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My mother just turned 99 and moved to AL in November. It was a big adjustment for her. She was living with me for many years and lived a very quiet life. In the AL there is a constant stream of aides, cleaning people, laundry people, etc coming and going into her room. She is not used to all the hubbub. At first she didn’t like that they just enter, but she has adjusted to that, she just requested that they knock before entering.


Her mind was pretty good, but since she’s been there she is so confused and her short term memory has gotten very bad. I attributed it to the stress of the move. But I figured by now she should be adjusting. She started having trouble keeping track of her meds so now the facility is handling her med management. She is exhausted all the time, as she is getting PT and OT 4-5 x/week due to poor mobility. She can walk (with difficulty) short distances but usually they take her down to meals in a wheelchair, since it is a distance from her room.


She is not complaining or asking to come home, she realizes it’s where she needs to be. It was her decision to move there. I just wondered if this memory thing could be temporary due to the stress of moving. I was so hoping she would have an easier time there. I read other people’s posts that their parent is “thriving” in AL. That’s what I was hoping for. To me she seems to be declining.

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She is 99, what would you expect to happen at that age? Be it at your home or in AL.
I really doubt that it is temporary memory thing, the shade has started to draw down, nothing unusual about this at age 99.

My mother is 98 in AL, her mobility is dwindling, she is tired and at times confused, nothing serious just moments of confusion.

Her thriving days are over, it is now about safety & comfort.

Nothing in life remains constant it either gets better or worse.

Accept the decline, obviously she has.
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A decline is common with any move. It could have been to a siblings house, it could have been moving from one room to another in your house.
Once a decline occurs it can take a long time to get back to "baseline" if that happens at all.
At this point I would suspect that her cognition is going to continue to decline. That could be due in part to age as well as the move.
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Are you looking for people who have a 99 year old parent to write to you that the parent is thriving? Because no matter where that parent lives, I think that you will find they are unlikely to be thriving. Your mother asked to move to a safer place because she was cognizant of what is coming. I am 80. I am knowing what is coming now. Mentally. Physically. And I am knowing I will have to move to ever increasing levels of safety for the good of myself, and for the good of my family, who should not have to make their lives all about ME.

I don't know how many will write you to say their century old parent is thriving. But I have been some years on Forum, and I doubt it will be many.
My own father, nearing his mid 90s, told me he was exhausted with life and longed only for the long- long nap as he called it. He said it was so difficult for him to get out of bed and participate. He had had a wonderful life; he had no complaints, but he longed to "go".
Many of my patients when I was an RN felt the same. They told me that they could not tell their families this because their families would not hear it, would negate every word they said. So they were left to share their truth with a virtual stranger, their RN.

You lovely Mom will not complain to you. She will likely go just as she has lived. With grace. You are so lucky to have had her all this time. My heart goes out to you BOTH.
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Justsotired Apr 2023
Thank you. I realize at 99 her mental capacity won’t get better, it’s just that it happened so quickly after she moved. Like your father, she often tells me she is ready to “go”. I think it’s just that I am not ready for her to go.
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I think folks "thrive" in AL when they move when they are younger (think mid 80s) and more resilient.
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God Bless your mother at 99. She has lived and thrived in the past but has declined enough to want more rest. It does take longer to adjust from a move, a major stress event but hopefully not much longer. Like in infancy, comfort is vital.
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I am 67 and want to eventually move to where I will age in place in the next five years. With my disability, moving will be a major adjustment for me and hopefully supported enough since my only family able to help lives out of state.
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My mom declined with the move. She was at a deeper stage in dementia that it sounds like your mom is. I am not sure if the move caused the decline (changing environments is certainly stressful) or if she was already confused and hid it well due to her familiarity with my house. I suspect a little of both. She was so familiar with my house that things came easy by routine. When she moved she had to remember and think about every function and that was stressful for her. She did not adjust well. She did not like so many folks coming into her room. She was an introvert and wanted to be left alone which is impossible in her condition. She did finally begin to enjoy some things and was there about 5 months and passed in November. I suspect congestive heart failure even though we are not sure.

I have written before that I believe personality plays a role. I saw many folks adjust very well. They were social and enjoyed having new friends. That was not my moms nature and that made it more difficult. She would have been happy had I been able to stay every minute with her. I was familiar and made her feel safe.

Give it time. Your mom is going to meals. (my mom would not). She may find friends that can give her new energy. I wish you well during this difficult journey.
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Justsotired Apr 2023
Thank you. Everything you wrote is identical to my situation.
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Safety and comfort for her as well as free time for you. Last leg of the journey, don’t second guess yourself and agonize over the specifics.
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I am sure the move is the issue. When my dad turned 99 his doctor and others he interacted with were all amazed how he was at the top of his game as they described his mental capacity, mobility wise no. I imagine the PT is to much for her at her age. My dad said no more PT and PT agreed his knees were shot and PT hurt making it exhausting. My dad in his last weeks said I guess I will need to go into a AL living now. I said why? He said because my mobility is not getting better. I told him he was not bed ridden yet and with the sit to stand moving him from bed to wheelchair etc was easy. He made it 6 weeks after he turned 99. We kept him in his home. His last six weeks I slept at his home during the night but was not there all day. The night before he died was the first time he showed any confusion. He said something that was off the wall. The next morning I could not stir dad. If your mom is slipping now she is in AL. Be prepared. Maybe stop the PT and see how she does.
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May want to have her checked for a urinary tract infection as this can cause confusion in elderly.
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When you have reached that many years in life, it’s normal to not adjust to a new situation. Before moving, she felt secure in knowing what each day would be like. Her surroundings were familiar with her things and family, she knew the foods she would have that day, where her tv was, her bathroom, her clothes, etc. She knew her reality and routine. All that has changed and she has to develop new ways in her brain to remember all this newness. It’s very exhausting, challenging, stressful, and a bit scary. Some people adjust and others never do. I hope that it gets better for her. Best of luck!
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Our memory slips and foibles are less noticeable in the context of our old familiar surroundings and routines, that could be part of it. Plus I think that at 99, forced to give up her past life (however willingly), either subconsciously or overtly there is the realization that this is the end of the line, and the drive to push on wanes.
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As someone said, do not second guess yourself. You said she knows it is where she needs to be.

Yes, the environmental change could be throwing her but she could have been on the cusp of a mental decline before moving. Because she sounds like a private quiet person, it is a bigger adjustment than for some. Parental care decisions are so tough. My MIL has had periods of sudden mental decline with and without environmental changes.

Some have suggested that she drop PT. You might talk to the doctor. Does your mother have a good or bad attitude towards it? My MIL seems to thrive mentally after she has some physical activity. A couple weeks ago when our son was visiting from out of state, her conversation was nonsensical. We then went to chair volleyball and played with her and the other residents. She enjoyed it and seemed to be more "with it" after playing. Same is true after exercise class. Exercise programs are a key element in memory care so if you do drop PT, try to get her to any exercise classes that may be offered and maybe walk a little bit with her...as long as it is safe.

I suggest when you visit, go to activities with her. Talk to the other residents and draw your mom into conversations with them. Also, try tapping her long term memory as it is usually better than short term memory. That success in remembering certain things would make her feel good and if she doesn't remember, there is the good excuse that it was a really long time ago. I took a 1949 picture of my MIL when she was 16. It was her standing in front of a train in Denver before leaving for National Girls State. I know she had not seen the picture for a long time but she knew the name of the girl her age in the picture and that her suit was blue. She told me a little bit about that trip. She told me once that she didn't mind me asking her questions about things she did in the past.
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This " decline" has been experienced by many in the midst of adjusting to new residence. Even though " she decided to move there" ( and this is a blessing that she cognitively made decision and is not fighting to leave), there are still challenges. And, you say that she is 99 years old !!! God bless her ( and you). Honestly she may have sensed her decline more than she let you know while still living with you ; and her decision to go to AL may have been guided by her sense of decline and change : and she may have wanted to protect you.. It certainly sounds like she is getting a lot of therapy; you may want to be sure that her PCP is informed about the changes being observed and perhaps have her assessed further for level of care needs. There's always the chance that all of the PT and OT etc is actually too much for her. Ask her what she wants; does she want the OT , PT ? As long as she is cognitively expressing herself well, respect what she wants and does not want; " patient rights". Sometimes family want lovingly to see their loved one " thrive" and, hard as it may be, the treatments , therapies etc help the family feel better more than the pt.
She may just need to rest more and, take a less scheduled pace for a bit. Again, talk with her; ask her what she wants and, honor that.
Practice self care for yourself!!!
Blessings
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Yes after a fall for a broken hand my wife was in a care facility for a month. Before going in she could walk with a walker go to the bathroom shower and feed herself. After that month stay she is bedbound and can not stand and wears a diaper. Everything has to be done for her.
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Unfortunately your person has intuitive knowledge of being moved, feeling orphaned.
Try having a heart to heart as to the reasons that you are protecting her by the move, financial, physical or social.
Ask God to direct your words.
We are all connected in our souls.
Old people like children are more intuitive than those of us tied up in daily living.
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LoopyLoo Apr 2023
How do you know she feels orphaned?
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To be blunt she will unlikely "thrive" ...because she's 99. My mother is 98 and finally we had to move for her to assisted living last July, and she is now on hospice level. Though she is mentally relatively alert, her memory is declining. Yes the move was disconcerting for her, but the fact is at 98 few are thriving. She can't do things for herself, she can barely see, she can barely hear so she can't participate in conversations, she can't walk past a few steps, she can't go to the bathroom by herself, and she needs assistance with...everything. This does not make for a fulfilling life for most people. My mother had lived long past a natural life span, and everything is starting to go, naturally. She was in PT but complained about it a lot as it was hard for her, and because she has congestive heart failure etc they stopped the PT and she just goes to exercise class now and then. I think the PT was hard for her because it seems pretty ridiculous honestly to expect her to "improve" at 98. As I am 62 and she's my mother I have a bit more emotional acceptance (I understand more the pains and difficulties of getting older then I did 20 years ago), and I'm ready for her to go.
Your grandmother is in the right place, and she is lucky to have such a loving caring grandchild. We should all be so lucky to have one person at least who doesn't want us to go. But at her age she's not going to thrive. Just keep loving her and that is the best support you can give her.
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I would add one more comment to this topic. You cannot change someone’s basic personality. You cannot make them what they are not. As much as I begged my mom to go to the dining room, participate in the activities, make a friend….she would not. When she was younger she could go for days and not speak to anyone but me on the phone. She loved her own company. She certainly adjusted some but was never going to thrive. Dementia does not change their personality. It may just bring it out more. I ended up providing activities that she would enjoy when she was alone. Helping her be herself and not pushing her to be something she was not. I hope I am making some sense.
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Justsotired: Perhaps her age is the primary factor.
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Agreeing with those who say to drop PT. My mom is in AL, just six weeks now, and is also cognitively declining. The PT they insisted on doing—because insurance ok’d it, so they were off and running—totally wore her out. And aggravated her stenosis, IMO. Dropped the PT this week and now doing occupational therapy 2x a week. A therapist takes her to activities, and around the facility (so she becomes accustomed to it) and so forth. There will be just 4 weeks of this. Then I want them to leave her alone.

Mom is 85, and is also having a hard time with the lack of privacy.

We are going to try to wait it out, smooth the bumps. But like you, I was hoping that mom would enjoy some of the activities and meals more. Perhaps it will take time. But I am prepared for the possibility that the decline that forced her into AL might continue at an accelerated rate... hard to accept that things might not improve. No one lives forever, unfortunately. :(
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My mom is also feeling overwhelmed in AL after moving 2 months ago after a fall and delerium . Now on hospice with Lymphoma and Alzheimers aged 92. I am blessed to able to visit her often ( almost everyday) and her biggest stressor is the staff " popping in" as she calls it. I have reframed it for her as it is finally her time to be catered to , and this seems to please her, as she has always had Narcissistic tendancies. She knows and verbally expresses that she is in a safe and comfortable place , but this is very hard for me not knowing where she is exactly , in both the lymphoma and Alzheimers processes. She is noticeably weaker and more confused , but also has some good days where I can take her to bingo or outdoors to sit in the sun in the few nice days we have had so far. . My brother refuses to help, wont even visit her, and her entire family is now gone, so my husband and I are her only contacts other than occasional hospice workers.Being older myself( 68) , with many health issues, including newly diagnosed long COVID after breakthrough case in November, im very tired and stressed as POA for both health and finances , trying to keep all her affairs in order ..not knowing her prognosis or what to expect in the days ahead...The most exhausting and frustating part is to try to keep on top of her cares, as the AL staff and hospice dont seem to communicate too well with each other.....!
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I think I have a different perspective.

My Mom was 99.5 years old when I put her into Memory Care (she went willingly). At the time, she was a fall risk and we had caregivers who came in 9 hours a night to ensure that she did not fall when she used her walker to use the bathroom (in excess of 20 times a night) and the kitchen. She could not cook for herself and was starting to piddle on the floor and say it was not hers. She wasn't strong enough to turn on a faucet by herself or cut meat with a knife. She also went to senior day care where they ensured she did not fall during the day. Although she complained, she pretty much had people ready to help her in whatever she did, She did have edema in her legs. I made her exercise nearly every night because if she sat too much, her arthritis in her back would be very painful, instead of the constant dull ache.

She went into Memory Care using a walker full time. I did not want to pay for a caregiver to watch her, therefore, we did the "at night, they come by every 3 hours to check on her." After about a month, she started falling, nothing hard, just a crumple, usually when she was sleep walking. no bruising. I became more vigilant about the exercise and she didn't fall any more. However, I did notice that the MC was trying to get her to use the wheelchair more.

...and her incontinence was getting worse so they put her on a toilet schedule...and her ability to judge distances was worse which made the wheelchair more important. However, the caregivers were so so kind to her and in fact, would jump up and get her something if she requested it, therefore, she never really had to get out of her chair, they would bring it to her. She wanted to go to point A, they would take her to point A. They would help her get up out of the wheelchair, help her stand, help her wash her hands, etc.

At the one year doctor visit, my Mom's memory was worse, my Mom's mobility was nearly confined to the wheelchair, and she was going through Depends 2-3 times faster than a year earlier. Her balance was worse also.

However, her blood pressure was closer to normal, the edema in her leg wasn't as bad. According to the doctor, at 100, she was medically healthier than when she was 99.

So, even though I thought she was worse, apparently overall, she was better. She will be 102 in July.

...and yes, I still do exercises with her. She can't do them as long, however, I've noticed that once I get her started, "muscle memory" takes over. If I skip a couple of days, muscle memory takes longer to activate. Something like stepping on or off the curb or getting in and out of the car, taking on/off the seatbelt, takes an incredible amount of brain work from her.
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bundleofjoy Apr 2023
you're amazing.
:)
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It happened with my grandmother when it was time to put her in the nursing home 4 years ago. She died 7 months after she was put in. She was 87 when she died and when she passed away, she looked 10 years older than she was.

I should note the nursing home she was at wasn't the best option where I live and the care provided isn't as good as it could be.
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This is the reason I fought my brother against putting her in AL at the age of 96 (she lived two more years). Mom had at home care 24/7 for almost 3 years. She had been in a nursing home a few times after falls and hated it. The AL facilities I contacted told me that I would have to hire private care during the night shift when I expressed concern that she would try to get up in the middle of the night to use the bathroom, fall, then lay on the floor all night. They had only one staffer for 40 patients during the night. Fortunately, Mom could afford homecare to a trust and investment funds left to her in Dad's will (he died 15 years before she did). Mom was able to have meals, showers and get up when SHE wanted. Her lead CNA told me that she would be dead in three months if she went to AL/NH, as she would hardly eat and was down to 68 lbs. a month after my brother filed for guardianship and wanted to put her in a facility near where he lived, 160 miles from Mom's home. The CNAs assisted her in waking around the house with a walker several times a day. I visited near every month and filed the freezer with home cooked meals, desserts and quick breads, which I knew she would eat. Not everyone has this option.
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Hi Justsotired, has your mom improved with her transition?
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Justsotired Apr 2023
Thank you for asking. The past few days, the staff has noticed that she is “not right”. I noticed it too when I talk to her - very confused. Her PT noticed it today and said she will talk to the nurses and suggest a urinalysis for UTI. I read about UTI’s and confusion all the time here on the forum but it just did not cross my mind. I feel so stupid that I didn’t make the connection. Hopefully they will get to the bottom of this.
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When my OL entered her “hotel” (her word) she APPEARED to be relatively intact cognitively, at 89.

She LOOKED GREAT, and was able to maintain a social conversation with a stranger.

At her entry, she was self identifying as a fall risk, and had refused to stay by herself in her home, and had also refused modifications to that home, where she’d been born.

About 6 weeks after her admission, she’d begun to reveal significant cognitive breaks and had become a flight risk, and was transferred to a locked Memory Care unit in the same building.

I immediately sought a formal cognitive evaluation, and the psychiatrist informed us in layman’s terms that she’d been able to construct a “donut” of lucid discourse to conceal the fact that the core of her ability to understand, reason, and retrieve information was rapidly deteriorating.

We, her family, realized that this description was what we’d observed even before she’d been placed.

As she adjusted to her new surroundings, we could see the overall effect of her dementia get slower or faster over time, until a COVID infection resulted in a more significant loss.

My guess would be that this may be a more common occurrence than some of us as loving caregivers might easily miss. We were surprised at the psychiatrist’s assessment, but soon realized that her comments were accurate.

Hope some of you may find this possibility helpful.
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