With Alzheimers, is there a way...

[creekland]

My MIL has Alzheimers (or dementia) with pretty much all the classic symptoms.  We (family) are quite used to answering the same question a gazillion times, listening to stories that never happened, putting correct people into stories that did happen, rants, and on and on.

 

However, now she has started getting glasses and dishes out of the cupboards, using them, maybe rinsing them (maybe not) and returning them.  This not only is quite gross, I'm of the belief that it's also rather dangerous although her and my FIL seem to be proving the statement, "That which doesn't kill you only makes you stronger."

 

Getting them in house help is out of the question (it's been suggested).  Having either of her sons or DILs here full time is out of the question.  Getting her to see a dr is out of the question (also suggested - she gets downright violent with that one).

 

My FIL takes her out to eat for practically every meal (good thing!), but it is still an issue.

 

Does anyone have any ideas for "training" her out of this?  They have a dishwasher - she refuses to use it.  We've been using it cleaning everything and anything, but even when we're here she's still using glasses, dishes, silverware, etc, and putting them back.  Last night she did it when she finished eating even though the rest of us were still at the table.  Talking with her about it "matter of fact" only gets her really angry and doing it more.  (sigh)

 

I'm thinking we're going to have to rely upon "That which doesn't kill you," but I thought I'd try a last ditch attempt from the Hive for possible solutions as the Hive can (almost) solve anything.

 

We have made my FIL aware of the situation.  I don't think he was before.  (He's 86, she's 84.)  He's not ready to put her elsewhere and she'd be VERY violent if anyone tried to do so.  In general, he's great at taking care of her, but at his age, he has limits too.

[LLMom]

What about paper goods until maybe she has had some time to "forget" about it or change to something else. Pack the others away for now.  My dad had Alzheimer's.  He did some really weird things, but they came and went in phases.  Hopefully she gets out of this one quickly.  

[OneStepAtATime]

Hugs Creekland.  Both of my grandmothers and a great aunt had dementia.  Maybe someone else will have a different perspective but honestly there will be no "training her out of it".  Her brain is no longer functioning correctly.  The functionality will continue to deteriorate.  If you are concerned that your FIL is drinking out of glasses she has already used and just put back, honestly, it probably isn't a big deal unless there is something like rotting milk stuck to the glass or something but would FIL be willing to set aside a set of dishes just for him?  He could keep them away from the other dishes and just use those maybe?  

 

My own grandmother got it into her head that dishwashers didn't clean the dishes well so she went back to strictly hand washing.  Only she was doing a terrible job, left lots of stuff on the glasses/dishes, and they usually had dried soap stuck to them as well.  And that was just the tip of the ice berg.  Nothing we could do.  I hired people several times but she had not been labeled incompetent so she fired them and I couldn't stop her.  I was pregnant but I was driving 9 hours each way to go see her, set up her meds, clean her house, run her business, just to buy time until my parents could retire and take over her care.  My great aunt started using toilet paper then tucking it behind the toilet instead of flushing it down the toilet.  Totally gross but trying to convince her to stop was pointless.  She was not remembering she had done it or why and the next time she used the toilet she would have completely forgotten our conversation.  

 

Your MIL is trapped in a mind that is broken.  She can't help what she is doing.  You might post reminders in the kitchen for her to remember to thoroughly wash dishes after use, or have FIL rewash anything before they sit down to eat or something, but she really probably can't be "trained" to do anything differently than she is.  I am so sorry.  This is hard.  Alzheimers is hard.

 

By the way, I did want to add that if there IS any way to get her to have an exam by a doctor, there are some meds that can help a bit, at least for a time.  And honestly there are some medical conditions that appear to be dementia and are not.  My grandmother in law was one of those.  They were going to put her in a home because her mental faculties had deteriorated so badly.  SIL took her to a different doctor and found out she had another issue entirely.  Once they found out what the real problem was they were able to help her and she is now 98 and still reasonably functional mentally.

[OneStepAtATime]

What about paper goods until maybe she has had some time to "forget" about it or change to something else. Pack the others away for now.  My dad had Alzheimer's.  He did some really weird things, but they came and went in phases.  Hopefully she gets out of this one quickly.  

:iagree:

[NicksMama-Zack's Mama Too]

My FIL has dementia and it's common for people with dementia to develop odd habits. 

 

He has been in a private assisted-living facility for the last two years.  Upon diagnosis, he spent two weeks a the John Hopkin's Memory and Alzheimer's Treatment Center in Baltimore, MD.  They were able to put together a treatment plan that has addressed the kind of behaviors you are describing.  

 

Patients with dementia develop all kinds of behaviors (some are rather gross and disturbing) and you really need help from a medical professional to deal with them.

 

http://www.hopkinsmedicine.org/psychiatry/specialty_areas/memory_center/

[fairfarmhand]

Paper goods. I think that's all you can do.

 

Kind of like taking the knobs off of the stove you know.

[texasmama]

I agree with packing the dishes and moving to disposables.

 

Dh's grandmother has advanced Alzheimer's.  Before the disease was as advanced, I got her a Keurig to put in her assisted living apartment, wrote out simple instructions and taped them on the counter in front of it.  She kept removing the instructions and throwing them in the trash.  I finally gave up. She never used the machine.

 

I don't think it is possible to train her not to do this.  It is possible that you can break the habit by using paper goods and then move back to disposables when she has forgotten, but this may take some time.

[Davysmom]

I agree with the others. There is nothing you can do to train her. She gets upset and even violent because she is confused and afraid not because she is really objecting going to the dr.

He needs to take her out to a meal and detour to the doctors. She needs to see a doctor. Sometimes this can be treated. It depends on what is causing it. It could be any number of things.

 

There are medications that can help. I would not delay any longer with getting her some medical help. It's important right now. She is not thinking clearly. Things are not what they seem anymore. It's more than just forgetting things.

 

It is very helpful to just listen to stories. Correcting can cause more confusion and lead to frustration.

[Plateau Mama]

There is no training her. Trying, as you've seen, will mark her angry or more confused. With Alzheimer's, as long as they are safe you've just got to love them where they are and let the rest go. Playing with knives in then middle of the night unsafe. Dirty dishes no big deal. (we had to put DH's grandpa in assisted living when we found him, more than once, playing with knives while grandma was asleep.)

 

I first delt with Alzheimer's while working in a retirement center when I was 15. The lady would keep her oranges in the bathroom and TP in her fridge. You could move them but the oranges would always be in the bathroom when you returned.

[m0mmaBuck]

Think about it this way.... As children, we learn tasks in a specific order. For example, one of the first things we learn is to get our hands to our mouth to feed ourselves. Later we learn to walk. To ride a bike. To drive a car. And so on. The layers of skill/ability/knowledge build upon lower layers, sort of like an onion.  With Alzheimers, those affected lose those abilities in the reverse of how they gained them; the most-recently acquired skills go first. Once the skill/knowledge is gone, it's gone. There is no regaining that lost skill. There is are no new skills to be learned, no new short-term memories to be made.  There is only the layer they are at and the layers beneath it. The outside layers of skill/knowledge/ability are lost, layer by layer, until the person is left with only those most basic of function, those learned in infancy.

 

It's a terrible disease. Help her to function where she is with what she knows. Make sure she does as much as she can within her current level of abilities. But don't expect to teach her something new, or remind her of how to do something that she is no longer doing, because that layer is gone.

[OneStepAtATime]

By the way, I thought I would share something that helped me understand my grandmother better, just in case it might help in some way.  In the beginning, when I realized that Grandma was doing some odd things, making weird decisions, struggling to function with bill paying, etc.  I tried to talk her into going to the doctor.  My grandmother was really resisting going to the doctor (this is common) and I couldn't understand why.  I kept pressing.  She finally broke down and admitted that she had been independent all of her life and people had looked up to her.  She was afraid that if she was diagnosed with some form of dementia no one would listen to her anymore, no one would respect her and believe in her anymore, she would be treated like a child and then abandoned in a nursing home somewhere.  

 

In other words, she was terrified of how much she struggled to remember things and do things the right way, but at least she was still in her own home and still doing her own thing and people were still asking her for advice or inviting her to gatherings, etc.  With a diagnosis of dementia she was afraid that would all go away.  And that it meant she no longer had any value, that all she had left to look forward to was being a burden on her family.  So I worked really hard, as others have said, to meet her wherever she was at, and to show her compassion and respect and try not to point out where she was tripping up, since she couldn't help it.  I did what I could to help her function independently as long as humanly possible and to show grace even when she made tons of aggravating decisions and turned angry and belligerent and was no longer the loving grandmother I had once known.  That conversation helped me remember that even though her mind was no longer what it had been, she was still a thinking, feeling human being who needed love and understanding and respect, KWIM?  

 

FWIW, I did finally get her to a doctor and they put her on Aricept, which seemed to help for a while.

 

Not sure that was useful at all to you but I thought I would share, just in case.  

 

The paper stuff really does sound like it might be your best option for the immediate issue.  

 

Hugs, Creekland.  And best wishes....

[Hen]

my grandfather has dementia and has always thought he is perfect, so he would not see a dr. problem was, we needed him to see the dr. so we could start the process of having him declared incompetent.  We ended up telling him we were all going for my grandmother's appointment and then to lunch, and then when we were at the office, he didn't even notice when the Dr. gave him the exam and asked him all the questions.  We've had to take him back several times, unfortunately and we always get stressed out because he has a horrible temper- he threw a chair at bingo last week... but it seems to just work out when we don't say where we are going and just do it, and we keep talking to him to distract him. The gross stuff- he was washing dishes in water that sat in the sink for a week- he has a weird thing about wasting water, and he was also re-using his tp after wiping to use it later...well, it was pointless to try to change it, no one else ever used the dishes without washing them first ourselves and we didn't go into his bathroom.

[creekland]

Thanks everyone!  The idea of having my FIL keep his own set of dishes/glass elsewhere is one we suggested to him and he might actually do it.  Time will tell.  He also said he's going to be sure they go out for every meal rather than "almost every."

 

Paper products work for lunch as long as lunch is sandwiches or hot dogs.  She gets angry at paper any other time.  It's not how she was raised.

 

With all the other stuff, I agree.  The whole family has learned to listen and to have her do what she can rather than cutting her out of our lives.  Some of her changes are good (she's finally accepted me into her life(!) after years of being angry that I corrupted her son and raised her grandsons "wrong"). I often "babysit" when we're there so hubby can spend quality time giving his dad a much needed break.  Others aren't so good - no need to put all of those on here.

 

Doctor?  We've (meaning both boys - blood relatives - and my SIL since she's a physical therapist and has a bit of medical knowledge) have talked with my FIL and he did try some a couple years back.  He tried just driving there while making her think she was going elsewhere.  He tried talking with her about going for something else (arm pain).  She ended up being quite mean to him and threatening to jump out of the car while it was moving.  In the parking lot she refused to get out.  He's since given up and won't try that route again even though he understands things could end up better in the end.  He does not want her forcibly taken from him - his marriage vows are super strong.  He has, however, seen how much she's declined, so has admitted he might not be up to caring for her until the "end," so time will tell.  The whole thing is rough on him IMO, but I admire him too.  Many guys would have left her long, long ago.  (I'm also glad I married his son!)

 

The rest of her health isn't doing so great either, but she hardly looks like imminent doom.  She might outlive him as he has known (and cared for) heart issues.

 

So... for now... our visits will be more often and we will sneak in a bit of cleaning while there (bathrooms too!), he knows to be super careful with dishes - plus he just might keep some aside for himself - he seemed open to it, and we'll see how it goes.

 

And I'm going to mull the idea over of "forcing" the doctor issue (can that be done legally?) somehow.  All 4 of us "kids" (blood relative "boys" and DILs) get along really well - very, very well, having been friends since our college days.  It might be something worth a discussion if I can tactfully bring it up.  They all see what is going on.  But the final decision will be theirs and FIL's.  If some of her functioning could be returned, I think we'd all appreciate it.  Right now I think they all just assume that's the way it's going to be.

[Pippen]

 

Paper products work for lunch as long as lunch is sandwiches or hot dogs.  She gets angry at paper any other time.  It's not how she was raised.

 

 

Could you try some nicer disposables--ie clear plastic Chinette?

[creekland]

Could you try some nicer disposables--ie clear plastic Chinette?

 

We'll take some on the next visit and find out.  Of course, she might just put these away used...  :glare:

 

I am thinking of different ways to be creative, yet keep things "ok."

 

We removed the dishtowels toward the end this last time and replaced them with paper towels.   When she asked about the towels they were always in the laundry.  Paper towels worked.  

 

Some things might work.

[G5052]

And I'm going to mull the idea over of "forcing" the doctor issue (can that be done legally?) somehow.  All 4 of us "kids" (blood relative "boys" and DILs) get along really well - very, very well, having been friends since our college days.  It might be something worth a discussion if I can tactfully bring it up.  They all see what is going on.  But the final decision will be theirs and FIL's.  If some of her functioning could be returned, I think we'd all appreciate it.  Right now I think they all just assume that's the way it's going to be.

 

Laws vary, but generally you can't force the doctor issue unless they're driving impaired and/or they hurt someone.

 

I tried and tried to get mine to the doctor.  All of the markers where there including several blackouts that I was 95% sure were mini-strokes.  Her doctor at the time was in denial ("Old people fall, that's normal.").

 

Then family friends began calling me with hair-raising stories of her driving.  I suspected this because she always made me drive when I visited.

So I called the Medical Office of the state DMV, and she said to write a letter anonymously outlining the concerns.  We decided to go ahead and sign it and provide our phone number because we wanted them to be able to reach us if there were questions because we were many states away,  I could provide the names of the people who called me, but they all said not to do that unless it was absolutely necessary.  DMV called me several weeks later and said that they would be sending her a letter requiring a doctor-signoff to keep her license.

 

Right after I mailed the DMV letter, I sent a fax to new doctor (the old doctor retired) outlining my concerns and letting her know that I had contacted DMV.

 

The end of the story is that my mother passed the office dementia tests, but the doctor hadn't realized that she had fallen so much recently until I related that in my fax.  She found that troubling.  So she sent Mom for a neurological work-up, and they found 8 areas of brain damage where she had suffered mini-strokes.  The neurologist refused to sign the DMV form, so then she went to a neuro-psychologist who tested her more fully.  He also refused to sign the form, and she lost her license because she didn't get the doctor form sent back to DMV in time.

 

So that was how we got the diagnosis.  Painful, but how would I have felt if she had been in an accident?

[creekland]

It would not bother my MIL to drive without a license... she'd rant about it forever, but she wouldn't stop.

[HS Mom in NC]

My husband's maternal Grandmother only rinsed her dishes because she apparently didn't understand germs.  She had what she called "dysentery" for decades-go figure. She never had Alzheimer's.

 

There is an Alzheimer's Association.  I suggest looking them up online for the kind of information you need. They deal with this kind of thing all the time.

[creekland]

My husband's maternal Grandmother only rinsed her dishes because she apparently didn't understand germs.  She had what she called "dysentery" for decades-go figure. She never had Alzheimer's.

 

There is an Alzheimer's Association.  I suggest looking them up online for the kind of information you need. They deal with this kind of thing all the time.

 

My MIL gets "the runs" all the time.  My FIL blames it on her excessive milk drinking (roughly 1/2 gallon per day).  I'm not sure if that's it or if it's due to the glasses she's using at this point.  Maybe both.

 

I tried telling her we were out of milk one morning and she threw many things out of the fridge in her quest to find what she knew was there (that I'd hidden in the back).  FIL tells me that if they really are out, she'll go to 7-11 (right down the street from her house) and buy herself more, so that's probably a lost cause.  I only tried it because we were at a cottage they own and it's about 20 minutes from a re-supply.

[G5052]

It would not bother my MIL to drive without a license... she'd rant about it forever, but she wouldn't stop.

 

I'm not convinced that mine did either.  But from a distance, I had to try.  When my Dad died, I disabled the car and asked a friend of theirs to get it sold (I told him what I had done).  Thankfully he took care of it, so she didn't have car at all after that.

 

There are all sorts of legal issues associated with driving with dementia.  It isn't pretty.

[creekland]

I'm not convinced that mine did either.  But from a distance, I had to try.  When my Dad died, I disabled the car and asked a friend of theirs to get it sold (I told him what I had done).  Thankfully he took care of it, so she didn't have car at all after that.

 

There are all sorts of legal issues associated with driving with dementia.  It isn't pretty.

 

Fortunately, she loses her keys often.  FIL rarely helps her find them.

 

She only has a couple of places she drives - and even then she can get lost, but they are close to home, so she just keeps driving until she figures it out.

 

I suspect she shouldn't be driving, but losing her license wouldn't stop her.

 

Disabling the car is intriguing, but FIL would have to be on board and chances are she'd hound him to death until he got it fixed for her.  BUT, I'm wondering just how long it could stay in the shop before she caught on.

 

She can be violent with FIL when things aren't going as she feels they should, so we'd be stepping on potentially thin ice.

[6packofun]

If she is not on *any* medication, I would encourage you to encourage her dh to do it NOW while she is still functioning as she is!  There can be a real halt to the progression of the disease; there are many options, although the benefits will be temporary.  There are medications to help with explosive behavior as well.  It doesn't have to mean she'll be numb, either!  My dh's grandmother was in the beginnings of the late stages of Alz. when she started a new combo of meds and it gave her a few months that were better before it plateaued and the decline started up again.  Starting meds now would HELP her to keep some of the her daily living functions, such as using the toilet as independently as possible.

[Harriet Vane]

Gently...

 

What you are describing in terms of your dear MIL's condition is serious. Allowing her to drive is a very, very dangerous choice. She really could kill someone. I know firsthand just how hard it can be to stand up to someone like this, but you really must put a stop to the driving. It's way, way, way more important than the dirty dishes.

 

:grouphug:

[G5052]

Fortunately, she loses her keys often.  FIL rarely helps her find them.

 

She only has a couple of places she drives - and even then she can get lost, but they are close to home, so she just keeps driving until she figures it out.

 

I suspect she shouldn't be driving, but losing her license wouldn't stop her.

 

Disabling the car is intriguing, but FIL would have to be on board and chances are she'd hound him to death until he got it fixed for her.  BUT, I'm wondering just how long it could stay in the shop before she caught on.

 

She can be violent with FIL when things aren't going as she feels they should, so we'd be stepping on potentially thin ice.

 

The courts are not kind to people with dementia who hurt other people in an accident.  It can get very ugly as the lawyers look for who knew that the person was impaired and let them keep driving.  It's handled like letting a drunk person drive in some cases.

 

And the violence is a concern. Spousal abuse is another big issue with dementia.  My mother beat up on my Dad quite a bit, but he would never press charges or get help.  I tried, his doctor tried, and home health tried.  It was really sad.

[creekland]

  The FIL is actually the bigger problem as he is enabling her behavior. 

 

This.  There's really only so much I can do to be honest.  I've no idea how her driving is in person.  She might be fine with that.  She hasn't even had a minor fender bender.

 

They live 4 hours away from us (with no traffic issues) and 2 hours from my B/SIL.  We don't know anyone nearby personally.

 

I know it was only two years ago that I convinced hubby that we NEED to visit his dad.  He'd call his mom up and ask if we could come and she'd say no, so he didn't go.  However, whenever we'd stop by without asking (associated with a trip or something) she'd always be happy to see us.  He needed to bypass his mom and just ask/tell his dad we were coming, but his mom has run the household for so long - essentially forever - that it took him that long to agree with me.  Now he does just that and both are always happy to see us - esp his dad.

 

But trying to get them to do anything with his mom is difficult if not impossible.  I think it's easier being the "outsider" to see it, but I can't actually do anything other than make suggestions for the larger deals (doctor/driving).  Even my PT SIL can't "do" anything other than suggestions about the doctor bit.  When we're visiting I can do things like dishes/cleaning/babysitting, etc.  She never drives when we're there.  Someone else always does.

[Harriet Vane]

:grouphug:

[creekland]

 

And the violence is a concern. Spousal abuse is another big issue with dementia.  My mother beat up on my Dad quite a bit, but he would never press charges or get help.  I tried, his doctor tried, and home health tried.  It was really sad.

 

As far as I know, she's only gotten dangerously violent once and as with your dad, my FIL would never think of doing anything about it.  It took him a bit to admit it to hubby.  I'm pretty sure his method of coping is to just give in to her when she gets something in her mind whether it's car stuff, doctor (or lack thereof), or what she wants to eat/drink.  So far, that's working.

 

I talked with hubby about her driving last night and he doesn't know how she is IRL with that either, but he did mention she hasn't even hit anything around their house and there's nothing wrong with her hearing or eyesight, so she might still be ok other than the getting lost bit.  FIL is keeping track of that (supposedly) and is not helping her find her keys.  He's also staying home a LOT more than he used to so she doesn't have to drive if she wants to go somewhere.  He may even give up hunting if she's not able to be safe home alone.  If he does, that's a huge sacrifice on his part.  Even when we were living in FL and could only visit once per year for a couple of days, he wouldn't give up his hunting (even though he went oodles of days when we weren't there).  I didn't think anything could pull him away from that addiction.  He may not be willing to stand up to her or force her to see a doctor, etc, but his dedication to her is incredible IMO.

 

[Suzanne115]

We went through this awful disease with my grandmother.  I agree with the others who posted that you can't train it out of her.  Instead you and your family will have to develop coping mechanisms.  I would be very cautious about the whole driving thing.  My grandmother ran into a bank.  She lived alone in Florida at the time so we weren't aware that there was a problem.  Thankfully, no one was hurt.  She thought she was applying the brakes and she was giving the car gas.  I'm sorry for what you and your family are going through.  I know it is very difficult.

 

Suzanne 

[creekland]

We went through this awful disease with my grandmother.  I agree with the others who posted that you can't train it out of her.  Instead you and your family will have to develop coping mechanisms.  I would be very cautious about the whole driving thing.  My grandmother ran into a bank.  She lived alone in Florida at the time so we weren't aware that there was a problem.  Thankfully, no one was hurt.  She thought she was applying the brakes and she was giving the car gas.  I'm sorry for what you and your family are going through.  I know it is very difficult.

 

Suzanne 

 

Next time we are there (likely reasonably soon), I'll see if I can assess more of how much she actually drives and whether it appears to be a problem or not.  I could kind of envision a brake/gas mistake with the way she makes other mistakes, but it's all scenes in my mind extrapolated out.

 

In the meantime, I'll see if the rest of "us" can have conversations about it and/or any sort of plan of action.  The only way anything will be done is if the blood relatives and FIL are on board.  We DILs are accepted, so no complaints there, but it's not our "turf" for big decisions.

 

[J-rap]

(I haven't read all of the replies.)  I second the paper plates, or maybe take away most of the dishware.  If it brings you any comfort, when we visit our daughter in Latin America, we find that many people there only rinse and dry their dishware, and are doing fine.  :)

 

I see that this thread has evolved into other issues, so my response is kind of outdated.  :)

 

 

 

[Suzanne115]

I hope you and your family can come up with a good plan of action.  I understand that you need other family members on board.  Before my grandmother passed away, she was like a child who had to be monitored almost all the time.  Unfortunately, it usually gets worse not better.

 

Blessings,

Suzanne

[creekland]

(I haven't read all of the replies.)  I second the paper plates, or maybe take away most of the dishware.  If it brings you any comfort, when we visit our daughter in Latin America, we find that many people there only rinse and dry their dishware, and are doing fine.  :)

 

I see that this thread has evolved into other issues, so my response is kind of outdated.  :)

 

Your response isn't outdated at all.  I'm glad to know rinsing and drying tends to be sufficient.  I'd just have to get her to rinse and dry things.  She does sometimes rinse - not always - but she hasn't dried any that she's used herself.  She will dry things we have already washed and set into the rack or hand her to dry, but that doesn't carry over to things she's used and then puts away for some reason.

[MotherGoose]

It concerns me that you used the word "violent" a couple of times in your description. I don't know what this means, exactly, in your case, but it's not okay for her to be abusive towards her dh. People with dementia have killed others in a fit of violence.

[Jamee]

Lots of hugs.  My grandfather had Alzheimer's.  My dad always said it's a disease that has no effect on the patient, but kills the family.  Going off our situation, there will probably come a point where they'll need help whether they want it or not.  My grandfather got violent too, he didn't even know who my grandmother was anymore--they'd been married over 60 years.  Can a doctor come to the house?  I think when you said FIL enables, that's a sign that the children are going to have to become the parents.  I wish you the best.  This is a horrid, horrid disease.

[Orthodox6]

If she is not on *any* medication, I would encourage you to encourage her dh to do it NOW while she is still functioning as she is!  There can be a real halt to the progression of the disease; there are many options, although the benefits will be temporary.  There are medications to help with explosive behavior as well.  It doesn't have to mean she'll be numb, either!  My dh's grandmother was in the beginnings of the late stages of Alz. when she started a new combo of meds and it gave her a few months that were better before it plateaued and the decline started up again.  Starting meds now would HELP her to keep some of the her daily living functions, such as using the toilet as independently as possible.

 

I wish this were more true than it is.  The writer's relative had a good experience with medical intervention at the earlier stages.  In general, though, the medications currently prescribed for Alzheimer's do very, very little and are effective for only a short time.  This is both my direct observation of my mother, and also explicit comments from her gerontologist (with additional training in dementia). 

 

Medication for hostility may be helpful for what OP describes, but it is not targeted to the Alzheimer's. 

 

The husband, who sounds to be the primary caregiver, is heavily at risk without ongoing intervention and assistance.

 

I have posted in the past about my life with my mother's Alzheimer's.  She is in the seventeenth year of this horrible disease, is ninety-one years old, and has lived in a nursing home since early 2012.  My father nearly died from his loving, unselfish, full-time care for his wife.  (I do not exaggerate this.)  We rescued him from the situation, also in early 2012,and he has lived with us ever since.  (Dad is ninety-two.) 

 

Frank talk among all family members about the couple's finances and resources, about medical options (an experienced gerontologist and/or gerontological neurologist IS essential), about living arrangement options, about the entire range of "senior issues" will help everybody enormously.  As you work through all this, more questions will arise.  Even an "eldercare attorney" is important.  The woman's dementia may be so advanced that she no longer can make legal decisions, and whatever legal decisions already are in place no longer can be changed.  (her power of attorney, her DNR decision, and much more) 

 

As awkward and difficult as these discussions, planning, and decisions are going to be, the situation only worsens as time passes without matters being taken care of.

 

My most sincere of best wishes to OP and her extended family.

[zoobie]

Next time we are there (likely reasonably soon), I'll see if I can assess more of how much she actually drives and whether it appears to be a problem or not. I could kind of envision a brake/gas mistake with the way she makes other mistakes, but it's all scenes in my mind extrapolated out.

 

In the meantime, I'll see if the rest of "us" can have conversations about it and/or any sort of plan of action. The only way anything will be done is if the blood relatives and FIL are on board. We DILs are accepted, so no complaints there, but it's not our "turf" for big decisions.

 

It's not just gas/brake. It's backing out without looking--one of my professor's DH did that and broke someone's leg. If it had been a child, he would have killed him. It's driving the wrong way down a one way street--an old boss did this in a parking garage and caused tens of thousands in damage but luckily didn't hurt anyone. It's forgetting to stop at stop signs and red lights, etc., etc. It's very, very dangerous.

[FaithManor]

Fortunately, she loses her keys often.  FIL rarely helps her find them.

 

She only has a couple of places she drives - and even then she can get lost, but they are close to home, so she just keeps driving until she figures it out.

 

I suspect she shouldn't be driving, but losing her license wouldn't stop her.

 

Disabling the car is intriguing, but FIL would have to be on board and chances are she'd hound him to death until he got it fixed for her.  BUT, I'm wondering just how long it could stay in the shop before she caught on.

 

She can be violent with FIL when things aren't going as she feels they should, so we'd be stepping on potentially thin ice.

Creekland, I am sooooo sorry! I can't imagine dealing with this. But, as someone who has recently survived a horrible car wreck, I have to ask you to put others ahead. FIL may have to endure what he has to endure, but everyone else on the road does not deserve to be killed by her and if she has dementia she is a true threat to other motorists. Not only should her car be disabled, but FIL's keys for his car should be somewhere unknown to her.

 

If she gets violent, despite his misgivings he should call 911. Police know what dementia looks like and so do paramedics. When they arrive, all he has to do is pour his heart out and tell them what he is dealing with and how she refuses to be doctored. He is in danger. She is a danger to herself and others. The police are authorized to force transport to the ER where she will be admitted to the psych floor for 72 hours. This is how MANY mentally ill patients end up being diagnosed and treatment protocols put in place. My dd has transported more than one Alzheimer patient and the family is always, always relieved when it finally happens because they need the help so badly but can't physically force care on their loved one. She gets thank you notes often from these families.

 

It will be scary for MIL, but necessary. There are medications that can really help improve quality of life for a while and that is worth the scary proposition of calling 911, reporting the physical assault, and begging for help. He can tell dispatch what he is going through and the medics should be prepped before they arrive. He can even wait for them on the lawn.

 

Also, dd says to please get anything like knives, scissors, letter openers, heavy objects such as glass bowls, sculptures, paperweights, (these can crack skulls pretty easily) etc. out of the house because she may attack him with them. DD barely saved a male patient whose wife with dementia attacked him with a kitchen knife. It was a terrible scene. He'd been going it alone with her for a long time. The psych ward got her on some meds which really stabilized her, and social workers helped him get respite care and make the house safer for both of them.

 

One other thing, with both of the Alzheimer relatives in dh's family, there came a time when despite the immense desire to keep them in the home, it became beyond the realm of what the family could do. Both constantly wandered away from the house and were quite adept at unlocking windows and doors. They wandered into the streets almost being struck several times. One set the house on fire, accidentally for sure, but still...the list is long and horrifying. They needed literally 24/7 watching. So, I would suggest having this discussion now, and then look at nursing facilities in your area that specialize in Alzheimer's. We have one only 9 miles from here and they accept Medicare/Medicaid as well as private pay insurance. They are literally wonderful. It's a lock down ward. Beautiful. The patients are lovingly cared for, but it's safe, and family can visit...the hours are very liberal...even take their loved one home for a day for the holidays, etc.

[Storygirl]

I've lived with and helped care for both my grandmother and mother through during their time with Alzheimer's. Unfortunately, as others have mentioned, it will not get better, only worse. Your FIL sounds like a sweet and caring person, but he will need to be able to stand up to her and do what is necessary and right, even if she resists. Because it is a degenerative brain disease, those who suffer are not in a position to make informed decisions for themselves.

 

Often there will be strange behaviors and compulsions, and family will need to work around these issues; they cannot be changed. My mother, for example, wanted to wear the exact same clothes 24 hours a day. We had to find ways to deal with this. She didn't want to shower. Ever. I had to insist on her into doing it once or twice a week (I had to help her with every step and go to some extreme lengths to get her into the shower) and deal with her being angry and mean about it. Caring for her was physically and mentally exhausting. She has been in a nursing home for about three years now. The things that your FIL is facing now will only get worse.

 

About driving and staying home alone: my mother continued to do these things long after I was comfortable with it, because my dad was unwilling to step up and make the necessary decisions for her (I lived hours away but eventually moved her into my home to make sure she was receiving proper care). Once they lose their ability to make logical and rational decisions, they should not be left alone, just as one would not leave a young child home alone. If the loved one would not know how to respond to any kind of emergency while at home (stranger at the door, fire, appliance malfunctioning, minor or major injuries, scamming phone calls, pet getting loose, etc.), they should not be left alone. Although someone can seem to function fine with routine driving, it is important to remember that not all driving is routine. One must always be ready and able to respond appropriately to unexpected events on the road, whether caused by another driver, weather conditions, stray animals, malfunction of the car, detours, etc. Driving is a complex activity, and Alzheimer's patients are unable to safely and consistently perform complex activities even in the early stages. 

 

This is all so tough. It is not at all unusual for family to take awhile to understand the new limitations and to predict the ever changing needs and safety concerns. Would your FIL go to some support meetings or read materials by the Alzheimer's Association to help him understand what she is going to need from him? My dad is a very passive person who will never tell someone else what to do. As I mentioned above, I had to take my mom in to care for her, because he could not see what to do, and honestly, he did not know how to care for another person, because my mom had done all the caretaking when we were growing up. It can be as hard for the caretaker to come to an acceptance of their own limitations as it is to accept the limitations of the Alzheimer's patient.

 

:grouphug:

[creekland]

I truly do understand what y'all are saying about her driving and I totally agree with it.  It's just not my decision.  I will do my best to tactfully and persuasively bring it up though.  It may take a few "talking" sessions TBH, but I'll try.

 

Regarding violence, there was one episode we were made aware of (after the fact) that worried all of us.  Fortunately, FIL wasn't seriously hurt.  I know hubby and BIL talked with him then, but they didn't get far.  I have not seen signs of more happening to that level.  Most of her outbursts are verbal, but she's been that way since I've known her.

 

There are areas where she's gotten better.  She very seriously didn't like me for years - literally.  I corrupted her son (he left both the Navy and the Methodist church).  I was raising her grandkids incorrectly (didn't demand first time obedience, etc).  I never kept my house clean enough.  We didn't visit enough.  But now... all that appears to have been forgotten.  She enjoys my company and thinks our kids are wonderful + successful.  She hasn't gone to church herself in years, so that part appears to have been forgiven.  She rarely visits our house (wouldn't be able to handle our upstairs-only bathroom).  She can't remember how often (or not) we visit.

 

In the "old days" she threw potted flowers at me once when we arrived about 20 minutes late (traffic issues) after having spent time with my B/SIL - time that should have been spent with her - all my fault of course.  Now?  She confides in me with all of her rants and raves about everyone and everything else.  :glare:  (I've matured enough to just listen to it all and get amused when the stories change - in the "old days" I'll admit to not always doing so - part of her feelings toward me).

 

So, in some ways she's actually better and perhaps less violent (aside from verbal when she gets stressed).  When she threw stuff out of the fridge, it wasn't at anyone or anything.  It was merely to the floor.

 

But I could see hubby and BIL getting more insistent should she get more violent physically.  I think his FIL would cave then too.  Lately he has been admitting that she might be more than he can handle, but he's still not ready to give up trying.

 

Nonetheless, I'll work on persuading hubby to have a deeper talk on the issue next time we visit - driving first and foremost (using some options thought about via this thread - like the car being permanently in the shop) - then options for other care.

 

Hubby told me last night that FIL's health is decreasing a bit (heart issues again) since we were there in July.  I believe we're going to try to visit again later in Sept...  Fortunately, with empty nesting, our schedule is more free than before.

[Jane in NC]

The challenge here is that your father in law may not always be up to being your mother's keeper. Truly, I would be more concerned about her endangering others than herself at this point. 

 

Your position as daughter in law is that of an inside-outsider.  Family members have been living with the slow deterioration for some time.  An outsider is often the one who can stand up and remind everyone how bad the situation has become.  It is a tough position but the situation may necessitate it.

 

Lots of hugs,

Jane

 

 

[creekland]

Hubby and I had a good talk on a couple hour drive we had to make today.  He's pretty much on board and will be talking with his brother soon so the two of them can come up with some real, concrete paths FIL can think about and decide between.  Hopefully BIL will hop on board too.  Time will tell.  If so, we will all help FIL along whichever path he chooses.  Keeping the status quo is not one of the paths, though in home help could be if he doesn't want to leave.

[songsparrow]

I talked with hubby about her driving last night and he doesn't know how she is IRL with that either, but he did mention she hasn't even hit anything around their house and there's nothing wrong with her hearing or eyesight, so she might still be ok other than the getting lost bit.  FIL is keeping track of that (supposedly) and is not helping her find her keys.  He's also staying home a LOT more than he used to so she doesn't have to drive if she wants to go somewhere. 

 

 

Just a thought . . . perhaps FIL can be convinced to make sure the keys become permanently "lost."  If MIL doesn't get upset when she thinks she has misplaced her keys, perhaps that's a non-confrontational way to stop her from driving.  

[Laurel-in-CA]

About the driving. That was the very hardest thing for my dad to give up...he'd been a patrol cop, after all. He KNEW how to drive! He'd always been the driver.

 

Then we found out he'd been driving down to the marina @ midnight while Mom was asleep and he was actually brought back by the cops. The keys got "lost" as in disappeared from the house and never came back. Mom's keys went into a pocket safe and she "forgot" the combination as needed.

 

But some things you can't solve so easily, like the time he thought he heard a burglar and my mom woke up to him prowling the house with a butcher knife to keep her safe....luckily he didn't think SHE was the burglar when she got up to find out why he was wandering around.

 

Early medication does help somewhat with some of the mental decay, but you also have to consider what is best to keep *both* of them safe and well.

 

This is very, very hard, and especially when you factor in distance. Can one sibling take the lead on parent-care? Often senior centers have consultants who will help locate and connect people with resources in their local communities.

 

ETA: No idea of finances & logistics, but you might consider evaluating assisted living facilities that have multiple levels of care. That way he could be onsite with her and care for her but there would be backup from staff and security to keep her from wandering, which is increasingly likely. The meals could be served to them a bit like a restaurant. I ate with my mom @ her place several times...they could have guests in and bill the extra meal to their account. They could also pay for services like laundry and have snacks in their rooms. My mom's facility also had a 24x7 care facility right across the street under the same management. Although that turned out not to be the best option for her when she needed more care, it was comforting to k now it was available.

[creekland]

Just a thought . . . perhaps FIL can be convinced to make sure the keys become permanently "lost."  If MIL doesn't get upset when she thinks she has misplaced her keys, perhaps that's a non-confrontational way to stop her from driving.  

 

I don't know.  It could be a suggestion.  FIL drives the car when they are both together.  He has his own truck he takes when he's alone.  She gets mad that he won't give her his key, but he's stayed firm with that so far (mainly because if he gives her his and then loses hers, he can't rescue her if she's out).

 

Maybe this a dumb comment but could FIL make clearing the table his job? That way he knows what goes where. Whether it's paper goods into the trash or dishes into the sink/dishwasher? That actually seems like less of a headache to me than driving someone out for every.single.meal and racking up the restaurant bills.

 

He's of the age where men didn't learn to cook, so there's very little he can make/prepare on his own.  At his age I don't think he cares to learn much either.  I suspect they have enough funds for eating out.  I've never seen him do anything with dishes, but then again, we always cook and do dishes when we're there (now).  MIL always did them in earlier years.

 

 

This is very, very hard, and especially when you factor in distance. Can one sibling take the lead on parent-care? Often senior centers have consultants who will help locate and connect people with resources in their local communities.

 

One of the suggestions I gave hubby was to contact the Alzheimer's Support Group that must exist in their area as it's a much larger area population-wise than ours and we have one according to our local newspaper.  I suspect they would have info on places/people/services locally to consider.  I think it's best if he and/or BIL get some very specific/concrete plans to offer.  (Move here or get help from ____ and things like that - not just grand ideas.)

[mommymonster]

One thought, can you convince her to go to the doctors for an "annual check-up"? No big deal, just go in, get your temperature taken? I ask because my dear great aunt was diagnosed wth dementia, and they were about to have to move her to a memory care facility because she was doing so poorly. She went to see her GP and was diagnosed with a severe urinary tract infection. After IV antibiotics, she was back to herself in a matter of weeks (she's a little bit forgetful still, but that is her whole family). I'm not posting this to say she isn't suffering from Alzheimer's or dementia, but instead to urge some medical eyes on the issue. It might give you new perspectives or options.

[creekland]

I was under the impression that they were able to manage cooking, but were avoiding it just because of the plates issue. If cooking is an obstacle then I understand the eating out. 

 

The glasses are the main issue because they do use those at home and she uses hers for milk, then puts it away (dirty) and will pull it out again, etc.  When I went to get things ready for the first dinner I was making there the plates were also wet and smelled like fish - quite gross to be honest.  Bowls also had dried "who knows what" on them.  Serving dishes too.  The both still fish at their cottage and it may be one of the things FIL will fry up or perhaps she does some stuff on her own yet when he's not there, but in general, when at home, they go out for actual meals.  Their cottage is further from civilization (not very far, but by comparison).

 

One thought, can you convince her to go to the doctors for an "annual check-up"? No big deal, just go in, get your temperature taken?

 

I bet she hasn't been to see any doctor since she had kids.  She's worse than I am about that, but I can relate to her thoughts (overall), esp after I came back from an appt I had today... I can REALLY understand her reasoning... as I'm discontinuing what I had started due to frustration.

 

That said... mine wasn't as critical... and if/when I feel it gets critical, I'll just find someone else (I think).  Or, one of my more recent thoughts is to wait 8 - 10 years until middle son finishes med school, then be first in line wherever he works.  He'll owe us a bit of freebies after med school after all! I won't care if he chooses pediatrics or something totally unrelated!   ;)

 

She'd likely let middle son be her dr, but I doubt she has the time to wait.  We weren't thinking ahead enough to advance him from 4th grade to his senior year so he'd be finished with med school in time... hindsight always works better!   :lol:

[ZooRho]

I'm so sorry you are going through this. My dad had dementia and things got bad at home until my mom could no longer care for him, sadly it was a week before they would have moved in to a senior living place. no idea if that would have been good enough for him and her to have made it. 

As it was they went to a Continuous Care facility. I would suggest you look to see if there is one of those around.  My mom was able and still is living on her own in a nice apt there.  but my dad was in the memory care unit. It was nice though since Mom could go see him easily, and leave when he was not in a good mood. Mom really enjoys it and has lots of friends there. They have a maid once a week with sheet changes and linen care.  She gets 2 meals a day there.  She does have a small kitchen but does no real cooking there.

Hopefully someone can talk your dad in to getting mom to the dr.  how about a change in Ins plans, the dr requesting it of all patients etc.  

Oh and my brother put a GPS on my dad's car so he could locate him if he got lost,   He also had diabetes.  and would have low blood sugar.  My brother then disabled his car not sure what he did but he never asked my brother to fix it.    My mom was driving until a year ago when she fell and hurt her back and couldn't drive and now she feels unsure THANK GOD.

 

[Storygirl]

I truly do understand what y'all are saying about her driving and I totally agree with it.  It's just not my decision.  I will do my best to tactfully and persuasively bring it up though.  It may take a few "talking" sessions TBH, but I'll try.

 

Regarding violence, there was one episode we were made aware of (after the fact) that worried all of us.  Fortunately, FIL wasn't seriously hurt.  I know hubby and BIL talked with him then, but they didn't get far.  I have not seen signs of more happening to that level.  Most of her outbursts are verbal, but she's been that way since I've known her.

 

There are areas where she's gotten better.  She very seriously didn't like me for years - literally.  I corrupted her son (he left both the Navy and the Methodist church).  I was raising her grandkids incorrectly (didn't demand first time obedience, etc).  I never kept my house clean enough.  We didn't visit enough.  But now... all that appears to have been forgotten.  She enjoys my company and thinks our kids are wonderful + successful.  She hasn't gone to church herself in years, so that part appears to have been forgiven.  She rarely visits our house (wouldn't be able to handle our upstairs-only bathroom).  She can't remember how often (or not) we visit.

 

In the "old days" she threw potted flowers at me once when we arrived about 20 minutes late (traffic issues) after having spent time with my B/SIL - time that should have been spent with her - all my fault of course.  Now?  She confides in me with all of her rants and raves about everyone and everything else.  :glare:  (I've matured enough to just listen to it all and get amused when the stories change - in the "old days" I'll admit to not always doing so - part of her feelings toward me).

 

 

My mother was always opinionated and argumentative, and Dad said that she became much easier to live with and get along with a couple of years into the Alzheimer's. So mellowing does happen. But it doesn't always remain that way. Mom became harder to live with again after entering a different stage of the disease. Unfortunately, that's the stage that I got to take care of her. Even on good days, living with an Alzheimer's patient is a constant state of stress. My dad became visibly worn down, and he did not really do the kind of constant caretaking that she needed. Someone who is spending 24 hours a day with a loved one without any kind of relief help is likely going to have their own health suffer.

 

 

Just a thought . . . perhaps FIL can be convinced to make sure the keys become permanently "lost."  If MIL doesn't get upset when she thinks she has misplaced her keys, perhaps that's a non-confrontational way to stop her from driving.  

 

My dad "loaned out" my mom's car permanently to their granddaughter when she needed a vehicle.

 

 

 

He's of the age where men didn't learn to cook, so there's very little he can make/prepare on his own.  At his age I don't think he cares to learn much either.  I suspect they have enough funds for eating out.  I've never seen him do anything with dishes, but then again, we always cook and do dishes when we're there (now).  MIL always did them in earlier years.

 

 

 

My dad never cooked, either. I live several hours from him, so when I visit, I try to bring some things that I know he likes portioned out into individual servings for his freezer. My sister and SIL have him over for dinner or give him leftovers. And he buys ready to eat meals from the store and also eats out. He has always eaten lunch out (he still works at age 80).  He doesn't starve. I'm sure your FIL can manage. However, if he relies mainly on going out to eat, he will eventually find that he can no longer take his wife with him to a restaurant, and he'll need to figure out some other ways to provide meals.

 

One more thing to add to your list of conversations to have with the family. Eventually your MIL will need help not only with bathing and dressing but also with toileting needs. She will lose bladder and bowel function, and someone will need to change her adult diapers. Will your FIL be willing and able to do this? This is not something that maybe might happen. It will. It is part of the disease. And it may come sooner than he expects.

 

If he is intent on keeping her at home and caring for her himself, he will at least need to hire people to stay with her while he does errands and anything else that will take him out of the house. Unless there is family nearby who will take turns staying with her whenever he needs to go out. He may not realize when the time comes that it is not safe for her to be at home alone. That time may be here already. If not, it will probably arrive soon.

 

There are so many things to deal with. It's hard.

[Liz CA]

I agree with packing the dishes and moving to disposables.

 

Dh's grandmother has advanced Alzheimer's.  Before the disease was as advanced, I got her a Keurig to put in her assisted living apartment, wrote out simple instructions and taped them on the counter in front of it.  She kept removing the instructions and throwing them in the trash.  I finally gave up. She never used the machine.

 

I don't think it is possible to train her not to do this.  It is possible that you can break the habit by using paper goods and then move back to disposables when she has forgotten, but this may take some time.

 

Agree with this. Unfortunately, she will likely get more adamant and perhaps even violent when people point it out. It is part of the course for some people afflicted with Alzheimer's. I am so sorry things have progressed to this stage but I want to gently suggest to prepare yourself for the fact that either outside help will have to be hired or she will have to be admitted. In either case, it sounds like she will pitch a fit but I would disregard it in much the same way as we deal with toddler melt downs. If she becomes unmanageable and may harm herself or others, it is much kinder to make sure she is in an appropriate facility. Also, your FIL probably needs to get some kind of relief and know that not all responsibility lies on his shoulders. Nobody can supervise someone all the time.

[Storygirl]

 I want to gently suggest to prepare yourself for the fact that either outside help will have to be hired or she will have to be admitted. In either case, it sounds like she will pitch a fit but I would disregard it in much the same way as we deal with toddler melt downs.

 

The bolded is absolutely true. My mother lived with me for almost a year before admittance into a nursing home. She did not want to be here. She asked repeatedly (constantly -- dozens of times per day) to go home. She cried about it and told me I was mean to her. She had a great big fit during a birthday party for my kids when she realized I was not going to let her go home with my dad. When she was first admitted to the nursing home, she begged my dad to take her home every time he saw her. We all had to do what was best for her, even though she did not want it, just as you do for a child. It was heartbreaking.

 

After awhile in the nursing home, she got used to being there and no longer asked to leave. I hate that she has to be there, but I know she is well looked after in a way that I can no longer do. I was opposed to putting her in a nursing home, yet in the end, I was the one who decided it had to be done (I lived three hours from the rest of my family and could not continue to care for her without help; no one else in my family was willing to be her caretaker). I had to make the choice that was best for her and for me as the caretaker, even though it was the last thing I wanted.

 

Family can care for Alzheimer's patients in their homes. My mother, my sister, and I took care of my grandmother at home until her death. My mom was the primary caretaker, but she had a LOT of help from us, and she never devoted 24 hours a day to her mother without anyone else there to lend a hand. If your FIL insists on keeping her at home, the rest of family will need to ensure that he has plenty of help.