Alzhiemers:

Dr. Brilliant Cliché;

My wife’s dad was just diagnosed with Alzheimer’s dz and he has been quite forgetful and less able to take care of himself. Her family is divided about what to do, with most of them wanting to put him in an assisted living facility near us. The rest of the family wants to wait until he makes a choice to move himself. He currently flat out refuses to go.  My wife has been under tremendous stress over this whole thing. I know she is suffering. There’s guilt in wishing he could be out of his misery. There’s the strife between her brother that is taking his dads side (“why move now, he’s getting along,”) and her sister, who argues that when there’s a crisis (as there will be) it will be too late. My wife is caught in-between them all. Needless to say, she and I have also been fighting more now than ever before in our relationship. When she talks to me it is with the tones that I am an idiot. I know that she is maxed out and under a lot of stress but those tones just push my buttons. The end is nowhere in sight and I am not sure what to do. I don’t want to be angry at her… nor do I think it would be good for our relationship to just plain ignore her.

-Dee Mentia

Dear Dee Mentia;

As you will hear me repeat often, there are no definitive answers but you, as well as she, have the right to be angry, upset, sad, and fed up. She does not, however, have the right to talk down to you or disrespect you; nor should you retaliate or disrespect her. It is normal to feel these things; it is not OK  to act on these feelings. What might help is if you tell her how you feel as a human being. “I understand you are under a lot of stress but you make me angry when you use those tones, it is hard for me.” And leave it at that. You said how you feel, that is your right. Do not expect it to change anything, but very often it does. So long as you’re willing to say how you feel your resentment will not build up. Expecting nothing in return allows her freedom to choose what to do. It prevents a tit for tat spat, or a diversion of her sadness into anger towards you; it also leaves no cause for retaliation. This is especially important because you are right: the situation may persist for a while. Try to be kind and be available to listen when you can. Hug often. Do not suggest solutions unless she asks you. That is the biggest way to engage a fight. And good luck, it is never easy.

A friend responded to this essay and it moved me, he gave permission to include it below.

-Dr. Brilliant Cliché

Alzheimer’s Lament

I have guilt.

For not acting sooner.

For having to put my dad in assisted living for alhz.

For making my wife and kids live through this inconvenience.

For being miserable at times.

For not visiting enough.

I very often think of my parents so when I’m at peace I don’t want to have even my family mention them.

My dad’s problems came on pretty quickly a urinary tract infection sped it up. He started by calling late at night once, thinking the computer was linked to the TV, radio. Thinking that he should tell me information but not knowing why. Sometimes even now he acts totally the same as he did before. The little things didn’t add up until it was too late.

My brother who works with hospice says most times it takes a tragedy or near one to make the family act.

My dad reacted badly at first and one time I saw him screaming in tears, “Why me?” He told me shortly before that he wished his brain worked like it did before. He was very frustrated but has since settled down and seems almost content. He plays bingo and other games, eats at a table with others and talks. He reads the newspaper and is still interested in his old loves [sports etc.] it is hard to explain but when you read how people progress with alzh it really in my case is true. I see as kids adapt the elderly do too just different.

My own problems stem from my inability to forget and space myself apart from my parents.

I get very upset if someone else mentions my parents if I’m at a rare time of peace. I feel guilt and stress if I don’t go see them every time I just think about them. I feel guilty my family life [activities, drives, so on] suffers from my parents problems. I know they wouldn’t want me to neglect my kids and wife. My dad has told me he understands I have a family and can’t always get to him. I know I’m very moody still [my dad has been out of his home since the end of May of this year.]

I am getting better at handling as time goes on. I like talking to others who have suffered with the same situation but not so much with people who haven’t been through it saying to me it’s just part of life. This usually just makes me want to say fu..

I know it’s hard and maybe talking to hospice or other like professionals would help. It did for me but the most comfort I get is talking to others who experienced it [not family.] 

After reading Dr. Brilliants reply Granny Dr. had a strong and pertinent reaction:

Dear Dee Mentia,

If your father has Alzheimer’s, he is no longer in a position to make life altering decisions. Any court of law knows this. It’s time your wife knows this too. Your wife is clinging to the hope that nothing has really changed by insisting Dad should be the one to make decisions. But denial only makes the problems worse. Your wife (and you) should know something else- the health risk for care givers of Alzheimer’s patients is extremely high. Trained professionals do this for a living; they are trained to deal with it. They are paid to do it. If you attempt to take care of a parent with Alzheimer’s, understand that you are placing yourself at risk for heart problems, cancer, depression, you name it. The fights that are going on now are just a taste of what is to come. No one’s opinion really matters here. The way your wife is treating you and the way you are angry at her are just symptoms of a bigger problem that has to be solved. What matters is taking care of the problem properly. Put your differences aside. Put your wife’s father in assisted living. He will be far less distressed as his disease progresses if he is properly cared for by trained professionals, than if he is cared for by bickering relatives who are secretly wishing to kill him to end it all.

You can see why Granny Dr’s aren’t given licenses to practice psychiatry. People’d sue the pants off us. 


-Granny Dr.

 And another reader wrote:

Dear Dr. Brilliant cliché,

The problem I had with your answer is that while it zeroed in on the methods of treating the emotional problems between the husband and wife and the rest of the family, it left out something that is very important- the protocol of how to handle the vitriolic fallout that comes from a problem like this is not the central issue. The central issue is that Dad needs help and the relatives are leaving him to swing in the wind while they bicker among themselves. People who have no idea how to handle ill or incapacitated seniors will argue amongst themselves and make asinine decisions solely out of guilt or for other personal reasons that have nothing to do with the issue at hand. The emotions that relatives suffer from the demise of parents is their problem. It should not be Dad’s problem. And unfortunately it is, until they can bring themselves to make an intelligent decision that addresses HIS needs. Maybe there should be a law that that people who make BIG decisions for neurotic selfish reasons rather than considering the facts at hand should not be allowed to make life altering decisions. Ooops, I guess none of us could then. Perhaps the legal processes require one to get Dad declared incompetent first, but anyone with a brain in their head should know that letting a person impaired with dementia of any kind make major life decisions is like letting someone who just drank a bottle of scotch drive a car.

-Ida Know

Dear Granny Dr. and Ida Know

I agree the best thing would be to put him in a nursing home to prevent him from injury but as Dee Mentia mentioned he refuses to move. At this point until he injures himself or such he cannot be moved against his will. In order to do so he has to be declared incompetent first. This can be a lengthy, expensive, and not so easy a process if he is fighting it. Ultimately the family has to decide whether to peruse this option and should seek legal counsel as to whether or not it is possible at this point in his dementia. 


-Dr. Brilliant cliché


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About Dr. Brilliant Cliché

Dr. Brilliant Cliché and the Granny Dr. are a fictional web presence and advice blog. Together we offer a joint perspective that is deep but not academic, entertaining but not fluff, and educated yet street smart. By joining the internet community we hope to share thoughts and stimulate insightful conversation around pressing issues that affect us all. Looking forward to hearing your thoughts. (This is not a site for therapy nor does it intend to replace medical or other professional care. ) You can leave comments here or email The Dr. at dr.brilliantcliche@yahoo.com and don’t forget to like us on facebook. Our facebook page is Dr. Brilliant Cliche
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One Response to Alzhiemers:

  1. Bob Fish says:

    The topic of home care for the elderly, well, hits home. I was my mom’s primary care giver from 1997 till 2005. She did not want to go to an elder care facility. I was in agreement. What I learned from a past stay of hers in an elderly facility for rehab is that, as a primary care giver, you have to work way over the limit as a visiting care giver. It’s much harder than if you keep your parent at home, because of the conditions of the care facilities themselves.

    The facilities in RI, for the most part are inadequate. I was told by a med nurse that as many as 6 medical mistakes are made EVERY evening with patients. Staggering statistic! There are some really good really good facilities, but they are very few.

    The consideration of whether to put a parent or whomever in an elderly facility really depends on the competency of the facility. The realities of a health care facility are rarely even considered. Often it’s necessary to make decisions without even visiting these facilities. A suggestion: have a few meals at different times of the day at the locations you’re considering. Not an easy task I realize, but try at least one. One facility I visited served a slice of pizza that looked like a relic and half a plate of iceberg lettuce whites for one of their Sunday eve meals. I was always going to the Burger King down the street to get my mom food. Fortunately, she was only in there for two months. Location is another factor. A close location is great but you have to monitor every aspect of care, literally. You could be close but a bad facility is a bad facility. You can’t really go by ratings cause the owners usually know the inspectors and know the dates of the inspections so they put on full crews, which is rare, and they spiff up the joint, so to speak.

    Bottom line is that if the one you are caring for is in an inadequate facility you are going to have to spend considerably more time attending to them in order to catch all the mistakes the facility makes as well as correct them. It’s a staggering job once your parent or whomever is in an elderly facility. As mentioned, here in RI, there is only one facility I know of that you can actually trust.  And even with that you have to remain highly vigilant.

    My brother thought I should write a book about my experiences because there’s hardly any info on the subject other than the rhetorical discussions, “should we put dad in a facility or not”. What people don’t realize is how inadequately these elderly facilities are run.

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