Minding Our Elders

Puzzled readers often ask why certain behaviors their elders exhibit seem to mirror classic Alzheimer’s disease, yet other behaviors don’t. Many are surprised when I suggest that the elder may have a “mixed diagnosis.”

I'll never forget sitting at my uncle's side after the nursing home had called me and said they thought he may be dying. The message wasn't a shock. He'd had several massive strokes, the last of which put him in a local nursing home.

You’ve taken your mom to the doctor and she’s upset with you because the doctor’s office was cold. You’ve helped your dad with the yard and he’s annoyed that you didn’t put mow the grass in the right pattern. Why do many elders complain about everything you do?

If we could control events, most of us would never want our elders to be so sick that they need the care of a nursing home, especially homes that are still operating in the dark ages, as some of them still are. Many homes have now moved forward into person-centered care, and reluctant caregivers often find their elders thrive, once they have adjusted. Still, it's hard.

Hospice helped both of my parents through the death process. For that, I will always be grateful. In “Hospice Care as Seen by a Grateful Daughter,” I relate my experience and express my gratitude to this amazing organization.

I often hear about elders becoming difficult and even abusive toward their adult children just at the time the elders need help. Mom and daughter always got along well, but suddenly Mom is telling her daughter she's too bossy and wants to run her life.

Dear Carol: We are having problems making a decision. My father-in-law passed away and my mother-in-law has Alzheimer’s disease. She only remembers her husband when someone mentions his name. Otherwise she doesn’t talk about him or even seem to know about him. She’s more worried about her parents who, of course, are long dead. Do we take her to his funeral?

For most people heavily involved in writing about Alzheimer’s, or working with people with the disease, there is an increased awareness of the fact that they could one day also be diagnosed with Alzheimer’s disease. I am no different.

In my family, I was the default caregiver. Not only was I the one who lived in the same town as my parents, my aunt and uncle, and my in-laws, I was most suited emotionally to caregiving. It's always been in my nature. I was, however, fortunate to have a sister who lived 50 miles away.

People stare. Most aren’t unkind, they are just curious, but when someone “different” from the norm becomes part of their environment, they often stare – without intending to be unkind. Anyone who has cared for a disabled child knows this. Anyone who has a visible disability of their own knows this.

The fact that many elders don't get around to bathing or changing clothes, common as it is, may not be a health issue. It's certainly a social issue, however, and it's one caregivers are acutely aware of. Personal hygiene is rather subjective to begin with, so when people ask about getting their elders to be "cleaner," I generally ask about past habits.

Most people find some satisfaction when a goal of some type, even a small one, is achieved. Why should people with Alzheimer’s feel differently? According to an article on Medical News Today titled, “Achieving Goals Empowers People with Dementia,” researchers at Bangor University, Wales

Human beings, especially loving human beings, seem to have a penchant for "beating themselves up" over imperfections. This isn't the place to go into all the various psychological issues that make us feel we need to do everything perfectly, but the most common and obvious issues generally stem from trying to please our parents by being very, very good, and not feeling as if we measure up. Just because we are all grown up, doesn't mean we are, well all grown up.

Dear Carol: My wife’s dad suffers from kidney failure, diabetes and has had two strokes. She is just 29-years-old and is his legal guardian. She feels very much stuck in her life and I worry that this will have long term effects on her, as stress can certainly make people sick. There is not sufficient money to cover the cost of care for assisted living or a nursing home, and I think he really needs that. We live in Minnesota. Where does she turn? Frank

Nearly anyone who has known or cared for a person with Alzheimer's has heard the heart-breaking plea, "I want to go home. Take me home."

My first elder caregiving experience was with my neighbor, Joe. His wife died, and he was left old, deaf, and alone. His only son lived half a continent away. It was instinctive for me to help, and I never thought, "How long will this last?"

It was when my mother died that the truth of studies on hearing, as it affects those in a coma, really came home to me. My mother had been in pain for years. Once she was declared terminal and the care the nursing home staff provided couldn't cover her needs, we called in hospice. Our local hospice worked seamlessly with the nursing home staff to care for Mom.

I received a nice note about a press release issued by the Boston Better Business Bureau. Since senior scams are rampant, I felt that this video was a worthy reminder for my readers.

However, there is also the sticky issue that I wrote about in “New Plan to Diagnose Alzheimer’s Before Symptoms Apparent Not without Drawbacks.” My concern that people could have a hard time coping with the fact that they are on the Alzheimer’s track is echoed in the a quote in the Times article.

Make it a point to not let anyone, no matter how well meaning, dictate how you get some respite from caregiving. Just be sure to do something for yourself that you enjoy. If your elder can be left alone for a bit, it's easier.