歪歪漫画

Dear Carol: My mom, now 87, voluntarily moved to assisted living three years ago. She said at the time that she loved it. She continues to have chronic pain from rheumatoid arthritis and takes medications for the usual age-related issues. Even though she forgets things more often than she used to, she doesn鈥檛 seem to have dementia.

Lately, though, she鈥檚 started complaining about being 鈥渇orced鈥� to move to 鈥渢his place,鈥� saying that she hates it. Of course, she likes some caregivers better than others, but nothing major seems to have changed regarding her care. I visit several times a week, bring her treats and take her out for fun. What more can I do to make her happy? 鈥� PS.

Dear PS: Over time, most older adults will experience life changes that can eat away at their sense of autonomy. For that reason, I remind caregivers that they can鈥檛 鈥渇ix鈥� aging. Sometimes the best thing they can do is listen with empathy, letting their older adults know that they are heard. Validate their feelings and mean it. Some of these challenges could make anyone cranky.

That said, what concerns me about your mom is this abrupt change in her personality. While I stand by the validation approach in general, I鈥檇 also suggest that you consider underlying causes, including staffing changes.

If there鈥檚 nothing dramatically different with her care, the next step would be to investigate any medication changes. If there are no medication red flags that could explain this change in your mom, then she could be reacting to pain.

While smart doctors avoid using pain medications that can slow thinking, cause falls or increase the risk of bleeding after a fall, there鈥檚 a downside to such caution. Older adults are sometimes reluctant to report pain so the doctor may feel that it鈥檚 managed as well as it can be, yet that may not be the case. With patience, perhaps they can find a more effective medication option that has an acceptable risk/benefit trade-off.

If the doctor(s) who are already treating her can鈥檛 find a reason for the change, I鈥檇 suggest that you take your mom to see a neurologist or a memory clinician. These specialists are trained to evaluate her to see if her mild memory issues may have been a precursor to dementia. This is a common progression so she may be having increased anxiety over the changes, or she could even be experiencing some delusional thinking. While most types of dementia can鈥檛 be cured, some symptoms can be slowed with medications. Others can be better managed once the physician knows what type of pathology may be involved.

You want your mom to return to being content with her life 鈥� and better yet, happy. That鈥檚 understandable, but it may not be possible. Comfort her. Validate what she feels. Check into what can be changed and follow through. Then accept that you鈥檙e doing all that you can. The reality of aging care is that there isn鈥檛 a 鈥渇ix鈥� for every problem.