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My MIL was recently diagnosed with dementia. She currently has no physical issues, just cognitive symptoms including difficulties with memory, word finding, and attention to task. She takes blood pressure medication. She loved to cook her entire life and now is having trouble with recalling the steps, keeping attention to remember what ingredients she put in, etc. My FIL cares for her in their home. He is a kind man and just wants to help his wife. Problem is that MIL is in complete denial of any symptoms. She was assessed by a memory center and they told her she had dementia and explained but it didn't penetrate with her. She often says there is nothing wrong with her and that the problems comes from my FIL. Since she can't recall to take her pills correctly my FIL gives them to her at breakfast each day. But some days she says she doesn't need them and refuses to take them. She doesn't want to go to doctors but my FIL has had some success getting her to a new geriatrician. The doc will enforce that she take medicine and she may agree but again her compliance on a day to day basis is variable. My FIL tries to help with cooking: they will discuss a dinner item, agree on something, get out all the ingredients, and mom will then forget and/or deny they discussed it and want to make something else. Because cooking was never my FIL's role, my MIL will often refuse his help (which she needs to stay on task, and then can be successful) and say she could do it better if he just left her alone. My FIL has begun to attend a monthly support group and that helps a little. I am wondering if anyone has dealt with this in caring for someone at home and how to get them to comply? We're afraid if they get a caregiver to come in that will essentially be a stranger to mom and she won't accept help from them either. She really doesn't accept help from anyone. Any ideas are greatly appreciated.

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The advice you REALLY need is how to help your FIL on this long and often cruel journey. I hope you can support his efforts as you would reinforce success in a child teaching it to walk. His world has fallen apart. And there's no "cure." His world will keep getting worse until he is finally overwhelmed and long-since heartbroken.

It isn't necessary that MIL acknowledge her disease. It's a waste of time and a guarantee of frustration to try.

YOU make a list of her meds, take them to your pharmacy, tell them your FILs problem. Ask which ones can be crushed and/or made in liquid form. Carry that helpful info back to FIL so he has an alternative other than arguing with her about her meds.

When you make meatloaf, make two. Spaghetti sauce or stew? Twice as much. Bring them meals whenever you can. Enlist other family members to do the same. When you take them over, if FIL wants them in the freezer, mark the containers with the contents and how to reheat.

Encourage your husband to take his dad out for lunch once a month while you go over to keep MIL company. If there is other family, try to become the organizer for others to do the same.

Encourage your FIL to spend money...on house cleaning, home care for his wife, etc.

Look for ways you can support FILs efforts. Give him an outlet to unburden his frustrations without being judgmental. Encourage him to talk to the doctor about her medications -- those that will help her with anxiety, help her sleep, etc. Many but not all, of Alzheimer's behaviors can be modified with meds. Encourage him to reach out.

There are so many other ways you can support your FIL that I'd be a bandwidth hog to keep going. Bring his concerns here. We are a fountain of helpful suggestions for specifics.

Just one last thing. There may well come a time when FILs health or spirit may preclude his taking care of his wife. To that end, some life planning is VERY important. Do some investigating and refer him to an the elder law attorney. VERY IMPORTANT. Knowledge is power.
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It serves no purpose to argue with her or try to get her to understand that she has dementia. This is a basic symptom of the disease, she can no longer reason. Use this site to learn how to deal with dementia.
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One more thing, Rosie. See if your library has Roz Chast's book "Can't We Talk About Something More Pleasant?" I think it's one of the best books a caregiver can read.
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So sorry to hear of your MIL's diagnosis and that things have been challenging. The good news is that her physical health is still good, which is a positive. Has she been seen by a neurologist that specializes in dementia care? Sometimes working with a specialist who is sensitive to the issues involved and has the expertise to give an accurate diagnosis and treatment plan can help the person come around more to accepting help.

It's fantastic that your FIL is seeking support. He may also try reaching out to the local Alzheimer's Association chapter. Many have early-stage programs designed specially to help caregivers work around denial and help the person come to terms with the diagnosis and work on living with the disease.
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There are great points listed in the posts above. Especially about getting Durable Power of Attorney and Healthcare POA. Family members need the authority to act on her behalf, since she will not have the mental ability to do it down the road. It's important to that before she is deemed incompetent, since then you would need to go through a court proceeding.

I would agree that trying to explain her condition to her, convince her to agree on meals, menus, household matters, is not productive. Her brain is not working right and there is no way to sufficiently make it work for her. You have to agree with her, do what needs to be done, even if behind her back and protect her as best you can. If your dad needs help caring for her and running the household, then it has to be arranged. Even if she opposes, it has to be done. The family will have to override her protests, since she is not able to comprehend her situation and the need for care. She will not be able to decline help at a certain point. It's like the protection and care you provide to a toddler. We can't let them decide how they are cared for. Eventually, she will adjust and/or not remember that she was opposed to help.

IMO, a top priority would be to monitor your father. He is with her around the clock. He will get the full force of the stress that comes with dementia. The partner or caregiver undergoes enormous stress, because they have to deal with the manifestations of dementia and somehow deal with it, such as, repeating, constantly asking questions, disagreements, false accusations, pacing, false memories, misplacing items, bizarre and inappropriate behavior or comments. It's very stressful to deal with this over time. I would keep an eye on it and discuss future plans for her care.

I would read as much as possible what to expect with dementia. It will progress and eventually, there is incontinence, inability to walk, chew, etc. Making plans for in home care or placement would be prudent. It might be difficult for your dad to do this alone. It is great that he is in a support group. That would make me feel much better.
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Men as caregivers often deteriorate much faster than their wives because of the amount of stress they are under. Re-read Maggie's post and get your FIL lots of help and respite care.

Although my MIL isn't demented, she refused to accept her illness and limitations and didn't do what was asked of her like use a cane back when she still could walk. Many of us on this forum have gone through it. Learn to say "do this now" "because I asked you to" and "we are doing this right now" because your MIL will never comprehend an explanation. This is going to break your FIL's heart to watch but it's necessary for every one who interacts with MIL to learn.

Acceptance was a big challenge in our family. We had family members who thought they knew better, didn't follow instructions and landed my MIL in the ER.

Learn to trust your gut. Someone has to take charge and, in my opinion and from my experience, it should not be FIL, who is going through his own crises. Have a family meeting and decide upon who gets POA and who the backup POA will be. Whoever takes charge needs to have good judgment and keep the family informed. And the family needs to respect POA's authority because it comes with a huge amount of responsibility. I wish you lots of luck!
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Ditto on the Roz Chast book. She's an amazingly funny cartoonist and totally captures what we go through with stubborn elders.
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Thanks everyone I really appreciate the advice. I will definitely check out that book and pass it on to my FIL. Sorry I didn't provide more background, I came to this forum b/c my mom has dementia and I have always gotten great advice here that's helped me understand the disease. FIL has 5 children and they are all supportive. We have had family meetings, we have a calendar of supportive activities planned for them, we are working on meals. And rest assured no one is throwing that diagnosis in her face, I just wanted you to know she'd heard it before. Power of attorney, all that stuff has been thought out and in place. I can imagine how difficult this has to be for a spouse b/c as a daughter it broke my heart everyday I helped care for my mom at home. I was lucky in that my mom, even though she doesn't know she has dementia, always knew on some level she needed help, and followed my directions. I was used to making lots of modifications for her. But this stage of dementia with my MIL I find difficult...my mom is further along, and so there is more acceptance of things like white lies, which I had to learn to tell (you can't walk to your room right now b/c it's being cleaned, rather than confronting her about the fact that she can't walk). What baffles me is what my FIL should do if he says "We're having this for dinner" and she argues they never discussed it? How do you agree with her yet tell her "this is what we're doing" when she won't accept that and has other ideas? I truly am not trying to be "smart" in asking that question, I truly am baffled. I've watched Teepa Snow videos and she's got great strategies, but I really am confused on this one. We all are. I appreciate all the help, this is a wonderful community.
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Would your MIL accept being told that dinner is a surprise? If your FIL started acting like Julia Child in the kitchen, making every dinner a special surprise, would she argue with that or would she feel pampered? How about while he's cooking she's asked to watch a TV program so she can tell him what's going on? Or while he's cooking a family member calls her on the phone and has a conversation that's just long enough for FIL to finish making dinner? Get her friends involved too - have them call while FIL is making dinner - and ask her friends to tell her how lucky she is that her husband is making all these special meals especially for her. Use the power of persuasion. I wish you and your FIL lots of luck!
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Thanks for the tip and for the heads up on the book, NYDIL!
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