Alzheimers and Challenging Elders: Behavioral Strategies

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Author: Jacqueline Marcell

Article source: http://www.kabish.com/. Used with author's permission.

Caregiving of any kind is challenging enough, but when an adult child has to care for a difficult elderly parent, it's one of the hardest things they'll ever do. I know--I went through a year of heartache with my obstinate father before I figured it out. I had been the light of his life, but when I had to step in to help him care for my ailing mother, he turned on me, doing and saying things I would have never dreamed he could do.

ELDERCARE LESSONS

Having no experience with eldercare--I just didn't get it. I thought that my father's nasty temper was just the stress of caring for my mother for so long--which it was, but it was also the beginning of dementia, namely Alzheimer's, which intermittently distorted his thinking.

When my father threw two little worn out hand towels at me, screaming and swearing at me for throwing them away, I was stunned and cried my heart out. With the knowledge I have now I'd say, "This seems illogical--this seems irrational. Oh, red flag--it IS illogical and irrational", and I'd know to get him evaluated by a geriatric dementia specialist right away. I'd know not to waste time with his regular doctors who weren't trained to uncover the earliest stage of dementia. Instead, a whole year passed before both of my parents' Alzheimer's was properly diagnosed and treated.

ALZHEIMER'S CAN BE SLOWED DOWN

Stage One Alzheimer's is so subtle and intermittent, it comes and goes, and statistically families and many doctors who are not dementia specialists ignore it for several years, thinking that the short-term memory loss, confusion, irritability and odd behaviors are just a normal part of aging and untreatable senility.

When your loved one asks you the same question over and over, or gives you incorrect directions in the area they've lived in for many years, or has sudden mood changes, or has any behavior that you find yourself questioning--it's time to have them tested.

Dementia can't be stopped, nor is there a cure, but the symptoms can be slowed down with medication: Aricept, Exelon or Reminyl, and for later stage, Memantine. Keeping a person in Stage One (typically 2-4 years) longer can save a family a lot of heartache, not to mention money, because Stage Two (2-10 years) requires full-time care. Stage Three, the end, typically lasts 1-3 years.

BALANCING BRAIN CHEMISTRY

After the dementia specialist slowed my parents' dementia down, the (often-present) depression was medically treated, as well as my father's aggression. Once their brain chemistries were properly balanced, I was able to implement some behavioral strategies. I learned to use rewards and discovered that the offer of ice cream worked the best to get my father in the shower, even as he swore a blue streak at me that he had just taken one—yeah, a week ago!

DISTRACTION

Instead of using logic, reasoning or arguing, I calmly learned to used distraction and redirection. When my father would get in the broken-record mode and harp about something ridiculous like we shouldn't be using the garbage disposal, I'd say, "Oh, Dad, did I tell you what Aunt Rose said the other day?" Or, "The laundry is dry--here, help me fold everything before it wrinkles." Or, "I heard there was some bad weather near Uncle Roy's--let's turn on the news." .

LONG TERM MEMORY STILL GOOD

I also discovered that even though my father's short-term memory was damaged, the long-term memory was still quite good. I capitalized on it by asking questions about the past to distract him. "Dad, they're thinking of going to the moon again. Where were you when that happened?" Or, "It's nearly your anniversary. How did you meet Mom again?" Or, "What happened the day I was born—the blessed event!"

VALIDATE FEELINGS

Then I learned to validate feelings and to live in the reality of what was real for my parents. When my father would dramatically insist that something had happened, that I knew hadn't, instead of correcting him on the facts--I'd ask him to tell me more about it. I realized it wasn't as important to be accurate, as it was to make him feel good about what was true for him at that moment.

Then one time, instead of crying about what this horrible disease was doing to my parents, I knew what to do when Dad declared, "Guess what? I got a part time job today!" I said, "Really, what are you doing, Dad?" He grinned from ear to ear, "I'm in charge of taking care of Clark Gable's horses!" Mom nodded, "Yes, honey, we're going to have to get some hay." Even though I knew they wouldn't remember it in the morning, it warmed my heart to see them beaming with such pride when I hugged him and said, "Oh my gosh, that's so wonderful, Dad. I am so proud of you--what an incredible honor!"

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Permission is granted to publish all/part of this article free of charge as long as: the author's byline is included, the links are live, and the author is notified: J.Marcell@cox.net or 949-975-1012.