songbird

Ever since my parents told me in May that they suspected my mom has
Alzheimer's, I've been visiting this group regularly, and I value your
collective knowledge and opinion.

On your advice, we now have all the proper POAs, HCPOAs, safe deposit
accesses, etc. etc.

Mom goes to the doctor on Tuesday (willingly) to discuss her symptoms of
mroe than two years. She has never mentioned them to him before. He has been
alerted in advance and is checking her file for any drug interactions, etc.
that could be causing the trouble. Depending on what he says, my parents and
and I must decide when they will move nearer to me so I can help.

Help me figure out what should be the indicators that *now* is the time,
whenever *now* is.

Her symptoms: Mostly forgetfulness. She asks the same questions over and


meds. She has never been a "joiner," but she is even more withdrawn socially
and quieter than she used to be. She is easily moved to tears. She can be
unsteady on her feet, but we think that is due to another unrelated health
problem.

Their situation: They live in their "dream house" on a lake in a fairly
remote area, nearly five hours away from me and more than three from my
brother. (However, we have all agreed I am the Kid Who Will Take Care of
Parents.) The nearest hospital is an hour away. She has no friends that she
would visit with. (It's remote!) She has no pattern of activities as far as
clubs, church, etc. to keep her tied into a social network. (My dad is a
retired minister who does fill-in work, so they are often at a different
church every Sunday.) She prefers not to leave the house without my father.
She does seem to be able to keep up with household chores, though
cleanliness is slipping. She can still cook if she follows a recipe. Dad has
some physical limitations due to hypertension and diabetes, and he is
increasingly anxious about having sole responsibility for her. He feels
(rightly or wrongly) that he cannot leave her alone. In-home care would be
difficult to find becuase of their location in what is basically a vacation
community with few year-round residents.

They have found an independent living facility in my hometown that they
could afford and which would provide 12 meals a week, plus activities (I
think she would go if they were right there in the building),
transportation, security and emergency response. The apartments are 10
minutes from my house and 10 minutes from the hospital. In-home care is
readily avialable, so she could live independently there longer than she
probably could in her current home. It is affiliated with an assisted living
facility with a dedicated Alzheimer's unit right next door, and if she has
to move over there, Daddy will even get a discount on his rent in the IL
building. (I just say this to show how integrated they are, though
technically different facilities under the same ownership).

Obviously if it is a drug interaction, we can hopefully wok that out and all
will be moot!

But, my theory is that if this is AD (or some other dementia form), moving
sooner is better than later because
1. It gives her the maximum time to form new memories of her new home.
2. It gives her the opportunity to establish a relationship with a health
care team here while she can still participate in decision-making.
3. It gives my father the opportunity to make new friends and establish the
support network he will need as her condition worsens.
4. It allows me to help monitor her condition and give my father regular
respites.
5. It gives me the safety net that if my dad's condition were to suddenly
worsen, I would not be having to move both of them in somewhat dependent
states.

Dad says he is ready to move, but says Mom is not. I am going to see them
this weekend to have a loving conversation about the doctor's report and my
concerns. I think if I say, "Mom, won't you move closer so I can help Daddy
take care of you?" she will agree, with lots of tears. (I know she hates the
idea of leaving this home but intellectually knows it will be necessary at
some time.)

I just want to make sure my thinking is well-reasoned and makes sense. I
know their moving closer will be more work for me, not less, so I see no
ulterior motives in my reasoning. Also they have both been realists, and if
I can lay out the case for moving clearly and logically, it will make their
decision a bit easier. If now is not the time, when is?

What do you think? What have I overlooked? Am I anticipating too much
trouble too soon?

Thank you all for being here!

Songbird

gwen love

Songbird, I think you are being very smart to think of all these things before
a move is required quite suddenly and you might not find a place available.
If the problem with your mother is medication, then you won't have to worry
quite yet. But if it is any kind of dementia, my opinion is that the sooner
the move is made the better. Since your dad is for the move, if your mother
can be convinced that it is the best thing to do for them and for you and your
brother, then I would move full steam ahead. Seems to me it would be much
better for everybody. You will be in my prayers.
Gwen
-----------------------
Right is right, even if everyone is against it; and wrong is wrong, even if
everyone is for it.
- William Penn

evelyn ruut

Songbird you sound like you really have it all together and have covered all
the bases! Your thinking sounds very reasonable to me. As for your mom
not wanting to move, it isn't going to get any easier, it is going to get
more difficult and more overwhelming by the day.

If you do it sooner rather than later, you will be able to get maybe a
little more cooperation from her because as time goes on, they tend to lose
the realization that anything is wrong at all and cooperation gets even more
difficult.

In my alzheimer support group locally, a man said he was totally astonished
to realize that his wife never once asked him "what is wrong with me?" She
lost that sense quite early on.

If you can convince them to move into the place you have in mind, maybe you
might manage it best if you do it without her participation,..... meaning
like taking her somewhere for the day or the weekend, and then you can
manage all the moving (since you are the one in charge) and bring her to the
new location with the move all complete. You could put their apartment
together and have it all cozy and ready to use. That might make it a lot
easier for her. You could wind up all the loose ends after they are
somewhat settled in the new place.

Can you just imagine how incredibly confusing it must be to a person with
this illness to even begin to contemplate orchestrating a move? It has to
be the hardest thing imaginable. My mother in law could not even figure
out how to pack a bag for a weekend, but that my husband had to do it for
her!

When I moved to this place three years ago, I thought it was the most
difficult most mind bending, challenging, most upsetting thing imaginable.
My husband was super, and he did everything (almost). We worked non stop
for months and even still we are working at getting this place fit to live
in, three years later, and we are two healthy people with no major
challenges! For an old person with this illness, it has to be pure hell.

The best thing you could do for your parents is to organize and orchestrate
this move yourself, keeping her out of the fray till it is all said and done
with, if it is at all possible to manage it that way.

Of course this is just my opinion and free advice, and if it is not
applicable, please ignore it. Meanwhile, I hope all goes well for you and
your family throughout the reorganization of their lives to suit this new
cir***stance.
--

Evelyn

"Since everything is but an apparition, perfect in being what it is, having
nothing to do with good or bad, acceptance or rejection, one may well burst
into laughter." -Longchenpa

songbird

A very good point. I had wondered if the thought of packing, etc. was too
much. My dad has already mentioned the rigamarole of getting utilities
hooked up and new car tags obtained and visibly relaxed when I reminded him
I can do for that for him since I have POA. (Plus this is a small city, and
I know the heads of all the utilities, banks, etc. -- if there's a glitch, I
can get help pretty easily.)

I had already thought that I might approach the actual move by figuring out
with them what furniture goes where, which pictures will go with them and
which into storage, etc., ahead of time on the floor plan. I don't want them
to think I am taking over their lives, and I think they need to exercise
what control they can. If you know you have some choices, it makes it easier
to accept the ones you don't have.

We will need to hire movers which should not be too expensive, because they
do not need to move appliances -- those will sell with the house. Then I'm
going to suggest they go off for a few days together, perhaps visit her
sister, and let me superintend the packing/unpacking, loading of truck, etc.
My brother can probably get a few days off to help on that end, and I have
lots of "family of the heart" here to help. One friend has already
volunteered to come hang all the pictures and window treatments.

If we can move them out before their house sells, it will be easier. We can
always go back for a few more lamps, or whatever, that we may discover we'd
like to have.

Thanks for all your advice. I just started to wonder if I was borrowing
trouble or if I was right to think we should move with some degree of speed.
You just never know how quickly this will progress, and I can see a change
just in the last nine months.

Songbird

niederlandisch

I'll go along with all that has been said. I think sooner as well
since the adjustment will hopefully be easier.

I sent my mother to her room to pack a few things for a couple of
nights away. This was before I realized she was so bad. She packed a
coffee can full of wooden clothes pins, a plastic cup of quarters and
a box of tissues. What a shock.

Also you might want to say to Mom that you would like them to be
closer to you because of Dad's health. To help her take care of Dad.

The Cranky Genee

beth

Songbird,
You catch on fast; your plan sounds like it's exactly what's needed.
Assuming your mother does have AD or something similar--I definitely would
try & leave her out of the confusion/decision-making as much as you can.
One of the big hurdles is your transition out of the child-role to
her---it's tough. But at least you can let your Dad decide details.

You do not ask her if it's ok to move......it's decided. Act as if she has
already agreed. And she did it to help him (or you), because she knew it
would make things easier that way. She just doesn't remember. It is
unlikely that she would agree to any change-partly because she can't project
ahead like she used to; however, there's a good likelihood she'll go along
just fine with your Dad's reassurance- as long as she's not involved in the
decision-making. Don't plan much with her, she won't remember anyway. Just
take 1 day at a time..... When you/she has bad days, be comforted to know
that she won't remember them. I would suggest you focus your support on
your Dad. Your Mom will probably do just fine if those around her are calm
& determined.

Best wishes and keep us posted.
Beth

glenfiddich

Your father's worries about her _may_ mean that he sees more in her
condition than he is sharing with you.
Denial of just how bad the AD has gotten, by those who love them
is not uncommon...

If your mother DOES have AD, a remote area where she could forget her
way home or wander off by herself is less than ideal...

I DO hope that is what it is - but I'm writing this on the assunmption
that it really is AD.

All good sound reasons, in my opinion.

If it is AD, the move will get more difficult _for your mother_ as it
progresses.
IF she can be persuded to go willingly, now is the right time to do
it; she will probably enjoy life more there than at her present home,
no matter how lovely that home is.
Several people here have mentioned that an active social life seems
to delay AD.

And, after all, going into an AL facility is not the end of the world.

dpharris

these are the important reasons. your father knows he needs
help, and that's a 99% improvement over the denial that many
families face.

you just need to tell her that the move HAS to happen because
your father can't take care of her by himself, especially with
his health problems. this is only the first time that you'll
have to ignore the tears or pleading and go ahead and do what's
best for her safety and your father's health.

you are fortunate the that an almost ideal facility is available
so close to your home, and that your father wants to move there.

evelyn ruut

Songbird, it sounds like a good plan, if you ask me..... Good luck with the
move!

When we moved my mother in law it was already late in the game. She didn't
want to leave her home, and remained far past the time she should have.
We took her here initially under the ruse that it would be 'a brief weekend
visit.' She still thinks that now, three years down the road!

The house was a shambles, beyond all imagination. This was formerly an
immaculate housekeeper! Since she lived a couple of hours from us, we had
to go back time after time, arranging babysitters and dog sitters, so we
could clean up and clean out the house. Time after time we went, and each
time it felt that we had accomplished very little.

It was almost a year and a half after she came to live with us that we
actually got the place sold and the final cleanup done. We actually ended
up taking less for the house than we should have, because it was just so big
a task. We gave away lots of things just to get rid of them. I got some
help packing (very little), but for the most part we had to do it all
ourselves.

She had tons of clothing, most of it inappropriate for her present life
cir***stances. Just making heads and tails of the disorder alone was a
massive job, not to mention that she had lived in that house since the mid
1950's and there were belongings from several previously deceased relatives
there that needed to be cleared up as well. Sorting out what was
important, what was valuable, what was to be tossed or donated or given
away, from what was worth saving for her granddaughter or her son, was quite
a job.

It was a nightmare, but there was no one else to do it as my husband is her
only child. On the other hand, you are lucky since you have a brother and
your dad is still doing well enough to realize and to help and to advise.
Getting her to visit her sister is a very good idea. Getting them all
moved in to the new place in a reasonably functional setup is probably the
best idea, then going back for whatever items they may need additionally,
might work out well.

Be ruthless..... her needs will be a lot simpler as her illness progresses,
and "less is more" is definitely the way to go. The moving is nothing,
it is the sorting out part that takes the most time. Accept all the help
that you can get. You will need it.

--

Evelyn

"Since everything is but an apparition, perfect in being what it is, having
nothing to do with good or bad, acceptance or rejection, one may well burst
into laughter." -Longchenpa

mary_gordon

Just to add my voice to the chorus - you've really thought this
through, and yes, now is the time. Just keep repeating to yourself -
now is as good as it gets. If you wait, things are not going to get
better - they will get worse, and perhaps dramatically - adding to
everyone's stress and making everything more complicated and
difficult.

Don't wait until your mother says yes - that day may never come - if
she has dementia (and from your description, it does sound very much
like early AD), she won't be able to reason through her situation or
recognize her own problems. She won't want anything to change since
she is barely able to cope with the world as it is. As others have
pointed out, moving is daunting for those of us with our health and
minds intact. Moving is going to be doubly terrifying for her - not
just the packing and sorting aspect, but the whole idea of leaving
familiar surroundings and having to adapt to new people and places.

Don't ask for her permission - just put your head down and bull ahead
and make the arrangements - the decision should be regarded as a done
deal, details to follow. You are doing the right thing. Carpe diem!

Mary G.