My mom and dad live on their own in their condo. They have a housecleaner come every other week, they installed stairlifts, they order weekly remade meals. Dad drives locally. They are trying out some in home help. However, they are struggling. My mother is difficult. She is showing signs of dementia in the form of her behaviors and attitude. She rules the roost. She is trying to be in control of everything, she feel she needs to manage my dad who is sharp as a tack but forgetful and slow moving. She gets confused, has difficulty understanding , is angry and agitated. She recently had a hospital stay for Afib. Oh and UTI recently but her behaviors have been going on for quite some time. Meanwhile, dad is doing his best to be a good and dutiful husband (his words). He does the best he can to not stir the pot and keep her happy. You can’t reason with her, she doesn’t take advice, she can’t tell you what her needs are (mind you it’s her And dad). She worries and tries to control everything. She even feels that she has to help the helper get dinner on table because she has to tell her how to do it. My sister and I both live hour to 2 hours away. We have met as a family to make some plans but mom will only rehash and has every reason why ideas won’t work. She works off of assumptions, fear and hearsay. My sister and I have made phone calls to collect facts on elder care. We’ve made some progress but she rules the roost! Dad has gout and pseudo gout- poor guy shuffling along trying to do the best he can. Our hearts break to watch them struggle but mom is in control. Ironically, they’ve got all their financial and medical ducks in a row. Until they are done calling the shots I guess we just have to be patient. I will have POA when it gets called. Thank you for listening. If you have been in similar situation I’d love to hear how it went for you. Oh and they are 94 and dad says they only have months left- not sure how he came up with that but that may be a big part of just going with the flow because end is near??? All perplexing

It may be good to have a honest chat with each of your folks - separately.

The big stuff. If the other was in hospital/got too unwell for home/not here - what would be acceptable for you? Stay in your home & manage in-home care to support you? Move to somewhere with assistance? Stay in your state? Or be closer to family?

If you have a good idea of their values, when a crises hits you can hopefully support them to pick their path through it.

Sounds like Mom is like many many others that struggle with adjusting to change to her independence level.
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Reply to Beatty

Assuming that EACH OF THEM has granted you their POA, it MAY be helpful to attempt to have BOTH of them assessed for cognitive functioning by a professional trained in geriatric psychiatry or psychology, with hopes that on or both of them are no longer capable of managing without your support.

If as sometimes happens they have made each other POA unless BOTH are found incapable of managing their affairs, you still need to have some idea of how each is functioning cognitively and emotionally.

Candidly, if your father is “sharp as a tack but forgetful”, he may be expending a lot of energy to keep up appearances. “Sharp as a tack” and “forgetful” don’t typically operate in tandem.

I care for a LO who had been diagnosed with “depression” before she entered a good local AL, and when she began to function more irrationally there, a diagnosis by an excellent professional trained in geriatric psychiatry revealed that her “normal appearance and behavior” was being preserved by her at the cost of an enormous amount of anxiety.

Once she was properly diagnosed and began receiving a small dose of medication, she began enjoying her life once more.

If they are cared for by the same medical personnel, make notes of some BEHAVIORS you see that indicate to you that they may be in need of help, and send your notes to the doctor before they go.

Your situation is not unique, but it is more difficult because of the distance. You may find that it will take an “emergency” to begin making changes, but that is certainly one of the tragedies with geriatric care.
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Reply to AnnReid

You are asking how to help but what outcome are you looking for? To fix your mom's challenging behaviors so that your dad has more peace? Your mom's medical PoA maybe should consider getting her in for a discretely requested cognitive and memory test just so it's in her records and everyone understands the level she is operating at, even if the PoA is durable and doesn't require a "proof" of incapacity. Then perhaps medication to reduce her agitation can be considered (and this may take a while to adjust to her body). Also request a retest for UTI as sometimes the antibiotics don't treat it completely the first time, or she got another infection, which is extremely common in elderly women (my MIL included, like literally every other month). It doesn't have to do with hygiene necessarily but physiological changes in an aging body.

I also recommend that your family, including your Dad and all hired in-home aids, watch some Teepa Snow videos on YouTube. She's a well-known expert on how to engage with dementia patients and behaviors so that interacting and living with our LOwD can be as calm as possible. If your mom does have dementia, her brain is breaking and she can't help it. She can no longer change, so you mus. Here are some I have found helpful:

Phrases to Learn for Caregivers (Teepa Snow, dementia expert)

Dementia Communication Strategies with Joan Lunden & Teepa Snow

Understanding Symptoms and Behaviors of Dementia - Teepa Snow Webinar

How Dementia Affects Language Skills (Teepa Snow)

Common Issues With Dementia (Teepa Snow)

4 Common Dementia Caregiver Mistakes (start 3 minutes into the video)

And also:

Rules for Engaging with Dementia

1) Agree, do not argue
2) Divert, do not attempt to reason
3) Distract, do not shame
4) Reassure, do not lecture
5) Reminisce, do not ask “Do you remember…?”
6) Repeat, do not say “I told you”
7) Do what they can do, don’t say “you can’t”
8) Ask, do not demand
9) Encourage, do not condescend
10) Reinforce, never force

Wishing you and your family success in creating a more calm environment!
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Reply to Geaton777

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