Elder Care & Elder Rage: If I Only Knew Then-What I Know Now
by Jacqueline Marcell
For eleven years I begged my obstinate elderly father to allow a caregiver to help him with my ailing mother, but after 55 years of loving her, he adamantly insisted on taking care of her himself. Every caregiver I hired to help him sighed in exasperation, "Jacqueline, I just can't work with your father--his temper is impossible to handle. I don't think you'll be able to get him to accept help until he's on his knees himself."
My father had always been 90 percent wonderful, but boy-oh-boy, that raging temper was a doozy. He’d never turned his temper on me before, but then again, I'd never gone against his wishes either. When my mother nearly died from his inability to care for her, I had to step in and risk his wrath to save her life--having no idea that in the process it would nearly cost me my own.
JEKYLL & HYDE
I spent three months nursing my mother back to relative "health", while my father, who was telling me he loved me one minute, would get mad about some trivial thing, call me nasty names and throw me out of the house the next. I was stunned to see him get so upset over the most ridiculous things, even running the washing machine could cause a tizzy, and there was no way to reason with him. It was so heart wrenching to have my once-adoring father turn against me.
I immediately took him to his doctor and was astonished that he could act completely normal when he needed to. I couldn't believe it when the doctor looked at me like I was the crazy one. She didn’t even take me seriously when I reported that my father nearly electrocuted my mother and that he nearly burned the house down. Much later I found out that he’d instructed her not to listen to anything I said, because all I wanted was his money. (Boy do I wish he had some.)
Then things got serious. My father had never laid a hand on me my whole life, but one day he nearly choked me to death with his bare hands for adding HBO to his cable package, even though he had eagerly consented to it just a few days before. Terrified and devastated, I frantically called the police who took him to a psychiatric hospital for evaluation. I was so stunned when they quickly released him, saying they couldn't find anything wrong with him. Similar horrifying incidents occurred four times.
I couldn't leave my father alone with my mother, because she'd surely die from his inability to care for her. I couldn't get the doctors to believe me, because he was always so darling and competent in front of them. I couldn't get medication to calm him, and even when I did, he refused to take it and flushed it down the toilet. I couldn't get him to accept a caregiver, and even when I did, no one would put up with him for very long. I couldn't place my mother in a nursing home--he'd just take her out. I couldn't put him in a home--he didn't qualify. They both refused any mention of assisted living, and legally I couldn't force them. I became trapped at my parents' home for nearly a year trying to solve the endless crisis, crying rivers daily--and infuriated with an unsympathetic medical system that wasn't helping me appropriately.
You don't need to have a doctorate to know something is wrong, but you do need a doctor who can diagnose and treat it properly. Finally, I stumbled upon a compassionate geriatric dementia specialist who performed a battery of blood, neurological and memory tests, along with P.E.T. scans. First he ruled out the numerous reversible dementias, and then, you should have seen my face drop when he diagnosed Stage One Alzheimer's in BOTH of my parents--something that all of their other doctors missed entirely.
TRAPPED IN OLD HABITS
What I'd been coping with was the beginning of dementia, which is intermittent and appears to come and go. I didn't understand that my father was addicted and trapped in his own bad behavior of a lifetime, and that his old habit of yelling to get his way was coming out over things that were now illogical and irrational... at times. I also didn't understand that demented does not mean stupid, at all, and that he was still socially adjusted to never show his "Hyde" side to anyone outside the family. Even with the beginning of dementia, it was amazing that he could still be extremely manipulative and crafty. On the other hand, my mother was even sweeter and lovelier than she’d always been.
BALANCING BRAIN CHEMISTRY
Alzheimer's is just one type of dementia and there's no stopping the progression nor is there yet a cure. However, if identified early, there are medications that can slow the progression and keep a person in the early stage longer, delaying full-time care. (Ask a dementia specialist about the FDA approved medications: Aricept, Exelon and Reminyl. Also, medication for later stage--Memantine.)
After slowing the dementia, the doctor prescribed a small dose of anti-aggression medication, which smoothed out my father’s volatile temper without drugging him out. My parents also received anti-depressants, which made a huge difference in their moods. Once their brain chemistries were properly balanced, I was able to optimize their nutrition and fluid consumption with less resistance. I was also better able to implement behavioral techniques. Instead of logic and reason--I used distraction, redirection and reminiscence. Instead of arguing--I validated their feelings.
Finally, I was able to get my father to accept a caregiver (he’d alienated 40), and with the use of Adult Day Health Care five days a week for them, and a weekly support group for me, everything started to fall into place. It was so wonderful to once again hear my father say, “We love you so much, sweetheart.” Then, after several more years of loving each other—my parents passed, just a few months apart, still living in their own home. Even though being responsible for every aspect of their last years was the hardest thing I have ever done--I am proud to say I gave them the best end-of-life I possibly could.
AHHH HINDSIGHT--IT'S ALWAYS 20/20
What is so shocking is that none of the many professionals who treated my parents that first year ever discussed the possibility of Alzheimer’s Disease with me. One out of every ten persons by the age of 65, and nearly one out of every two by age 85, gets A.D. Had I simply been shown the "10 Warning Signs of Alzheimer's" I would have realized a year earlier what was happening and gotten my parents the help they so desperately needed. If this rings true for you about someone you love, I urge you to reach out for help from a dementia specialist sooner than later.
TEN WARNING SIGNS OF ALZHEIMER'S
1. Recent memory loss that affects job skills
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation of time and place
5. Poor or decreased judgment
6. Problems with abstract thinking
7. Misplacing things
8. Changes in mood or behavior
9. Changes in personality
10. Loss of initiative
Jacqueline Marcell is a national speaker on eldercare and the author of, "Elder Rage", a Book-of-the-Month Club selection being considered for a feature film. Over fifty endorsements include: Hugh Downs, Regis Philbin and Dr. Dean Edell. Jacqueline also hosts a radio program heard worldwide on: http://www.wsradio.com/copingwithcaregiving . For more information: http://www.ElderRage.com
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