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I learned something very upsetting when I visited the elder law attorney yesterday.  That is:  Changes can irreparably harm cognitive functioning.

Over the past six months, as my mother and I have adapted to her progressive memory difficulties, we have had a series of home health aides in to assist with memory care.   Some have been caring and warm, but irresponsible with respect to her health needs- failing to recognize, for example, that reminding her to take her medicine “later” is not sufficient- later she will not remember.  Others have been responsible with respect to her health needs, preparing nutritious meals and assisting personal and memory care- with no affect of caring or personal interest.  Which is better?  The gestapo that keeps her healthy or the wonderful companion who makes her laugh but leaves her sick a week later because she has not had necessary medicine?  In an effort to find a home health aide memory care provider who is both caring and responsible, we have run through many.  As it turns out, the continual changes may be as bad for her long term cognition as the inadequacies in caregiving she has experienced.

I did not know it.  Change can irreprably harm congitive functioning and speed decline of faculties.   The confusion of not knowing who is coming to the door from one day to the next takes its toll on a brain that is already frail.

What’s more, we are looking at life changes ahead that include a change of residence for mom.  We do not know yet where she will move.  Of course, we want to be together, so where she will move depends upon where I will move to.   Since I will not know that for a few months yet, it had been my hope that she could visit with my brother for a period of time, while I settle into a new job.  Then, she could move near me.  In a few years, she might be ready (willing) to consider an assisted living community, where she might make friends and have larger support systems while I am at work.  My siblings and I all think she would be happier in a community with friends her own age and support systems, but she wants to stay in her own home, so we have juggled.   Most of the juggling has been mine- I have been with her now in her home, with infrequent visits to my own home 2000 miles away, for over 2 years, in an effort to keep her safe and secure, in accordance with her wishes.

The elder law attorney was adamant:  “Change can irreparably harm cognitive functioning, wearing away at an already over-taxed brain.  It is imperative to minimize changes to preserve memory.     Individuals with memory problems need one stable residence that is home.   Even a series of caregivers can be confusing and minimize the amount of time that memory will be preserved.    One permanent residence or situation with continuity of care will lengthen the amount of time that cognitive capacities remain intact.”   His case was strong:   The selection of an assisted living community should be accomplished earlier than later.   Minimizing changes is essential to preserving cognitive functioning and memory, and to slowing any potential decline to dementia.

This entry was posted on Monday, June 14th, 2010 at 2:37 pm and is filed under Caregiver Tips. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.