Q: I just returned home from spending the holidays with my elderly parents (ages 88 and 92). I was a little shocked at how much my mother had declined since my last visit. Physically she is in fairly good condition but her dementia has significantly increased. She functions fairly well as far as her personal care and completing small tasks around the house. My father has taken away her check book, closed all her credit card accounts and has given several pieces of expensive jewelry to another relative for safe keeping. I noticed he has become rather impatient with her and frequently raises his voice when he is frustrated with her behavior. They both sleep a great deal of the time, which is a new development. I am at a loss as to what to do. Could you provide some insight as to what I could suggest to them?
A: With the information you have provided it appears most issues are directly associated with your mother’s cognitive decline. Hopefully she has been assessed by a neurologist to determine the underlying cause of her dementia. If this has not occurred that would be the first line of action. It may be too late for any of the medications available to make a difference but it is definitely something to consider.
Your father may intellectually understand his wife has no control over her behavior or functional status but emotionally he doesn’t seem to be handling it appropriately. It could be very beneficial for him to meet with a Family Caregiver Specialist through the Area Agency on Aging or an associate from the Alzheimer’s and Related Dementias Association where they live. He needs a greater understanding of how to react when your mother’s behavior becomes difficult to deal with. A quote from Joanne Koenig Coste’s book, Learning to Speak Alzheimer’s, comes to mind... “reasoning with someone who has lost the power to reason only ensures confrontation”. Without intervention his responses could cross the line of emotional abuse.
The sleeping factor could be due to advanced age, an undiagnosed medical condition or a red flag to indicate depression in both of them. Encourage them to address this during their next appointment with their personal physician. Your father could be dealing with his own mortality and worry about what could happen in the near future. Caregivers of individuals with dementia have a high risk of death prior to the person they are caring for. Stress has a significant impact on the well being of caregivers.
You didn’t mention they are connected with any services as of yet. It is unrealistic to expect a man of your father’s age to assume total responsibility for his wife’s care and all the household chores. Respite care is definitely in order and should be arranged as soon as possible. Fortunately you indicated finances is not a concern, the service level should be sufficient to allow your father to get away from the home to interact with friends or engage in activities that are of interest to him.
You should keep connected with other family, friends or neighbors in the area to be your eyes and ears as to the home environment. Without some changes the situation could be one incident away from a crisis. Having an elder care professional involved should keep things more stable and it would be helpful to you to know someone is monitoring their functional status on a regular basis.
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