Alzheimer's Personal Advice Column - 12/8/2003 Update
Express what is on your mind. I hope my answers will provide a stepping stone for you to change your life for the better. Also, your questions will inspire others - those who did not ask. If I don’t know the answer, I will consult with my experts to give you a response. Sometimes just writing down an issue of concern helps to resolve it - similar to the time when you just made an appointment with the doctor and the symptoms disappeared.
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When my husband hallucinates about things happening around him how do I respond? Do I go along with him or do I try to correct what he thinks is happening to him?
Correction never works. The best thing to do is to gently redirect attention. What your husband sees is very real to him and it is very hard for him not to believe what he is seeing. To negate what he is seeing will be frustrating to him. Help him through the vision if it is upsetting. For example, when my father saw a room full of people in his home who wouldn’t leave, he had my mother call me up because she kept telling him no one was there. He was upset and wanted to know that I thought. I acknowledged his reality and said that we would take care of it. He could go to sleep and the visitors would leave one by one. I told him how much I loved him and then a few jokes. He laughed and grew calm.
You could play music and get out the photo album to redirect his attention. Photos are a very good way to refocus attention.
My mother is in the late stages of Alzheimer’s and has been hospitalized for other health complications. I feel guilty that I don’t visit her daily, but the truth is that I am busy taking care of my husband and children and just hate to see my mother groggy and weak. I return home depressed and depleted, yet how much longer will I have my mother anyway and so I ought to go visit more for that reason alone. (Guilt-ridden, Dallas)
I don’t like your name at all. That’s my first suggestion, get rid of your name. Guilt is a destructive, paralyzing emotion. I sense that you are a wonderful daughter and have done the best that you could to juggle family and care-giving. The professionals at the hospital are in the front line managing, fluids, edema, infection, blood gases, etc. Also, I beg to differ with you again. You will have your mother with you always, but in a different form. When my father passed away from Alzheimer’s, I dedicated a joyous thought to him every day: a proverb, a joke or comment he used to make. I feel that my father is always with me. Letting go of a person, does not mean giving up on that person. Sometimes, the body is so afflicted that it is okay to whisper for the soul to go. I always tell my children, just don’t pull the plug on me while I am napping! A little humor always helps to rid the body and soul of stress. Try to be as kind to yourself as you are to your mother.
I have been reading about exercise and Alzheimer’s. My husband is in the early stages and is 75 years old and used to be more energetic and athletic. Should I get him to exercise? (Mrs.Tired All the Time, Seattle)
Dear Mrs. Tired All the Time,
Exercise will do you both some good. If you enroll your husband in a program specifically designed for Alzheimer’s by contacting the Alzheimer’s Foundation, your husband’s mood will improve and he will be stimulating the brain oxygenating it through exercise along with learning new movements for better motor coordination. Your husband will have a better life quality and will function independently for a longer period of time - that will be a boon for you! Care-giving is a 36 hour day. You need to de-stress and revitalize. An exercise program specifically designed for you like a Silver Sneakers Program at a gym, or working with a personal trainer with senior certification will give you the get up and go, the social interaction and numerous health benefits of stress-reduction: from heart smart to head smart.
I’m trying to get a housekeeper for my father who is in the early stages of Alzheimer’s. However, he fires all of them, claiming that they are lazy and that he has no need for a housekeeper. He cannot be left alone and I need to go work. What can I do? I feel so stressed about it that I am developing stomach problems. (Margo from Atlanta)
It is hard to give up one’s independence and admit infirmity. Although you don’t specify it, I think the expense must be bothering him too. Here is where my background in fiction is useful. Why don’t you concoct a little story and tell your father that the housekeeper is free, a benefit from the insurance company or the state. Be inventive. Also, try to find a patient woman, who is soft-spoken with a sense of humor and who smiles a lot. I think you will have solved the problem and you will be feeling a lot better.
My mother had a terrible reaction to Haldol and I felt so guilty giving it to her. But her caretaker said that she was agitated and needed it. In fact the caretaker said that she would quit if my mother wasn’t medicated and she has been with her for 4 years and I couldn’t bear the thought of losing such a fine, responsible woman who is being driven crazy because my mother is agitated during the day and doesn’t sleep much at night despite the Ambien. What should I do since I can’t give her anymore Haldol but I need to keep the caretaker happy? (Cynthia from Texas)
Haldol is a strong measure and can cause lasting neurological side effects like paralysis. Because of your mother’s reaction, consult with a geriatric psychiatrist for something more appropriate- if necessary. But first try: music, lavender oil, a foot massage, frequent hugs and reassuring talk. Tell the caregiver not to argue or try to exert her will. Give your mother the sense that she is worthy of respect and give her some craft work to do, painting or coloring—simple tasks. Also, try to get your mother into a program, adult day care for Alzheimer’s, in your locale. Contact the Alzheimer’s Association in your area for the various centers that offer Alzheimer’s programs in your town. These programs are stimulating and provide social interaction for patients and will give your caregiver a much needed break to refresh. However, as much as you love this caregiver, be aware that caregivers for Alzheimer’s burn out. She was good for your mother during the early stages, but now that the disease has advanced, you might need someone else. Every stage has its necessary skills.
Debbie Mandel, MA is the author of Turn On Your Inner Light: Fitness for Body, Mind and Soul, a stress-reduction specialist, motivational speaker, a personal trainer and mind/body lecturer at Southampton College. She is the host of the weekly Turn On Your Inner Light Show on WLIE 540AM in New York City , produces a weekly wellness newsletter, and has been featured on radio/ TV and print media. To learn more visit: www.turnonyourinnerlight.com
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