Caregivers’ Corner: Dealing with Dementia

Joan Jackson
By Joan Jackson June 15, 2011 13:14

By Joan Jackson

When a loved one slides into dementia, the progression is not straight line. What they were able to do last month, last week, or even yesterday may suddenly no longer be possible.

We often hear caregivers describe the frustration of trying to get a parent or spouse with dementia to follow through with what seems like a simple task. “Mom was fine last month and now she yells at me if I ask her to take her shower,” explains an exhausted and frustrated daughter.

Mom responds with escalating anger because it’s all so confusing. A task that includes undressing, turning the water on, adjusting it, stepping into the spray, soaping down, rinsing, turning the water off, stepping out, toweling off and dressing, is just too complex and perhaps scary for her now.

Mom is not being deliberately ornery. The daughter is seeing illness-caused behavior; her mother now needs hands-on help to get that shower.

One wife notes with a tired sigh that her husband with Parkinson’s has turned into a terrible grump. “The doctor says his mind is great,” says the wife, “but he never smiles anymore. I keep telling him to cheer up.”

People with Parkinson’s can lose the ability to control facial muscles but still actually feel as if they are responding. He may not know he’s not smiling. Depression is also high among those who suffer with Parkinson’s.

The wife is seeing illness behavior, not deliberate unkindness.

A husband with advancing Alzheimer’s suddenly becomes obsessed with sex. To his wife’s chagrin, her formerly gentle and considerate spouse demands Viagra from their doctor, and makes flagrantly inappropriate public comments to her and to female relatives and friends.

No, she hasn’t been living with a closet Lothario for the past 50 years. The disease tears away inhibitions and socialization. This is the illness speaking, not her husband.

To further confuse caregivers and families, as dementia or other illness steadily robs dad of his ability to reason, mom of her even temperament, and your spouse of her logic and understanding, the days and months of deterioration may suddenly be punctuated by a window of stunning clarity.

For an abrupt moment a mother is able to recognize the daughter she has not known for many months. Dad stuns the whole family with a lucid, cogent comment that dances with all the old energy and aliveness of his personality. Your spouse, who has been staring uncomprehendingly at a television program, turns to you with clear, alert eyes and says, “You’re the best. I love you.”

In many ways, these flashes of clarity can be a cruelty for the family, fueling a silent undying wish that mom, dad, wife, husband or loving partner might magically be “back” one day.

Wisdom comes when we recognize that the progression of illness is not straight line. We accept these brief moments of clarity as small, precious gifts and move on.

Joan Jackson is a partner with Peter Carrillo in Practical Dreamer (588-1835), providing caregiver and family coaching and other services, including free caregiver support groups sponsored by the Area 12 Agency on Aging.

© 2011 Friends and Neighbors

Joan Jackson
By Joan Jackson June 15, 2011 13:14