Ideas for mum in care home

[Mxflamingnoravera]

I've been here before in cockroach cafe, telling the tales of the Grimm bros. Luckily they are out of our lives now. Mum is in a care home and has vascular and Alzheimer's dementias. Since Covid the home don't have regular activities and mum needs to be occupied otherwise she ruminates and invents things to be angry with me about. Currently it's accusing me of stealing her car which she drove to the "hotel/train/boat" where she believes she is staying. She's in mid stage of her dementia has no short term memory and is ruminating about "going home" to her mum and dad, or her (dead) husband and gets angry when I don't drop everything to collect her and take her "home".

I know these kind of accusations are normal for dementia sufferers but I need ways to divert her away from this topic. I tried getting her a simple pattern and wool to knit, but clearly she cannot knit any longer, I visited yesterday and the balls of multicoloured wool had been tangled into mini balls divided by their colour but all still joined and she accused "someone" of unravelling the knitting she had done. I could see what had happened, she'd tried to knit but knitting ribbing was too much for her because she can't remember whether the last stitch was knit or purl and unravelled it and then (probably) thought that sorting the balls of multicolour wool into individual balls was what was needed and made a huge tangle of wool. So, I realised that knitting is not a good occupier of her time and thought she clearly likes or is motivated by sorting tasks and wondered what else I could give her to do that will keep her occupied.

Are there any sorting activities that others have used to keep their folk occupied whilst living in care with little to do apart from eat and sit?

After yesterday's visit I came home and wept, she was so angry with me about the car and exposing her inability to knit any longer, she is full of anger and anxiety and I take the brunt of it. I dread visiting and phone calls because I know it's going to be the same old round of accusations and anger towards me. I'm an only child, I live alone and work full time, I'm exhausted by the responsibility and accusations.

How about a nice box of buttons to sort out? A big basket of socks to sort and ball up (ask everyone you know for outgrown socks), similarly gloves. Tangled up ribbons/ wool to make into skeins. Basket of dolls clothing which needs folding. If you can find enough things (you could get beads instead of buttons and a divided box for her to put things into by colour or whatever she likes) you could just rotate them.
Maybe another sorting sort of thing would be putting recipes (you'd need a stack of magazines to tear them out of) in a scrapbook if she could manage a glue stick

I'm hoping I've understood this properly as I don't want to offend - how about a large box of small bits of lego she could sort by size or colour? Perhaps tell her the school needs it doing? Coloured paper clips?

Ooh buttons, I have loads of buttons all sorted by colour in jars! I could tip them all into a big tin and ask her to help me by sorting them (back) into their colours (obvs, she will just get the tin of mixed buttons and won't know I've desorted them for mum to fiddle with.

Ooh yes, lego, I've loads of that! And she was a teacher she might like that too.

I work in a care home and there is an activity team who help distract/ entertain the residents. One of our residents is a real magpie and if anything is lost we look in her room first ! Do you have an odd sock bag ? Maybe take it in and she could have hours of fun pairing socks or suggest she stuffs the socks and makes dog toys…this really worked with our magpie 💕

Nora what subject did she teach?
There might be something connected with lesson prep.
Glad the Grimm Bros have exited your life. So sorry you were in tears yesterday. It truly is painful when you are the punchbag.

You can buy fiddle cushions or muffs. She might not be at the stage for them yet but when she just wants the stimulation of different textures they can be useful.

Something like this www.nrshealthcare.co.uk/health-aids-personal-care/games-craft/sensory-stimulation/fiddle-muff-denim-cord?sku=S07284&gclid=EAIaIQobChMIx9OlvIr48wIVmpntCh2wlADYEAQYAyABEgJEofD_BwE

I think it is very hard to deal with the accusations and anger, I've had that, I'm onto the stage where she doesn't know me and can't communicate well. It is a horrible condition.

I hope you are getting some support.

She taught chemistry, physics and biology. But loves anything to do with children, so the Lego might work.

The home had a wonderful activities coordinator but he retired in December and has not been replaced because of Covid. So the general staff seem to be trying to organise stuff but they are busy caring, I was going to move her to a specialist dementia unit but she's not at the stage yet where she would accept it- she'd look around and get angry with me because most of the other residents are further down the dementia journey than mum is.

I don't have odd socks to take her but buttons and lego I have aplenty.

I wondered if she could make fiddle muffs but the knitting thing has made me realise that perhaps she's nearer the stage of needling one than I thought. She'll do stuff if she's told to; jigsaws, painting etc but won't instigate them herself so I think she just sits and ruminates. And she's such an extrovert she suffers existential angst if no one is validating her.

Playing cards - muddle up several boxes with different backs and have her sort the individual decks.
Shame Covid makes Duke of Edinburgh / prospective Medicine/ Nursing student applicant activity visits difficult. She could have done some ‘tutoring’ for a young person who was actually spending time visiting her to achieve ‘work experience’. Probably too difficult to do online.

I used to take Mum the old photo albums she made when she and Dad were traveling. She could pour over them for hours. Once she stopped recognizing people and places I'd just make up stories about 'my friends' in the pictures. Then it became folding a stack of cloth 'hankies' over and over. Eventually she was just lost to our world and alone in hers. We lost her to Covid last February, but I've been 'missing her' for years.

The accusations are so painful. Our once lovely mum accused my DB and I of drugging her to steal her money/silverware/some random trinket. She accused my DB (who lived with her and was her carer) of 'keeping women captive' to the point where she actually called 911 on him in the middle of the night telling the police she could hear a woman crying in his closet. When she started to wander and bang on neighbor's doors in the night, that was when it was decided that she would have to go into a care home. Oddly enough, once she was in the care home most of her delusions vanished.

I wish you luck. It's a hard row to hoe. Truly the 'long goodbye'.

Great ideas about button sorting etc!

Would she be able to manage simply jigsaws do you think, op?

I noticed when looking for Christmas animal drawings that there are lots of colouring books for seniors. Would she like colouring in?

Crayola has some pencil type crayons called Twistables that don't need sharpening.

The other thing I have seen is lifelike stuffed dogs or cats. People will dementia often like to "care" for them. It sounds silly but I have seen it really work.

When my grandmother was in a care home with dementia, doll therapy absolutely transformed her quality of life. It gave her a purpose, something to love and care for, and a companion. I would recommend it to anyone.

Simple jigsaw puzzles, adult colouring, collage and maybe even very easy quiz/ crossword things are often enjoyed by my patients with milder dementia and are things they can do by themselves although they tend to lose concentration on things quite quickly if not supervised.

They love to feel useful so sorting out/ folding laundry, laying the tables, making their bed, watering plants or doing some dusting are also things they can do and like to do.

Reminiscence with old family photos or maybe old photos from the local area is usually a good one and she might be able to write labels or a memory for some of them for you and/ or stick them in an album.

It's really a shame that staff are not engaging her with things like this because she probably isn't able to start and persist with things on her own but could if encouraged by staff. They only need to start her off and check back with her and if they get a few people doing an activity together in the lounge it shouldn't be so onerous. There really should be an activity co-ordinator and regular stimulation for people as part of basic good dementia care so I think you should ask the manager what is being done about replacing the activities.

Are there any other residents in the same boat who could play a very simple game with her eg dominoes, snap or beetle drive?

When you visit you could try to do one of these kinds of activities together or look at photos of grandkids/ read newspaper together to distract her away from making accusations

Good suggestions already. I would want to rule out depresssion/under treated depression and/or anxiety too. Does she take any medication for her dementia e. g memantine?
Eyes recently tested and hearing OK?
Any pain or suspicions of pain?

Your right these are common features of dementia but changes can also be due to a number of other things.

Are you able to decorate her room like her old home or bring in photos or pieces of furniture from there so she feels orientated? Distraction is the best technique to be honest, go along with their story or beliefs and don't keep reminding them where they actually are as this causes more distress that they don't have the cognition to effectively deal with.

Mum is on sertraline for depression and has been for 2 years, she is also on memantine for agitation which was awful for a few months but settled after 12 weeks as the drug titrated up and settled in her system.

She has all her old pictures, photo albums and family photos along with vases and a dementia cat which she loved at first but now rarely touches. She has her paints and loads of crayons and colouring books to hand but she really is just lost without being instructed to do anything. She can do jigsaws and has loads but needs someone to sit with her to remind her to keep going, otherwise she just sinks into sitting and the rumination starts and the sundowning comes up on her and she wants to go home to her parents. I have done loads of reading about the symptoms and they are all classic of her conditions.

She refuses to let me make an opticians appointment for her but has not had her eyes or hearing tested in at least 2 years so I suspect her sight is declining and her breath smells of mothballs so her teeth need a good clean by a dentist but no local dentists are doing hygeinist appointments and she is not registered with one locally. I have to take her to all her appointments outside the home and this means I have to take time off work to do this.

You are right about the long goodbye Across the Pond it is an awful thing to see a clever woman who was so capable and in charge dissapear in front of my eyes.

I frequently get the photos out when I go because it whiles away the hour or so of permitted visits and she loves to remember all the people in them. Her long term memory is still functioning but her short term is gone completely, nothing is retained for more than a second or so.

Thanks for all the ideas, I will take buttons next time I go and ask her to do me a favour to sort them out for me by the next time I visit. I think I may also resort to "just nipping to the loo" on departure because me leaving causes the car stuff to re-ignite and I end up leaving her angry because I have no satisfactory answer to where her car is (I have said it is in the garage being repaired, I have said there is no petrol so no point, I have said it needs an MOT/insurance and so she cannot drive it- but she gets furious and says I have stolen it and I am lying and she wants it NOW).

I just wanted to say OP that you are a wonderful daughter and your Mum is fortunate to have you.

It is so very hard to watch a parent decline like this. My Mom had dementia and she too could not knit any more. She was an amazing and gifted knitter all her life.

She was also a fantastic cook. She was reduced to storing tomatoes in the dishwasher.

It was so very sad. I really empathize with you. You are doing all you can. I expect the car thing will pass. My Dad had only mild cognitive changes but he too was obsessed with his car. It is a real symbol of independence.

A work colleague found music therapy useful with his Mom.

Take care and be kind to yourself.

First of all does she have the cognitive or fine motor skills to attempt an activity independently? Apart from that she probably only has a short concentration span so will need constant prompts to keep on task.
You could provide lots of person centred resources for her to use but she needs 1 -1 supervision to get any value from them and stay on task.
Possibly you have seen those battery operated cats that move, miaw and purr, expensive at over £100 but may be worth a look.
How would she respond to a real life baby doll, it may sooth her, or a good quality soft toy animal.
I am an activity coordinator in dementia services.

Make pom-poms? - you could do the cardboard bases and show her what to do. Might she be able to manage that?

We have an optician who visits DM in the care home who specialises in dementia - goodness knows how they test her …
Dentist visited DM a month ago as she’d pulled out another tooth and care staff asked for it to be checked.
Chiropodist also attending.
Maybe you could run through a list with the admin person about which services are still running and avail yourself of all those if that could save you taking her and using precious leave.
Also there are some companionship services out there- Driving Miss Daisy is one that springs to mind. Would her pension stretch to you paying someone else to visit her once a fortnight and maybe taking her for a car run?

Second above - the care home I work into also has visiting dentist, optician and chiropodist. Residents pay through admin.

She had a dementia cat, it was great for about a week, but now she just looks at it and says "it's not a real cat".

She can still paint watercolour reasonably well, but the pp who said she needs one to one is right, her concentration is almost zero.

She was horrid to me as a baby and small child (post natal depression in the early 60s) she's not one for baby stuff as far I know, she's always liked older children better. I'd be happy to try a baby doll but I suspect she'd ask me why I've brought a doll. She's very lucid on the surface but totally in her own world underneath. She needs to feel needed and to hear thanks and praise (a bit of a narcissist I've often thought) babies don't offer that reinforcement. There's a reason why I'm a singleton.

Could she cope with a knitting Nancy? Or a simple child’s sewing or weaving kit? Or a children’s craft kit eg painting cork drinks coasters?

I’ve been there, it’s horrible. My mum just refused point blank to ‘do’ anything! It’s so hard.

I need to get firmer with the home I think. I need proper updates and to know what their plans are to replace their activities co-ordinater. I'm a bit scared of being "too demanding" they are constantly reassuring me that she is fine.