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Today Mum has been
diagnosed with vascular dementia. This was done in hospital
by neuro-psychiatric assessment. They say she needs more
care, preferably 24 hour care. I don't see how 24 hour care
can be given at home via NHS and family. Mum lives alone,
and she has deteriorated so quickly. Home help goes in 3
times per day, and my eldest sister goes in the evening with
a meal and puts her to bed. She is then left alone and
obviously gets up and goes out - she goes upstairs, which
she is not supposed to, and basically nobody is sure what
happens after bedtime.
All the family care is
left to my eldest sister and her daughter. My youngest
sister and I live hundreds of miles away. Mum is now
bladder incontinent and very confused, with impaired memory
and no sense of time. The double edge sword bit is that if
24 hour care means residential care, the clinician said the
strangeness of the new place and routine would make her
illness worse as she is still familiar with her own home.
My eldest sister is
getting very tired working and looking after Mum. She
doesn't have a car and walks back and forth at night and
weekends to Mum's house.
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It appears that you and your family live
in the UK, but I believe that what I have to say will
apply to seniors and their families anywhere:
You are correct that 24 hour care at home probably cannot
be provided by your National Health Service, or by our
Medicare system here in the States. Even with family
living nearby, your mother is alone for varying periods
throughout the day, and all night. Obviously, this is not
working for her or for all of you. And being alone at
night is putting your mother at serious risk. She could
wander away or injure herself, and no one would be the
wiser possibly for hours. This is not a risk I would want
to take.
It is true that relocating older people with dementia is
often difficult for them, and it sometimes does result in
some deterioration. This is not universally true, but we
have no way of knowing how any one individual will react.
But she is already seriously ill, so a move will not "make
her ill." She is presently deteriorating at home, and she
is also in danger. So I would recommend that you look into
a residential program that can give her the supervision
she needs. She may also be bored at home, and wandering
about because she is awake and looking for something to do
or someone to be with. In a supervised residence she would
find those things whenever she needed them.
After an initial period of confusion many seniors with
dementia adjust very well to a new residence. My own
observation has been that the earlier the move occurs, the
easier the adjustment is for new residents with dementia.
The stability of having the same people there every day,
and the routine of congregate living is comforting to
many. If they were previously social most make new friends
fairly quickly. Those who were never social usually appear
to be content observing from a distance.
Please investigate the alternatives for safer living that
are close enough for family members to visit regularly. It
will probably be as much a relief for your mother as it
will be a relief for all of you who are trying to cobble
together a plan that simply won't work long term.
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