Expert: Michalene Peticca - 10/23/2006

Question
I don't know where to begin, my mother started showing obvious signs of alzheimers around 4 years ago and was diagnosed around 3 years ago, she has always been a volital women, 14 children, who wouldn't be, she refused to believe anything was wrong and so we had a difficult time getting her cooperation on anything. At the same time we were dealing with my sisters decline and death in January due to years of illnesses, her death and hernia surgery seemed to throw my Mom deeper into the Alzheimers, since then she has fallen 3 different times that were severe enought to put her in the hospital, where she is today with a staff infection in her knee, they are moving her to skilled nursing to monitor the infection and so on, my confusion is that she is so agitated that she fights to get out and pulls all her lines and iv's and when she talks it makes no sense, although I still think she knows what is happening to her and that kills me, my father has had her at home and they are several of us that take turns staying with them to help weekly. The family is divided as to how to proceed with her care, I am her trusty should my father pass before her, I think my mother need to be in asssited living now, she has hurt herseld so many time and can't eat without assistance or dress without assitance its really taking a toll on us all, especially after doing the same for my sister. Is she in the last stages? Am I being cruel in wanting her to live her last days not being told NO every second and have her cry like a child. Please help.

Answer
Hello Deborah,

Thank you for writing.  This sounds like a very challenging time for everyone in your family.  

Your situation is very common with an aged parent who may have Alzheimer's disease, and i applaud your family for wanting to take care of your mother and give her lots of love.

While every family is different, i do suggest you all try to meet and decide on the best plan of care for your mother.  I think one or two siblings making a decision without input from the others can lead to a long term upsetness within the family.    

It may not be an easy meeting, but bring along information on Alzheimer's disease and/or dementia that may provide your siblings with education if needed.  The Alzheimer's Association website has some good, basic information.

Now, on to your questions.  Your mother's present behaviors and extensive forgetfulness most likely are due to present medical illness, medications and the change of environment.   If you decide to move her to an Assisted living or keep her in the skilled nursing facility, you may see this change over time as she becomes more settled in and "even out" with her behaviors.  But, remember, changing the environment again will mean another several months of getting familiar to a new environment.   

You are NOT being cruel to having your mother lead the best possible life for her and your siblings and families.  Often times i ask people to think about what would be the best situation for caring for their parent.  Can your family provide a regular routine, calm environment, flexible with an Alzheimer's persons' needs (ie, sleep in day, up at night?), secure environment, etc. or would it be better for your family to work through a new environment, develop a rountine and have familiy visits that are meaningful, comfortable and calm?

I think it's a place to start.   My hopes are with you.

Best Regards,
Michalene Peticca, MA