My elderly relative has not been diagnosed with dementia but clearly has it. Sundowning is very prominent. We have good days & bad days, as far as cognitive function. There is a subtle downward trajectory for sure, but we still have many lucid times & meaningful conversations. My question is how do you differentiate between a person's actual challenges, and learned helplessness? Examples:
* rarely initiates eating and does zero food prep (will not make a sandwich, or toast, doesn't serve a portion from a larger dish of something, rarely will heat up a plate left in the fridge) but eats when it is served.
* doesn't put clean laundry away...just takes from the pile which inevitably ends up strewn around/tipped over.
* doesn't carry dishes to the kitchen or put things in the dishwasher
* doesn't cover food appropriately
* misplaces mail or doesn't open at all
* stops and starts tasks without finishing them, often
I'm curious if it sounds like this person has become overly dependent on their caregiver, or if they are suffering from age-related decline and just need additional support.
I ask this because my mother (84) when it starts getting dark often starts working herself up into a panic attack. Rocking back and forth with her hands over her face like she's crying.
I completely ignore her of course because this has been going on since she was 40 years old.
It's a performance with her. Often elderly people give performances the same as a child when they're not getting the amount of attention they want.
Learned helplessness is a real thing. Her caregiver has to make her do chores that she is able to do. Like folding her own laundry and putting it away. The caregiver may have to assist, but make her do it.
As for not carrying dishes to the kitchen. There's no reason why she should be taking her meals anywhere besides the kitchen or a dining room if there is one. Instruct the caregiver to prepare her meal then call her into the kitchen to eat at the table. Never allow meals to be taken all over the house because it will become a habit.
Please instruct the caregiver on assisting your elderly relative with ADL's like reading the mail. Or putting the laundry away. Or properly wrapping up food to store it.
If your relative lives alone and the overly dependent behavior continues or gets worse, then they can't live alone anymore. They will need a live-in caregiver or placement in an assisted living facility.
Without participation on those who are well, the person in decline will likely continue in this trajectory even to the point of all hygiene, the ability to dress oneself and etc. It requires the same sort of constant guidance much in the way that a toddler does to keep the person motivated, and with some dementias there is no motivation, and in fact pushback. Certainly executive functions such as mail and bills fall away very very quickly in many cases. It is time now for an evaluation that is complete and involves the neuro-psychiatric branch as well as some guidance for caregivers in maintaining as much self caring as possible.
I think sundowning is a good indicator that changes have taken place though.
You ask about learned helplessness; did this exist before your relative segued into these behaviors?
You stated that this relative clearly has dementia but hasn't been diagnosed. Is there some reason why this person hasn't seen a doctor for specific determination of dementia?