at the nursing home we visited every day in order to oversee her care, encourage her, and learn the ins and outs of a long term care facility. As we became accustomed to the staff and they became accustomed to Mom and us, we learned to be more comfortable with not seeing her each and every day. The 16 mile one-way mountain road drive every day soon became too costly and too much for us. After all when you have a 96 year old mother who was married at age 17, you are not youngsters!
 
The idea came to us that we should purchase Mom a simple cell phone on our Family Plan so we could at least talk to her every day. So we soon showed up at the nursing home with her new cell phone resolved to teach a 92 year old woman with dementia to use a cell phone. We were told we would more than likely not teach her to use it but we were determined. Every time we visited, we practiced as well as calling every day we didn’t visit. Soon we were able to teach Mom to open the phone and say “Hi.” Then after talking, say “Bye” and close it. This was a time that more effort on our part was not too much because even with her dementia we could still have great conversations. It has been wonderful over the past 3 ½ years to be able to talk to Mom almost every day and to be a part of her daily care giving.
 
 
We are so thankful for the staff of the nursing care facility who are all familiar with Mom’s little purple cell phone. They have been very helpful and have cared enough to go beyond their call of duty to keep the phone charged and turned on. They have taken the responsibility of reminding Mom to wear the colorful strap around her neck with the purple cell phone attached so she would be ready for phone calls from family.
 
Monitoring medications is a huge deal when you have a loved one in a health care facility. Prior to Mom breaking her hip she took supplements of the best quality and up until about 2 years prior was on no prescription drugs and that was only blood pressure medicine and a medicine for nerve pain in her legs. This is almost unheard of for someone age 90 and over.
 
Nursing homes and care facilities have their own unique set of rules regarding medications (prescription and over-the-counter) including supplements. Everything has to be approved by the facility doctor and go through the facility pharmacy. Nothing else is allowed. This was very disappointing to us because that meant Mom would have to go off her best quality supplements as they were not allowed.
 
Fast forward 3 years!
 
It seemed Mom was failing as she was becoming more confused and even agitated as well as sleeping a lot because she felt tired all the time. The facility staff approached us about the need to move her into the ‘memory care secured unit’ because she was being aggressive about trying to leave the building and she needed more individualized care. We reluctantly agreed to move her because it would be moving her from a familiar room to an unfamiliar room yet she needed to be in a safe environment. Also, we were told she would be receiving more help with daily activities.
 
The move seemed to agitate Mom more. It got to the point that we were suspecting she might have had a stroke as she was having difficulty speaking. She couldn’t get out what she wanted to say and when she did her speech was slurred.
 
One night Mom was trying to get the attention of the CNA as she was feeling strange. They took her vitals and found her oxygen level was quite low. Immediately she was put on oxygen which brought her oxygen level up right away and soon stabilized. She did not want to go to ER so the ambulance left without her. We were not told about this incident until we visited Mom the next day! This was a time when more communication with family would have been better!
 
We followed up by double checking what medicines they had given her and what she was on routinely. They had given her an anti-anxiety med when her oxygen level dropped as she seemed very anxious. To our dismay, we found that we had not been notified of the anti-depressant medication prescribed by the facility psychiatrist over 2 months prior.  Then about 2 weeks prior to the drop in oxygen level, that anti-depressant medication had been doubled!  In the follow up, we were told there was a standing order for anti-anxiety medicine to be used only as needed. This met with our approval as we are aware of the seriousness of a real anxiety attack. Again this is when more family communication would have been better!
 
Things started to make sense to us. The timing of the addition of the anti-depressant medicine correlated with when Mom was more confused, agitated, and tired especially when it was doubled! We also found that the standing order for the anti-anxiety med as needed was being given to her when she became agitated. More medicine was too much!
 
As we discussed this with the Director of Nursing, she agreed with us that the anti-depressant was causing more confusion, agitation, tiredness, and could have even been what caused the oxygen drop. We told the DOM to decrease the dosage back to the original amount and we knew what Mom really needed was to get her off the anti-depressant completely. The DOM checked with Mom's doctor and he agreed with our assessment.
 
Yes, this was definitely a case of more being too much! This sweet 96 year old lady was being drugged to the point of not being able to think or express herself at all. It made her irritable, agitated, and very tired. As soon as the anti-depressant was cut in half we noticed a definite improvement in Mom’s speech and confusion level.  She is now totally off both the anti-depressant and anti-anxiety medicines.  What a difference in her quality of life!
 
More medicine was too much!
 
Yes, healthy care giving for an elderly parent with dementia is a common problem as our parents are living longer.  It is an honor and a challenge to take over their care while allowing them to keep their dignity as individuals. 
 
There is much we get to learn as we travel this path of learning when more is too much when involved with the care of our loved ones.
 
Watch for the continuation of Mom's story of when more is too much!  Coming soon!
 

 
 
Pat Moon
 

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Pat is a Health and Nutrition Coach.  She helps people make healthy lifestyle and nutrition choices.


Pat has been married to the same man for over 50 years, is the mother of 3 adult children, and grandma to 7 grandchildren.  Growing up in the country gave her a head start to living a healthy lifestyle.  This grandma became interested in nutrition, health, and fitness as a mother and the past 26 plus years she has specialized in teaching others the importance of good nutrition.  Challenges along the road have been many; her father overcoming congestive heart failure with nutrition, her husband's battle with GERD and avoiding a major heart attack, her daughter's battle with a brain tumor, her grandson beating Hodgkin's Lymphoma, and others.  Her goal is to help others have the BEST REAL HEALTH possible and slow the aging process.  The products Pat personally uses are featured at www.bestrealhealth.gnld.net.

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{ 4 comments… read them below or add one }

1 Pat March 21, 2012 at 3:56 am

Pat, thanks for sharing this story about your mother in law. The story about the medication is so disturbing and I am sure not an isolated one. How fortunate that you can check up on her care and that you figured this out.

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2 Pat Moon March 24, 2012 at 10:07 am

Hi Michele,
Yes, we were glad we finally found out what was happening with the medication. I am sure it is a very common problem in nursing homes – so sad. It is very important for family to stay on top of all care – I cannot express that enough. Thanks for your input.

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3 MarVeena March 16, 2012 at 10:03 am

Excellent article! We all need to be planning for this. My sweet grandmother lived to be 100 and died in her own bed at home. She was pretty healthy to the end , it was a challenge to take care of her but also brought rewards in it's own way.

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4 Pat Moon March 20, 2012 at 8:55 am

Thanks for sharing about your grandmother, MarVeena. We have been so blessed to still have both our mothers with us. They offer so many treasures as we pray for strength and wisdom in making the best care giving decisions with and for them. Thanks again for sharing.

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