She was able to live alone for about a year until, with her agreement, we moved her into assisted living. That was 2 1/2 years ago. In that time her short term loss has accelerated, now to the point that she cannot keep track of what we're talking about during a normal conversation. She's seen doctors on a regular basis since her stroke, never been diagnosed with alzheimer's but was on Aricept a couple of times (but the side effects weren't worth the supposed benefits.) I see her 2 - 3 times a week, and she always asks how my kids are doing, where are they, are they out of school (they both graduated from college years ago and moved out of state), what's new in my life, etc. etc. I know this is not uncommon in the elderly. But not long ago, she asked where her husband (my father) was, and I reminded her that he passed 17 years ago. She said, "Oh that's why he hasn't been around." The other day she said, "I know this will sound like a dumb question, but is my mother still alive?" So I reminded her when her mom passed, how old she was, and so on. But it's the lack of short-term memory that's so frustrating, for her and those around her. Again, I suppose this is not unusual, but during a typical hour-long visit, she might ask 10 - 15 times, When is Christmas? What are the plans? Do I need to do or bring anything? (as if.) And then ask randomly, again 10 -15 times, So what day is today? And what is the month? October? September? Oh, December? Have we had Christmas yet? What are the plans? Then again, What are your kids doing? Where they now? What's going on in your life? Sometimes I take the time to give her complete answers about my kids, their college years, current occupations and cities they live in. Other times I just breeze through short answers. She is unwilling or unable to do anything, like go to exercise class, try to read, etc. She picks up the TV remote when trying to answer the phone, randomly looks at a calendar/notebook/daily schedule that my sibs and I fill out for her, looking for information about -- for example -- what year her mother died. On that one, I had to say, "Mom, I don't think that notebook is going to say anything about when your mom died." She's mobile with a walker, but has a difficult time getting out of a chair (over weight, but who isn't?). She's getting assistance with dressing, showering, etc. She has not gone through any personality changes or mood swings. She still knows the names of her 6 kids and recognizes me when I arrive. She's able to laugh at her forgetfulness, or the lack of logic in her asking if her mother is still alive -- when you take the time to do some math with her (her mother would be like 140!) But again, it's the short term memory problem that's so frustrating. We've all accepted that she is incapable of forming new memories (and starting to lose some old ones; however, she can recite poems she learned in grade school). I try to just focus on the moment and enjoy the time together. But I find myself rambling on, trying to keep her mind engaged, see if anything I say will fill in some gaps or trigger any recollections of her own. Or I'll Google something we've been talking about or saw on TV and simply read from the search result. Add to both our knowledge base! I've to her read from old journals she kept, old letters to and from her sister that my aunt saved, my Dad's old WWII POW "memoirs" that I typed from pages of scribbled notes, watched re-runs of Ed Sullivan (Hey Mom, that's Jim Nabors. You remember him, right? No.) But whatever I do or whatever we talk about, she will have completely forgotten about it maybe 5 - 10 minutes later. I don't get angry, of course. It just all seems so pointless. I guess I have two questions. First, in the absence of things like personality changes or irrational mood swings, could this very severe and accelerating short term memory loss indicate alzheimer's? Second, is there anything I can do to make these visits more enjoyable, or maybe...I don't know...more meaningful? Any words of wisdom?
Your mom sounds lovely. I say that because you mentioned she was in an ALF. So she agreed to move without months and months of trauma and drama. Good for her and for you!
I know the forgetfulness is frustrating for you as it would be for most folks. It's difficult not to get impatient having to repeat yourself constantly. I agree that it doesn't sound like Alzheimer's. Alzheimer's is more insidious and life-shattering. Like mental illness on steroids. However it does sound like more than just mild cognitive decline (MCI). If a diagnosis is important to you take your mom to a geriatric psychiatrist or neurologist.
As for making your visits more enjoyable or meaningful, they ARE enjoyable and meaningful for your mom. True, she forgets what was said 5 minutes later but in the moment she's inquiring about your kids (as she remembers them), she's realizing her husband hasn't been around for years because he's dead (without going through the grieving process from square 1), and she wants to know if her own mom is still alive. Again, not falling apart emotionally when you tell her that her that her mom is not alive.
Your mom still has her social graces (which tells me right there it isn't Alzheimer's) and is interested in the goings-on of the family. You hit on the solution in your post. You have to stay in the moment. Literally. As maddening as it can be to repeat yourself over and over you're showing your mom kindness and respect and love by being in that moment with her. I know it isn't easy and it's exhausting but you're already doing the right thing.
Maybe old photos would entertain your mom (old photos are the go-to for people with dementia). Photos from her childhood if you have them or photos from your childhood. She may not remember the photos but talking about who's in the photo and what they were doing might capture your mom's interest for a short time. But if she continues to not remember photo after photo after photo it would be best to put them away so as not to frustrate her.
How about music? That's something you can do with your mom without having to talk. I once burned some CDs of Big Band music for some patients of mine and they loved it. Of course nowadays we don't have to burn CDs, we can just put the music on our phones. But maybe if you know of some music she'd enjoy or how about the soundtrack to a musical she's seen?
It's not necessary to see your mom with tricks up your sleeves to keep her entertained but these things might give you a break from the non-stop repeating and might be nice to whip out on occasion.
When doing some research (how I found this site), I did consider vascular dementia, as well as the possibility she's had subsequent small strokes that no one caught. Some of the symptoms don't seem to fit, but I'm going to do more research. She has been seen several times by at least one, possibly two neurologists. I can't say if they were geriatric neurologists, but that's how she got on Aricept. Both times she tried it, she got super depressed. With her declining mental and physical condition, there's always been elements of depression, and she's currently on Lexapro. But it was worse on Aricept. At that time she was still living alone, and during most visits she'd end up in long bouts of crying, with an inability to articulate why she was so (or more) depressed. I've never seen increased depression listed as a side effect, but from the perspective of her kids, she was not improving, there was a pretty clear connection to her depression and the Aricept.
I have worried about alzheimer's of course, but she's been seen by several docs, and she does get regular check ups. Mainly for blood pressure, cholesterol, thyroid, etc. And she hasn't shown any changes in her basic personality. She retains her sense of humor, doesn't complain about the caregivers or her treatment, and generally remembers close family -- although she can't remember who my sister's been married to for the last 30+ years, but part of that I believe is because they moved across state 6 or 7 months ago, and she's only seen him at big family gatherings.
So for now, I'm looking forward to finding a little free time to really read all the replies. I can tell there are many good ideas for coping, lowering or dealing with frustrations, activities I haven't thought of, and ways of adjusting my own attitude and expectations that will help.
I was puzzled myself, looking back, that it wasn't until my mother's second stroke that anybody said the words "vascular dementia" to me - but it explained so much! Ask your mother's doctor if this is a possibility, and if so where you can find information and support for patients and families.
Dad likes to reminisce and I often bring up topics to get the conversation going. He still reads his magazines and watches TV but I can tell he doesn’t do it as much as usual.
So I would guess your mom has vascular dementia. You said she has a hard time getting up...have you considered a recliner chair that raises her to standing? You could have Home Health assess her by bring in an OT or PT to see what can be done.
Alzheimer's is a slow and steady decline where as Vascular dementia can be steep dramatic declines. My Husband had both, slow steady declines then all of a sudden he would not be able to do a task he had done the day before. (He walked on a Sunday and Monday he could not/would not walk)
As far as the medications go. He had been on Aricept for quite a while. Later Namenda was added but that did not last long due to the side effects. I did not notice a decline when he went off Aricept but who knows what the decline would have been like without it all along.
Personally just from reading your post she sounds like she is doing a lot better than many. If she knows you and can ask about your kids and have a complete conversation you are lucky. (Does not matter if she forgets is in a few minutes) Conversation is the key. My Husband had been non-verbal for almost 8 years and it was frustrating for me and I can only imagine for him as well not being able to express frustrations as well as pain, hunger and other basic needs.
And...does she have a DNR or a POLST in place? If so make sure there is a copy with her at all times also post one in her apartment and keep one for anyone that takes her out.
Give her a hug for me.
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