My mother is a very healthy 98-year-old who has been living with me for many years. The past two years have been so difficult, her dementia became violent and she hallucinated that the sitter and myself were trying to kill her. She no longer recognized me. She wanted to move back to her native country of France. I actually took her there to visit for 6 weeks and I almost lost my mind. She did not recognize the place or the family and screamed for the police to get her out of there. She refused to eat what I prepared because she thought it was poisoned. We came back home in what I can describe as the most difficult flight of my life and all she has been asking for is to go somewhere else where there are people her age.
I found a beautiful Memory Care a few minutes from my house and got on the waiting list. It took 3 months and every day she would pack her bags to go there. Finally we moved her in and once she was there she wanted to leave and go back home (meaning France). It has been three weeks and it's been a very rough start. The first night, the nurses aide came to change her and my mother refused. The aide got very rough with her and forced her on the bed and forcefully changed her. Thankfully I have cameras and was able to see this and report it immediately. She was fired on the spot.
Now my mother gets aggressive and screams and kicks any time someone wants to change her, put her in bed, etc. She has "forgotten" to speak English and only speaks French to the helpers and to the other patients. She says she does not understand English at all. We have lived in the US for 50 years, she spoke English all that time. She is on Seroquel and an anti anxiety med.
I am at a loss of what to do. I visit her every day, bring her gifts, nothing works. Surprisingly, she now recognizes me as her daughter. I am considering bringing her back home with me but I am afraid she will do the same here. Any suggestions?
None of the behaviors you’ve described are surprising, and none of your efforts to comfort her or please her are unexpected in your position as a loving and devoted daughter.
Unfortunately you mother may have arrived at the point in her progressive neurological deterioration that none of your good ideas can make ongoing sense to her.
Three weeks is actually a VERY BRIEF span of time to expect even limited adjustment to a totally new environment. When my LO entered a very good local MC, we were thrilled when after about 6 months she began to respond positively to her new lifestyle.
Unless the staff has encouraged you to do so, you may be visiting too much (and worrying too much and empathizing too much), for her welfare AND YOURS.
Part of the adjustment to residential life is for the resident to slowly realize that caregivers are there to HELP THEM. If a caregiver/relative is too often present, you can see how that process can take longer.
Obviously you and she are both still dealing with the horrible, DEPLORABLE experience with the banished aide, but assuming her current care is acceptable, she will hopefully move forward.
The bilingual issue is interesting. As long as she has some comprehension of what’s said to her AND a willingness to communicate in some way to express her needs, it may not be too important at this point.
You have attempted to move Heaven and Earth (literally!) to do your best for her. Now give her some time to just observe and become accustomed to her routine, BY HERSELF.
Your concerns about bringing her home (another MAJOR CHANGE) are fully justified. Her “illness” is progressive. Change can exacerbate her struggles.
You may want to enquire whether there is a psychiatrist on staff at her MC. A small dose of medication may be helpful. It was a Godsend for my sweet LO.
Hugs and hopes that you and she find a good balance at some point in the not too distant future.
You need to give your Mom some time to adjust. I see nothing wrong with showing up sometime during the day but don't stay for long. Get her out in the Common area where there are other people. Let the staff do for Mom.
I would not bring her home. Stop feeling guilty about something you have no control over. You will enjoy her more if you're not doing the constant caring. France is not going to happen. That is not your fault. Your Mom is 98! The mind and body have to give out at some point. Look at the years you had together.
T Champ is correct, regarding the language and brain layers. If you think of that onion being eaten away from the outside in, you can get an even clearer picture of what is happening.
At my mother's MC, there are MANY Hispanic people there. Most were truly bilingual before dementia, but who now only speak English. In Florida, luckily for them, we have many caregivers who are bilingual.
It might be interesting to know if your mom has any "receptive" English left. Like if a caregiver asks her a question, can she indicate a preference? Like, Mrs. Smith, would you like an apple, or an orange?"
If not, can the caregivers use more objects, or picture cards to show her the choices that she may have to make?
As an ESL teacher, I had many sets of cards that would have a representation of an object or an idea. You could make or buy some.
Here are some body part cards that you could print. I'm thinking that you mom might be able to point to something that is hurting her, for example.
https://en.islcollective.com/english-esl-worksheets/search/flashcards?vocabulary=body-parts&student-type=elementary-school
Here are some from Amazon that you can buy:
https://www.amazon.com/eeBoo-French-Flash-Cards/dp/B07F6XHY4F/ref=sr_1_1?crid=20BV1MLBLB4VO&keywords=flash+cards+food+french&qid=1651076668&sprefix=flashcards+food+french%2Caps%2C81&sr=8-1
I've even made Powerpoint slides and posted them on walls for new speakers of English.
Feel free to send me a personal message, if you need more ideas.
Thanks!
A practical suggestion is an interpreter. Any health care facility has access to this, and it is usually required by law. This can be a speaker phone or iPad connection to an interpreter who will interpret anything said in both directions. There is usually a charge for this, but it is reasonable for short amounts of time. You might also find someone in the community willing to do this or a bright teenager willing to help for community service hours.
Yes to flash cards & printed commonly used words in French for the care staff to see. They will soon get used to using those familiar words to communicate to your Mother for bathe, dinner etc.
While it is very common for people to revert to their original language, it seems that aggressive incident may have sparked a fear reaction & more sudden loss of English. I am so sorry that happened.
Having some French books, films, being 'culturely inclusive' should be the aim for any Memory Care for all their residents.
Another angle I have heard of, is to have a someone visit from a local community group. I had heard a local Polish Club would send two ladies as volunteers to meet any new Polish resident & staff - as another resource. While not medically endorced translators, having visitors that speak your language for a friendly chat was wonderful & brightened a newcomer's day. Is there a local French Community Club/Group at all?
I hope your Mother settles in & can feel at ease very soon. (((Hugs)))
I found some great shows and German music on tv that bring him back in time in Austria and lets him be in his world. It brings him joy most days and others he is now to the point he falls asleep in front of the tv or he doesn't understand what is going on anymore to enjoy the show either in English or German. Cooking shows, polka dancing from Tirol showing the town and people dressed in their traditional clothing , etc is good.
If you don't speak French I am happy to find something that maybe will work, my French is rusty, lol.
Happy shows that do not involve people also change the mood, like funny baby/dog videos, etc
Or
It is a way to control the situation and have you feel like you need to have her move home because only you can understand her. Does she speak English to you on the phone or in person and then talk to others in French or appear to not respond to them speaking in French?
As a side note, my dad reacted very badly to Xarelto he went off the wall and was very reactive to anything we would do. It was a nightmare. He also went through a time in which he would fight changing clothes or getting ready for bed, but now he has advanced and doesn't have the sense or energy to do that anymore.
I also have much more luck if I stop and tell him the next step (I mean every minute step) in anything we do, make sure his hearing aids are working and have enough light around him. I move VERY slowly from task to task or movement around him.
Be mindful of your face because they can lash out at any time and knock teeth out.
ok, here we go, one last thought. She may be feeling very horrible due to the change in surroundings. Is she using the bathroom like normal? The change may make her hold back or forget her bowel movements. When he needs to go, sometimes we have to sit with him and tell him to go because it can be days with his bowels and he is very "full" in his abdomen.
Contact the local High School or Community College. the department that teach languages might have a student or two that would love to practice their French.
As to your mom's agitation, can you talk to the director or the nurse and see if they can not medicate her prior to changing her? I can totally understand how frightened she must be after being forcibly changed. (thank goodness you witnessed this and reported it)
Just so you know, I don't have personal experience with what you are dealing with. However, I have travelled to other countries and know there are some very subtle differences on how people interact with each other. I think you were on the right track when you visited France. However, your Mom might be too acclimated to the American version of France. Are there any Memory Care facilities anywhere in the US, in a French-American environment? I suspect what could be triggering a lot of the aggression is her lack of security, with her illness and mental state, and also the way she is being treated; it is just not close enough to the respect and empathy that she expects. An acquaintance ended up putting her mother in a facility in Japan because the way that they treated the people in assisted living in Japan, was more aligned to what her Mom expected. Her mother lived the first 18 years of her life in Japan. She needed the Japanese "structure" once dementia took hold. 2 years later and her Mom is thriving.
I have been told that it takes a minimum of 6 weeks before one can get an indication of whether the AL facility is compatible with an elder. That's with people who hear and think and have grown up speaking US English in America.
I feel for you. Please take care of yourself. Keep on observing and changing and trying. Flash cards are okay, however, as good as the facility is, finding a facility has care givers that speak French, even if it is not native, might bring your Mom more peace.
I wish you a lot of luck.
P.S. Dementia is weird in that some new experiences are kept and others just pass through. Because your Mom had a bad experience at that facility, she may never ever feel safe again there. I've been told that bad experiences are stronger memories and therefore are more likely to be retained and used as reference.
Even dementia patients have rights to communicate.
I am caring for my bride of 31 years. The day she goes to Memory Care will be the hardest day of my life. But once I place her I know bringing her home would be a very unwise choice. I would suggest you not bring your mom home. It will make your life even tougher for both of you.
I’m sure you visit with the neurologist but you may ask him/her if meds need to be adjusted. Care for one living with this wretched disease is nothing short of an arduous journey. It is a moving target. Therefore meds need frequent adjustments.
Besides Seroquel there is Trazodone, Memantine, and a host of other pharmaceuticals that can help calm your mom. When my wife gets too agitated, which is rarely, I have to administer Haldol.
I hated using meds. I felt guilty for doing so. But at times it is the only way possible to get her to a place of rest and peacefulness. And I don’t mean for me, but for her as well. No one wants to live in torment and fear as your mom does when she needs changing. It’s scary to her. So meds can definitely help.
One more thing. If you or your mother can afford it, consider having a caregiver from an outside agency come to spend a few hours a day with your mom. Maybe you can ask agencies if anyone speaks French. If someone visits her daily at the MC facility she would get used to them and maybe they could help change her when necessary.
Praying for wisdom and peace for you!
If your current neurologist cannot adjust her meds appropriately, then find a second opinion.
I wouldn’t bring her back home unless you have a team of helpers to assist you.
Supporting you in spirit~
This lady's videos are very helpful:
https://youtu.be/r5Mj6yzVo_U
Do not take her back to live at your house. Please don't do it. You will be sorry you did. Stop visiting her every day too. In fact, don't visit her for a few weeks. She has to get acclimated to her new surroundings. She also has to get used to being taken care of by people who aren't you. As for the aide who 'got rough' with her when it was time for a diaper change, your mother is aggressive. In such a case the facility should have sent two aides to get it done. Or had one of the nurses on duty get up and go with the aide. The facility instead fires the aide for what was their mistake in the first place.
Let your mother get used to her new place and the new people caring for her. Don't visit for a while. Call her daily and request that a staff member communicate with you daily or every other day during the time you're not visiting to keep you updated. Give it while. Your mother will adapt.
As for the aggressive behavior, my mom had become extremely aggressive towards me at home, that is the reason I agreed to place her in memory care. What I have learned since then is her aggressive, and paranoid behavior was a reaction from her seizure meds (keppra). You may want to read up on her meds and check what the side affects are. Since my mom was transitioned to a different seizure medication her behavior is much better. I wish I had known that before, I would have kept her at home with me, Good luck.
It’s a big help if the ‘right’ language is available, but sometimes it isn’t. Remember that a very very small number of Navaho speakers were actually used in WWII as an alternative to code, because no-ne else could speak the language except this tiny group of older people. Where I am, the local language groups usually have a club (often with fantastic food), and some of them actually operate a NH. Mostly the bigger groups, like Greek and Italian, but if you could find a French club they might have some good suggestions. Older people losing their most recent language is very common, you might find that Alliance Francaise have ways to cope in your area. The last poster I suggested this to, went out and found Finnish speakers in Melbourne! Don’t give up!
Hugs 🤗