Hello!
My thoughts about your question based on my experience with my mom is '"it depends". On the big issues -- financial and major health care decisions -- then I'd say you need to go with the person's best interest. If the issues aren't that pressing, then I'd say let the loved one who has dementia have a say. For instance, I had to take over the reins concerning Mom's medications when she came to live with me since she wasn't properly medicating herself. And as much as she didn't want to go there, we did place her in a nursing home due to her need for skilled nursing care.
Otherwise, I tried to pick my battles carefully. And I found that I had to determine what were inconveniences and which were potential crises. With inconveniences, I'd give Mom a voice in what happened. In a crisis, I'd take control. I wrote about this at:
http://www.healthcentral.com/alzheimers/c/42/8596/lessons-crises
Hopefully, you or someone in your family has power of attorney and the major legal documents are completed. This also should help drive your decisions. I wrote about this at: http://www.healthcentral.com/alzheimers/c/42/1667/care-legal-road. Knowing what a loved one would have wanted (prior to Alzheimer's setting in) is so helpful in guiding decisions. For instance, Mom had made her intentions clear concerning a feeding tube (she didn't want one) and had signed the appropriate legal documents to that effect. So when we were faced with the prospect of that decision, we knew what Mom wanted. I wrote about this at:
http://www.healthcentral.com/alzheimers/c/42/8522/moms-feeding-tube
I'll be interested in seeing what others say in response to your question. Take care and stay in touch!
Dorian
Elders lose so much decision-making power that I feel that we must override them only when they are in danger or it's something very serious. They have likes an dislikes (and that includes foods). Is it worth the battle to make sure they have a balanced diet? There are supplements (liquids) out that can help them maintain health, and fluid is more important than food, anyway. If they don't have much appetite, fighting won't help, anyway.
Clothing? Who cares? If they want to wear a red sock and a blue sock, it doesn't matter. So many things don't matter. Not really. Sometimes, such as going out for a walk alone when they could get lost, really matter. Then, you have to prevail, but if possible, be sneaky about it. Distract until they forget. Take them "home" by driving around the block. Just try to stay away from arguing because Alzheimer's always wins.
In the end, it's about importance and how your preserve their dignity. Try to make things seem like their idea. Try to show respect, even if you aren't feeling it. And try to let them have their way as often as possible. The rest of the time, you need to punt. Weight the decision each time. How important is this?
Carol
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