My mom was diagnosed with VD about 10 years ago; she is now 90 and my dad is 92. Two years ago they moved from the senior community they loved to an independent living facility when my dad told me he could no longer deal with the responsibilities of the house and mom even with in- home help. My mom has been on Prozac most of her adult life and, as her doctor said, is quite the narcissist.
Mom's VD appears to be progressing and she is often depressed for which she blames my dad. He is too stubborn (and too cheap) to hire more help to take care of her and sometimes he loses his temper. Recently he blew up at her and she is now very depressed, brining up all of their marital problems for the past 67 years. When she calls me, she says that I "don't know" how "bad" dad was to her all these years because she was taught not to talk badly of her husband. She says I always take his side and that dad does not tell me the truth. I know she is irrational due to her dementia, but I really do not know what to say to her, so she ends up saying she is sorry she "bothered me."
Dad really does not have the capacity to take care of her when she gets this way, so he has taken to letting her sit on the couch all day and sleep. Dad tries to over protect her which she finds controlling, but the truth is that she really cannot do much for herself and often falls, ending up in the hospital, which makes him furious.
I spoke to her doctor about mom's complaint that Dad is "abusive" but he has been no help. The psychiatrist says he can increase her Prozac, but I am not sure this will really help.
Is it time to move her into assisted living separate from my dad? He is resistant to this because of the cost, even though he can well afford it. I feel caught in the middle of a cheap, stubborn dad and a crazy mom. I thought maybe a month in respite care might be a good idea, but I know it is not a long-term solution. Thoughts?????

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HI Judy,
I guess I don't understand why your folks moved from a senior (non-assisted) community to an independent living (non-assisted?) facility. Do they get more care in the IL facility than they did in the senior community? (e.g. help with housework, transportation etc.)

In my humble opinion, a 92 year old is too old to have the responsibility of caring for a dementia sufferer (your mom), especially if they don't have a great marriage. My grandparents didn't have a loving marriage. My grandmother, at 85, couldn't care for my grandfather, 92, with Alzheimer's. He wound up having to go to a memory facility. IMO, her adult children (my aunts, uncles and mother), who handled the transfer, took far too long to get him placed and made grandma suffer (she wasn't a well woman) caring for him when he should have been admitted at least months before he was.

Maybe you could talk to his doctor who could reinforce that he should not be overwhelmed with such care taking tasks.

Why not do a 1 month trial/respite in a memory care facility for your mom. Dad may actually like the free time.
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Thanks for more information. You have your hands full. I'm glad you are sure your dad isn't verbally abusing your mother and that your dad is healthy. If she would benefit from therapy, so would he by default.
The rehab needs to be ongoing. She probably doesn't do any of the things she is supposed to do on an ongoing basis. Few do. Even those without VD and severe depression and other mental issues. That's why the in home therapy is so good, it gives her a boost for a few weeks and can help to break the cycle she is in right now. She gets to interact with someone else besides your dad. She will feel better for moving around and getting off the couch. Exercise is one of the best things for depression. That and a good diet. A change of view. An occasion to laugh. The therapist are usually great with older women. But do get your dad on board with it before you try it so he doesn't discount it with reminding her that she has already done that and it didn't work. For that 20 to 30 min twice a week she would be up and moving and the benefits are cumulative.
Look into her diet and of course, as always, the UTI factor.
Your dad probably doesn't let you see how hard it is for him if he is like most parents. He is 92 after all. I'm glad you are going to the appointment. Maybe you can spend a couple of days and nights and see what's really going on. Most can't maintain a facade more than a few hours.
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One more thing... I do think mom needs a support group or therapy, but getting her there would be a burden to my dad, since he has given up driving and she cannot go alone. He really does not want to go and I am too far away to take her. She has had extensive psychiatric therapy, but it cannot change narcissism, which is a personality disorder, or dementia. Mom thinks everything is dad's fault - she has never taken responsibility for her choices in the past and now she does not have the cognitive ability to even understand the concept. While she knows how to blame and complain, she can't or won't accept her part of the problem; her "poor me" attitude predates her dementia. I would not wish this on anyone...
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To clarify, Dad is NOT abusive... he is over protective to keep her from hurting herself and mom does not like it. She falls because she refuses to use her walker. She has had tons of PT/Rehab and has been taught how to move, retrieve things, etc., but she does not follow what she has been taught. Over the years she has complained about being abused by her father - something none of her 7 siblings could corroborate. She has accused people of stealing things that we also know never happened. She has told us a number of times that she pitches a fit just to get her own way. And I have seen it first hand many times. While dad sometimes loses his patience with her, he is generally kind and caring and sees to it that she has everything she needs...and even things she does not need, like $38 lipstick!
My dad is in possession of all of his faculties - still handles all his investments, etc. and does a great job. He wants to leave a financial legacy to his children (which is why he won't spend money needlessly) even though we have all told him we want him to spend the money on taking caring of them.
He says it is his "job" to take care of mom... he takes very little time to himself and won't unless I can stay with her. Unfortunately, I live two hours away. We have been trying to move them closer, but they are on wait lists. If HE was not so picky about the size, dimensions and amenities of the place, we could have had them close months ago. He has to own that part of the problem.
There are days he thinks about putting her in a MC facility, but she does not wander and does not need a lock-down facility. He may also be so tight with money because he knows that at some point she will need more expensive care... It is a vicious cycle that we cannot break.
To the person who said my mom may not want to be in a separate facility, I know that, but this week she said that is what she wants. I know if we do it, she will be crying for him to come get her and that wanting to call the "bluff" of an irrational person is itself irrational on my part, but I do think that a time out from each other might be helpful. I have put that idea out to dad...all I can do is try... There is a doctor appointment scheduled for the end of the month... I will be there!
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Are POAs and advance directives in place, handled by a younger person than the spouses? That is step 1.

Step 2 is to realize it was a big deal to get Dad to move to any type facility. That's seen by them as giving in/up. It will be hard for him to give up control of mom, for whatever reason.

But I agree that mom should go to a higher level of care. If she needs memory care, install her! You might be able to talk to the administrator of the current facility and have them assist you with moving her. Perhaps the current facility could have a meeting with the family to say that with the number of trips to the hospital, she has graduated from their level of care and needs to find an alternative. That's where you come in and take over mama's care.
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First of all, do you have the authority to do anything? Next would mom want to go to a separate facility from your dad? Many times, even though one spouse will complain about the other, they really don't want to be separated. They become mutually codependent.

Having said that, it doesn't sound like your mom is being taken care of if she is falling often and winding up in the hospital. Can you look into getting her some physical therapy? Medicare will pay for it. The therapist will come to her home and work with her. This is good for her mentally and physically. Is mom just seeing a psychiatrist for meds? Perhaps she needs a support group or a talk therapist? This would allow her to vent and you not have to be in the middle of it.

What are dads health issues? Perhaps he needs a little Prozac himself to stop the abuse. How often does he get away from his care taking duties?

One of my regrets in life is not doing more to protect my MIL from the abuse she suffered from my FIL. Her children had become numb to the verbal abuse their mother suffered. I listened in horror as I heard my SIL husband read a note that fell out of MIL bible after she died. It was about her abuse. The SIL and her husband laughed heartily at what MIL wrote. Even if what she said wasn't true (I think it was) it was clear that MIL believed it and was in pain when she wrote the note.

Perhaps the area on aging could come and do a needs analysis and help you decide if you could do better for your mom.
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Oh, Judy! What a sad and complicated tale!

Does the psychiatrist see both of your parents? In general, I have found geriatric psychiatrists to be the last MDs standing who see the whole patient and the whole situation. Increasing mom's prozac could be a good thing, as her brain becomes "more broken".

There a comes a point, I think (and I will freely admit that I have not had this experience; dad died 20 years ago) where your parents have very different needs. You need to advocate for both, perhaps in different facilities.

My aunt hid the fact that my uncle was beating her up to get the house keys so that he could wander along the highway. My cousins got him into a good facility and he lived for quite a bit after my aunt passed away from cardiac issues, almost certainly made worse by the stress of full time care giving. Hugs to you in this dilemma.
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