Elder CareTips:
Mastering The Eldercare Maze™

January 15, 2006

Good morning fellow travelers. Is everyone over the chocolate/sugar high of the past few weeks and ready to settle in for the long haul until Memorial Day? I actually am ready. The lack of a schedule and way too much food just about did me in.

Well, it's the start of a new year, and what better time to change your smoke detector batteries and update your Vial of Life medical information form? It's so important to keep this form up-to-date with your current medical and prescription information. If emergency personnel are called to your house they have immediate access to your information so they can give proper
care.

What - you haven't picked yours up yet? Go get it now!

My mother is 80 and has dementia. She lives with me and I work full time. I'm not sure I can take care of her if she gets any worse. I wonder if I should look into assisted living  now or until she is less aware of what is going on.

Dear Wondering:

It would be a lovely thing if we could all live out our days "bright-eyed and bushy-tailed" until one morning we just don't wake up. Sadly, most of us aren't so lucky.

When someone you love has an Alzheimer's or stroke-related dementia the one thing you can be sure of is that it's not going to get better, and that it will probably get worse. And the more these dementias progress, the less an older person is able to adjust to changes.

When someone with dementia is alone during the day, even if he or she hasn't gotten into any particular trouble yet, it's lonely and boring. Lonely and boring can lead to the temptation to go outside for a walk - a really dangerous temptation for someone with dementia. If they don't go outside, they are more likely to open the door to strangers or get involved with telemarketers who love to engage lonely older folks in long and expensive conversations.

Lonely and boring also leads to sitting in front of the television for hours on end with no particular purpose and no real mental stimulation. This just contributes to the mental decline.

Your desire to keep your mother at home as long as possible is an admirable thing, but in the long run quite possibly she would be much happier and healthier with a structured day and other people to socialize with. She will be more able to adjust to this kind of change now - and she'll also be able to benefit more now - than she will when her condition is much worse.

Have you given thought to finding a day activity program she might attend while you're at work? This would give both of you the benefit of allowing her to be at home while you're there. When you're at work she would have things to do and the supervision she needs so you don't have to worry.

Whether her dementia is caused by Alzheimer's or some other cause, your local Alzheimer's Association can direct you to good day care programs in your area. 

The more "highly functioning" a person is, the more he or she will benefit from a good day program. I have known several seniors who were terrifically resistant to going in the beginning. After an initial adjustment period they really miss going on their days off. Many families start with one or two short days a week and quickly move to full days every day because they are so pleased at the positive changes they see.

If a day program isn't available I'd certainly recommend looking into assisted living now. While she still "knows where she is" your mother is much more likely to be able to adjust to a new routine, learn to find her way around the building on her own, and even make new friends. If you wait until she can no longer do these things she will miss out on this
chance to make the new residence a real home.

By the time someone with dementia no longer "knows where she is" most assisted living residences will no longer accept her. The physical needs that come along with not being aware usually require nursing home care. If you can slow the progression of the disease by giving her a safe place to live, a consistent routine every day, stimulating activities that are geared to her abilities, and the opportunity to be successful
at whatever she can still do, her disease may progress much slower than it would at home where she's alone all day.

For all these reasons I say go out and look now. In the right place your mother will be safe and get the benefits she needs now, rather than later when she won't benefit nearly so much.

Here's a resource I haven't had a chance to mention before. When an elder is relocating it's a very difficult time for everyone. If you aren't up to doing all the deciding, packing, van-loading and unloading and new room arranging I highly recommend you consider using a Senior Move Manager. These professionals are used to working with older folks
who are going through a hard time. They move a little more slowly, speak a little more distinctly, and understand that treasures don't always look like treasures. They can move the stuff while you concentrate on being there for our elder. It's a win-win thing.

You can check the National Association of Senior Move Managers at  for a move manager in your area. If there isn't one, ask a local eldercare specialist for a referral to a good senior mover who might not be a member of this particular organization.

Turn on the lights. Older eyes need more light, and they need it without glare. More lamps scattered around the room will do more to increase vision than one really bright light and gloom in the corners. If your elder has a box of tissues, a telephone, her reading glasses, five magazines and assorted odds and ends on the table near her favorite chair, consider a floor lamp.