December 20, 2017
Last month we discussed signs of Alzheimer Disease and other dementias (Click here for Dealing with Dementia, Part 1). Among the biggest challenges in caring for a person with dementia are the handling of money and addressing emotional issues.
Often one of the first signs that things are not quite right with an older parent is their handling of money. She may suddenly make bizarre purchases or accuse others of stealing her money. He may be defrauded by an unscrupulous salesman. Bills may go unpaid. We saw this with my mother-in-law. She had formerly been the head bookkeeper at a local bank, but now she couldn’t balance (or even find!) her own checkbook.
Many elders will resist turning over their financial affairs to their children. This is one of the reasons it is essential to have legal documents in place long before the need arises. Thankfully we were able to get my mother-in-law to sign necessary legal documents such as the Medical and Durable Powers of Attorney. This allowed her older son to handle all of her financial and legal affairs.
It was especially helpful that, as the caregivers, my husband and I did not have control over his mother’s money. Then when she stormed around the house yelling about wanting to control her money, I could tell her that she would have to talk it over with her son the next time she saw him, that I didn’t have anything to do with that, and that I was “just the daughter-in-law.” This kept her from viewing me as The Enemy.
Getting on “her” side was especially important for me when my husband was on extended mission trips out of the country: I had to know that I would be safe alone with her. We settled into a “best friends” relationship with lots of joking, teasing, and watching old movies while eating popcorn. Mom has been with us for five years now and has never attacked me personally, verbally or otherwise.
I believe part of the reason that she regards me as an ally is that I am not responsible for making financial and legal decisions on her behalf. It is not always possible to divide the responsibilities in this way, especially if you are caring for your spouse, but it is a consideration. If the decision-maker is not living in the same house, your loved one may cut you some slack as you face the common “enemy.” Remember that reasoning with her will generally be useless; if her reasoning ability was still intact, she would not need your care.
Caring for the emotional needs of a dementia patient can be challenging but it is vital, both for the elder and for the caregiver. The elder sometimes realizes that she is not acting normally and is embarrassed about it. Compassionate family members and friends will learn to enter into the space/time reality she is living in at the moment.
It is useless and cruel to correct her misconceptions. If she can’t remember who you are, just tell her that you are someone who loves her. She may be reliving her teen years and not believe you when you say that you are her son or daughter. And if she keeps asking where her late husband is, don’t repeatedly remind her that he died twenty years earlier. She will go the through the pain and grief of the news over and over again as if it is the first time she had heard the news. Instead, reassure her that she will be seeing him “someday soon.”
During the early days, Mom could easily communicate her feelings to us—and she did so quite loudly when upset about her loss of independence. We learned to think carefully before speaking to try to avoid topics that would trigger a negative response. For example, we didn’t use the words home, ranch, or money. We learned that reasoning with her accomplished nothing and only agitated her more. If she could reason things out, she wouldn’t have dementia. We reminded ourselves often that she was doing the best she could with what she had left.
Sometimes we were able to redirect the conversation to a safer topic, avoiding an emotional meltdown. Sometimes we could get on her side emotionally with comments such as, “That must be really frustrating for you” to show that we had heard her concerns. At times she just needed to spend time alone in her room, often napping and waking up having forgotten the unpleasantness. Mostly we prayed for all of us that no root of bitterness would grow in our hearts and God has been faithful to prevent that.
There are many other challenges in caring for a person with Alzheimer’s or other forms of dementia. As dementia progresses, the person’s ability to care for herself decreases until the caregiver is feeding, dressing, toileting, and medicating the elder. For a more detailed treatment of this and related subjects, see Home-Based Eldercare: Stories and Strategies for Caregivers.
© 2017 by Marcia K. Washburn who writes from her home in Colorado. Through the years, Marcia has cared for four adult relatives in her home and presently cares for her mother-in-law who has Alzheimer Disease. Marcia is the Assistant Director of Christian Family Eldercare. Her most recent book, Home-Based Eldercare: Stories and Strategies for Caregivers, is available at ChristianFamilyEldercare.org.
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