It's hard to have a parent with dementia. Not just for the obvious reasons -- the dementia. However, the other really big difficulty is the change in relationship.
Dementia takes away a number of very important abilities. That's exactly why the many dementing illnesses, of which Alzheimer's is only one, are so hard for families.
As adults, we make our own decisions. We plan. We follow through. We pay bills. We shop. We keep doctor's appointments. We drive to our friend's house for dinner. We live our life. At some point in the course of dementia, all of that will be stripped away.
The stripping usually begins item by item. Each step of that process poses a new dilemma for you. When do you take over each part of your Mom's life? How do you know if it's too soon? How do you know what you should do? When do you become boss?
For the outside person, a professional caregiver like me, it's much easier. So you could always start by asking yourself a few vital questions that we outsiders would ask.
Five Questions to Ask Yourself:
1. Is Mom safe in all she does?
2. Is she eating, drinking, bathing and dressing adequately?
3. Should she be driving?
4. Does she take her medicines properly?
5. Is she safe in the kitchen?
If you can't answer a resounding YES to all these, you do have a problem. Or rather, you have a dementia trend which results in problems, some of them very dangerous. Time to intervene.
Usually, already when families have the question -- when should we intervene with Mom? -- the answer is already "Now"! Family members are asking the question because they have already noticed signs of things not being okay.
It's always helpful to list the issues. The things you've noticed, the signs of decline, the factors that worry you. Run my Alzheimer's test: see what fresh foods are in the refrigerator, run your finger along the stove and see if there's the dust of an unused appliance, check washing machine and dryer to look for signs of
laundry in process, ask Mom what she did yesterday, sneak a look at her mail for unpaid bills and too much junk mail.
I know this sounds underhand, and it is, but for a very good reason. You want to know if your Mom needs help and she won't admit it. Two reasons: one is she doesn't remember the chaos her life is descending into and two is that she's too afraid to tell you.
Five Things Your Mom Hides:
1. That she can't manage;
2. That she's very frightened;
3. That she's confused;
4. That she can't remember;
5. That she's not willing tell you her needs.
She's in a very difficult stage of her life. She's a responsible adult who can't be that any more. So now she's a responsible adult with childlike fears and adolescent attitudes. That's why your relationship is getting complicated.
You are now the boss of her. But you must not boss her. You must support, nurture, protect and tiptoe forward subtly to pick up her slack with tact and kindness. Do not turn anything into a battle. You will both lose and it will be emotionally wrenching.
Five Things to Do Right now:
1. Bring meals over (or have them delivered);
2. Organize help with the housekeeping;
3. Dementia-proof her environment;
4. Call a family council;
5. Make a family plan.
Be kind to your Mom. That's the only way she'll trust you.
Frena Gray-Davidson is a longterm Alzheimer's caregiver and her latest book is "Alzheimer's 911: Hope, Help and Healing for Caregivers", available from http://www.amazon.com. Go to her website at http://www.alzguide.com/ and sign up for her free monthly email newsletter for caregivers.
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