We are trying to keep my MIL with moderate dementia in her own house as long as possible. We monitor her on security cameras as she refuses to wear a fall alarm. It is not a good solution, but she is super stubborn and fights almost everything we do. What are we supposed to do? Staple the alarm to her? We cannot force her into a care facility. Her PCP says she should be in one.
A new problem we have encountered is meals. We had been stocking her freezer with frozen meals (Marie Calendar, etc.) and her fridge with deli items, grab and eat and things I had cooked as she hasn't cooked in the last two years. I found a freezer meal in her microwave Friday. It was still there Sunday. What is she doing with food? We can't tell what she eats and what she throws away.
I tried something new. I pulled granola and cereal bars out of their boxes and put them into a basket as she was not eating them out of the boxes. That seems to interest her more and signal FOOD. I had been leaving each food item I had prepared in a plastic container with a red lid in her fridge. Recently, those don't seem to have been opened. This week I have tried plating her food into meals on divided plates with clear covers. My husband say he observed her taking a bite or two out of each of the six meals I had plated yesterday. She lives 3 miles away and we are newly retired, so running food over two or three times a week is not an issue. How can we do better on her being able to recognize and access meals? We don't do going over for every meal. Living with us is a no go. We do have our boundaries too.
We know that some type of care facility is in her near future. We know we are only playing a delay game to make her remaining time a pleasant as possible. Her doctor is arranging a visiting nurse to help with things she won't let us do like personal care and bathing.
Stop providing meals and everything else that you’re doing. None of that is in her best interest anymore.
Do whatever it takes to get her transitioned. It may require a call to APS if no one is her PoA or legal guardian. Or, a trip to the ER where it may be possible to work with their social worker to get her directly admitted to a facility.
I’m not going to go into ideas for meals, I’m sure others will.
But here’s what I want you & hubs to pause & seriously, SERIOUSLY, think about: what if there is a fire? Do you really want her putting something in the micro and setting the dial on till forever and having a fire happen? Do you actually want her reheating food on the stove? Even if she has an induction cooktop, there still is burn risk. Do you think she has the ability to tell if a food is safe to eat? I’d be really concerned about this, especially in the current heat wave across the US. The way you describe her, she does is not seem competent or cognitive enough to safely be able to live on her own and be able to judge if something is an issue or an emergency.
Did her MD tell you she needed a skilled nursing facility aka a NH or did he/she leave it more open ended? If so, please have her get a needs assessment done. It’s usually Where a duet of RN and SW come to her home to talk with her and observe her to see what her abilities are so that they can recommend what level of care she needs. You don’t want to be wasting time and energy looking at AL or MC when it’s a NH that she most definitely needs to be in.
Sometimes IL or AL type of facilities will do “play dates” rather than a required outside assessment. My moms did: we went for a tour and lunch, they had her eat at the residents table and then she went off to participate in a regularly scheduled residents activity (maybe arts & crafts, or gardening) that’s interactive. All done to see if she “fit” in for ADL & social level somewhat expected. Mom even tho in her 90’s was good for IL. FWIW the IL had regular fire drills and if a resident could not do them (the big fail was waiting for elevators), the resident got a 30 day notice they needed to move to higher level of care. Fortunately my mom aced the fire drills, her final straw to go from IL to NH were wandering hallways at night and imaginary animals.
I’d also be really concerned about MiLs dehydration. If she doesn’t understand eating, I bet she’s not drinking enough fresh water. If she gets confused and goes outside in current heat wave, it’s really a health concern if not a crisis for folks. One advantage should this happen, is that she will be taken via EMS to the ER/ED and it is a way to get her out of her home permanently so instead of returning her back to her home she goes into a facility. Just sayin’….
Her PCP ordered home health care. He feels it will be better for an incident to move her from the ER to a facility.
We are aware that there are risks to leaving her in her home.
I can't even get to her a beauty shop. I don't know how I can get her to look at AL.
We tried to get her to agree to look at AL two years ago. She adamantly refused.
We think she would prefer to die in a house fire, awful as that sounds. She insists she will not leave home, that she wants to die there.
The kicker: she was once a discharge planning nurse. She put people into NH.
You say in your post you can not "force her into a care facility"
Why not?
Is your husband POA? If not who is? The POA is the one that makes the decision that can place her in Memory Care or not. Particularly since her PCP states that she should be in Memory Care.
Actually if anything happens to her while she is living alone there is the very slight possibility that APS may be contacted as it might be considered "neglect".
Unless you or someone else is going to be there with her for meals there is no way that you can be assured that she is going to eat.
That is the least of the potential problems.
What if she goes to get the mail...and decides to take a walk...and gets lost.
What if she leaves the water running ... how soon would it be before you discovered the flood?
Is it possible that she could leave the stove on or have you disabled it?
I would be very uncomfortable allowing her to continue to live alone.
We do have POA and healthcare POA.
As far as wandering, she is unable to walk very far because of arthritis. So that keeps her home.
She could leave the stove on. We do have cameras that monitor the kitchen. I have not caught her using the stove. She uses mostly the microwave.
I do not know why people keep saying it is unpleasant, my mother has made new friends her own age, bus trips, activities. Being alone, eating alone is not the answer.
Take a good long look from the outside, this is not about what your needs are, what you want to do....it is about what is best for her, it is always better to do this before it becomes an absolute necessity, they adjust much better.
Might be time to reframe your thinking.