MT Lady .......
Namenda ... is one of the drugs that my Mothers new doctor took her off of late last Fall. She was on it for a little over a year - but this doctor actually believes less medication for a 95-year old is better than more. It seems that the only difference without the meds she was taking is that her occassional nightime episodes have stopped. Of course, no kind of medication will bring back her memory, stop its deterioration or reduce her level of dimentia - but it was surprising that the lack of Namenda actually improved probably the most frightening of her symptoms. The last nightime episode was last August, and it put her into the hospital (from her own home with a live-in caregiver). Her typical episode would be waking up in the middle of the night - then screaming that someone was in her house and trying to kill her. She once left the house and ran over to her neighbors house at 3am ... and once called the police herself ... and the last time, she actually had developed enough trust in the live-in caregiver to call for her. There were three times in a period of a year - not a lot of episodes - but they were horrendously frightening to her.
One other thing - from your story of your Mothers history to current reactions - it sounds like she is a very strong-willed person. Mine is - as well. Picture, if you can, a 95-year old who was driving her 20-year old car until 2-years ago - still buying weekly lottery tickets until last August (and hiring a driver or taking a cab to get the tickets) - still wanting to control her money (even though I have been paying all of her bills and handling her taxes and small investments for three years) but understanding next to none of her bills - and refusing to ever go to a nursing home for the past 18-years, since my step-father died.
Upon leaving the hospital (first time with any psychiatric help or observation) in May of 2011, her primary doctor said she could not go home without having 24/7 care in her home. I live over 20-miles from her (for the past 23-years) and am fighting several life-threatening illnesses myself - and my house is a two-story with both bedrooms upstairs (impossible for her to climb). So ... a caregiver in her home was the only option ... not to mention there was no way she was going to move in to my house (her own words)!
The next 15-months worked well. She had her independance. She was able to boss around the caregiver (and she did like that) - although one of them did quit and had to be replaced. She kept writing the checks for her hairdresser and for the weekly groceries - giving her a sense of purpose and control ... while I kept writing the checks for her utilities, taxes, insurance and other bigger bills. I did get over to her house every week (at least once weekly) to spend some time with her - and called her daily at around 5pm so she knew when to expect a call each day. It worked well for 15-months until her last evening episode which sent her to the hospital for tests and observation.
Please note ... those 15-months were expensive from my Mothers account. Between the cost of the caregiver and operating cost of her home + food, insurance, etc. - half of her lifetime savings disappeared.
When leaving the hospital the last time (last September) - her doctor, then the staff Psychiatrist said she could no longer live at home - even with a 24/7 caregiver. The caregivers are just not adequately trained - as a registered nurse would be. After walking thru 6 different facilities - from marginally OK to very nice ... I was directed to a facility that specializes in dimentia and parkinsins - only!!!
She has been there for the past 9-months and even though she will occassionally still ask "when will she be going home" it is a good place for her. You see ... she always has been somewhat of a "loner"! She never would let any of the neighbors get close to her - even the same for her few close friends! One of the philosophies I really like at her Assisted Living Home is that they will not allow any of the patient residents to sit in their rooms alone (unless of course they are sick). They have a huge program of planned activities daily, they have live-in animals (dogs and/or cats) for therapy and a relaxed atmosphere, and they do have entertainment that comes in 5 or 6 times a month. In good weather, they have one outing a month and provide the transportation and assistance for it.
My Mother is virtually always out of her room. She has become a "bingo addict" and she loves the entertainment (even if it is just a little corny sometimes). The big screen tv in the family or great room often has DVD's of "I Love Lucy" shows or "The Dean Martin Show" or others from the 60's and 70's! They have a large but very nicely done Dining Room with table clothed tables and very decent food. I've eaten there twice so far.
Now ... this is not cheap, but it is less in cost than paying for a live-in caregiver and the upkeep of a house. For 9-months, I have gone to her house at least weekly for mail, to check the vacant house for any break-ins and to water her few plants. Last Friday, her home was just sadly put on the market. It had to be. She never will return to it ... the rest of her lifetime savings will be gone by next Winter ... and the sale of the house will keep her in this fine facility for another two years beyond that - if she is able.
Besides the emotional difficulty of dealing with a parent having dimentia, the costs ultimately have an impact too. Over the past two years, I have done some research in financial assistance. If someone has $20K a year coming in (as my Mother does with SS + a small pension) as income, there are very few government programs available for cost assistance.
Medicaid requires that the patients total net worth is no more than 30K - and that includes a house, car, bonds, mutual funds, etc. Once on Medicaid, the government will pay for a nursing home. TRUST ME - you don't want to send her there if at all possible. At the least, they are under-staffed, often dark dingy places - that shout "this is where you will die"!!@!!! If it's a Medicaid home, it is likely to be that way! I hope there are exceptions!
There is another assistance program, but the person has to be either a veteran or the spouse of a deceased veteran. Here again, it is only available to people who have nearly nothing left financially (I think down to their last 30K of total assets). It is up to $1000. a month of cash, and if the person has SS and/or a small pension - as in my Mothers case, she could total by then be bringing in about $3000. per month.
Summary ...... when I see the joy on my Mothers face and watch her clapping to an Elvis impersonator performing before 30 or so patients, I know for a moment at least, she is happier there than she ever would be now at home. Same goes for a Bingo game ... she actually has a reputation there of being a good bingo player. For your info ... the name of the place is "Silverado" and they do have many facilities in several states. My experience so far in 9-months, is that the caregivers I have talked to do care ... and there is a registered nurse on staff - 24/7!
If the day comes for you to make that decision, try to think that this will be for her best interests - and try to find a place that specializes in the care of dimentia.
Peace ... and good luck to you ... and yours!