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We had our first care planning conference yesterday - me, my brother and my sister-in-law were there along with the director of nursing, social worker, dietary and the activities director. Mom's admission MMSE score was 9. Yes, 9 - lower than even I thought. So, she is severely cognitively impaired. The psychiatrist also feels that she has vascular dementia (possibly on top of AD, possibly not) and to me, this answers some questions in my mind about why she has progressed so fast.
She is very docile there, she will always say "no" if she is asked to participate in activities, so they have just started saying "come on, we're going to...." and she will do it. She doesn't really talk to anyone else there and the staff wanted to know if she was kind of a loner before (she was). They are going to try to pair her up with one of their chatterboxes who doesn't require responses to things and see how that goes.
She is eating, but she does stop in the middle of a meal and needs to be prompted to continue eating. I did notice I was having to remind her she had food in front of her for the 2 weeks prior to her admission. She hasn't lost any weight, though.
She still does make a statement every once in a while that she doesn't like it there, but it isn't accompanied by tears. The only medication she is on is Effexor XR for depression (which she was taking when she went in) and as usual, my brother inquired as to whether they could give her anything for sleep (he is obsessed with this and refuses to understand that the disruption in the sleep cycle is part of the disease). I am rather upset with him because I just found out that the weekends he had her, he was giving her Tylenol PM so she would sleep at night. I am disappointed that he would do that, because he did ask me a while ago if he should and I told him NO because the psychiatrist clearly said that he didn't want her on anything sedating because her balance is so bad she could fall on the way to the bathroom.
They basically told him the same thing - her sleep is in cycles like their other Alzheimer's patients and they try to avoid sedatives due to the fall risk. So, I am even more glad she is there because their philosophy is right along with mine. I am seeing her every other day and that seems to be working for now.
Also, next Tuesday, she is going with a small group of residents to the movies and out for lunch (they bring enough aides so the ratio is 1:1 on trips like this). The day of the meeting they were having their monthly resident birthday party and I actually sat on the porch during that because she told me she would see me after she had her cake and ice cream. LOL
_________________ Judy, caregiver to my mom, Joan
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