Parents caring for the parent support thread (Part 1)

There are some really decent ‘briefs’ as we call them in the skilled care facility - go on like underwear and pull ups. The more serious ones (heavier absorption) go on like a diaper with the tabs to adjust on the side.

88 YO MIL had briefs on at Christmas and at our recent visit (she has to wear all the time for leakage and moderate urinary incontinence) - at Christmas she was having so much fun playing cards that she didn’t stop to take care of business, and leaked through to the padded chair. On recent visit, on the wooden kitchen stool. 88 YO FIL wears briefs at bedtime,

Just buy some, put in their bathroom. Encourage to put on at night ‘just in case’.

If she knew how common it was to need these she wouldn’t hesitate. It’s so much better than the stress of trying to get to a bathroom in time or hide accidents. Most independent living facilities don’t “kick you up to assisted living” for needing these products–if she can put on/off herself. But as you’ve realized, they don’t want residents having accidents. Other independent residents don’t want to feel like they are living in a nursing home.

I’ve heard staff always talk about them matter of factly as if everyone would want them. And always call them briefs not diapers.
Aside My dad in assisted living (with a little filter loss due to dementia) showed them to my visiting aunt, uncle and cousin and bragged aout the free disposable underwear his facility included in the price.

I got a call on Friday that my mom was on her way to the hospital via ambulance because she could’t breathe. Now, she had called my sister, who is local, and when she couldn’t get her called the ambulance, told them where she wanted to go (where her cardiologist practices) and how to call my sister. Apparently, her pulse oxygen levels were dangerously low and her BP very high. Many hours, tests, and doctors later she was admitted because of long term congestive heart failure, fluid in her lungs, and a need to be sure there were no pulmonary emboli. My sisters stayed with her and she went home yesterday. Arriving home, my middle sister noticed that mom had not included her usual diuretic in each day’s pill box. Duh, of course the fluid built up.

Though she is fighting us, we have now decided that one of us needs to fill her pills weekly to be sure that she takes what she needs. This is a woman who managed her meds and our dad’s for 47 years (and between them they were on a lot of meds) and she is having a hard time relinquishing that control. I think we finally got through to her, but it isn’t easy. She has also agreed to sell her townhouse and move to an apartment (not a senior facility) closer to my sister. It’s a compromise - we think she needs more community but she is a solitary person and wants to just have her own apartment. It’s 5 minutes from my sister and she’s willing to take on the responsibility of creating a life for her there, so it’s what will have to be. I often feel like we scale one peak only to be confronted by another.

@HImom Is your mom aware of the incontinence? I only say this as my father, with his advanced dementia, pees multiple places as he doesn’t recognize the toilet as a toilet. He will pee in the closet, in the heating vent, drawer…I think if someone can’t or won’t recognize incontinence, independent living may not be a good option. Perhaps your parents will respond better to a non-child. For my dad’s problem, briefs won’t work so they bring him to the toilet hourly and try to get him to pee in the correct spot.

@runnersmom

So true! I hope the apartment is a sustainable solution. But, it sounds like she certainly has her mental faculties. Besides not taking her medicine correctly.

@BerneseMtnMom getting caregiving counseling is an excellent idea. I will be going to counseling for my sleep issues and I suspect that will be the recommendation for me.

As far as I know, my folks both recognize toilets as where they are supposed to do their toileting, but there are just LOTS of accidents.

No one has broached the subject with them except a urologist when dad had a urinary infection. Clearing the infection didn’t improve the accidents much. I will raise the issue with my (and their) internist when I go did my check up this week.

I haven’t posted here in a while. Just caught up from April-- that was a lot of pages.

We had a scare with my mom a couple of weeks ago. She had fainted while her aide was giving her a shower and was taken to the hospital. They didn’t find anything; perhaps the fainting was caused by dehydration. Anyway, she was released a couple of days later, back to her apartment where she has a 24 hour a day aide.

My sister called that evening, in tears, saying she thought Mom was dying. Mom was just lying in her bed, unresponsive, mumbling. My two sisters were both there, and one of my brothers.

My sisters are not alarmists. I wasn’t convinced our mom was dying, because I couldn’t figure out why she would be dying at that point, after she’d just been released, but I didn’t argue, I just got an early flight the next morning. I called my best friend’s wife, a nurse, who reassured me that the symptoms Mom was showing could be easily explained from exhaustion from being hospitalized. Lo and behold, by the time I got there the next afternoon Mom was awake and perky!

It was a good visit, with my mom and with my sisters. I’m so glad I went. Mom’s cognitive function, sadly, has declined even from my last visit in August. Previously she had been forgetful but oriented. This time she asked me if I could go pick up my dad at work. “It’s a little early in the afternoon to pick up Dad,” I said. It’s a little late to pick up Dad because he died nine years ago, I did not say. It makes me sad to think about it, but she is now spending some time in a world where my late father is still alive, I’m not going to take her out of it.

I have been reading along, but there is still not a lot of change here. My mom is slowly headed downward, but nothing drastic enough to make changes. My brother called her the other day, and she didn’t know who she was talking to; that is a total shock because they talk a few times a day; a little while later, he called and she knew who he was. He is close to having to be admitted to a memory care facility, so if she gets more confused about him that will make it easier if he forgets her.

@“Cardinal Fang” It sounds like one of those visits that you will remember and treasure in the future. I have to say, those moments when you don’t have to lie gives me comfort. I was able to truthfully tell my my mom 4 weeks ago, as she was packing expecting her parents to pick her up, “I don’t know how to get hold of your dad.”

@mykidsgranny I think I missed that your brother had such memory problems.

I spent a few hours in the ER with my Dad on Monday night. I got a call at 12:30 AM that he had fainted so his Memory Care unit called the paramedics. When I got there he was at his baseline (asked me when we were going to Sees Candy and how my dog was, which is our usual conversation). He actually looked pretty good (good color, evidently he had a shower recently because his hair was clean). They had done a CT scan, EKG, urinalysis, blood work, etc… My dad had no idea why he was there. The doctor said they could keep him overnight or send him home and I said that he should go home. They have found him on the ground before (maybe once every 3-4 months), but this is the first time they sent him to the hospital. I guess they have changed their protocol. What was interesting was that after I was talking to the doctor and he was going over everything they had tested and how everything was normal, my Dad said “So he is OK?” (meaning himself). I took him back to his place, but I guess the hospital would have sent him in a “transport” back to his facility.

An early-indicator detail question for people here. My mother seems on top of everything, but sometimes I have to go over times with her and feel like she might be confused by them. For example, she has a 9:30 appointment tomorrow, it takes fifteen minutes to get there, so I told her I’d pick her up at 9:00. The math seemed beyond her – she sounded like she didn’t quite get how my being there at 9:00 would relate to being on time for the 9:30. She sounded a little frustrated but not belligerent and finally ended up saying, “All right, just tell me what time I need to be waiting for you in the lobby.” Good enough for the morning, but am I correct in thinking this might be the slow start of memory deterioration?

There are little things that can momentarily confuse any of us, including that backwards timing. My visitor got confused about who’s parking where in the driveway tonight, so I can get out at dawn.

Not understanding she has a doc appt or how to get to the lobby would be more worrisome.

Remember, forgetting which door this key unlocks isn’t some big sign. It’s more forgetting what a key is, how you use it.

My Dads time issues first presented as having difficulty with AM and PM and thinking 1AM meant it was morning and time for breakfast.

@ tx… hugs, hospital trips get harder And harder I think.

@HouseChatte one of the quick memory tests is drawing a clock with a particular time on it. Seems like visualizing time goes away early on. But it might have been a momentary blip too.

Just for reference since we haven’t mentioned it in a while, here’s a link to the MMSE / Mini Mental State Exam.
Med folks usually ask the questions casually. http://www.dementiatoday.com/wp-content/uploads/2012/06/MiniMentalStateExamination.pdf

Keep in mind that not all of us easily count backwards or have our county at the tip of our tongues (especially the elderly who may no longer need to know) and not all questions are always asked. It’s just a check of sorts.

My mother wouldn’t be able to answer any of those questions, but then she turns 97 this week. I’m not sure she could have answered them 15 years ago either, though.

Sometimes you can look back and laugh, and the MME questions triggered a few things. FIL had a stroke in fall of 2015. Note this is 2015. Not the election year, the year before. His son got him to a stroke center quickly. Per protocol, staff would come into his room every 10 minutes or so and ask him questions - What is your name? What year is it? Where are you? Why are you here? What state are we in? Who is president? How many fingers am I holding up? (not all questions each time, but multiple questions each time, on some kind of cycle)

After a while he was tired of it.

What state are we in? “Misery” (we were in Missouri)
Who is the president? “Donald Trump”
Who is really the president? “Barak Obama”

He never really recovered - combination of stroke effects, underlying heart issues, too much hospitalization and refusal to cooperate with PT/OT and other instructions. He was back and forth between hospital and rehab. While in rehab, he kept thinking he was at a hotel, and kept coming up with stories to explain why - he was at visiting family in his home state, on vacation, or, very often, at a church convention, which would have involved lots of long meetings. DH was good about playing along with wherever he though he was, ad-libbing things like “Mom (who had died the year before) is stuck in the committee meeting, she’ll be back when they adjourn for the night.” It was sweet to listen to.

My mom could possibly answer 2 or 3 of those. She has no idea what day, date, month, year, or location she’s in and can’t remember unrelated objects. One time when asked who the president was she said Roosevelt. When we told her who it really was, she said, “Well. Really? He is? Why would I want to remember that!”

@HouseChatte - My father died this year at almost 93. He had a dementia diagnosis for almost 2 decades, but was not a traditional Alzheimer’s patient. He had memory loss; first his short term was compromised. Then in his last 5 years, many long term memories were faded or gone, too. Yet, he always recognized me (saw him at least once a week), spoke coherently, was cheerful, interacted appropriately, made witty jokes and was never confused about what to do with every day objects. He died “coherent”. Yet, when memory fails you, decision trees and information processing become more complicated and eventually impossible. Too many steps and they can’t all be retained simultaneously. Executive functioning depends on memory, as well as other skills.

Time taught me how hard he was working to keep his head above water; particularly evident with changes in routine. Anyone can have a bad day, moments of confusion or being overwhelmed; infections are notorious for impacting an elder’s cognition. Time provides a lot of context for understanding what you may be seeing. It helps to notice the changes, maybe jot them down with a date, and see where the data takes you. It may or may not become significant. Your mother is lucky to have you in her corner.

@tx5athome Glad your dad is back to baseline and you are able to continue having conversations. I have signed something with my parent’s care home recently to not send my dad to the ER unless he is in pain that cannot be managed by the staff. If ever there, hopefully I can help them avoid any testing. I suspect the protocol has to do with who is on staff at the time.

I’ve heard “if you see one person with dementia patient you’ve seen one person with dementia.” So true. My mom can draw a perfect clock and the time but she was agitated yesterday morning while waiting for her dad to pick her up.

@HouseChatte I think it does show a decline executive function which is a hallmark of dementia. But, it doesn’t tell us much about her rate of decline or the trajectory. Tomorrow it might be better. As @lookingforward says, it might be one of those temporary things that confuse us all. For dementia, we look at a pattern of behavior, rather than isolated incidents.

Dad’s internist thanked me for tipping him off to dad’s incontinence issues and suggested Imodium and pads and disposable briefs. I asked whether he can help broach the subject when he sees dad for exam in 2 months and he said he’d be happy to and will schedule extra time.