How can I be the best granddaughter I can now that my dear grandmother's health is in decline?

May 17, 2011 12:15 PM

How can I be the best granddaughter possible now that my dear grandmother's health is in decline?

This may very well have been covered before, but I couldn't find anything for it; please feel free to point me in the right direction.

My grandma is 86--we've always been close and I've lived within an hour of her (if not 10 minutes) pretty much my whole life. Though her age is getting up there, her health has always been relatively very good (with the exception of diabetes, which she's managed with diet change). She lives alone in a two-story house and has a little dog that is the love of her life, and she seems to take care of both with no problem. She "can" still drive, although we've all encouraged her not to and avoid letting it happen because she's done some scary/reckless stuff in the car as a result of the following factors: In the past year or so, her hearing and eyesight has started to decline, as well as her memory (for example, every time I see her she'll ask "what is it that [I] do again?" [for work], and things about my boyfriend like whether he has any brothers or sisters and where his parents live [we've been together over two years and I have this conversation with her almost every time I see her]). My mom finds it particularly strange/troubling that she seems to randomly recall memories of when she [my grandma] was little (down to the name of their next-door-neighbor] but doesn't talk about when my mom was little or tell stories from even when *I* was little (it's not that we're self-centered and upset she doesn't talk about our childhoods--it just seems weird that she remembers stuff from 80 years ago but not 10 years ago).

Newest development: She broke her hip last week (was in the backyard and tripped while stepping up on to the brick patio from the grass). She (and the whole family) were hoping that this was just a minor set-back--that she would have to spend a month or so in rehabilitation and then could go back to her house, probably moving in to the downstairs bedroom for ease of living. However, my mom and uncles have reached the conclusion (through talking to her doctors I assume) that she will not ever be able to go back to her house; rather, she will have to spend the "rest of her days" in an assisted living home, which breaks my heart more than I can even say.

At the moment, she's in a rehabilitation center for the hip thing--I'll be going to see her tomorrow. I'm really worried about my grandma's mental health now more than anything. My mom said that since she's been in the hospital it seems like her memory has really taken a nosedive; I thought maybe it was because of the trauma but my mom thinks that because my grandma is a pretty smart lady she's just been able to hide it a lot better until now. Also, I'm pretty sure she's depressed--because of her age, she's seen most of her friends die (my grandpa died about six years ago) and I think she feels like she doesn't have much left to live for...my mom has said she's made comments like, "I wish I would just die..." I am just wondering if there is anything I can do, in addition to visiting and just *being there*...I was thinking maybe I could bring pictures of family and friends from her house to have at the rehab center...? What else?? I just keep thinking, "Jesus, if I was already depressed because all my friends were gone and then I broke my hip and realized I'd have to spend the rest of my life living in assisted living..." I don't know what someone could say to make ME feel better! Sorry this is so long; I'm very sad about this and my thoughts aren't very structured--this is the first time I've ever really had to deal with something like this (and yes, I realize I'm lucky that she is still alive). Any words of wisdom would be so appreciated--my mom is also having a very hard time with this so if you've ever had a parent in this situation I would very much appreciate knowing what the best way to deal with it would be...

posted by lovableiago to Human Relations (15 answers total)

When my great-aunt with memory issues was in a rehab hospital after breaking her hip, after which she moved from her own apartment to an assisted living home -- where she is very happy, incidentally -- I just visited her a lot, brought her food, and listened to her tell me the same story several times in a row, or told her stories. Make sure she eats, because that has been rather the problem for my elderly relative when they were injured. Sometimes just being there during meal times helped, because I could remind or gently badger them to eat.

If you can, I'd bring her the dog to visit as often as possible, but speak to the rehab centre about that first.
posted by jeather at 12:26 PM on May 17, 2011 [1 favorite]

Despite her failing memory, sit down with an audio recorder and get her to tell stories. It'll at least document what she can remember at this point, and even if her memory is fuzzy you'll always appreciate being able to go back and listen to her. It was on my new-years resolutions list this year to do it with all my grandparents, and I did it last weekend. All of my grandparents had a lot of fun doing it - they dredged up things they hadn't thought of for years, so it wasn't just fun for me. You could do it in addition to bringing photo albums, as prompts for things to talk about.

Although you might not feel like "being there" is much, if she's lost a lot of loved ones over the years, just playing cards, folding laundry, watching TV, etc., with somebody is probably going to be more significant to both you and her than you realize.
posted by AzraelBrown at 12:30 PM on May 17, 2011 [3 favorites]

When my gramma was in rapid decline, the thing that kept her the happiest was being encouraged to talk about the things she could remember rather than focusing our concern on the things she was forgetting. So if she didn't remember that she'd just eaten dinner, we'd let her eat another little something while telling us stories of her factory work during the war instead.

Elder memory loss is funny like that, though. The short term stuff seems to be the first to go.
posted by elizardbits at 12:32 PM on May 17, 2011

Best answer: It really hurts, going to visit someone in decline. There comes a point when you just. don't. want. to. Do it anyway. It's so important to them. That's where most of us let them down.
posted by Ys at 12:34 PM on May 17, 2011 [2 favorites]

Best answer: Visit. OFTEN. Listen, ask her questions, laugh at her jokes, agree with everything she says, and cherish every possible moment with her. It's all you can do. I envy you being close enough to go even once a week - I managed to fly to Florida every 4-6 weeks in the last year of my maternal grandfather's life, and my only regret is that I couldn't be there more often. It meant the world to him - I know, because he told me so, every time I was there - and in the years since, it's come to mean the world to me, as well. I have great memories of being with him, learning from him, across the whole first thirty-odd years of my life, but the memories of that last year... I think most often of those.
posted by OneMonkeysUncle at 12:35 PM on May 17, 2011

Best answer: Ys is so right about the hurt. God, I just dreaded it every time! I was lucky enough to live near my blind 89-year-old grandmother, so I visited every Wednesday afternoon and Saturday morning. I'd drive out there with little treats, food she liked (her tastes changed a lot in the last few months of her life, so I was always trying new stuff), music she might remember, Nero Wolfe mysteries on CD, and sometimes my friends would come with me so she'd have someone new to tell her stories to. The dread was just intolerable, but then I'd walk in the crummy little apartment with her few possessions in it and see her dear face light up. Think I have something in my eye ...

By far the thing that comforts me the most now is that I was present for her. She was (ZOMG) so bored all the time because she was a smart lady and there just wasn't anyone in "the home" for her to talk to about the things that interested her. The stock market, food, books, and whatnot. She only had her family around her.

So, let her tell her stories. Don't get too concerned about accuracy. She might have a strong desire for autonomy, so if you can arrange for her to make her own decisions wherever possible, I know that helped my Gran a lot. Keep her guessing if she likes surprises. Mine didn't, but I know a lot of the ladies she hung out with enjoyed them.

I used to take photo albums to her bedside and just describe the pictures to her. She'd tell me about the people in the pictures (that's how I identified many mystery photos, by the way). Like there was one of her on a ladder, helping Grandpa build their house.

She liked visits from children a lot, though she'd get overwhelmed easily. She loved to go on outings, though that may not be an option for you. If you can arrange it, Gran loved the flower show, a visit to a dairy farm, the zoo, stuff like that.

We buried her on Sunday. The memories I have of our time together late in her life are unspeakably precious. I can't say it any more plainly than that.

Also, for you and your mom, manage your time better than I did. I tried to do too much and I wore myself out.

Wishing you and your family well. Memail me if you need to talk.
posted by S'Tella Fabula at 1:30 PM on May 17, 2011 [1 favorite]

Statistically, breaking a hip is often a very bad indicator. It's physically traumatic, and this is probably the explanation for her current mental status. It's depressing, it keeps her from being physically active, it keeps her indoors. Let her talk about being depressed, sad and frustrated, but if she is truly depressed/suicidal, medication can help.

If you are in a position to live with her in her home, that *might* help her return home.

Visit as often as possible. Ask her about her youth, how she met her husband, her boyfriends before him, your Mom's childhood. Ask her what it was like in her family. Most (old) people love to be asked about themselves. And this is your chance to preserve family history. Plus, it stimulates her mind to recall things.

My Mom and my aunt both responded well to the music of their youth. Get her a small cd player & speakers and some cds of WWII era music. Get her to tell you about going dancing. My Mom was of that era, and she danced to some amazing bands.

Framed, labeled photos of every family member are nice to have. Take in some of her everyday china and flatware, and use it when you visit; familiar items are comforting. Take in some favorite foods. Even it it breaks her diet, it will comfort her and help her adjust. Take in some things that will help her room smell like home, look like home, sound like home. Her senses must be reeling.

Get her to tell jokes or funny stories; laughter is aerobic and a great energizer.

She's lucky to have you and you're lucky to have her; I hope for years to come.
posted by theora55 at 2:20 PM on May 17, 2011 [1 favorite]

My MIL is in much the same situation as your grandmother (including being in a rehab center recovering from broken bones); it was my dad's turn three years ago. One thing no one else has mentioned: listen to your grandmother about her wishes. Where does she want to live? How does she want to spend her time? How hard does she want to work at regaining her mobility?

My biggest regret about my dad's decline and death is that I spent more time siding with the doctors against him ("You'll be fine. If you just work at your physical therapy, your life will be as it always was. Etc. Etc.") rather than being his advocate with the doctors. He wanted to let go and accept his demise gracefully; I (and the rest of my family) wouldn't listen.

And definitely work at getting her dog into the rehab center to see her. Most rehab facilities I know are delighted to have dogs - any dogs - visit.
posted by DrGail at 2:26 PM on May 17, 2011

Is she on pain killers of any sort at the moment. I know when my husbands grandfather was in hospital recently after having broken his leg in a fall we all got worried he's suddenly become senile from the stress and pain. Turned out it was the pain meds he was on, even the very mild stuff was affecting him terribly. It took almost 2 weeks for it all to get out of his system and now he's back to his old self again. But it was a scary couple of months there and his sons started to org anise assisted living for him, but he was able to move back home after his rehab.

Not saying it's the case here, but it might be worth having a look into.
posted by wwax at 2:53 PM on May 17, 2011

Presuming that they replaced the hip, of course she is still suffering badly from the anesthetic -- it will take a while for her memory and mental sharpness to recover. For future plans it is probably best at this stage to wait and see how she recovers, while discussing options with her. She may not need very much support to stay in her own home if that is what she wishes, but she might feel safer somewhere more supervised. Bad falls tend to be frightening for the old person and for their family, so don't let people take decisions too quickly.
posted by Idcoytco at 4:07 PM on May 17, 2011

There are assisted living apartments. They vary from having someone on site to keep an eye on the residents and usually a shuttle to the grocery, doctor appointments to ones that have their own dining hall (more expensive).

If your grandmother is normally able to take care of herself, try looking at senior apartment first. The library or grocery will often have a newspaper (Senior Living here) geared to seniors with tons of ads for these kind of apartments that list what they offer. These apartments are more expensive than normal but much cheaper and generally nicer than a nursing home. My grandmother definitely liked it better than when she had to be in a nursing home. She enjoyed the card games and watching basket ball games they had in the group area.

Make sure to visit any place you're considering. Bring an extra person with you so while one person does the tour, the other can get the low down from the residents (they'll tell you everything). Ask if they allow pets since I'm sure this would be important to your grandmother. Try to find some place near a family member. It makes it so much easier if you need to go along to a doctor's appointment or want to visit.
posted by stray thoughts at 5:59 PM on May 17, 2011 [1 favorite]

If you see alarming changes in your grandmother's mental state now--forgetfulness, agitation, etc.--take them seriously, but don't panic or feel hopeless about it. She's probably on drugs now that she's never taken before, and she's in a strange environment, detached from all her normal routines. My mother went through this, but after she was able to leave the rehab facility her mental status improved a lot. The degree of healing possible from a broken hip can be pretty remarkable. Don't think that there are no good days ahead.
posted by Corvid at 7:00 PM on May 17, 2011

Best answer: I work at an assisted living home (a pretty nice one). Some of the residents are happy to be there, and some of them are miserable. The happier residents tend to be more involved in the community- so if your grandmother ends up in assisted living, encourage her to get to know her new neighbors, go to events, and just generally get out of her room and talk to people.

Every single one of my residents is SO happy when their relatives come to visit- they don't always get the names or relationships right, but they never fail to introduce them to the staff! From what I see, it really brightens their day. So visit, and if you have any way of helping her get into a good assisted living home, your grandmother might not be too unhappy. Obviously health issues (particularly depression) can make a person unhappy wherever they are, but a good home can help.

Besides that, just try to be cheerful and smile as much as you can. Note but don't react too much to mental slipups like forgotten names. It is really difficult to deal with the decline of a loved one... the important thing is providing all the attention and affection that you can! good luck
posted by Baethan at 9:14 PM on May 17, 2011

This is just one small thing, but it was important to my grandma even during her decline: She used to send cards to everyone for every occasion. Late in her life, every year, my Christmas gifts to her were a year's worth of cards (occasions and blanks - they now sell pre-assembled boxes of them at Hallmark stores, I think) and stamped envelopes. As her eyesight and writing failed, when I visited, I'd go through her calendar and address book with her and organize it and address the envelopes and send out the cards with her. That was something important to her, and she didn't ask me to do it, I only noticed when I didn't get a card one occasion and realized it was because she couldn't do it on her own. She'd never have asked someone to help with something like that, it seemed so small.

I'm not saying that's what to do - but if there's something that she's known for among friends and family, be it sending a lasagna to a sick friend or great baby gifts, or garden cuttings, try to help her keep on doing something that's part of her identity, her self-worth or that she's always been proud of. (I also remember that my gram would go to the bank for crisp new bills when she gave money as a gift. It did make it more special.)
posted by peagood at 7:08 AM on May 18, 2011

We had a 94-year-old neighbor go through this. Her relatives, also elderly, live far away.

Luckily her pension & insurance are excellent, because it has taken her 6 months to reconcile with the fact that she can't move home in a wheelchair.

For your current situation, encourage everyone to visit: friends, neighbors, church members. I'm sad to report that her church was not as helpful as I'd expected. She got one visit from each member of a committee, and that was it. We called her pastor to encourage more visits, and that helped. She loved getting flowers, treats and cards.

She went from the hospital to a nursing home/assisted living facility. She was very bored while in the nursing section, and it was hard to visit and see her like that. It's also taken a while to adjust to assisted living. She now has her own furniture there, which helps. The staff insists that she come to meals, stop by her apt. to say "a concert is starting down the hall," and encourage her to join in.

For your family, you might want to start a group on lotsahelpinghands to organize visits and gifts. My friend with cancer blogs at caringbridge, and it's been a big help in keeping us all informed.

Good luck!
posted by MichelleinMD at 8:28 AM on May 18, 2011