She is very overwhelmed with paperwork/mail. Doesn't seem to know what is important and what's not so she lets it all stack up until I can look through it. She's also getting confused with medications. At 89 she does not take any daily meds, basically antibiotics for UTI's. She has a major incontinence problem and asked to be referred to a urologist to see if she could have surgery. To make a long story short, he gave her a prescription for oxybutynin 5mg to try. She would not take it saying that she was allergic to it. Now she has another UTI and was prescribed an antibiotic. She took one and said it made her dizzy so she found the oxybutynin in her cupboard and took it and says she's feeling much better. She has chronic lymphocytic leukemia which effects her immune system. It is impossible to get her to understand that I am trying to help her and not control what she is doing.
To make matters worse, I spend 7 months in Arizona and 5 in Ohio. She lives in Ohio in her own condo. My husband and I took her to AZ in Oct, hoping that she would stay with us but she decided to fly home mid Jan. with a friend of ours. We want her to come to AZ, even offered to purchase a condo in the same community. I worry about her being alone!!!
She's been a widow since 1982 and is extremely independent. She does trust me but doesn't realize that she is having memory issues. Who should talk to her about it and would she understand?
I am her health and financial POA.
First, there is actually a medical term for when a person is unaware of their own condition, so it is a thing (Anosognosia). My mom, 91 and single most of her adult life, is also very independent. Even though I've been having gentle conversations all along with her about decline (she has 2 older sisters, one with advanced dementia) she seems in total denial about her own memory issues, occasional confusion, etc. I'm an only child and she lives door to me (luckily). I no longer bother trying to get her to "admit" her issues. Instead, I act like I've found a convenient way to do something ("online banking! I don't have to think about it and it's safe! Here's what it looks like. I can help you do it too!"). As her financial PoA you will need to think about how to protect her sensitive info from others, and herself.
What she wants vs. what needs to happen to keep her safe, maintain a quality of life. My philosophy is that caregiving/oversight must be amenable to both the care receiver and their caregiver/PoA. There's no point in it being onerous for you since this will cause stress and eventually burnout. It's trickier when someone is very independent. But if there begins to be a need to "orbit" around her this only props up a pretense of independence, so what's the point? She (like most people) has "romanticized" aging at home. You can attempt to have a conversation about making it work for the both of you and try to get concessions, but the problem with the senior mind is that it often forgets what it had agreed to.
Long-distance caregiving won't be easy and you will most likely spend a lot of time fretting since you know things are falling apart at her end. You may have to consider having her join you in AZ (but in her own little place or an IL care community) and then create a "therapeutic fib" to keep her there longer, or permanently. Eg: problem with the home (no heat, bug infestation, etc.) If she can be engaged in activities and with people in AZ, being away from her OH home may be less of an issue. Or, you can do like I did with my very senior Aunties and go over her financials and show her on paper that it will just drain her sooner. You will need to keep up this conversation but in a non-nagging way or she will avoid talking to you about it altogether. Also, I strongly recommend you do not move her into your home in AZ unless you wish to evolve into her full-time (and then some) caregiver. This will not be good for your marriage, your health and maybe your finances. Others on this forum will support this perspective.
I think you have plenty to think about. Others will have helpful input. I wish you all the best in working it out with your mom, and peace in your heart no matter how it goes.
But long term...you need to plan. Seems like you are planted in AZ and clearly much stress from her being in OH. So start scoping out places, so when the time is right you can move her. It will only get harder as the dementia progresses which may be a slow process.
I live with my elder parents and I can tell you the course of this up to diagnosis and beyond...well, it surprises me and shouldn't in retrospect. Some highlights: Mom was having trouble in the kitchen, didn't know what to make for her and dad's dinner; baked a cake mix in a loaf pan, burned something to the point of significant smoke one time, trouble doing bill paying, not remembering about finances...one particular memory is that Dad (the breadwinner) wanted to get a new car. They had the funds. She forgot about an account. Was very upset and found her crying. I think she sensed she was "not herself" and made statements like that once in a while like "I'm losing it ha ha ha". One year they went to visit the "good" daughter in FL. I anticipated this would be their last adventure and my last staycation of peace. Sister called within hours not knowing how in the world I could think mom could travel. The trip itself went fine...but the change in environments...and then the discovery that mom had inadequately packed...that led to a review of basic signs of Alzheimer's...a visit to the MD and he was surprised at how poorly she scored on the mini-mental. An attorney suggested for various reasons having her assessed. A packet with an assessment was sent out. I received it at our PO BOX. This was in May. The appt was not till Sept. One day I discovered a big envelope from the place in mom's space. Empty. Thought this indicated her own-self awareness and concern...Day of the long awaited appt learned they had in error sent a packet to me AND mom, and mom, on seeing it, called immediately and cancelled the appt.
We ultimately went...and mom was diagnosed with dementia/mixed type. She remains, I believe, totally clueless...and yet on the rare occasions she sees the MD and there is a postvisit print out, I am quick to take it because the diagnosis of dementia is on there. She's going on 98 and there really is no benefit to confronting her with this truth.
You might want to google "long distance caregiving" for some books or literature; contact your and/or her local office on aging or Area Agency on Aging which may have some literature or guidance on places to check out or in home help...which is no doubt cancelled during this COVID time. When you are next in and if she saves up the bills for you, pay by mail (to alleviate phone hassles and having to provide POA documentation) and check those little boxes about change of address and change it to her name c/o your name and address...and then take her checkbook and checks if you can. Or do the on-line access, or do both...
It takes time, will have some frustrating moments, but it will come together...
1)” The 36 Hour Day : A family Guide to Caring for People Who Have Alzheimer Disease other dementia’s and memory loss.” by Nancy Mace
excellent book !
* Can’t recommend these books enough look it up on Amazon for more info.
2) “Creating Moments of Joy Along the Alzheimer’s Journey, Guide for Families and Caregivers.” By Jolene Brackey
Unfortunately, you're entering the time when you need to say things to create the least stress, and worry a bit less about the accuracy of what you say. I don't argue with my mom that her husband is imaginary, and she's happy. Your mom doesn't need to be made to understand she is having cognitive issues -- it is what it is.
Consider having your mom come out to AZ while her house is being "worked on," and have her stay "temporarily" at a memory care facility for a couple of weeks. By that time she'll likely feel like that's her home, and you can continue to stretch out the stay as long as needed. (Your house is also getting the guest room redone, so she can't come stay right now.)
I know this all sounds duplicitous, but your local Alzheimer Association can help as well as a memory care facility you choose. Once your mom is settled and cared for, you'll be so much more relaxed knowing she's safe.
Your situation sounds similar to mine (except for the distance). In our case my mother was first told of her dementia by a neurologist who insisted she not drive any more, then by an occupational therapist when she went for a driving assessment. Once the professionals had given her the diagnosis, we were able to talk about it with her.
Her condition has continued to decline. We first started having home care a few times a week to help her. But she was mixing up her medicine, burning things on the stove, falling - and we finally had to make the decision to move her to a memory care facility.
Our mother, despite acknowledging that she would forget some things said that she was old and entitled to forget a few things. The problem was she would forget what she was forgetting! She also had included AL in her plans for the future, when she felt the need. That went out the window with dementia. In her mind she was "fine, independent and could cook." She wasn't and couldn't. Two of us lived more local, but still a long drive, so we had to make plans for her care. We did try bringing in help so she could stay in her condo longer, but that didn't last long (only 1 hr/day sanity/med check, to be increased as needed.) Plan B was move to MC (she refused to consider moving ANYWHERE, so we had to come up with a ruse/fib to facilitate the move - others suggested that here too.)
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