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I'm getting ready to visit my father and step-mom in Arizona. She has Alzheimer's and they live independently in their own home. I have not seen them since Labor Day and have asked my step-brother for an update on how they're doing as he spent Christmas with them. His formerly, very pleasant mother has become rather nasty and is taking it out on everyone. Especially my father. How should I handle her behavior? I can deal with her lashing out at me as I truly understand this is the disease but I'm afraid I'm going to "lose it" when she turns on my father who has been wonderful in taking care of her. I want this visit to be as pleasant for my dad and intend to relieve him of most of his responsibilities while I'm there. I hate to admit that I'm dreading this trip.

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The step mom's brain is broken. I would be concerned for you taking on so much responsibility.
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1. Talk to dad to see if they have funds to cover a caregiver for 4 hrs a day. This can allow dad time to take care of anything or his favorite activity. And or light cleaning or cooking.
2. Is there a senior center around with adult daycare type activities for stepmom?
3. Learn about ‘sundowning’ and try to determine if that is going on.
4. Ask about medications. Is Namenda being prescribed, anti depressant or other drugs? Are there any interactions?
5. Yes have Dr check for UTI
6. Be the researcher for your dad.
7. Have stepmom sign release papers for you with Dr offices. That way you can help by following up.
8. Has dad prepared POA yet? Will he automate payments so he doesn’t have to do bill paying? Is that something you can do for them?

I’ve done most of this for my uncle as he is single. Dr office knows me and returns calls to answer questions.
9. Learn what county they live in and see if there is document available listing all senior services. Get 2 copies, one for you and one for dad.
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I am so glad you are going to visit and Dad will be very pleased to see you.
Do not think you can take over completely and tell dad to go away and you will take care of stepmom.
You may understand the process of dementia but do you know the effects on the body of a sufferer. Irrational behavior, refusing commands, wandering, yelling all night, messing with thermostats, hiding all kinds of things, spitting out pills, refusing to bathe or change clothes. Worst of all the incontinence, refusing to change Depends or wet clothes, stuffing toilet paper everywhere, clean or used. Leaving the stove on and many more difficult to handle situations.
Remember your Dad is intimately connected to your step mom and can handle things and her more effectively. zMany things dad can do but step mom may not let you.
You can certainly help dad a gread deal but it may not be the hands on caregiver you envisage.. There are probably repaired around the house you can do. probably not much yard work in Arizona but there is probably plenty of shopping you can do.
Get together with your stepbrother and try to find out what actually Dad needs help with. He knows his mom better than you do.
Don't worry about the visit just take your cues from dad and don't try to re organise his life unless he asks or you see he is no longer capable of making sensible decisions. As someone else suggested go to a hotel if you feel step mon finds your presence difficult.
Remember above all he mind has gone and she has little or no control over her actions.
Use this as a fact finding visit so you can really help Dad in the future.
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A suggestion & he flew off the handle. Well lesson learned. Leave it there & 5 min later or less remove it when they're not looking & no problem. They don't even remember putting it there. Just keep in mind THEY CANNOT CHANGE BUT WE CAN.
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Understand....that means she is in her world that cannot be changed. You live in a different world that can be changed so we must adjust. First have UTI checked. If non I have found my alz hubby gets angry if I try to get him to chg what he in his world thinks is right. As little as placing a kleenex on buffet folded or unfolded his way. I don't want them there so made asuggest
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If you are coming this week, bring a jacket. Coldest weather all winter the next 10 or so days.

I think that you should try to get dad out solo to let him vent, then find out if there is a plan in place when his wife gets beyond his care, which she will. Let him make the decision about what should happen, lovingly give him options and help him get a plan in place if there is not one. Good opportunity to find out his long term wishes but do not make promises about never putting him in a home, you may not be able to keep it then you would have guilt on top of dealing with a declining parent. You obviously love your dad, so when his wife walks all over your buttons, remember you love dad and he loves this woman, don't intervene. It only makes it harder for him. You are fortunate that they live in the retirement capital of the USA, you have loads of options and from what I've read here it is much more affordable. Maybe it is time for them to downsize and AL with apartments are great ways for seniors to transition, I tell my dad it's like having servants, a cook, a housekeeper, laundress, gardener etc. Your dad may be so overwhelmed he can only put one foot in front of the other, minute by minute.

Go and be a solution for dad and his loved one. You'll be happy you did and so will he. 
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Oh my goodness. This is their life and how they function. I would tread lightly at first to test the waters and not commit to stay with them the entire time if the cost of a hotel is possible. Perhaps get them out of their elements and do something fun in Arizona. A nature walk in park or botanical garden might be good for the spirits and body if they are up to it. Anything to get them out even if in their own yard. If they watch tv much there is so negativity it can fester us to the bone even the commercials of prescription drugs. I hope you have a good visit and positive vibes and they can’t wait to have you back. (((Hugs)))
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Remember that dad lives with this everyday. He isn’t going home at the end of the visit. surely you can maintain a few days. Also remember that your dad might be frightened of your visit. That you will want to change things. That the change which you will see as positive could be the end of an era for him. An end he may not be ready for. Give him an opportunity to talk to you about his life and feelings. He won’t appreciate your being harsh with his wife.
Read the book “Being Mortal’ by Atul Gawande.
You are a good son. It’s natural to be upset when your parent is being mistreated but be cool. Allow dad an opportunity to share. Then decide if alternate action is needed. It’s good you have a relationship with your step brother. Be sure to tell dad and step brother about the UTI Ff mentioned.
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Pat, it is time for your Dad to take his wife to the doctor to see if she has a Urinary Tract Infection.

In older folks, a UTI can make a person act angry, belligerent, etc. The symptoms she has no control over. Usually antibiotics can help clear this up. If it is a UTI, Step-Mom will feel soooo much better after treatment.

An UTI is one thing that is usually overlooked when there is a personality change.
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I'd take notes on what you see. I'd keep in mind that your dad may be covering for her and trying to keep things on the downlow. I'd keep in mind that he may be exhausted and stressed out. And, that no matter what you say to your mom, it won't likely help. Either she will resent you, get angry, disagree or do all that and then forget about it. So, trying to get her to act better, isn't really productive.

Do you intend to meet with her and her doctor? That might be helpful. Does her doctor know what's going on? Has she been diagnosed?

Good luck.
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What do you mean by .....You intend to relieve him of most of his responsibilities?

I’m long distance from my folks also. I know about dreading these trips.

But you said you understand the disease of dementia. You have to keep reminding yourself of this. It’s hard. So many times I just wanted to smack my dad.....But, deep breath, calm down, get through it.
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I would be dreading it too. What can you do for dad? Make sure he KNOWS that caring for a loved one with dementia is very difficult even for younger people. It is physically exhausting to say nothing of emotional. Let him know, in no uncertain terms that it is ok for him to say he cannot do it any more. Let him know you love him and will help find a place for mom. Maybe do some shopping while you are there.

What would happen if your dad suddenly passed, as many caregivers do, before the one they are caring for.

Safe travels.
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