When he asks what temperature the doctor wants his heating pad set to, what do I say?

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He has muscle aches and nothing worth calling a doctor for. I know that it is his dementia talking when he won't take "no doctor" for an answer. To fake talking to the doctor doesn't work because he's smart enough to know the difference. Explaining patiently doesn't help, he wants to be the boss.


(Sometimes his real personality seems to bleed into his dementia and it makes it harder to deal with him. He is sweet, especially now that he's older, he's definitely softened, but at the same time, he seems to feel the need to demonstrate his authority in little ways "do it because I'm Dad." When it's particularly bad, he will cry and say to my bro, his caregiver, "you're my father, you have to do what I say.").


Or he wants to learn everything. Now. From the beginning. What is an email? What do you do with a smart phone? I am so glad he wants to start over each day, he wakes up not knowing where he is and it takes hours to remember. He won't accept that at 86 you can't learn things as easily or as much as when you were 30. He won't be realistic. It's like he doesn't know he's old, and that's the saddest part. He was successful in life because he wouldn't quit, wouldn't give up, and now it is his biggest frustration, because he has his sights set too high. If it isn't important, he doesn't want to do it. He won't do word games or puzzles, or art, because to him they have no value. At a senior day care center, he isn't interested in anyone or anything.


I'm getting ready to insist on paid help since he is so needy and I live 3000 miles away and his caregiver can't do enough to keep him happy, and the caregiver is under so much stress that he also can't be happy, but the argument is that he never likes any caregiver. To me, that is sad, but no reason not to get professional help. I am increasingly frustrated that he, the caregiver, is so unhappy, but won't pay for professional help. Dad should have enough money for it, but I certainly would be unwillingly to talk about finances with the caregiver since he is so stressed, I could get a lot of friction just for mentioning.... Do you think it is appropriate for someone who has financial control over his father's care to offer to share information on how he is spending the money? I do, but I could be biased.


Dad's in his dementia a good deal of the time, though usually it just exhibits itself as fixations, ascribing meanings to innocent things, but increasingly there is a standard delusion that he has that causes him to want to alter parts of the house and windows, and it seems like just when you have a way to figure out how to solve him imaginary problem, he changes it. If you find holes in his logic, he changes the story, 180 degrees sometimes. Almost like the only purpose is to show that he can control things.


I have a difference of tactic from his daily caregiver, and I don't get to exercise my thoughts, but I feel that if you let patients know their thoughts count, they are less inclined to be defensive and need to exert authority. His caregiver, perhaps because he's learned what works, tries to not give him an opening from the beginning. Caregiver wants his authority respected. I wonder if that isn't what fuels Dad's delusional attempts to control things.


This is all over the place, but really for now, when he asks an obvious question that will have an answer he won't like, what do I do? All other observations also welcome. Thanks so much.

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I enjoy exploring the way my Dad's mind works. I'm told by caregiver that when I do that I am "enabling his psychosis." For instance, exploring the heating pad thing. The rice heating pad is a great idea. I also thought today that a scarf would help. I would not think of these things if I did not talk to him about his feelings and thoughts. Even dementia sometimes hides a kernel of truth.
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I feel like I can be blamed for not helping as an excuse. Dad's money is being used to support the household, and I think that is appropriate. I also think he can be consulted, but his caregiver gets so tired of questions that he will not even discuss things with him. Although he says he does this when I'm not there. I like the idea of schedules. Say the first of every month we talk about how much money you have and then don't raise the issue again unless there is a question.

The biggest discrepancy that I have with the caregiver is this. I like the comments about Dad needing to feel in charge and important. Caregiver feels to give an inch is to give a mile and refuses to let him think that he can have any say at all. Insists that Dad has asked him to handle the expenses and that is what he does, period. No discussion of what those expenses might be other than vague, "electric, food, etc." Caregiver's wife sleeps in an outdoor area they have set up as her bedroom, caregiver sleeps in the house so Dad isn't alone. Dad feels he's a wedge in their marriage. Caregiver insists it's none of Dad's business where his wife sleeps and calls him nosey and instrusive. Dad feels alone most of the time because the house is so quiet and I think if the wife slept inside there would be some basic family noise that may be comforting. She eats in the house and uses the bathroom in the house. She watches tv, plays on her pc, talks on the phone, all outside the house and caregiver says "all she does is sleep outside". P.S. He has all the money because he is trying to save it to use as living money for our sister. He told me he and my mother made a deal before she died, that "the VA will take care of Dad". Well, he may get his wish soon, he's getting pretty dementia addled. I think it's cruel the way he cares carefully for his physical health but ignores his mental state. He doesn't even have photos for him to look at, expects him to turn on the pc and look through the huge photo database that is not sorted, just all the family photos in one big folder. sorry for the dump....
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I just want to caution you on judging your brother's situation from a distance. Sometimes caregivers just need a chance to vent, and you may be a convenient person to vent too. So, while he may sound at the end of his rope with you, it may be that he's still not quite ready to give up the day-to-day care of your father. I think it would be OK for you to suggest an Alzheimer's support group for your brother. I started going with my mother-in-law (her husband has Alz/LBD), and it has been wonderful for both of us. Just having other care givers to talk to can help you feel more sane. It can also help you to make the hard decisions -- like bringing in help, or putting a loved one in a care facility. Step softly with the money issue. As a previous poster mentioned, you don't know if dad has placed limitations on brother regarding talking about money. My husband is in charge of the finances for his parents, and has opted to be transparent with his brother. But that isn't the right step for everyone. You might say gently to your brother that you expect NO inheritance, so feel free to spend dad's money on his care in any way he sees fit. That may help him to feel better about using the money in that way. Good luck to you! Speaking as the part of the caregiving team, I really do feel for the family members at a distance -- it is so hard to know your parent is in need and not be there for them and also not to really have a say. But unfortunately, that's what distance does. I know we appreciate it so much when family comes in from out of town for a week or so to give us a break. Just being another person to talk to can be a boon to the Alzheimer's patient. Lots of love to you on this journey.
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As Sunnygirl said heating pads are dangerous for any ill or older person. Put that away and get about a pound packet of rice. Microwave it for about 20 seconds till it feels warm to the back of your hand. Wrap it in a towel and place on where Dad aches.
We are very familiar with posters on this site who complain that their siblings are full of good advice but never come to and a hand.
If you can't take your turn being that hands on person please don't try and run things from a safe 3000 miles away. If brother wants advice he will ask for it.
Does anyone have POA for Dad?
One thing you can do is consult an eldercare lawyer and find out just what you and brother can do to manage Dad's affairs. 3000 miles probably means a different State so be sure the advice is appropriate for where Dad is living.
Sounds as though Dad had a successful career and quite rightly wants to continue to direct his own life. Unfortunately dementia came calling and he does not even know where his abilities lie. Arguing with a dementia paint is a pure waste of breath and leads to frustration for both parties. If Dad wants to make changes in the house for example and it is something you and bro agree needs doing. Have dad draw up the plans, take the measurements etc then call in a professional to do the job the right way but tell Dad how helpful he has been "the guy could not have tackled the job without you Dad"
Above all bro needs regular breaks so one thing you can do is make that happen.
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Trying to make things make sense or to satisfy the person with dementia is sort of like herding cats. It's not that easy nor likely to happen. After jumping through hoops, making elaborate plans, explanations, etc., we realize it was all for naught. We may happen upon something that works one day, but not the next.

If you are seriously concerned that your brother isn't able to handle things full time caring for your dad who has dementia, then I might weigh the options and step in. I'd get a legal consult with an Elder Law attorney in his jurisdiction to see what the options are and if I had the evidence to proceed. Knowledge is power, IMO.

OH, ABOUT the hearing pad. I have read that one should NEVER use a heating pad on a person with dementia. Their brain can have a deficit in the part of the brain that feels sensation and they may not know they are burning. Even with a pad on low, it can get too warm. I'd research and talk to his doctor. A hot water bottle might be safer. (If they even make those anymore. lol)
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When he asks what temperature his doctor wants his heating pad set to you say "High for the first 5 minutes and then medium for up to an hour." That is, give him a believable answer that he can accept.

But you live 3000 miles away. It is your brother who has to deal with these daily issues. Depending on your relationship with this brother, perhaps you can gently suggest ways you would handle things. Respecting Dad's input is a great suggestion. BUT Bro is the one on the firing line, and having him feel your are criticizing his methods is harmful -- it is worse than no help at all. So tread gently.

As for spending Dad's money to bring in more help, yes, that is something you can support. You can make it clear that you want to see anything done that will help your brother do this exceedingly difficult job, and you are NOT interested in having money saved for an inheritance.

It is a little late to expect Dad's personality to change significantly now. As you say, he may have softened a bit and become mellower. But he still wants to be in charge. He still wants to use his time for only significant tasks. I have known people like that. When they can no longer play bridge they are not about to start playing something that takes lesser skills. If they can't drive a car, don't even suggest a personal mobility scooter. If they can't be in charge of the meal they aren't willing to chop the onions or set the table. This, to me, is sad. But it is who they are.

I am ever so grateful that my husband was willing to do what he could, without regard to what he used to do. Even though he used to bowl in the high 200s he was thrilled when he broke 100 on the senior league. He was glad to get out and golf with the league for handicapped golfers, in spite of doing very poorly compared to his previous scores. When he could no longer be in charge of the laundry he folded towel as his contribution.

But I don't know of anything you can do to encourage this attitude. I think it is part of the personality that you have to accept and work around.
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Muscle aches can often be fixed just by applying Epsom Salt lotion. The magnesium sulfate (Epsom salt) stops the muscle spasms. I put it on my legs and feet at bed time.
Caregiver wins by letting Dad think all the good ideas are his. Create the illusion that he is in charge by asking what he wants and praising the correct choice. For a wrong choice, ask "What if you..." and redirect him.
As far as the financials, it is up to Dad. I will say that my father did NOT want any information shared with anyone, even his wife. So I kept my mouth shut. He didn't even tell her he had a Will; she asked the day he died. So you and bro have to respect the confidentiality of everything.
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You are so right about letting the patient know their thoughts count. My Dad lives in Independent Living and I asked out of curiosity if he could make any changes to where he is living, what would he do. And I listed to what he said.

Small things like the thermostat in his apartment is too small to read, which I fully agree with, it's hard to tell a 3 from an 8 from a 5 due to the LED green lights.

I asked Dad out of the caregivers who frequently come by to help him, who is his favorite and why. It gave me an insight as to why he likes this one certain lady, their personalities just clicked. I know Dad appreciated me asking him these questions :)

If you go through an Agency, the Agency is use to having different caregivers go to a client's house as it takes times to find the right match.
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