My mom is 77 and my dad is 81. She has moderate to severe Alzheimer's. (undiagnosed) She has not seen a doctor or dentist in probably 35 years. She is refusing to leave the house, see a doctor, see a dentist or take any type of medication. The good thing is - she is physically fine. Mentally - she does not know my dad at least half the time. She is having hallucinations of other people in the house. Most of the time she does not know me or my sister. My dad is choosing to be full-time caregiver. He had a stroke 2 months ago and fortunately has recovered fine. My mom needs some type of medication - she cries a lot, has sundowners every night and she doesn't sleep much. I'm not sure how much longer this can continue. It's been extreme the last 7 months. My sister and I both work full-time jobs and help as much as possible in the evenings and weekends. My 2 biggest problems are how do I convince him that he is not capable to provide the best care for my mom and how do I get her to a doctor?
I am Mom’s only child, and she would flip the F out on me whenever I tried to address her dire need for medical care. Mom had the best health insurance I’ve ever seen; a generous LTC policy; owned residential & commercial properties (all paid off); money in the bank. Mom thumbed her nose at all of her many, many resources.
Throughout, there was no shortage of well-meaning(?) people would tut and click and tell me - sigh - that I needed to step up. If Dante is looking to add a 10th Circle Of Hell, this is it.
Knowledge is power so here goes... hallucinations aren’t typical in dementia except for a certain type called Lewy body. There is also a dementia like condition that is curable. A shunt is placed to drain fluid from the brain. There are medications that can help delay the progression and help to manage the symptoms too.
So for these reasons alone explain to your dad that you want her to see a doctor. Preferably a neurologist that can diagnose and treat her dementia effectively.
Explain that you don’t want to take away his right to care for your mom in his home but that you insist that she get evaluated to ensure that she is getting all the help she needs for her condition.
Find resource materials and show him how medications like Aricept can help slow declines. She has symptoms that can overlap with a urinary tract infection too. That should be ruled out.
Ultimately if you are unable to get him to get her to a doctor I do believe you should call Adult Protective Services.
Explain to your dad that should he have another stroke and was not so fortunate to be ok after it, he would want to know that she was receiving the best care possible.
Hallucinations are often effectively treated with medications too. If something as simple as a doctors visit and a bottle or two of pills could improve the quality of both of their lives how could he refuse to get this help?
No one can force him into placing her elsewhere as long as he is caring for her. Reassure him that you have no intentions of putting her in a home, you just want to see her symptoms treated as best as they can be. He’s probably frightened that he will lose her. Reassuring him that he won’t but that he could be denying her help may get him to get her to a doctor.
Sorry, for the life of me I cannot recall the dementia type that is actually not dementia but cured with a shunt. I’ll think of it eventually.
He really owes it to her to get evaluated and the hallucinations need to be treated as they are very distressing to the sufferer.
All of my best!!
If so, a conversation with you and/or your sister and this professional trained in geriatric diagnosis might be able to begin the process of identifying cognitive weaknesses that could reveal Mom’s inability to continue to be safely managed at home without additional help for dad.
For the LO currently in my care, who was demonstrating some of the behaviors you are seeing in your mom, a gentle, sympathetic interview by a calm, quiet PA trained in geriatric care resulted in a successful trial of a medication, and subsequently the development of a letter which has been a helpful asset for getting her the best care available.
Although it is in my opinion, one of the most harrowing aspects of caring for a LO with dementia, at some point it will be absolutely necessary for the health and safety of both of your parents to “take over” the situation and have mom speak to some expert outside of your family, so that at the very least, dad is informed that mom is functioning so “differently” at present that she cannot safely continue without some supports outside of what the family is already doing.
All of the advice you are receiving here suggests different approaches to the same inevitable course, and yes, there will most certainly be negative consequences and anger and grieving, and for you and your sister, the grief and self doubt and remorse of whether or not you’re doing the “best” or right things for them both.
Ultimately, those of us who love and care for people who manifest difficult, negative behaviors ALWAYS are called upon at some point or another to make informed choices from a selection of options that we are aware will cause discomfort or unhappiness for our LO, but that MUST be made to keep our LO(s) safe, as comfortable as possible, and as comfortable as can be provided.
Unfortunately, you and your sister will be dealing with your mom’s behavior in terms of differential diagnosis to whatever extent possible, and at the same time your dad’s fragile physical condition and his denial of his wife’s present needs and the impact of those needs on his own health.
I think most of us would have to admit that we held off as long as we could, but looking back on my own family situation I have to realize that holding back didn’t make any of the process different than it came to be.
It DID help me early on to do some research about the different kinds of in-home support, residential care, and different reasons for dementia symptoms. Arm yourself this way if you can.
We cannot judge. We don't know what people lives are or finances. I think your clients family had enough on their plate. Maybe they thought you being there was enough. Its not easy getting in LTC. Medicaid is not that easy to get and ALOT of paperwork.
I'm glad to hear that he recovered well from his stroke. What he needs to consider is what will happen to your mother if he has another. Which, as I'm sure you know, is a greater threat the more pressure he is under.
What is he afraid of? What does he think will happen if he accepts help, support and advice from outsiders? Perhaps if you can list some concrete proposals and outline the plan in more detail, it'll reassure him enough to get him started.
E.g. He could call his own doctor and take advice on how to get your mother examined.
You could download information from alz.org for caregivers.
You could point out to him that your mother is suffering terribly from what she is going through and she deserves treatment to help her.
Take it gently, and make positive suggestions rather than dwelling on everything that's going wrong. If you can win his co-operation that will be the key.
Btw, if your mother had severe Alzheimer's Disease she wouldn't be doing much. Clearly there is a lot wrong, but try to keep an open mind about what it is. Do you remember roughly when she started showing signs of there being a problem?
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This site isn’t exactly an in-person support group but it’s pretty close, please keep coming back! Good luck. 🙏
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