Advice Wanted

BPH0598

Hello,

My dad was diagnosed with vascular dementia in late 2018.  He and my mom live in LA while my sister and I live in NC.  He can only be left alone now for no more than 1.5hours, is no longer allowed to cook (he’s almost burned the house down) and can no longer drive.  My mom is still working so he does have a sitter with him  while she is working.  He never wants to do anything anymore.  Doesn’t want to take a walk outside, garden, play cards, do a puzzle.  The home has cameras so me and my sister can check in.  Many times he is just pacing around the house and only ever wants to eat.  Occasionally he will sit and watch a show.  However not for long and he is back to just pacing and walking around the house.  If you ask him what he wants to do he will always say nothing.  Even if you say we’re going to do (insert activity) he refuses.  Just wants to eat and never really stops pacing around the house.  He no longer showers, but washes his face and brushes his teeth.  My mom has set up a spa like scenario in the bath room, but he is just not interested and if my mom says something he goes off on her.  He will wear pants for 3 days before changing them, but will change his shirts 4-5 times in one day.  And you guessed it, if my mom says something he will lash out verbally.  She has to wait for him to take one of his “naps” and sneak to wash his pants he has finally taken off.  He will literally take naps; like 2-3 hours at a time and then up again.  Does not have a typical sleep through the night.  Is there anything at this point we can do, from any of your experiences, to just get him to sit his tail down and be focused on something vs constantly pacing and eating?  Tips for convincing him to wash the rest of his body, or let her do it?  My mom is going to talk to his doctor because she says his delusions are worse on current cocktail of medications and sometimes because of that she feels unsafe at night with him. My mom is an avid runner and is just always in the house because he never wants to do anything or go anywhere outside of the house.  I have to watch him decline.  I hate to see her also decline while she takes care of him.  I just fell so helpless even as support for her with being in a different state.  

Arrowhead

There's probably not much you can do from that distance, but at least you can monitor his activities. Alzheimer's patients live in their own little world. All we can do is try to find a way in once in a while. They will not work with us, it's up to us to work around them. Keep trying to find something that works (you may not), then use it until it doesn't work any more. The best thing to do is what ever causes the least amount of conflict.

KawKaw

If you post in the caregivers message board, you will likely get more responses.

Caregiving is a very stressful occupation and I think you are wise to be aware of the strain on your mother as she attempts to cope.  It was my most challenging role in my life to care for my mother with dementia.

I am not aware of anything specifically which will cause your father to change his current behavior.  It sounds like effects of the dementia.  It is possible that a medical check might help confirm or deny this.

Not being able to focus for long is a common symptom in my experience.  

Also, both my mother and my FIL with dementia experience(d) time much differently than I do.  If my FIL naps, he often thinks a different day has begun when he awakes.

Eating provides a basic satisfaction on a deep level for a person.  I imagine this could drive a person to eat when they are not physically hungry.  Or, the brain might be firing incorrectly and hunger is no longer satiating for long.

Being apathetic is common, as is being restless and lashing out.  The social filter tends to disappear at some point, so words and actions your father might have easily kept to himself in the past are up front and acted upon.

It is a very good idea for your mother to check with the doctor about his medications.  She needs to be safe in her situation as a caregiver.  My mother's medication needs changed as she progressed to keep her as comfortable as possible, emotionally and physically.

My FIL is resistant to taking medications.  My spouse gets him to take them daily usually, but if he is having severe delusions, I will hide those that can be crushed in his food.  

Do you know what your mother's caregiving plans are over time?  Is placement an eventual possibility?

It is hard to support from a distance. Continue doing what you can, and take care of your physical and mental health.  Support your mother as much as you can.  Dementia of any kind is very challenging for all involved.  It is hard to deteriorate and it is hard to witness your loved one's deterioration.