caregiving for in-lawsYou expect to have to care for your own parents in their old age, but often times we find ourselves caring for our in-laws too. For many this isn’t a problem, as they’re your spouse’s parents and part of your family. But sometimes, this situation presents issues when we have conflicts with our in-laws. It’s also not unheard of for someone to be caring for their former spouse’s parents, even when they’re no longer married to that person. Then things become a little more complicated. Though gender roles are changing in contemporary life, it’s often women who find themselves in this situation. Sometimes their partner is helpful and supportive, but too often this isn’t the case. Men aren’t used to taking on nurturing roles like this and tending to someone physically. They may manage their parents’ finances or help with more manly tasks like mowing the lawn if his parents still live in their own home. And of course he calls the shots for the big decisions. But the women in his life end up taking on the responsibility for tasks like preparing meals and bathing – and this role is not always welcome on the part of the woman. If you find yourself in this situation, try appealing to your spouse’s desire to be a good caretaker. Once their parents have passed away, many children regret not doing more for them while they were still alive. Remind him that he’ll want to be proud of what he’s done for them. You’ll also want to remind him that doing so-called “feminine” tasks doesn’t make him less of a man – he’s getting hung up on stereotypes. If you work, you can also make it clear that you have just as much of a right to spend time on your career as he does. You have your other obligations too. In the end, you need to decide how much care you’re willing to take on, and then leave it to your spouse to handle things from there. Set strong, clear boundaries: ultimately his parents are his responsibility. Of course, if you’re married, you’ll need to take the health of your relationship into account with any decision you make. However, if you’re divorced, you have no obligation, though some women feel they should care for their former in-laws because they are, after all, their children’s grandparents. But the key point to remember is that you are in charge of your contribution.
caregiving positive attitudeThrough our communication with others and with ourselves, we create reality. Does that sound a little new age to you? Think about it. Everyone has a friend whose negative attitude makes them difficult to be around because you in turn start to feel more pessimistic. Or, on the other end of the scale, there are enthusiastic people who leave us feeling more energized. It’s a basic fact that the people around us influence what we think and feel. And this is true not just for our friends and family, but for ourselves as well. What we think and say to ourselves can change our lives. Examine your own thoughts about caring for your loved one. If you say to yourself, “This is a hard situation” you’ll experience it as being unpleasant. Try telling yourself, “This situation is a challenge” instead. Can you see how that might change how you look at things a little? Challenge implies that this is something you can overcome, and that will make you stronger as you deal with it. Watch how you discuss the events in your life, both what you tell others and what you tell yourself. Our words not only describe our feelings, but also create what we feel. Here are a few other tips for keeping a positive attitude:
  • Express thanks at the end of each day. Take some time to look back over your day and think about the things that went right. Even if you had a truly lousy day, you probably still have a roof over your head, food to eat, friends and family members you love, and a life in one of the wealthiest countries in the world. You can always find something to be grateful for.
  • Commit a random act of kindness. This can be one of the best ways to make yourself feel better and adjust your mood. Try bringing your mother flowers, giving a neighbor a small present, or paying for the person behind you in the drive-through. We usually think that to feel good we need to do things for ourselves, but doing things for others can have a powerful impact.
  • Take a minute to appreciate nature. Even if it’s just a small park or your backyard garden, there’s probably some place close by where you can go for a few minutes to clear your head and be in the moment. You don’t need to hike out into the wilderness. Just take a few minutes to admire the beauty of the world around you. Consider it a mini-vacation.
All of the above isn’t to say that you should never complain – to keep your frustrations bottled up inside clearly isn’t healthy. But be careful not to get carried away when you do indulge in venting. You may want to set a time limit for airing your greivances, and then when you’re done make a point of reminding yourself of the big picture. Caring for your loved one can be aggravating, but you are doing your best to make sure that they’re healthy and comfortable. Revisit your reasons for taking on these responsibilities in the first place. In this way you can connect to the deeper meaning of caring for someone you love, which is a deeper happiness that goes beyond day-to-day annoyances.
convince parent to move to memory careMaking the decision to enter memory care is difficult for seniors, and it’s a process to get them to accept that this is the right choice. They of course want to remain on their own as long as possible. A big decision like this can’t be forced. Your best chances of success lie in helping your parent own the decision, so that they have the feeling that this is something they’re choosing for themselves. Here’s a step-by-step plan for how to get your parent to accept a move to memory care. 1. Help mom or dad begin to get used to the idea. Identify problems that would be solved by a move to memory care and how that move would improve quality of life. For example: “You know, mom, you wouldn’t have to worry about hiring someone to take care of the lawn if you were in memory care.” Or, “Dad, wouldn’t it be nice if you lived somewhere with people your own age around?” 2. Offer to help them tour some nearby memory care facilities on a no-strings-attached basis. Try to seek out activity times when they can notice the residents having fun. However, it may still be too soon for them. Be prepared to just drop it if they show resistance to the idea. 3. Help them see the signs that it’s the right time for this sort of care by connecting this need to things that happen. For example, when mom leaves the stove on, gently but tactfully use the opportunity to point out that both of you would be less worried about these incidents if she were in memory care. Be careful not to be too pushy here, unless there really is a crisis brewing that would necessitate moving quickly. 4. See if anyone your parent knows has made a move to memory care, assisted living, or a similar facility who is happy with their choice. Or see if the relatives of any of your own friends are enjoying senior living. Take your parent to visit that person, or at least set up a phone call. This will help make the idea more real to them, and may make moving to the same facility more appealing. Even having one friend in a new place can help. 5. When you go on tours, point out all the positive aspects of the facility. Be as excited as you would be about renting a new apartment or buying a new home: focus on the possibilities. Would mom’s favorite antique chair look good in the rooms of a particular facility? Does the activity room have a piano so that dad could still play? Once you’ve gone through this process, wait for all that you have seen and discussed to sink in. Don’t expect that they’ll have that “Aha!” moment right away: unfortunately, it often takes some sort of accident or crisis for a move to seem necessary. They are making a huge life decision, and that needs to be respected. If you are feeling the need to move your parent along in this process, however, the most effective argument would be to say that you and other family members would have much greater peace of mind if they were in a memory care facility. Remind them how much their safety means to you. This will hopefully help them to see the importance of making the move.
Telling someone they have alzheimer'sMany caregivers wonder whether or not they should tell their loved one about their Alzheimer’s diagnosis. This is not an easy decision to make. Often the best course of action is to let your loved one determine what you should say and not say. At the time of initial diagnosis, early on in the disease, your loved one may know that they have some kind of problem and will have a lot of questions about what’s wrong. At this time, during the moments when they’re asking you directly, you should tell them that they have Alzheimer’s in an honest and straightforward manner. Your loved one’s doctor should help you with this task when breaking the news for the first time. However, you will likely notice that over time your loved one forgets about the disease. Should you remind them? In most cases, no. Constant reminders and explanations can irritate them and often make situations worse. Even if they ask what is wrong, try to say just enough to put them at ease and try to be calm and gentle. For example, if dad tells you he needs to go to work, don’t tell him he quit once he was diagnosed with Alzheimer’s. Instead, simply remind him that he’s retired without going into the details why. Try to get them to refocus on positive memories or employ some other distraction to bring their mind someplace else. This point may be challenging at times, but eventually your loved one will stop asking questions and become more accepting of their current situation. Trial and error will help you find the right approach for you and teach you ways to keep your loved one happy. Don’t let them feel frightened and alone, but don’t reopen old wounds about the diagnosis either. Consider using their own words for describing what’s happening. If they talk about “losing their memory,” use that as an explanation. Be flexible–if something’s not working, try something else. Watch your loved one’s reactions as you look for what gets results. Know that what works may change over time. There is little to be gained from discussing the diagnosis: it is painful and confusing information. What matters more is how life is lived every day and the way forward. Sadly, there is nothing that can be done to reverse the disease. Focus instead on enjoying the remaining time with your loved one and on making them comfortable. As hard as it is to not be honest, kindness is important too.
respect for someone with dementiaRespect your elders! It’s a rule that’s been drilled into us from the time we were small. But how do you respect mom when she forgets your children’s names or wanders into a neighbor’s yard four houses down in the night? To make things even more complicated, now when your loved one’s abilities are declining is when they need your respect and patience the most. The key is not to focus so much on their behavior now, but who they have been throughout their life and what their contribution to the world has been. Here are some tips for cultivating a more positive mindset.
  • Remember that the world you experience is not the same one that they’re experiencing. Try to join them in their world. If dad seems to believe it’s 1943 again, follow him there. There’s no harm in indulging him for a few minutes, and it will help you better understand how he’s feeling.
  • Don’t worry so much about perfect results. If Aunt Judy forgets that she’s already put on her lipstick or has been forgetting to water her plants, don’t fixate on it. Instead, just try to enjoy doing things and spending time together. It won’t kill either of you if you help her apply that third coat of fire-engine red. At least she’s having a good time!
  • Don’t ask them to do too much. That’s just setting you both up for disappointment, and your loved one will likely become upset and overwhelmed. Give them something simple to do. Don’t go overboard with this, though, as treating your loved one like a child also won’t help.
  • Let them do the things they are able to do. For example, mom may no longer be able to safely help you cut up vegetables for dinner, but maybe she can still assemble the salad once all the ingredients are ready. Let them have accomplishments, even if they’re small, and get them involved in everyday tasks.
  • Don’t rush to get things done or to get to a particular place. Take the time to talk to your loved one and find out how they’re doing. This will go a long way towards helping them feel honored.
Finally, the way to foster respect for your loved one may not require you focus on them so much as you focus on yourself. Be patient and try to manage your own stress. By taking care of yourself, you in turn will become a better caretaker.
bath alzheimersEven with normal aging, bathing becomes more difficult as we get older. However, the particular challenges of Alzheimer’s disease make this everyday ritual all the more nerve-wracking. If you’re finding it almost impossible to get mom or dad squeaky clean, read on for some advice. First, consider why bathing has become more difficult. Does mom think she just showered an hour ago when in reality it’s been a couple days? Does dad not know what to do once he’s in the tub, and thus gets frustrated? Does your loved one not know what’s happening and become fearful once they’re all wet? Once you’ve figured out why they’re avoiding this activity, you can better address the problem. If memory-related issues are the challenge, try to make taking a bath fun. For example, let mom know that you’ve planned an enjoyable outing where she’ll need to get dressed up, so that’s the reason why she needs to take a bath “again.” If your loved one is fearful or uncomfortable when taking a bath, see what you can do to correct this. Turn up the heat if the room is too cold, or install grab bars so that your loved one can support themselves. Stools for the tub and hand-held shower heads are also popular with the elderly. As you help your loved one, go slowly and explain what you’re doing. The bath will be much less frightening for them if they know what’s coming next. If your loved one is very frightened at bath time, sponge baths may be your best bet. You may also want to purchase some dry shampoo so that you don’t have to get them in the bath as frequently. Finally, consider whether your own expectations of cleanliness are part of the problem. Though the norm now in 2013 is to wash up daily, when your loved one was younger this wasn’t always the case. For example, in rural areas 75 years ago running water was a luxury, and many farm families took baths once per week. So keep in mind that your loved one may not be used to taking baths as often as you think they should, and that a bath every few days may make them a lot less stressed without causing much real harm. Making bath time a comfortable and welcome experience for seniors with Alzheimer’s is a challenge, but with some adjustments it can become a manageable task.
teens and Alzheimer'sAn Alzheimer’s diagnosis challenges everyone in the patient’s family. Teenagers may sometimes seem to be wrapped up in their own worlds, but a grandparent who has Alzheimer’s disease can be very troubling for them and significantly affect their lives. Of course, it goes without saying that when a teenager’s parent is diagnosed with Alzheimer’s, it is all the more devastating. Teenagers are likely to need some help from older members of the family in understanding the disease and what they can do to cope. First, reassure your teenager that the emotions that they’re going through – which may include fear, regret, confusion, and anger as well as sadness – are all normal responses. It may be helpful for them to hear that this will be a difficult time in the family, and for you to acknowledge that this experience is a hard one for them specifically. And of course, it may be good for them to know that they are far from being the only teen in the world dealing with a grandparent with Alzheimer’s, even if none of their friends have any experience with the disease. If there’s no support group in your area that they can turn to, you may want to point them to the website of AFA Teens, a branch of the Alzheimer’s Foundation of America. There they can find articles written just for them, a community message board where they can connect with other teens, and numerous other resources. One of the most useful things you can do is to explain to your teenager how to communicate with their grandparent. The following are some tips you can pass along to them:
  • Approach a person with Alzheimer’s from the front, so that they are aware someone is coming.
  • Use their name to get their attention.
  • Ask questions one by one, rather than giving them too much to think about at once.
  • Maintain eye contact.
  • Speak clearly and not too fast.
  • Remember that if they forget your name, it says nothing about how much they love you. Just be patient and tell them who you are.
  • Use a voice that is gentle and kind.
  • Smile and use hand gestures and other body language. This sets a positive tone and makes you easier to understand.
One aspect of the disease that teens have trouble with is how to spend time with their grandparent. How do you connect with someone who doesn’t even remember you? Let them know that their grandparent will be glad to have someone come visit them and pay attention to them, even if they don’t know who that someone is. Here are some tips for visits:
  • Help grandparents do some basic, manageable chores. The feeling of getting something done and being useful can be very therapeutic.
  • Ask them questions about the distant past, for example: “What was your life like when you were my age?”
  • Listen to your grandparent’s favorite music. This may also get them talking about the past.
  • Go through family photo albums, especially older ones.
  • Play a game together or work on a puzzle.
  • Read them something that they might enjoy.
It can be easy to forget the needs of teenagers during this difficult time, especially for a parent who is scrambling just to take care of their aging mom or dad. But remember that teens can be very sensitive to what’s going on around them. Spending just a little time to help them adjust to what’s going on can make all the difference.
spouse with dementia intimacyPart I of this series covered the emotions you might experience when putting a spouse into memory care. When your spouse moves out of the home you’ve shared and into memory care, you’ll need to work on building a new relationship, one that may not be the same as the one you’ve grown used to, but can still give you a connection to your life partner. You may find that your spouse no longer knows who you are. As heartbreaking as that is, they likely can still recognize you as an important person in their life. Don’t worry too much about convincing them of who you are, as this will likely only lead to frustration. Regardless of whether they know you as you, you’re still important. You’re probably the one they see most often, and they know that you care about them a great deal. It may be hard to accept, but know that that might be the highest honor your spouse can give you in their current state. Your visits, even if your spouse isn’t aware of them or doesn’t register their significance, are now the most important way of honoring your marriage. It’s possible to find new ways of enjoying intimacy with each other. A good care facility should give you ways of having uninterrupted time alone. Furthermore, now that you no longer have the burden of being your spouse’s primary caregiver, you can focus on the relationship the two of you have. You can be there for them in other ways beyond taking care of basic functions. You may even find that this new focus on love itself, without day to day hassles, brings you even closer than you were before, and eliminates feelings of guilt and resentment. Though it’s important to nurture your marriage, it is also crucial during this time that you care for yourself. While your spouse was still at home, you likely put off your own needs and desires, and now is the time to remedy that. Make sure that you address any of your own neglected health needs, both physical and mental. As you probably know, you can only help someone else if you help yourself first. There is no cure for dementia, but despite this a move to memory care can result in healing for both of you. You may not only be caring for your loved one’s condition, but also for the health of your relationship.
Spouse with dementiaWe all agree that marriages that have lasted decades are precious. These couples have come to know each other in ways so intimate that their other relationships pale in comparison. When one half is diagnosed with dementia and moving to a memory care facility becomes necessary, the separation is of course heartbreaking. Though there may in part be some relief on the part of the spouse who was serving as a caregiver, such a drastic life change requires much strength and bravery from both. This change often comes quite suddenly, and can be overwhelming. Possibly it was precipitated by an emergency hospital visit or a frightening incident at home. Indeed, this may be the most difficult challenge a couple’s relationship has ever faced. The most crucial time is the first few months, as they enter into new and unknown territory. The following are common emotions and experiences you may have during this time:
  • A sense of loss of control as you are no longer responsible for your spouse’s day to day care
  • Struggles with how to handle a sudden increase in free time and an empty home
  • Guilt at being unable to continue to care for your spouse at home
  • Anger and despair that the life you shared, and your closest friend, is gone
  • Fear about what the future may hold
  • Second guessing the decision you’ve made
It is important to acknowledge these experiences and emotions if you are to cope with this change successfully. You may wonder if negative feelings or feelings of relief are “wrong.” Or your feelings of sadness and grief may overwhelm you. However, it’s important that you come to view the situation in a new way that will not be destructive. This is a difficult decision to make, especially if your spouse doesn’t want to leave home. But remember that the decision to enter a memory care facility is in your spouse’s best interest, and demonstrates the utmost care for their well-being on your part. There they will be cared for safely and with professional skill. In addition to working on changing your perspective, you may also want to seek out counseling, support groups, or spiritual guidance. Time with family may also help. Finally, being open with your grief can also help you heal. The next post will cover how to foster intimacy in this situation and how to continue with your relationship despite the separation.
Talk with your parent's doctor about Alzheimer'sIf your parent has just been diagnosed with Alzheimer’s disease, it’s a confusing time for your family. One important item to add to your to-do list is to plan to have a talk with your parent’s doctor about their condition. Below are four important questions you’ll want to make sure you include. Keep in mind that in order to have this conversation, your parent will need to let the doctor’s office know that you have permission to discuss their health matters. 1. Why have you chosen a diagnosis of Alzheimer’s, rather than another disease? This question will help you better understand your parent’s illness. It can also be valuable in cases where family members or your parent wants to deny that they have the disease. Find out what signs demonstrate to the doctor that this is Alzheimer’s and not another disease or another form of dementia. You’ll also want to ask how your parent’s symptoms differ from the normal forgetfulness and confusion that can come with aging. 2. What medication is available that might help? Prescription medication is available that can help slow the progress of the disease or alleviate symptoms. However, not all patients respond to these aids, and the doctor may not think any of them are appropriate for your parent’s particular situation. Also know that at this point there is nothing that can be done to reverse the progress of the disease or to cure your parent. If the doctor does recommend medication, ask how it works and how it treats particular symptoms. Also make sure you understand the side effects, and what to do if your parent takes the medicine incorrectly or misses a dose. The doctor may be able to offer suggestions about how to make it easier for your parent to keep track of their drug regimine. If you or your parent is thinking about trying herbal remedies, be sure to include these in the conversation as well. The doctor may be able to share information with you that you haven’t previously considered, such as the latest research. He or she can also let you know if herbal remedies would be wise for your parent’s individual situation. For example, there may be harmful interactions with the medicine your parent is currently taking. 3. Are there clinical trials we can participate in? By participating in research studies on new treatments, your parent may be able to receive cutting-edge care for free. However, these arrangements are not without risks. Your parent’s doctor can help you determine whether volunteering in clinical trials would be a good idea. 4. How can I reach you if I need you? This may be the first time you’ve had any conversation with your parent’s doctor. Make sure you know the office’s procedures for getting in touch with the doctor. Does he or she take questions over email? What should you do if your parent is having a medical emergency and the office is closed? Having the answers to these questions can ease your mind greatly and help you prepare for the unexpected.