Mini-mental and Braaks stages

[GiCo]

I live 3.5 hours away from Mum who has AD and has 4 care visits a day at present. She has finally agreed to move down to my town so that I can support her better. (I work full time at a demanding job and have been driving to her house every weekend for the past few months and am exhausted.) She spent a fortnight staying with me over the summer while flood damage was repaired. (A small disaster - don't ask!) and was quite lucid when she said that she would miss her house and her friends (who she rarely sees now), but that she knew it was for the best.

I thought - result! I have her on a waiting list for sheltered housing close to me, and reckoned that within a few months she would living independently, but with the support of a care package and daily visits from me. However, she really struggled with the transition back to her own house and has just had a mini-mental and scored 14. I had been aware of a fairly rapid decline, but was quite shocked that her score was so low.

My question is: have I left it too late? Will she be able to make the transition to independent living close to me? I remember that care manager telling me months ago that her team could support someone at home with a mini-mental score as low as 12, and that seems awfully close. I am now worried that I am setting her up to fail in transitioning to my town.

At what Braaks stage do people usually need residential care?

 

[ITBookworm]

I don't know about Braaks stages I'm afraid but I can say that my FIL lived at home when his MMSE score was as good as zero! The score was slightly unrepresentative in that it was probably artificially low due to FIL's communication problems but at that stage he was able to do almost nothing for himself (wasn't washing, didn't change his clothes day or night, had no concept of time at all, was literally living on marmalade sandwiches and tea, ...). He would accept no help other than a girl to come in to give him his pills in the morning and that was it.

The general rule of thumb for living alone seems to be whether the person is at risk from their own actions or whether they are excessively upset by being alone when the carers are not there. So things like falls, tinkering with stoves or burning things, leaving the house unlocked, going out unsuitably dressed, getting lost and not being able to make their own way home and so on on the safety side and things like phoning a relative/carer endlessly upset that they see no-one, can't find something, something is 'broken'...

In our case FIL was quite happy and didn't see a problem If he hadn't fallen we were going to move him to a home before the winter because he would go out at all hours and in all conditions. While he could still find his way home, he wouldn't pay any attention to things like snow or ice if he thought he needed something from the supermarket and he was increasingly unsteady on his feet.

In your case you might find that the change of environment worsens things but if Mum is willing to accept carers in that will help to some extent. Dementia seems to affect everyone differently so how your Mum will cope will depend very much on her character, how her dementia has affected her, what skills she still has and what she has lost.

Does the sheltered housing know that Mum has AD? I have heard that some places will/won't take residents with dementia so might be worth checking.

Good luck getting something sorted to help the load on you.

 

[min88cat]

I agree with ITBookworm.

Make doubly sure that the sheltered housing that you are looking at accepts Alz/Dem residents. As to when someone needs to go into a home, this is almost impossible to say as everyone is different. My MIL coped at home for quite a while after her MMSE score of 7 (out of 30) but she was compliant, didnt fiddle with potentially dangerous things and didn't wander as she was almost immobile. She ended up with 4 double handed care visits per day, but was falling out of bed at night to be found by the carers in the morning. So she was admitted to a NH.