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Elder Care & Elder Rage: If I Only Knew Then--What I Know Now!
By Jacqueline Marcell
Wednesday, November 16, 2005
Rated "PG13" by the Author.
'Elder Rage' author, Jacqueline Marcell, makes the experience of caring for her frail mother and challenging elderly father manageable.
For eleven years I pleaded with my obstinate elderly father to allow a caregiver to help him with my ailing mother, but after 55 years of loving each other he adamantly insisted on taking care of her himself. Every caregiver I hired to help him called in exasperation, "Jacqueline, I just can't work with your father—his temper is impossible to handle. I don't think he’ll accept help until he's on his knees himself."
My father had always been 90% great, but boy-oh-boy that temper was a doozy. He’d never turned it on me before, but I'd never gone against his wishes either. When my mother nearly died from his inability to continue to care for her, I flew from southern California to San Francisco determined to save her life—having no idea that it would nearly cost me my own.
EARLY SIGNS OF DEMENTIA?
I spent three months in the hospital helping to nurse my 82-pound mother back to relative health, while my father went from loving me one minute to calling me nasty names and throwing me out of the house the next. I walked on egg shells trying not to upset him, even running the washing machine could cause a tizzy, and there was no way to reason with him. It was heart wrenching to have my once-adoring father turn so against me.
I immediately took my father to his doctor, only to be flabbergasted that he could act normal when he needed to. I could not believe it when the doctor looked at me as if I was making things up. She didn’t even take me seriously when I reported my father had nearly electrocuted my mother, but fortunately I walked into the bathroom just three seconds before he plugged in a huge power strip that was soaking in a tub of water–along with my mother’s feet! Much later, I was furious to find out my father had instructed his doctor (and everyone he could) not to listen to anything I said because I was just a (bleep bleep) liar—and all I wanted was his money! Boy, I wish he had some.
Then things got serious. My father had never laid a hand on me my whole life, but one day nearly choked me to death for adding HBO to his television, even though he had eagerly consented to it just a few days before. Terrified, I call the police for the first time in my life who took him to a psychiatric hospital for evaluation. I could not believe it when they released him right away, saying they couldn't find anything wrong with him. What is even more astonishing is that similar horrifying incidents occurred three more times.
CAREGIVER CATCH 22
Eventually I was finally able to bring my frail mother home from the hospital, but furious to find myself trapped. I couldn't fly home and leave her alone with my father—she'd surely die from his inability to care for her. I couldn't get my father to accept a caregiver, and even when I did—no one would put up with his temper very long. I couldn't get healthcare professionals to help—my father was always so darling in front of them. I couldn't get medication to calm him, and even when I finally did—he refused to take it and flushed it down the toilet. 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 Assisted Living—legally I couldn't force them. I became a prisoner in my parents' home for nearly a year trying to solve crisis after crisis, begging for professional help—and infuriated with a medical system that wasn't helping me appropriately.
GERIATRIC DEMENTIA SPECIALIST MAKES DIAGNOSIS
You don't need a doctorate degree to know something is wrong, but you do need the right doctor who can diagnose and treat dementia properly. Finally, a friend suggested I call the Alzheimer’s Association who directed me to the best neurologist in the area who specialized in dementia. He performed a battery of blood, neurological, memory tests, CT and P.E.T. scans. After reviewing my parents’ many medications and ruling out numerous reversible dementias such as a B-12 and thyroid deficiency, you should have seen my face drop when he diagnosed Stage One Alzheimer's in both parents—something all their other healthcare professionals missed entirely.
TRAPPED IN OLD HABITS
What I'd been coping with was the beginning of Alzheimer’s (just one type of dementia), which begins very intermittently 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 his habit of yelling to get his way was coming out over things that were irrational—at times. I also didn't understand that demented does not mean stupid (a concept not widely appreciated) and that he was still socially adjusted never to show his “Hyde” side to anyone outside the family. Even with the onset of dementia, it was astonishing he could be so manipulative and crafty. On the other hand, my mother was as sweet and lovely as she’d always been.
KEY: BALANCE BRAIN CHEMISTRY!
Alzheimer's makes up 60-80% of all dementias and there's no stopping the progression nor is there yet a cure. However, if identified early there are four FDA approved medications (Aricept, Exelon, Razadyne and Namenda) that in most people can mask the symptoms, keeping a patient in the early independent stage longer, delaying the need for part to full-time care. The Alzheimer’s Association reports that along with optimal lifestyle changes (proper nutrition, weight, exercise, socialization), a five year delay in the onset of needing care could save $50 BILLION in annual healthcare costs. Even a one month delay in nursing home placement could save the U.S. $1 BILLION annually.
After the neurologist masked the symptoms, he treated my parents’ depression which is often present in Alzheimer’s patients. It wasn’t easy to get the dosages right and it took a lot of time and patience and no, my father wasn’t suddenly turned into an angel, but at least we didn’t need police intervention any longer!
CREATIVE BEHAVIORAL TECHNIQUES
Once my parents’ brain chemistries were better balanced, I was able to optimize nutrition, fluids, medication, treatments, exercise and socialization with much less resistance. I was also able to implement creative techniques to cope with the intermittent bizarre behaviors. Instead of logic and reason—I used distraction and redirection to things they were interested in. I learned to use reminiscence and talk about the old days, capitalizing on their long-term memories which were still quite good. Instead of arguing the facts—I agreed, validated frustrated feelings and lived in their realities of the moment. I finally learned to just go-with-the-flow and let hurtful comments roll off.
And if none of that worked, a bribe of ice cream worked the best to cajole my father into the shower, even as he swore a blue streak at me that he’d just taken one yesterday (over a week ago). I was also finally able to get my father to accept a live-in caregiver (he’d only alienated 40 that year—most there for about ten minutes), and then with the benefit of Adult Day Care five days a week for my parents and a support group for me, everything started to fall into place.
IF WE ONLY HAD LONG TERM CARE INSURANCE!
Before long my parents’ life savings was gone and we were well into mine. I was advised to apply them for Medicaid and after months of evaluation they were approved for financial help from the government. I was so relieved, until I learned it would only pay to put my parents in a nursing home, not keep them at home with 24/7 care. And, since my mother needed much more skilled care than my father, they’d be separated—something they would never consent to, nor did I want after all this work to keep them together.
I could not believe it—I finally had everything figured out medically, behaviorally, socially, legally, emotionally, caregivers in place, the house elder-proofed, and all I needed was some financial help to keep them at home. If I’d just made sure my parents bought Long Term Care Insurance (or I bought it for them) years ago while they were healthy and before the diagnosis of dementia, it would have covered the cost of their care at home. Instead, I paid for their care, which nearly wiped me out in every way. After four more years of managing 24/7 care for my parents, I then survived invasive Brst. Cancer.
DEMENTIA OFTEN OVERLOOKED
What is so unsettling is that not one healthcare professional discussed the possibility of the beginning of Alzheimer’s (or any type of dementia) in my parents with me that first year, which happens far too often. Alzheimer's afflicts 5.4 million Americans, but millions go undiagnosed for years because intermittent subtle warning signs are chalked up to stress and a “normal” part of aging. Since one out of eight by age 65 and nearly half by age 85 get Alzheimer’s, healthcare professionals of every specialty should share the “Ten Warning Signs of Alzheimer's” when they notice subtle signs in their patients, so everyone can save time, money—and a fortune in Kleenex!
TEN WARNING SIGNS OF ALZHEIMER'S
(Reprinted with permission of the Alzheimer’s Association)
1. Memory loss
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation of time and place
5. Poor or decreased judgment
6. Problems with abstract thinking
7. Misplacing things
8. Changes in mood or behavior
9. Changes in personality
10. Loss of initiative
Jacqueline Marcell is an international SPEAKER on Eldercare, Alzheimer’s and Breast Cancer, and author of the best-selling book ELDER RAGE (print, audio, Kindle/Nook), a Book-of-the-Month Club selection receiving 50+ endorsements, 400+ 5-Star Amazon reviews, required reading at numerous universities and considered for a film. www.ElderRage.com
Site: Elder Rage
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|Reviewed by Karen Lynn Vidra, The Texas Tornado
|God bless you, Jackie, and God bless ALL our caregivers! Wonderfully informative yet much needed article! Very well done! :)|