Mom is 80 years old and in early stages of Alzheimer's. In late 2019 we noticed her issues and convinced her to sell her place and move closer to 3 out of 4 of her children. She now lives in an in-law apartment with my brother and is pretty independent but we know she is NOT taking her medications - an antidepressant and glaucoma drops - consistently. After discussing this situation, along with a medication change, the PCP suggested we watch her take her meds daily. All of us work, etc and it should not fall solely on the shoulder of the sibling she lives with in the in-law apartment - we would take a week a month to watch her do this - BUT - before we tell mom the plan, any ideas on how to get her to go along with this? She is in denial about her condition and need for any medications and she is just getting over being angry with us for making her move (we gave her no choice really, the in-law apartment or a graduated care community were her choices).
Is your mother alone in her apartment while your brother works? Does she have caregivers come in? What's the plan for when she can't be alone anymore?
At this point, unless you and your siblings wish to continually orbit around her every single day, a graduated care community might be the right solution. The caregiving arrangement isn't working if it doesn't work for both the receiver and the giver.
If she was diagnosed in 2019 and it's nearly 2023 now, mom is not in such an 'early stage' of AD any longer. Things have progressed, especially if she's refusing to take her meds. As the disease progresses, she'll only get worse and more difficult to deal with in general, so your best bet is to learn all you can about what you're facing with AD.
I don't know if you've ever read the book that was recommended to you, Understanding the Dementia Experience, by Jennifer Ghent-Fuller, or not. But it's important to realize that you can't argue with an elder who's suffering with AD; she's not going to agree with you if she's against taking her meds. Being argumentative and 'difficult' goes with the territory for most dementia sufferers. They have a tendency to follow orders more easily from outsiders than their own children or family members. My mother went into Memory Care AL with moderate dementia. She would have given me all levels of fits if I was trying to care for her b/c if I said white, she'd say black. If I agreed it was black, she'd suddenly say it was blue. That's how argumentative she was with her dementia (even more so than she was beforehand). So I'd have made NO headway with her had I been her caregiver, in other words. We'd have been butting heads the whole time and I'd have been forcing the meds on her at home. Yet in Memory Care AL, she loooooved her 'girls' as she called them, and would do as they asked her with no problems whatsoever. She was their little angel! Yet the moment I walked in, she was arguing with me left and right.
This makes a good case for hiring outside caregivers to come in to help your mom and to dole out her meds; have you considered doing that? It's just one more trick to keep in your arsenal. Always be prepared to update those tricks and come up with new ideas and plans as needed.
You chose to move your mother into an in law apartment for now. You'll have to come up with a plan to make sure she's taking her meds, whether doing so makes her angry or not. If she gets to the point where all she's doing is creating bedlam and chaos, then you'll have to consider moving her to Memory Care AL, whether she 'wants' to go there or not. AD often reaches the point where there's no choice about care options........safety comes first and that oftentimes means Memory Care AL b/c they're too difficult to manage at home for about 100 different reasons as you'll find out for yourself (unfortunately). The level of angst and chaos they can cause is often mind boggling. When my mother started Sundowning in the afternoons is when she was truly out of control and exhibiting some of the most anxious and angry behaviors I've ever witnessed. That's when Ativan was prescribed (at my request) and did help her to a degree.
Wishing you the best of luck developing a plan of action whereby your mother is cared for properly and you siblings can also function at the same time.
If meds are really important, then she may be best in memory care. Hiring someone to knock on her door may also be impossible to find since you would have to hire at high prices.
In the long run you will have to get over her anger since her mind is broken. My neighbor has a mom who acted similar. All sibs told her that if her behavior did not change, she would go into a higher level of care. Keep telling her that the doctor says she is not safe.
Rules for engaging our loved ones with dementia:
1) Agree, do not argue
2) Divert, do not attempt to reason
3) Distract, do not shame
4) Reassure, do not lecture
5) Reminisce, do not ask “Do you remember…?”
6) Repeat, do not say “I told you”
7) Do what they can do, don’t say “you can’t”
8) Ask, do not demand
9) Encourage, do not condescend
10) Reinforce, never force
The overall goals should be to:
1) keep them as calm and peaceful as possible
(because they are less and less able to bring themselves to this state on their own)
2) keep them physically protected in their environment and from predatory people
3) keep them nourished with healthy foods that they will accept without fighting or forcing
4) keep them in as good a health condition as is possible, that their financial resources will allow and within their desires as expressed in a Living Will (aka Advance Healthcare Directive)
5) keep them pain-free as possible and within their desires as expressed in a Living Will (aka Advance Healthcare Directive)
The caregiving arrangement needs to work for both the receiver and the giver. If it is onerous to the caregiver, then the arrangement is NOT working. Alternative types of care must be considered to avoid caregiver burnout.