Elder Care and Elder Rage: If I Only Knew Then What I Know Now
Eldercare and Caregiving
Eldercare is becoming a prominent aspect of many Baby Boomers' lives when they are thrust into the role of caregiver for an ailing parent, often after a crisis. First-time caregivers are usually unprepared for the tremendous physical, emotional and financial challenges and often become overwhelmed trying to find the right doctors, diagnoses and treatments, as their own lives go on "hold." I have lived this nightmare.
For eleven years I begged my obstinate elderly father to allow a caregiver to help him with my ailing mother, but after 55 years of loving her, he adamantly insisted on taking care of her himself. Every caregiver I hired to help him sighed in exasperation, "Jacqueline, I just can't work with your father, his temper is impossible to handle. I don't think you'll be able to get him to accept help until he's on his knees himself."
My father had always been 90 percent wonderful, but boy-oh-boy that raging temper was a doozy. He'd never turned his temper on me before, but then again, I'd never gone against his wishes either. When my mother nearly died from his inability to care for her, I had to step in and risk his wrath to save her having no idea that in the process it would nearly cost me my own.
Early Signs of Dementia?
I spent three months nursing my mother back to relative "health", while my father, who was telling me he loved me one minute, would get furious about some trivial little thing, call me nasty names and throw me out of the house the next. I was stunned to see him get so upset over the most ridiculous things, even running the washing machine could cause a tizzy, and there was no way to reason with him. It was so heart wrenching to have my once-adoring father turn against me.
I immediately took him to his doctor and was astonished that he could act completely normal when he needed to. I couldn't believe it when the doctor looked at me as if I was the crazy one. She didn't even take me seriously when I reported that my father had nearly electrocuted my mother and that he'd left the gas stove on and nearly burned the house down. Much later I found out that he'd instructed her not to listen to anything I said, because all I wanted was his money. (Boy do I wish he had some.)
Then things got serious. My father had never laid a hand on me my whole life, but one day he nearly choked me to death with his bare hands for adding HBO to his cable package, even though he had eagerly consented to it just a few days before. Terrified and devastated, I frantically called the police who took him to a psychiatric hospital for evaluation. After a couple days of tests and observation, I couldn't believe it when they released him, saying they couldn't find anything wrong with him. Similar horrifying incidents occurred four times.
Caregiving Catch 22
I couldn't leave my father alone with my mother, because she'd surely die from his inability to care for her. I couldn't get the doctors to believe me, because he was always so darling and sane in front of them. I couldn't get medication to calm him, and even when I did, he refused to take it, threw it in my face or flushed it down the toilet. I couldn't get him to accept a caregiver, and even when I did, no one would put up with him for very long. I couldn't place my mother in a nursing home, he'd just take her out. I couldn't put him in a home he didn't qualify. They both refused any mention of assisted living, and legally I couldn't force them. I became trapped at my parents' home for nearly a year trying to solve the endless crisis, crying rivers daily and infuriated with an unsympathetic medical system that wasn't helping me appropriately.
Geriatric Dementia Specialist Makes Right Diagnosis
You don't need to have a doctorate to know something is wrong, but you do need a doctor who can diagnose and treat it properly. Finally, I stumbled upon a compassionate geriatric dementia specialist who performed an extensive battery of blood, neurological and memory tests, along with P.E.T. scans. First he ruled out the numerous reversible dementias, and then, you should have seen my face drop when he diagnosed Stage One Alzheimer's in both of my parents, something that all of their other doctors missed entirely.
Trapped in Old Habits
What I'd been coping with was the beginning of dementia, which is very intermittent and appears to come and go. I didn't understand that my father was addicted and trapped in his own bad behavior of a lifetime, and that his old habit of yelling to get his way was coming out over things that were now illogical and irrational... at times. I also didn't understand that demented does not mean stupid, at all (a concept that is not widely appreciated), and that he was still socially adjusted to never show his "Hyde" side to anyone outside the family. Even with the beginning of dementia, it was amazing that he could still be so manipulative and crafty. On the other hand, my mother was even sweeter and lovelier than she'd always been.
Balancing Brain Chemistry
Alzheimer's is just one type of dementia and there's no stopping the progression nor is there yet a cure. However, if identified early, there are medications that can slow the progression and keep a person in the early stage longer, delaying full-time care. (Ask a dementia specialist about the FDA approved medications: Aricept, Exelon and Reminyl. Also, medication for later stage, Memantine.)
After slowing the dementia, the doctor prescribed a small dose of anti-aggression medication, which smoothed out my father's volatile temper without drugging him out and making him sleep all day. (How I wish we'd gotten him that forty years ago.) My parents also received anti-depressants, which made a huge difference in their moods. Once their brain chemistries were properly balanced, I was able to optimize their nutrition, fluid intake and medications, with much less resistance. I was also able to implement creative behavioral techniques. Instead of logic and reason, I used distraction, redirection and reminiscence. Instead of arguing, I validated their feelings and lived in their reality of the moment.
Then finally, I was able to get my father to accept a caregiver (he'd alienated 40), and with the help of Adult Day Health Care five days a week for them, and a weekly support group for me, everything started to fall into place. It was so wonderful to once again hear my father say so often, "We love you so much, sweetheart."
But then, after several more years of loving each other, my parents passed from heart attacks, just a few months apart. Even though being responsible for every aspect of their last years was the hardest thing I have ever done, I am proud to say I gave them the best end-of-life I possibly could.
Alzheimer's Is Often Misdiagnosed
What is so shocking is that none of the many professionals who treated my parents that first year ever discussed the possibility of Alzheimer's Disease with me. One out of every ten persons by the age of 65, and nearly one out of every two by age 85, gets A.D. Had I simply been shown the "10 Warning Signs of Alzheimer's" I would have realized a year earlier what was happening and gotten my parents the help they so desperately needed.
If this rings true for you about someone you love, I urge you to reach out for help from a geriatric dementia specialist sooner than later.
Ten Warning Signs of Alzheimer's
(Reprinted with permission of the Alzheimer's Association)