Dementia care: When the child must become the parent

Dementia care: When the child must become the parent

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You may have noticed a few changes in your parent, such as forgetting the rules of a game you’ve played together since childhood. You might have been surprised when your mother clearly did not remember you visited just yesterday. You may been a little shocked that you needed to tell her it was the Fourth of July and too hot to wear a heavy coat. Maybe you were startled when looking at herself, she asked, “Who’s the woman in the mirror?”

Many people with dementia deny they need support. Sometimes adult children choose to overlook warning signs in a parent’s behavior. Living alone compounds the problem, dramatically increasing the chances for self-neglect and dangerous behavior. If a parent fiercely resists help, adult children must change both their approach and role in the relationship. The child must become the parent, for safety’s sake.

Admit there is a need for help. A pile of unpaid bills lurks as a classic sign of a problem. Becoming forgetful is not normal aging. Check out this list “Know the 10 Signs,” at Alz.org and evaluate whether the changes you’ve seen in your parent are impairing daily functioning. Encourage your parent to have testing done to rule out reversible dementia which might be due to: a vitamin b-12 deficiency, a thyroid condition, a toxic reaction to medication, depression, alcoholism, or fluid or clots on the brain.

Find out as much as you can about your parent’s legal and financial situation. At the very least, learn the location of legal and financial documents and bank accounts, safety deposit boxes/keys and passwords. Your parent needs both legal and medical Powers of Attorney; without them, you will need to establish guardian- and conservatorship before you can legally take over. Dementia is a progressive disease and your parent’s need for care will grow.

Learn to live with your parent’s insistence that no help is needed, even if she becomes angry and difficult. Your parent is trying to maintain control. Total control has been forever lost to dementia. Avoid attempting to reason with your parent and disengage from arguments. Be as respectful as possible, preserving her dignity. “I am sorry, I know this is hard…” is a very useful phrase. Remember your goal is her safety, not her friendship.

Establish rules and limits. These often begin with a parent ceding financial tasks to the adult child. In early to middle dementia, you may need to insist on keeping the pantry and refrigerator stocked and taking your parent’s car keys. As dementia progresses, 24-hour memory care will be required, whether in-home or facility-based.

This new role is not an easy one for many adult children. The stress and anxiety of dementia care are magnified when a parent has a difficult personality, and treats those around her in a demanding and domineering fashion, all the while being unable to live independently. Remember, you are not the only person who can provide this support. From the start, share these duties with siblings, friends and professional caregivers. Seek help before you become ill or depressed. Know you’re doing the best you can—you’re working to keep your parent as safe as possible.

Lee Nyberg seeks to help families and those living with dementia through education and her company, Home Care Assistance.

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