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Senior Health

Geriatric psychologist

12/17/2004

Question:

My mother in law will soon be 87 years old. She has a family history of alzheimer`s (her father and a sister both died from that disease). About 22 months ago - she fell and broke her hip. She has recovered from that - but, she has very little short term memory. We had an MRI performed on her about a year ago - the results of that test were that she has suffered a series of mini strokes. She fell again about 3 months ago and was sent to the hospital. Other than bruses - she had no serious damage. After she left the hospital - she was sent to a rehab center and returned home in about a month. She was home for one week and had to be returned to the hospital due to "panic attacks" she was experiencing. After a few days in the hospital - she went to another rehab center for about a month and was then transfered to a nursing home. She doesn`t remember the panic attacks, and is desperate to be allowed to return home. My wife and I don`t know what to do. We want her to have the best possible quality of life for the time she has left. However, we are concerned because she seems to be completely preoccupied with the idea of going back home. We do not consider her to be a risk for doing anything that would hurt her and we have been her primary care givers for 17 years - we would be willing to continue to go see her and take her food, fresh clothing, etc. two or three times a week. Having her move in with us is not an option. My question is - are there any tests to determine if an older person can or should be able to continue to live alone? She is currently in the dimentia unit at the nursing home and seems very out of place in that unit. Aside from her problem with short term memory loss - she is very alert and very sharp. Thanks for any help you can offer.

Answer:

She seems to be at moderate risk to return home given her memory loss, falls, and recent anxiety history. There is no specific test to determine if she is safe to go home. The best judge is the clinical acumen of an experienced person who works with the elderly. This could be a nurse, social worker or a physician. Likely the nursing home could give helpful insight based on how well she is functioning in their environment. The best test" is a formal home evaluation usually conducted by an occupational therapist. Any home nursing agency or community elderly services program would know of one in the area.

One recommendation: have her screened for depression. She is at significant risk given all the recent changes and her deteriorating health. If she is depressed and successfully treated, her functional level may improve.

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Response by:

Elizabeth Joyner Gothelf, BSN, MAG Elizabeth Joyner Gothelf, BSN, MAG
Assistant Director
College of Medicine
University of Cincinnati

Steven Bartz, MD
Assistant Professor
College of Medicine
University of Cincinnati