Risks with downsizing and alzheimers

[Jones3A]

Does anyone know if moving house in early stages of alzheimers can have a detrimental effect on cognitive decline/anxiety and so on?

DM is 75 and hasn't yet had a diagnosis, (she changes her mind about whether she wants to know) she lives with Ddad and they have plenty of money to help address the challenges ahead.

They're looking at downsizing to somewhere they can single storey live eventually, and I'm deeply worried at how unsettled and confused it could make my mum.

She's independent now and walks and drives within the local area. She is increasingly chaotic and goes to wrong places / appointments/ doesn't buy the thing she's gone for etc, but is generally safe to be on her own still. she drives to my house in a town 7m away, a mall 20m away. She can collect my kids from school.
They've lived in their house for 30 years.

In conversation she's no short term memory at all, thinks she's never been places before (eg my siblings house they've lived in for 18m), can't remember where we all work, what day it is, or anything really that's happened since covid. Half the time she thinks we're fresh out of lockdown and insists she hasn't been out in 3 years. (They've been on about 8 holidays since lockdown none of which she can remember at all, including my siblings overseas wedding).

Anyway that's all just to give a flavour of her current condition.

I'm so worried that this understandably sensible move in many ways could totally confuse and negatively impact her. Her anchors and familiarity would be gone.

Any perspectives gratefully received.

Dfil moved when he was fairly early stages but had been stopped from driving and he was fine. He can’t remember his new address now but I think that would have happened anyway. Being somewhere more suitable (no steps) has helped them both cope.

Please watch out with your mum’s driving - if her short term memory is shot then driving can get extremely dangerous. FIL was a professional and excellent driver but would forget which exit to take at the roundabout, see an oncoming lorry but forget and pull out anyway, forget to stop at crossroads. We didnt notice because he never drove us anywhere and MIL was too loyal to say anything but BIL. Please let her drive you sometimes so you can keep an eye.

If she has Alzheimer’s then the only medication option is only available in early stages, so it’s now or never.

That is very tricky. Could the existing house be adapted for the future? Are there other condiseration like proximity to relatives etc?

On the alzheimers front, if you have time take a look at this>
https://charliefoundation.org/am-i-a-candidate/keto-for-alzheimers/

Both Ketogenic diets and mct oil are being trialled to help relieve symptoms associated with alzheimers.

Both our sets of parents moved in the early stages of cognitive decline/dementia. With my FIL I think it probably did make things significantly worse initially (though it's hard to know for sure, as you never know what would have happened anyway). He found it very hard to learn where the rooms are in the new house, and I think it made him more agitated and paranoid for a while, though things improved after a few months. But the benefit of living much nearer family I think outweighed the downsides.

My mum has only got MCI at the moment (though I suspect possibly the beginnings if Alzheimers). She says she bitterly regrets moving, as she misses her old house. And I think she does, but she also now forgets the reasons they moved. She couldn't manage the big garden (and hated the fact that she couldn't), and above all she wanted to give up driving and there was nowhere walkable from the house. Now she has a much more manageable house, a small garden she can potter in, and shops, library etc within five minutes' walk. However, she found the moving process incredibly stressful (I thought they'd pull out of the sale at one point because she just couldn't deal with the stress), and there's no doubt she's found things like the new cooker hard to get used to. She's settled now in that sense, but she definitely blames us and my dad for 'making' her move.

(And I agree re the driving - that sounds worrying. She might still know the basics through instinct and years of repetition, but what if she forgets to look in the mirror and reverses into a child, or gets lost and ends up on an unfamiliar roundabout and drives into a cyclist or a lorry? I think you should definitely try to experience her driving and see what you think.)

I agree with others, as her driving is the thing you should worry about.

You let her pick up your kids from school? I don't think this is a great idea, given what you say about her general confusion.

I'd be worried about the same thing as you - plus the driving. And I agree that the actual moving process will be an enormous surge of stress which may exacerbate problems for many months.

I'd also look at adaptations to the current house. Do you think she would agree to a specialist driving assessment?

My Fil has moved my Mil several times (!) as she was unhappy.

Each move has made her worse and as he was in denial for a very long time about the memory loss, so it's been a bone of contention.

It's not a linear relationship tho so you won't know unless they do move. But I would think very carefully about whether it will actually help. It depends on how unsuitable their current accommodation is, I suppose and where they go.

There is no way I would let her drive my children! Sorry, OP, that's obviously not what you want to hear, but just no. Not with the level of confusion and lack of memory that you are describing.

As for downsizing - yes, it probably will be a source of increased confusion or accelerate her decline. Are there particular, tangible benefits to down-sizing which will outweigh any disadvantages?

Should she be driving?

I really wouldn’t have her collect the children any more. She’s going to forget where she is going one day soon and endanger their lives.

Thanks so much for the replies, and you're all quite right on the driving, which isn't something I've been focused on (as she doesn't do it that much, perhaps).
Will certainly follow up with looking at assessments/safety and take whatever action we need to. Thank you.
I'm going to try to talk to Alz UK and Age UK today, to get any "received wisdom" they're able to share. I spoke to DD about it yesterday and whilst he understood the concern, he clearly needed more weight to the argument against, if we're going to consider it a potential game changer/total roadblock to a move.

Sorry to hear you've been through this, too.
On your last point, i have been trying to get this across to dad, to talk to the consultant and be clear what could be missed/lost opportunity if they don't do it or do it later.

thanks so much, will take a look at the link, and into the diets.
The house can absolutely be adapted. And location is straightforward too if they did move, they can stay in the town.
My dad is just pretty set on the house being too much for them, and requiring more effort and cost to maintain as time goes by. They can afford it, I guess he'd just rather avoid if if poss.

I think that talk of a driving assessment will be like throwing a grenade, tbh!!
She'd be outraged, furious and totally rebellious.
and no doubt devastated and sad ,and terrified of what this means.

It's the million dollar question. My dad has just moved to a ground floor flat because his wife has dementia and he's thinking long term. The short term upset and confusion has been distressing, but if they stayed in their old house she'd need 24 hour supervision, and if she declined she'd have to go into residencial care sooner. You can't really win, dementia is horrible.

They're both still totally physcially fit and able, so no current concerns re the house, but they are being practical and looking at the future before a crisis dictates it.
They have space and money to adapt, they just think it makes more sense to downsize instead. currently mum refuses a cleaner, which we'd have to overrule eventually, and i'd have to agree to take on maintenance management issues for them. gardeners should be straightforward you'd hope.
their location is central and brilliant, so no issues there, it's a .2m walk to the town centre, doctors, etc.

thanks for this and I'm sorry to hear it for your family.
is the need for 24h supervision if they'd stayed because she couldn't safely get up and down stairs?

Does someone have LPA for finance and health for your Mum (and Dad..that isnt your Mum). I would set those up sharpish if not.

Moving can definitely impact short term, but if someone is prepared to put in the work with setting up new routines and teaching them every day, then the impact can be mitigated. But the main thing is that you need to think long term, there is no stopping the decline, all you can do is reduce the severity of the impact on her and those around her. The later you leave a move, the more significant the impact on her will be as the fewer resources she will have left to adjust. If where she is living is not suitable for the long term for her and in particular your Dad (who has to cope with living alongside Alzheimers), then my advice would be to move them as fast as you can. To reduce the stress, it might be worth just sending them on holiday, moving them while they are away and have them come home to the new house with everything put away.

Yes, stepmother has osteoporosis and has had many broken bones over the years. If she fell down the stairs the risk is just too high, she'd be wildly distressed by any hospital stay. Tbh my dad doesn't really leave her on her own anyway, even in the new place.

gardeners
cleaners
get a downstairs wet room put in- that will future proof as there can be a bedroom and wet room on 1 level
dont move away-she could die tomorrow and your df would then also be isolated
community is very important

if you do then you need to protect your fathers assets- much easier if it is a house than cash in the bank.

NB one advantage of a larger house is if they decided in future that live-in care would be the way forward. But that's a very big if.

We've recently moved in laws into assisted living from 4 bed detached house double garage. OMG the stress - every cupboard room packed full of stuff. FIL declining for last couple of years, cries of I can't cope from MIL and then it would die down, and then start up again - repeat numerous times. They live about hour and half away from husband and his brother. There has been numerous attempted scammers on FIL's computer and over the phone. Keep losing creditcards and in total confusion about most things. Would put things down and then lose them - this was another reason for moving them as its a lot of space to lose things. We felt they were vulnerable in that location.

Came to a head in November - Found out FIL had a diagnosis of dementia after asking for help for the last 2 years. He'd forget his meds which is life threatening for him. MIL was walking around half naked when they were being assessed for care needs. They highlighted this to us so this was the final straw. We tried to get him assessed for driving. He had no chance of finding his way to the assessment centre despite being driven there and given maps. We've now removed the car from him for everyone's safety and said if he can find the assessment centre and do the test, he can have it back.

We did a quick part exchange for a ground floor flat in a lovely location - mil wanted it - with a walk in wet room - mil wanted it. Doctors, pharmacy in one building quick walk down the road and hospital across the road, Bistro they can get food.

Been in a month - absolute chaos. MIL packed her bags and wanted to leave. She is now getting assessed and we are awaiting an appointment at a memory clinic. FIL feels like its temporary accommodation and wants to move into another flat/house in the area. There is no chance. Both husband and brother have POA for health and finance. There is some new problem every day.

Sorry that was long. We all agreed that this has ruined everyone's Christmas with the stress of trying to empty the house. Do not keep shite you don't use. We are currently emptying our loft as we don't want to do this to our children.

She absolutely shouldn't be driving or collecting your dc/supervising them alone.

My grandfather was very similar and family just accepted him driving as he still drove safely. Until one night he drove the wrong way around a roundabout and nearly killed us all.

You won't know she's not safe to drive until it's too late.