Saturday, August 30, 2014

Sunday, July 05, 2009 trosclair, Community Member, asks

Q: Mom's so confused.

My Mom is in the 5th stage of Alzheimer's. We have recently (2 weeks ago) placed she, 81 years old, and my step-dad, 77 years old, (congestive heart failure) into a nursing center where they share a room. Since they have been there, she has forgotten they are married, thinks my dad, who passed away in 1995, is still alive and that he hasn't came to visit or call her. Her feelings are constantly hurt because the love of her life doesn't care enough to check on how she is. She also thinks she has 2 little girls at home with my dad and we are still living in my childhood home. my sister and I are 50 and 47 respectivly. Every time my brother or sister call her, she mentions the girls and dad. We have tried to explain, even brought dads death certificate and her present husbands marriage liscense to her. We realize explaining everyday doesn't work, she doesn't remember from 15 mins to 15 minutes, so daily reminders don't help. She also gets agitated, depressed, threatens to walk home, angry and it takes meds to finally calm her down. The staff have suggested that we change the subject when she talks about the "girls" or Dad. My problem is she doesn't take "no answer" for an answer. She gets upset when we don't tell her where the girls are or why dad hasn't shown up. I try my best to change the subject..does anyone have other suggestions? I miss my Dad and having to relive his death over and over is starting to get to me emotionally.

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Answers (4)
Carol Bradley Bursack, Health Guide
7/ 5/09 7:55am

Telling her "no" at this stage doesn't work. If you can say something like "you'll be seeing him soon." "Remember he loves you." and other things it may help. This is very difficult because in her mind she is married to your dad and she has little children. That is her reality. Changing the subject is good, but it doesn't last. However, that and letting her know that he loves her and she'll soon see her may help.

 

Did he travel? You may have to go so far as to invent a story "He's seeing grandma now, since she's been sick, but he'll be home soon." You have to go with your gut and the understanding of where she is mentally.

 

The move to the nursing home was necessary, but any change in environment is difficult and can temporarily or permanently send someone with dementia further down the road. She would have gotten there anyway. It's just that the change hastened it.

 

Go with your gut and kindness, and then just be as patient as you can. Let her vent, try to reassure her, and change the subject if you can. Then expect it all to happen again. That is the nature of the disease.

 

Blessings,

Carol

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Christine Kennard, Health Pro
7/ 6/09 9:16am

Hi trosclair

 

It is very difficult. She has just moved to the nursing home so I think what she is saying, symbolically, is that she is disorientated and her environment is unfamiliar. I think this situation will eventually settle down. To challenge her belief will not change them. What will hopefully change quite soon is that her levels of anxiety will decrease as her new routine becomes more established.

 

It is very hard for you to have to deal with a reminder of your father's death. I am so sorry for that. How does your step-dad cope? Can you provide each other with support?

 

Try distracting activities, take her out for a walk/drive/a walk round her new home etc. If you can both say the same thing to her then move the conversation in each time it will help to have a consistent approach. For example-Both of you say 'He/I am your husband now'. Always use a brief sentence in a calm soft voice, do not go into any great detail as she will not take the information on board (as you have found out!).

 

I agree with Carol kindness, reassurance, is the best way forward. Change the subject even when she continues repeating herself. Visiting in the morning (if possible) may help as she may act and think differently when she is less fatigued.

 

All my best wishes

 

Christine

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AFA Social Services, Health Guide
7/ 7/09 9:51am

Although your situation sounds complex, it is not atypical. In fact, having a loved one view the present as though it were the past, and refuse to accept reality despite presented “evidence” is extremely common for many individuals with Alzheimer’s disease. As a loving caregiver, it is understandable that you would want to take many approaches to reorient your mother and help familiarize her with her surroundings. However, the disease process takes over the brain in such a way that it is often difficult, if not impossible, for her to follow through on your efforts. On the bright side, there are a number of interventions you could use to help her through these tough moments. If your mother mentions the girls and dad, allow her to have this conversation with you. Try your best to fight the urge of proving her otherwise or not responding as a way of getting her to forget she asked in the first place. Consider the fact that she is bringing up these memories because, most likely, this was a very happy time for her and she is simply reliving it for herself to brighten up her days. Since much of what caregivers can do to help individuals with dementia is increase quality of life, do whatever you find necessary to keep her smiling and engaged. Go along with her questions by simply reaffirming that you understand she misses them, and turn the questions back on her by asking what her favorite memory was. If she wants to know about their whereabouts, you can simply say that you aren’t sure, but know that she misses them and wants to see them real soon. Once you have validated her feelings, pose a few questions about what she would like to do once they return. This can also be the perfect opportunity to say “Remember that time you took dad and the girls to the zoo? The girls had so much fun feeding the giraffes. Wasn’t that a great time?” Using techniques such as these will reduce sadness, frustrat ion, or any trauma that might otherwise ensue by disregarding the question or reminding her of her husband’s death. Just remember that staying positive and supportive is your best bet, and use any opportunity to reflect on better times to make her days as happy as they could be.

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NC, Community Member
7/ 9/09 12:14am

Hi Trosclair, All the experts above have provided important and true info. The only thing you can do at this point is to distract her with some thoughts that she can accept. We didn't know this earlier until my father-in-law came into stage 6 in the last 2 years. At times before July, we still tried to tell him the truth even though he forgets it the next day or in 30 minutes. Now he is so confused either way (the truth or the distraction in his way), but the distraction is better and more peaceful than the truth. e.g., when we told him the truth about his past and family and showed him the photos in 3 big albums, he got immediately bombed out and exploded and got very sad saying his brain has something wrong. In Jan/Feb. he even wanted to die saying he has nothing sane to live for.

In order to save some sanity for us all, we have decided to just leave the truth alone. Just tell him what he likes. It has gone so far that even if I told him his eyeglasses is ok, he would be mad at me as if it is my fault (it is just a medical fact that he does not like because he cannot read and understand the books and so he blamed the new eyeglasses.) He is antisocial so it is harder for him to be in this state.

 

Everyone is different, and I hope you find a way out for your Mom. Maybe she can play puzzles or games if she is sociable. A new home surely disoriented her very much and it could make her feel worse if no one can calm her down. Good luck.

 

God bless,
Nina

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By trosclair, Community Member— Last Modified: 12/26/10, First Published: 07/05/09