Caretaking the Caregiver

Mimirao

DH and I live about 50 miles from his mother who has mid-stage Alzheimer’s. She still recognizes all of us, but STM is rapidly failing.

Her husband (DH’s step-father) has done a wonderful job taking care of her. Up until the past two weeks, DH’s nephew was living in the house, so there was someone to give some relief…although he’s mid-20s and works full time.

Over the past year, we are noticing some changes in DH’s step-father. His memory seems fine. But he looks and acts as if he’s very tired. It also appears he realizes his wife has Alzheimer’s, but isn’t picking up on some of her hygiene decline. He also seems to be moodier himself.

He’s a very independent man in his mid-80s. However, I’m thinking DHsnd I need to make more of a concerted effort to give him some caretaking relief. Good idea or no?

towhee

Hello Mimirao, welcome to the forum. You are posting in a section that does not get a lot of activity, apologies for the lack of responses. You might consider posting in the Caregiver-general topic section or the Caring for a Parent section.

Absolutely you should provide your father-in-law some support. Did the nephew leave on good terms? You might reach out to him to see what support he was providing and what he would recommend as well as talking to your father-in-law. Hygiene issues are common in dementia and when it is a husband providing care it can be difficult. The person with dementia might find care embarrassing or the husband might not know how. Another thing that happens is sleep fragmentation which leads to fatigue for the caregiver, not to mention depression of the caregiver as care needs increase. You might want to read some of the posts in the Spouse Partner section, or just search Hygiene to get an idea of the difficulties involved.

harshedbuzz

@Mimirao

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

This is a difficult situation and given the distance you might not be fully aware of how dire things are. Given the distance, you likely make day trips which can obscure details. In his mid-80s, SFIL is likely not someone anyone would hire to take on the responsibilities of the job that has fallen on him either physically or emotionally.

This could be complicated by your MIL's presentation of dementia. Many PWD sundown in the evenings which you may be missing on a daytrip. Most PWD showtime to some extent which means they can get their act together temporarily and appear way more functional and pleasant that they are at the time. By the time ADLs like bathing are lost, there's a real likelihood of sleep fragmentation which will impact his ability to function through the day. And without help, he's becoming more isolated and stressed. What you are seeing in SFIL probably includes depression, but there is always the very real possibility that he is having a cognitive shift of his own. I would suggest a weekend— or longer— visit to get a better sense of the situation.

The hygiene failure is likely a function of the disease. PWD can be very resistant to bathing, shampoos and oral hygiene. Sometimes this is a sensory thing where they're cold or don't like the feeling of water on skin. Sometimes there's a belief that they've already showered for the day. Sometimes they, especially women, don't recognize their spouse and assistance feels like a sexual assault. Sometimes they don't recognize themselves in a mirror and think people are watching them. You, or a female HHA, might have better luck with hygiene. Or not.

HB