Suggestions needed

bcgcarter · February 19

My husband and I moved in with my mother in law (83) about a year ago to help her. She lives in a large home with an inground pool and the maintenance was becoming difficult for her to handle. We also noticed that she did not remember questions she had already asked us, or if she put food in the oven and would forget about it and it would start to burn. One time it started a fire which she never told us about until we saw her cleaning black soot off the cabinets. Both of her parents had Alzheimer’s as did her brother. It has become increasingly difficult to continue living with her because she refuses to go to her doctor to ask him to run diagnostic tests to see if she does have Alzheimer’s. She refuses and says she is fine and says she remembers the things she wants to remember and there is nothing wrong with her. She has 4 siblings that also see the signs but refuse to acknowledge it to her or discuss it. My husband and his brother have POA for medical and financial but only if she is deemed not able to make decisions on her own. This is truly putting major strain on my marriage because no one wants to make a move to make her acknowledge what is happening to her. Instead my husband becomes increasingly agitated all the time and becomes very angry very quickly and yells at her and says nasty things. He is very short tempered and I honestly cannot imagine living like this much longer! My 23 year old grandson says that he does not like the constant arguing and seems to keep his distance as well. I need help. Any suggestions ?

H1235 · February 19

Welcome. Most people with dementia have anosognosia. This is the inability to recognize their symptoms or limitations. It will do you no good to try and convince her there is a problem. You will not get through to her, her brain is not working right. You will need to work around her and probably tell a few fibs. Does her doctor have a patient portal, can you set one up? Use this to explain to her doctor what is happening. If that doesn’t work, bring a letter to the office explaining the symptoms you are seeing. Set up an appointment and tell her the doctors office called and said she needs to be seen …(here is where you need to get creative) for insurance purposes or she will lose her insurance, it’s time for a blood pressure check, they need to follow up on the… You could ask the pcp in the note if they would write the letter saying she is not able to make decisions, but I would guess the doctor will want her to see a neurologist first. It can take a while to get into a neurologist, but they should be able to write the letter your husband needs. This is really hard. Correcting or pointing out a person with dementias symptoms is going to be trouble. It’s hard to do, but it’s generally best to avoid any talk of dementia. If she says the sky is green then just agree with her. It’s hard to always be wrong. If things get too out of hand and she ends up in the hospital or if police become involved, tell them repeatedly “she is a harm to herself or others”. Demand a psychiatric evaluation. I will attach a few resources. I hope something here helps.

Anosognosia and Dementia - AgingCare.com.pdf

DBAT.pdf

pamu · February 19

I agree with the other posters… you can't reason or convince a PWD otherwise. When my mom is having delusions and is confused I'll just sit with her quietly and nod. I'll (try) listen to her patiently and will deflect the conversation to something pleasant. Sometimes it works, sometimes not.

Is she home alone often or is someone at home with her at all times? It sounds like she's at the tipping point where she will increasingly need more care and monitoring. If she can't stay away from the stove, maybe install a dedicated switch so she can't operate it. Of course there are other dangers at home that they can get into ….small appliances, medications, tubs/sinks and the pool. My mom somehow "broke" her toilet and other stuff around her apartment often. She couldn't stop herself from fiddling with everything. Toward the end of my mom living on her own she was throwing EVERYTHING away. Underwear, clothing, shoes, kitchen stuff, etc. On the surface she appeared tidy and able to clean, but underneath there was a lot going on. She was in her elderly housing apartment up until a fall in July. After being released from the hospital she had home health aides 8 hours a day (plus my sister and I doing shifts because she didn't qualify for rehab…another aggravating story). A month and a half later we found a lovely AL for her. She toured it, loved it, and moved in. 18 days later her symptoms ramped up so much that she eloped and was found delusional at a house down the street. She was brought to ER via ambulance, and she was monitored by Geri Psych for 2.5 days. She was then deemed incompetent, her DPOA was activated and released to MC. She was already on Medicaid so the hospital social worker was able to find placement quickly. A crisis can change things in an instant…the more info you have the better. We've been traveling this journey with my mom for 8 years. We suspect she's had it longer but that when she was officially diagnosed.

If your husband has a short fuse with your mom than he will have to limit his one on one interactions/conversations (difficult to do, I know). I've had to take a step back from my mom at times and not interact or respond every time I get frustrated. Dementia can bring out the worst in everyone.

Do you accompany her during her doctor appointments? If she's experiencing behavioral symptoms (depression, anxiety, anger,delusions) a geriatric psychiatrist can help with medication.

Wishing you the best.

psg712 · February 19

That POA needs to be activated as quickly as possible. Agree with pamu, she is probably soon going to need 24/7 supervision to keep her safe. No, not soon ... now.

If your husband is having trouble keeping his cool with her, realize that her needs are only going to get more intense as time progresses. He and his brother need to talk about how they want her to be cared for over the long term. And the stress on other family relationships needs to be a factor in that discussion.

In my opinion, these earlier stages are really tough. The PWD still thinks they can handle their own affairs, and family is hesitant to butt in and take over. Make sure that the sons have access to her bank records, investments, mail ... many a PWD in this stage has been scammed out of their savings. She doesn't have the judgment to evaluate financial situations. And please don't let her drive!

One good thing is that she accepted having your family move in with her. On some level, she knew that she needed help … or company to keep her from being alone. Don't be shy about giving her the love she really needs ... which means taking control of some things to keep her safe. Safety trumps happiness.

Btx4171 · February 20

I wrote a letter to my moms primar doc, describing symptoms. Then went to the next annual appt. IT may help set the stage for the MD to order some additonal tests, which makes the MD the “bad guy”, versus you or your husband saying she needs to see soemone about ALzheimers. Good luck.

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