Having trouble determining whether grandfather can't do something, or is just feeling lazy. I'm not his full-time nurse/maid/cook!

Can you surround the request with questions on what help he needs, and why, such as "are you not feeling well? " Or, "would you like me to write out the instructions to use the DVD player"?

What I'm thinking though is that some of these requests, especially those requiring steps (such as using the DVD player) are ones in which he's forgotten those steps and can't recall. From my experience, those sequential actions are often early clues of memory difficulties.

Telling someone isn't the same as writing very, very specific instructions.

You could also say something to the effect that your disabilities are really bothering you at that time, and could you discuss what he needs and work out a way that you can accomplish what he needs together? It might not be what you want, but it saves him from the embarrassment of admitting that he can't remember, or physically can't do something. And it could even be a bonding activity.

You can also set aside a certain amount of time to get done what he wants, then no more chores until the next respite time.

At 92 and suffering dementia, I would expect his physical and mental abilities to be waning. If you are not able to provide him with care, can you hire Caregivers periodically? Either through his insurance or private pay companies? I am not surprised that he needs assistance, I would not question it. I would not expect a person at his age and mental status to be able to live alone, certainly not. That would not be safe for him. Our senior loved ones deserve kindness with their required care. Getting old is not easy.

A 92 year old person who has dementia, likely needs the help. I'd let go of wondering what is necessary and consider it all necessary. His abilities likely do fluctuate, but, I'd just go with if he could do it, he would.

With dementia, their brain just stops being able to process info and get the body on board to get things done. He may not be able to verbalize a lot or even know why he's not able to do it. I would watch my LO try for 10 minutes to get into a car. Her limbs worked, but, they didn't work right. People appear to having working limbs, but, the brain signals don'e work and they may not be able to get the hand to the face or foot one step ahead.

I focused on making my LO as content as possible. Everything she said was right and her every request honored. (Wink, Wink). Well, within reason. She had so little control over her self, her surroundings and her life. I've tried to help her keep her dignity. As they progress with dementia, eventually ever single thing has to be done for them.

Hopefully the "living independently" doesn't mean he is currently living alone! Although that is another topic, based on your questions it is a concern. Hoping the family is working on a solution for that.

"The blunt version of this question is “Are you asking me because you cannot do it yourself, or because you don’t feel like it and would rather I did the work for you?”"

Although he was used to being doted on by your grandmother and this may have some impact on what he is asking for, more than likely the dementia is a bigger factor in asking for assistance. Seemingly simple tasks like operating the DVD player become a huge challenge for those with dementia. It looks easy, you've done it before, but it really comes down to not being able to follow simple instructions or steps to do what they used to be able to do. My mother was living alone, and it wasn't until we took the car away and I had to help her shop that I realized she was no longer cooking for herself. This was someone who always made elaborate meals, and even decorated cakes for family weddings, etc. She was still buying the ingredients to make meals, but I would find them still in the freezer or shriveled up in the fridge, because she was using packaged items and frozen dinners.

While it may appear to be laziness, it likely isn't. Covering up by wanting to do something else or "pretending" he just can't be bothered is more of a simple way to explain away his inability to do whatever it is. He certainly won't understand why, but needs to somehow reason with it and this is the best he can do! His "memories" or abilities to be able to do something certainly can fluctuate - my mother sometimes has "flashes" of memories, but it doesn't mean she is selectively forgetting or passing things off. It just means once in a while the brain manages to make that old "connection."

His needs ARE going to increase, which is why the family needs to get together and make a plan SOONER not later! As he forgets more and more how to do simple tasks, he will become more reliant on you. He could also just be reacting to what his brain tells him he needs, which is relayed to you.

If he hasn't been seen by a doc in a while, he should get a full assessment, including blood work and urine test. UTIs will often present in bizarre ways (mom's first in MC resulted in severe sun-downing, and since then show up as night time bed wetting! before or early dementia, she was not her usual independent self due to low potassium) If everything is good medically, perhaps a low dose anti-anxiety would help? It's just enough to take the edge off but not leave him dopey. Some people know something is off but don't understand what it is and it can make them anxious and they use various techniques to reason with themselves and to try to make sense of an ever more confusing world around them.

In order to "triage" his requests, try to list the ones that would be most important for his well being. Thirst, hunger, bathroom would be the top 3. If you can keep beverages and snacks handy, and make a point of helping him with getting to the bathroom on a regular schedule, that could reduce you running around to manage these tasks. Other requests could possibly be managed by deferring them for a while and see if he mentions them again. Keep the deferred time vague, like soon, in a little while or next time I'm up. If you feel the request is not critical or really unnecessary, try deflection, distract him with something else. Sometimes this works to get his mind off whatever it was, at least temporarily.

IF he can do something he may not even realize he can do it.
He is not being lazy or seeking attention. His brain is not working properly and it will continue to get worse.
With dementia at some point you are going to have to fulfill every request. And often the request will not be made. No more I have to go to the bathroom...you will be changing him, cleaning him.
No more I need a drink. He will not be able to verbalize his need for food or water.
He will get to the point where he will not be able to chew, he will not be able to swallow liquids unless they have been thickened.
It sound like the best place for gramps would be a Memory Care unit where his needs will be met.

Haven't read all posts yet but stopped at *living independently*. Is it time to rename this as *living alone dependantly*?

I was shocked when a social worker described my relative in this way. But I thought about it - it was true. Started a clearer look at the bigger picture.

You are knowledgeable & reasistic about the Dementia. You are doing your best to avoid Disabling by encouraging as much independance as is safe & possible. The triage & delay system I like! But with skills wavering each day you won't always get it perfect... that's OK.

Decision making powers? Not you but no probs as you know what you can/can't do & the family know who they are.

You got this! (as they say).

Just watch out for 'Denial'... by the family decision makers. (That's where mine is bogged deep).

When the time to eventually hire care or move into a care setting does come - it will be those sticky folk you have to convince, not your Grandfather.

Best of luck 😀

The man is 92 and has dementia. The easiest way to avoid conflict is to let his world be the real world.

As my mother's dementia progressed, my poor dad would get frustrated in the same way you're getting frustrated. I finally told him that she's basically become a toddler again -- no filters and she can't do things even though she won't admit it .

You have the same issues. If you look at his behaviors as those of a small child (but not treat HIM like a child -- it's a fine line), then the stresses seem to diminish -- at least they did for me.

A friend once told me, "we start out in diapers, and we end in diapers." That was more true than either of us realized, as it's as much a metaphor as a reality.

I don't envy you the situation that's for sure. We are going through this with FIL. And the biggest problem is if you do something for him once, he expects it going forward. And because my SIL who is his primary caregiver and has tried to help, he has literally lost the ability to do certain things because he stopped doing them for himself.
We has asked ourselves your question a million times. Finally we put it to the home health team. They assured us he was capable physically of doing a number of things that he wasn't doing for himself. So SIL asked him in front of them. The specific thing she called out was dressing himself. She lays his clothes out for him, and some times they sit there for days while he lives in the same shirt and changes his adult diaper when he goes to the bathroom. When the home health PT asked him why he didn't dress himself, he pointed the finger at SIL. Said that she only helped him get dressed if he had to leave the house. The PT asked him why he didn't get himself dressed. His answer was eye opening.
"Why should I do it when she can do it so much faster? Don't you think she should always do it for me?"
The PT was flabbergasted because he sounded so sure that she would agree with him. She told him no! That as long as you can do something for yourself, no matter how long it takes you to do it, you should do it. Because every task that you stop doing you eventually lose the ability to do. And that is how people completely lose any semblance of mobility and independence without even realizing it.
My advice, don't do it unless you are sure. Stand by if assistance is really needed. Leave the room but be nearby to listen in an emergency. Maybe provide him the tools to do whatever it is he is asking and walk away.
You mention that he was used to your grandmother waiting on him and used to getting his way. This is a slippery slope. We can barely get a handhold on the way down right now. Ask the dr if he is capable of certain activity. If the dr says he is, leave it alone. Let him do it. You do start to see where they really need help and where they just don't want to do something. Or even worse, can do it, but want someone else to do it for them, which sounds the same but is a whole other layer of controlling their world. You may find that he will try to wait you out. It depends on how deep the being used to being waited on goes. But the best you can probably do right now is just be blunt. You can be gently blunt if that works. We had to take the kid gloves off with FIL because he is also unfortunately a narcissist and will run his supply into the ground to get what he wants. So we have had to start with the tough love.
You have to do what works for you. But it is a fine line between helping them and enabling them.

One of the things that happens with dementia is that the patient loses the ability to initiate actions. So even if they would like to take a walk or make a sandwich, their disease stops them from initiating the action.

You can break an action down into very small steps (..Stand up. Walk over here. Open this) and guide them through the task you want them to do.

Like children, it would be faster to do it yourself. But the advice we were given is to have them do as much as they can for as long as they can. So we looked at it like their therapy.

But it's not laziness. It's part of the disease. Can you get some help in, even if you are there too?

Thanks for asking im going through some of the same things. My worse is when he demands or hints around at that i should do this or that instead of asking

When someone has dementia, their mind gradually becomes "unwired" and they forget how to do things they could do before. And just from my observation, even healthy people over 90 years old often lose their ability to do a lot of things. They can't help it, the body wears out. But with your health situation, it sounds like he should be in a senior facility where there will be a team of people taking care of him. You might want to try to wait until coronavirus is more under control in senior facilities, you won't be able to visit him if he goes to a facility. Can you talk to a social worker to find out what your options are? You might be able to get an aide to come in and do things for him a couple of hours a day.

First, do not engage in his requests.
Second, watch and observe.
Third, set limits.
Always, encourage and speak in a soft, kind voice.

The old saying, "You never know, until you walk in their shoes". When we are young it is something one can not imagine what it is like being "old". Well let me tell you, things just don't work the way they use to, even just a few years ago. And that is with normal/good health.

I am 79 and everything works much slower, more painful, harder to do, not real steady, not sure of, how to figure out, etc. Plus for each day over that to your Gramps age it multiples and multiples. You most likely remember him when he was younger and think he should still be able to do those things. Plus add dementia to it and nothing is normal or should be expected. Nothing!!! Old age is an experience and dementia is a trip through many experiences!

With dementia you should not be surprised by anything, no more then with a very young child. Love Gramps and enjoy every minute of everyday.

Dear Kat, I am a full time care giver for my husband who is 82 and diagnosed with Lewy Body Dementia. This disease is like a roller coaster with so many ups and downs. There are times he can't dress himself, because he seems lost as to what he should do. I use to dress him, because it was easier and faster for me, but after awhile my body started suffering. I then laid out his clothes and would sit next to him and let him dress himself. There were many times he would sit there and didn't know how to get started, so I would say (while he sat on the toilet) put on your clean underwear, now put on your pants, put on deodorant, now put on your shirt. I cued him for awhile, now I just lay his clothes out and he dresses himself. There may be times that he will forget what he is suppose to do, so I use him, then he seems to recall what he needs to do. With this disease, I questioned whether he was faking, but the more I read on the disease and spoke with his Dr's, I realized there will be times he can do things and other days he will not. I know as caregivers we have so much to do that it seems easier for us to do then wait for them to do it, but we are only burning ourselves out and keeping them from doing for themselves. My husband got use to me using the wheel when taking him to appointments, now, I have him use his walker so he can use his legs and get some much needed exercise, so he is doing a lot for himself now, but I have to be patient and let him do it at his pace. I hope this helps you out with what you are going through.

If he got used to others waiting on him, that is his normal. Maybe try another response to his requests: He wants a sandwich. You - Go check the frig and see what we have. I think there is ham, cheese, etc. Or, even that sounds good, would you make me a sandwich, too. Holler when it's ready, I'm going to clean the bathroom. See what happens.

Maybe beat him to talking about a task. At noon, ask him if he can fix both of you a sandwich because your back is really hurting today.

You could also bring a basket of clothes to his area and ask if he can help you fold things. (Don't fix anything he folds in front of him, just let him do the work). Tell him your arm is really hurting today and you could use the help.

Some of the problem, as you say, may be he really can't remember how to do what he wants, but he doesn't want to tell you that. If it's the dvr, hand him the remote and say - Remember? You just have to push this button. If it is food prep, then reply - Come in to the kitchen so we can fix XX together.

It is easier and faster to just jump up and do for others, but you have to keep telling yourself every time you do a certain task - you are removing it from their ability to do it themselves. Think about a lift chair. Yesterday you could use your leg and arm muscles to stand. You got the chair and had a bad day and used the lift. Then began using the lift because it became habit..and easier. In a couple of weeks, you will lose the ability to push yourself up. Putting yourself closer and closer to losing all mobility.

MarylePete, I totally, completely and wholeheartedly agree with your observations. It's comparable to the saying of walking in someone's shoes. Until we're hit with age slowdowns, complications and challenges of our own, we really can only try, try and try even more to conceive how challenging it can be for someone older, and that's not even considering the various physical limitations that can develop along the way.

Over the years I learned that one of the first things to determine in helping someone really is how much physically that person can do for her or himself. It's much too easy, too simplistic and unrealistic to assume that our parents can do the same things we can; their physical limitations are so different than ours.

Gramps will not change. His wife was how he got things done. That was in there life style. He will not change and do not try. He is not lazy..he has been a little like this for all his married life. You are taking the place of "his wife" and what she physically did for him. End of life issues are seen in "don't care". Just give him peace of mind. Do not assist him in any way that he can "maintain" himself. The cognative thing...always talk and expect him to talk back and if it needs clarifying....he needs to keep thinking and responding. Think out loud around him and if he responds go with it. One thing he has going for him is he likes to be waited on. That will make transition to a facility easier when you do not want to do it any more. Your pain issue..you can tell him ..."I just can not make myself do this,I just hurt all the time". If you have decided to end it. If not hire help you need for physical reasons. Remember, your pain lets you run out of patience and you both will suffer. If pain is exacerbated by physical stuff...for your sake..hire help. You will detiorate with or without meds.

I'm not sure at 92 how much you can expect from him. Dementia can definitely affect a person's ability to do activities of daily living( dressing,bathing,toileting,feeding oneself) and the instrumental activities of daily living(cooking,laundry,housekeeping,etc). So my question is what was he doing for hims3lf when you became his caregiver? Have you had him to try doing what you are asking while not jumping in to take over? It could be as the dementia is progressing that he really is forgetting how to do tasks? Have you spoken with his physician regarding this issue? If the physician is willing and you really want it for sanity's sake, you could request a in home occupational therapy evaluation? It would be covered by insurance and the occupational therapist would be able to advise you regarding his abilities. You yourself could also take a step back an encourage him to complete the task you are requesting. I'm think8ng though that you are dealing with two issues: his dementia and the fact that he is accustomed to people waiting on him. I'm concerned though about you and your chronic health issues. Perhaps you shouldn't be caring for him on you own. Maybe you need assistance with his care to care for yourself. Just a thought.

I’m going back to your own assessment that often GF can do things but has a lifetime of being waited on. You are not lacking in the sympathy and understanding urged by other answers, but you want help with triage.

‘I’ll do it in the morning” is a good idea. Or ‘later on’, or ‘after you have done xxx’, or ‘when I’ve finished the chapter’. Another idea is to have something adequate to offer which is not as pleasant as he would like. Have a repeat stock of a particularly boring frozen meal in the freezer (and get another small freezer if your fridge isn’t big enough), and microwave them instead of making other meals for him. If he asks for a hot drink, make him a mug of hot water (which is actually surprisingly nice). You should be able to think of some more alternatives for things that you think he may well be able to do for himself if he wants to. You can say that it’s easier for you, or just say that this is good enough. After a while he should get the ‘do it yourself if you want it’ idea. The less attractive alternatives are in fact ‘good enough’, so this isn’t cruel, and it might help with triage.

Good luck with the rest of the family!

I’m not sure why you say that he hasn’t progressed to a point that he isn’t able to do things, when he is not able to do things. I’d work to get him help and work towards understanding and acceptance of his limitations. Even if he didn’t have dementia, he’s likely tired and weak. If you fear burn out get help. It normally takes shifts of people to provide this kind of care. Many 92 year old people require total care.

Seems you will need to figure out which "tasks" are beyond him - have him attempt to do "it" and coach him through "it" if need be. If he can do the "task", he should do "it" all the time. If he can not do "it", then figure he has lost the mental instructions and others will need to do "it" for him.

If you are having problems with chronic pain, please take care of yourself. You can only care for others as long as you are able and feel well.

Imho, as your grandfather is 92 years, his physical abilities may be waning. Perhaps he can no longer do what he once had the mental wherewithal to perform.

This is a difficult one. It is fairly likely that he really is now unable to do even those things he did do previously, but if it's too much for you to do then you need to get support for him and yourself.

When my mother moved to AL near us, she managed the legal business of house-selling quite well without much help (at 82). She had been used to arranging her own transport to medical appointments, although she relied on friends to take her shopping as she won't use any technology to order things.

When she moved here I picked up a taxi card at the AL and gave it to her, thinking she would use them as she had at home. Her reply was: 'Why would I need a taxi firm when your husband can do it?' and over the last three years she has gradually stopped doing anything for herself: no cooking, no phone appointments, not paying her bills, not taking her own recycling to the bin store across the passage - she even makes us read her letters from utilities, etc. and do whatever is required. Now I know she is getting older and her cognitive abilities are maybe not as sharp as they were (we aren't sure if there is any dementia there - her mother and brother had it, so it's possible), but it does look suspiciously as though she decided when she moved here that we were going to be responsible for her life whether we liked it or not. It has caused me great emotional distress, as my mum and I have never been close (from my reading it would appear she is a covert narcissist).

My mum admits she is lazy and can't be bothered to do things, and we often just go along with her demands to avoid nasty comments, but we worry that we are enabling her to become less and less capable, which isn't really helping her. It is very hard to tell the difference between what she needs and what she wants.

We arranged for paid carers to come once a week to do basic chores for her and had to endure horrible emotional guilt-tripping scenes as a result, but these carers have kept her alive during coronavirus, so we hope she may be more accepting of them now!