Dementia Solutions – Caregiving Advice, January 2016

Endoflife

Dementia expert, Karen Tyrell, offers answers to www.carp.ca visitors for their situation-specific questions. Karen is a dementia consultant who can point you in the right direction, giving quick insight and personalized answers to help you with dementia care challenges.

 

January, 2016 Update

Breaking the News– Should We Tell Our Dad, Who Has Dementia, About Our Mother’s Death?

Dear Dementia Solutions

“My mother recently passed away and my sisters and I are conflicted about how to break the news to my father. He lives in a care home and, due to dementia, his memory is limited. We don’t think telling him will cause too much distress because he doesn’t often ask about our mother. However, we’re still concerned about his possible reaction and are divided in our opinions about what the right thing to do is. Should we tell our father or keep him in the dark?”

 ~ Conflicted Daughter

Dear Conflicted Daughter: 

I’m very sorry to hear about your loss. In the midst of dealing with the concerns about your father, I hope you and your sisters are also taking time to focus on your own healing.

In terms of whether you should tell your father, there is no clear-cut “right” answer. I can understand wanting to tell him the truth, as we’ve all been taught that truth-telling is the moral course of action. Yet, you also have to ask yourselves whether the truth may hurt your father to the point where it causes him to experience long-term distress and may even give rise to challenging behaviours, such as a reluctance to eat or a refusal to get out of bed.

To gauge his reaction, ask yourself the following: What questions does he ask about your mother? When you mentioned your mother in the past, what were his reactions? Does he get emotional in general, when seeing a sad movie for example, or hearing a nostalgic song? What usually triggers his feelings of distress?

You know your father best. If you sense that his grief may be unmanageable, then it may be best to not mention anything, especially if he hasn’t been asking about your mother much in past few weeks. If he does ask about her, but you feel too emotional to answer, simply take a break by pretending you have to take a phone call and tell him you will be right back.

If you do choose to tell him, try using a calm tone and say, “Well Dad, Mom has passed on” or, “Mom is in heaven now.” If he takes it hard, do what you can to console him. Over the next few days, ask the care staff at the home about his mood and behaviour. If he was upset, then the next time you visit try some Therapeutic Reasoning to uplift him. For example, you could say, “Oh, where would Mom be on a beautiful day like this?” or, “One thing I know for sure is that Mom was greatly loved!” Shifting the subject to a topic your father enjoys, such as gardening or his favourite music, can also help. (You can learn more about Therapeutic Reasoning on my website here.)

Remember that both dementia and grief affects everyone differently. Though there are no crystal balls to predict your father’s reaction, a bit of your own detective work can be greatly effective. I wish you and your family comfort, healing and peace.

 

Delayed Due to Dementia – How Do I Get My Husband To Be On Time?

Dear Dementia Solutions:

“I’m in a constant battle of wills with my husband who has dementia. Getting him to cooperate when it’s time to leave the house is an uphill climb. He often refuses to get ready and we’re usually late for appointments. Recently we cancelled an appointment with the podiatrist because he simply would not get changed!  When I try to get him to hurry up, he complains that I’m rushing him. I’ve started giving him a few hours to prepare before stepping out, but it’s not working. Please help!”

 ~Perpetually Late

Dear Perpetually Late:

Before doing anything else, take a deep breath. It’s something we could all do more of, especially when under stress. Know that your own feelings of stress are completely understandable. Having schedules and appointments blown off course can make life feel out of control, like a boat on a stormy sea. Though you may be feeling constantly on edge, know that there are strategies that can help anchor you.

One idea would be to try arranging appointments at home whenever you can. For example, there are specialists who offer foot care services in your home. There are also companies which provide care workers who can engage your husband in activities at home for times when you need to go out for your own appointments. By not going out too often, your husband’s anxiety may lessen and when he does need to leave the house, he may be less inclined to put up a fight.

Also, when turning the door knob to leave, remind yourself to take that deep breath. Showing anxiety could trigger your husband’s discomfort, leading him to worry about what he has to do or say whenever he goes out. Though you may be telling him the reason for the outing, memory impairment could lead him to quickly forget. It may simply be easier for him to say “no” since no one feels like saying “yes” when they don’t know what they are saying “yes” to.

The effects of dementia may also be hampering his ability to recall how to do things and in what order. Not knowing what item of clothing to wear first or how to tie his shoes could make him feel embarrassed and frustrated. To avoid these feelings he may be refusing to go out altogether. To address this, try an approach that assists him without making him feel like a child. In helping him get dressed you could say, “Honey, I love when you wear this shirt! Let’s see if it looks good with your favourite pants!”

Another creative strategy is to not tell your husband that he is going out for an appointment, but rather that you are stepping out for a treat—a coffee or lunch at his favourite spot perhaps. After the enjoyable meal or coffee, when you are both in the car, you can say, “Oh my, I just realized you have an appointment today! I think we’ll be able to make it on time.”

Though every day is different, and some strategies may work better on some days than others, by testing a few of the above approaches you can find ways to lessen both your husband’s stress and yours. Whether it’s a day of calm seas or choppy ones, keep sailing forward and remember to keep taking those deep breaths too! J

Do you have a specific question relating to dementia that you need answered? Please submit your questions by email to: [email protected]

Karen Tyrell CDP, CPCA is a Dementia Consultant & Educator and Founder of Personalized Dementia Solutions Inc. (www.dementiasolutions.ca). She also authored the book “Cracking the Dementia Code – Creative Solutions to Cope with Changed Behaviours.” Karen offers her expertise on dementia care through speaking engagements, workshops and by working one-on-one with families and caregivers to provide emotional support and practical solutions.