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Since we added several caregivers, my mom has shown increased cognitive decline. Wondering if the stream of strangers flowing in and out of her life is contributing to it.
I'm keeping the caregivers regardless; it's a matter of mental health for me. But anyway, I wonder...?

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Could be the frequent changes are causing her stress, so additional confusion. But, you need to take care of you too.
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BelleMolerab Mar 2022
I agree to both of your points. Great answer.

And a word to Rosa:
Perhaps you can find a nice and warm caregiver, of your mom's preference. Maybe that will make it easier for her?
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The cognitive decline in dementia is progressive and it has nothing to do with external factors. The decline is not uniform and it varies from patient to patient. The progression of the disease is due to the death of brain neurons and the rupture the lines of communications among them. Actually, the brain falls apart little by little and lose its functions independently to what is happening on the outside.
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gladimhere Mar 2022
External factors have everything to do with dementia and decline. A stable and familiar environment are among the most important factors in not increasing stress and agitation that will worsen and increase dementia symptoms. Search this website or Google it. It is well documented.

https://alzheimersproject.org/the-importance-of-routine-and-familiarity-to-persons-with-dementia/
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I can't claim to know one way or the other, but in another thread I mentioned a 101 yo woman I cared for with dementia. I mentioned how I observed that the manner in which other aides and family dealt with her caused her meltdowns. I didn't mention another observation.

Every day she told the same stories over and over. I asked the family permission to take her out for adventures, just the two of us. We'd sit by the lake or go junking in a couple old barns turned antique shops, that kind of stuff. Every time, the new stimuli would spark memories she'd forgotten. She had new stories! It gave her so much joy to rediscover these things.

There's a connection I'd like to draw from this to your situation, but I'm lacking the words/terminology to do it.

There certainly can be a connection between external factors and behavior (good or unwanted). I think memory care units use controlled stimuli.....
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The number hours a day your mother is with caregivers and how they interact with her can speed up cognitive decline. Is she with a different caregiver round the clock? Do the caregivers work WITH her or FOR her? This is important. Many caregivers treat their clients like helpless infants and will do everything for them because they lack patience. It's faster, cleaner, easier, and more convenient for the caregiver to just do something for them when they should be having them do for themselves. It's not better though. When an elderly client is treated like a baby they become like one. Any level of independence should be strongly encouraged.
Any caregiving position I ever took always came with an explanation to the family that I am not a child care provider or servant to them. I will not spoon-feed a client who is still capable of getting food into their own mouth because it's faster and makes less of a mess to do it for them. I won't. I'll clean the mess up. I always made clients of mine be pro-active in their own care as much as this was possible. Small things like making them comb their own hair or looking after the soap and holding the washcloth when it's showering time. Some clients I've had were totally invalid and all they could still do was hold on to the bed rail during their diaper changes. I always encouraged them to do it and thanked them for it.
As a caregiver I would create "chores" for my clients to do. Things like folding laundry, sorting socks, clipping coupons.
Everybody in my neighborhood used to drop off the Sunday paper with all the coupons at my house for my care clients. I'd give them a pair of childrens' scissors and go to it. Some were in advanced dementia and couldn't manage that, so they ripped the coupons out with their hands. Fine with me. It gave them something to do and made them feel productive. People need to feel productive even when they have dementia. A person with dementia goes down faster when they're treated like infants with everything done for them.
Observe how your mother's caregivers interact with her. If they're treating her like a baby waiting on her hand and foot, put a stop to that fast.
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bundleofjoy Mar 2022
"I will not spoon-feed a client who is still capable of getting food into their own mouth because it's faster and makes less of a mess to do it for them. I won't. I'll clean the mess up. I always made clients of mine be pro-active in their own care as much as this was possible."

EXCELLENT.

i bet you were a wonderful hired caregiver!!

"A person with dementia goes down faster when they're treated like infants with everything done for them."

use it, or lose it.
they start forgetting how to do it themselves.

"When an elderly client is treated like a baby they become like one."

YES.
i've noticed caregivers who speak in a baby voice to elderly people.
(they mean no harm, but it's very bad).
the elderly person also stars mimicking and speaking in a baby voice, when they're totally an adult and in many ways totally capable.

i bet you were an awesome caregiver, burnt!

i know you're still caring for your mother.

hug!! :)

----
dear OP,
:)

i'm sure you're doing an awesome job with your mother.
we had many caregivers at some point (agency). very annoying. i had to explain over and over, to new people what needs to be done please.
(we had a list that was very clear, but many caregivers didn't want to read.).

i hired private caregivers.
we had enormous luck. they are very kind, competent -- and now we don't need to rotate between many new people.

but often there's no choice:
for a long time, we had that agency (in other words, almost every day, new caregivers).

you're doing your absolute best, OP.
i'm certain you're an awesome daughter!

bundle of joy :)
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I agree with gladimhere, that it can increase aggitation and stress (which doesn't help one with dementia). There is no way to prove it speeds up decline since each person's cognitive decline will happen at a different pace, and you can never know how fast it would have gone for her in a different care scenario. Please work on peace in your heart that you are doing your best and not causing her decline to speed up, since this is unknowable. Put your energies into positve things and more self-care.
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rosadelima Mar 2022
Thank you so much.
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Because some people believe that "tender loving care" will improve dementia in a dear one, they feel very guilty after the patient dies. They blame themselves for not having done enough. It's true that TLC seems to "improve" the dementia symptoms, but it's only a superficial appearance. Inside the skull, the brain continues to crumble and shrink by the killing effect of the disease on the brain cells. Once dementia hits, it's a death sentence. They may live a short time or a long time, but nobody will ever recover. Let's be realistic and stop blaming yourself or the staff in memory care or NH, for not taking care of the smallest details in caring for a demented patient. Do your the best you can and that should be sufficient. Killing yourself for somebody who is already dead (for all practical purposes), is a non-sense.
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I don't think so. I know that cognitively my brother only improved after his move to ALF where he had so much more support, and yes, a lot more people around. He would have rather stayed in his semi-isolated almost monk like life alone, but he was diagnosed with a probable early Lewy's and he and I both felt it best he move where he had support. He had no computers, not even an answering machine, could not have made grocery orders to be delivered and etc. He made me POA and Trustee of Trust and had no long to consider bill paying or anything else. Took the tour bus to see Homes of the Stars and to movies which he hadn't done in many years, and he enjoyed that. Said it was a bit like commune living in the 60s right on down to the bickers. He improved, and the ALF, a marvelous one, said that wasn't uncommon in their experience when all worried about everything are removed. I think more often there is improvement, but given that we are all individuals and the progression of the conditions and our own personalities have a part in the play, it may vary. You can only know what is happening for your elder; you seldom can understand all the "what ifs" involved. Very best out to you. You are thinking and wondering and watching, and that's about the best we can all do.
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My mom has had caregivers in her home for 6 hours a day (2 hours in the morning, 2 in the afternoon, 2 in the evening) for a number of years. Recently we put her on temporary (we hope) round-the-clock care after a minor injury. The increase in activity in the house, many new faces, disruption to her routine, etc. has definitely had an effect on her cognition. (I do think there's something to be said for elderly people losing the ability to care for themselves OVER TIME if someone is doing everything for them, but this happened within a day of the schedule changes.) This is consistent with similar past episodes due to abrupt changes in her environment (and very common for most people with dementia). My mom generally adjusts within a few days. I would expect that the decline you're seeing, or at least the portion of it that's due to disorientation from these recent changes, will get better with time as she gets used to the "new normal," but this will also be dependent on the overall status/stage of her dementia. Best of luck to you!
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rosadelima; Imho, elders (even those without dementia) typically like everything status quo. The elder whose mind is altered by dementia could, per chance, be disturbed by too many or in your words, "several" caregivers.
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Outside events may exacerbate symptoms, but they have no effect on the speed of deterioration of the brain in Alzheimer's.
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