How to mediate between parents

alzheimerdottir

Hello, I’ve just joined this forum. My father has mixed Alzheimer’s and vascular dementia. He’s always been a very stubborn man, very controlling of my mother through their marriage. So now that she has to be his caretaker there are some very difficult issues occurring and I’m being placed in the middle constantly. They can’t seem to continue this way, I’m wondering if anyone has had luck with bringing in a caretaker to the home even when one spouse (my mom) is completely healthy and capable of taking care of my father but he fights her on everything and she just can’t remain calm/composed all the the time despite her best efforts. He’s going to fight going to a memory care facility. So I’m just trying to help them the best I can without picking sides. Appreciate any insight, help or suggestions.

M1

Welcome to the forum.  If one parent has dementia, i wonder if a shift in your thinking is necessary/would be helpful, as the affected person no longer has a rational point of view therefore doesn't have a "side."  Continuing to try to reason with our affected loved one is something we all do and have to gradually accept as futile.

maybe you could reframe the question as to how can you best support your mother in her very difficult caregiving role, while still letting your dad know you love him (if that is the case).  do you have siblings? These situations are very hard on only children.

there are many threads here about bringing caregivers into the home, rejection of help is common.  I was unsuccessful at convincing my partner to accept help and it proved impossible to find in our rural setting, she is now in memory care. If finances allow and there is constant conflict, memory care might be a relief to your mom.  Perhaps you could support her by helping to ensure that their legal and financial planning is in order.  Good luck, and I'm sorry you're having to go through this.

harshedbuzz

Hi and welcome. I am sorry for your reason to be here but pleased you found this place.

I had exactly this situation with my own parents. My parents had been married 60 years when dad was diagnosed with mixed dementia. There was clearly an imbalance of power in their relationship; at best dad was a benevolent dictator with her and could be a bully during rough patches in their marriage. 

When dad developed dementia and required significant caregiving things got really ugly for a number of reasons. Firstly, dad had a common dementia "side dish" called anosognosia which is when a person with dementia is unable to recognize that they have had a shift in their cognition and memory. His perception of reality was that he was not only just fine, but he was also superior to the rest of us. 

The second issue was my mom's anger. Even though this isn't really rational, she was angry with him for developing dementia which interrupted her idyllic retirement years. Her situation was a bit different in that one of dad's dementia was alcohol-related and self-inflicted in her thinking. This anger impacted her ability to be calm in the moment and made her resistant to the best practices of validation, fiblets and redirection. There was a time not long after dad was diagnosed in the middle stages, where I was at their apartment calming the pair of them down. 

The other piece was that dad was pretty obnoxious in his arrogance which triggered her. She was angry. She had the upper hand for the first time in 60 years and darn* if she wasn't going to exercise that. 

Three things helped. My efforts at explaining and modeling best practices with success (I was not one of dad's favorite people) failed, but when the folks at her IRL support group told her to do the same it did finally click. Another thing that helped was getting both their own psychiatrist-- we got medication to take the edge off dad's anxiety which drove most of his aggression and something for mom to help with her anxiety and depression. This essay also helped her find her usual compassion.

understanding-the-dementia-experience.pdf (alzconnected.org)

Even after we were able to get to a place where the major battles weren't ongoing, dad was not cooperative in being cared for. He refused to shower, change clothing, take important medication, abstain from alcohol, eat food or even stay hydrated. This was not the man she married. 

We did bring in caregivers for a time. Dad wasn't any more cooperative with them around hygiene, but they could usually coerce him into eating and having something other than Chardonnay to drink. This allowed mom some respite, but TBH, she just wanted some peace and quiet alone in her own home to process what her life had become.

Another aspect of having a caregiver in the home was that if mom stayed home to nap or tend to some household task, dad wanted her not the HHA. And having someone in the house felt a bit like turning the house into a single bed nursing home. 

Some folks have real success in bringing in professional help. We really didn't. The 15 hours a week weren't break enough for mom. Some of the folks the agency sent were awful-- one stole most of mom's jewelry and left some other client's checkbook in mom's bedroom. And it was really expensive. Mom paid over $30/hour 5 years ago-- with inflation and people leaving this line of work getting HHAs can be even more challenging now. 

What worked was placing dad in a good MCF where he responded well to their dementia trained staff and dementia-informed structure and activities. They were able to provide much better care than he'd allow at home as he saw these people as helping him. And it allowed mom to slip back into the role of doting wife and just spend time with him rather than being angry with him.

I agree with M1 that this isn't a situation where there are sides. And if there was, most PWD don't have the higher order thinking skills or empathy to participate in major decisions.

When one person has dementia, the couple/family has dementia. One thing that frustrated me as we navigated dad's dementia journey as a family was the assumption on the part of professionals that dad's wants/needs came first. I was going to lose my dad to dementia, but I wasn't going to allow it to take my mother down as well. My role became about advocating for what was best for both and then finding a way to make that work. 

HB

Quilting brings calm

Welcome.   This spouse forum and the caregiver one are here for you. 

Your dad cannot process logic, empathy or fairness, so there’s no way to mediate between them.  My guess is that it didn’t work when he could process logic/ it never did for my step-dad.  Speaking as a survivor child of a 58 year tumultuous marriage,  it can’t be your job anyway.  It can’t be because you are needed to just provide support to mom.  

What you can do is better equip your mom with tools and respite.  Point her to these forums and additional Facebook groups where she can vent her frustrations to additional people besides you. One of the nice things about alzconnected is the anonymity of screen names.  You could both be here as long as you don’t provide unneeded details.  Buy her the book ‘the 36 hour day’.  Open HB’s above link to a free PDF ‘understanding the dementia experience’.  Both will help her and you understand him a little better 

Make sure your mom gets out of the house by herself to breathe, to connect with friends that she will need over the long haul.  Offer to start taking dad to medical appointments some  of the time- where you can discuss the need for mood altering medications for him with the doctor.  

Also give consideration regarding whether your dad is actually too much for your mom to handle physically or emotionally.  Aggression can be displayed by stubborn people with dementia.  Give some  thought to whether moving him to an assisted living facility might be the best thing.  Even if mom decides she needs to live there with him, the presence of assistance and buffers in the form of 24/7 staff can be helpful.  It is for my parents.  Mom was the first one why dementia, but step-dad has  caught up to her.