Greetings all -
My mom has early stage Alzheimer's and is doing well, all things considered. She is still competent, knows most people in context, knows she has memory issues, feisty over the word Alzheimer's and sensitive on some days to directions and help - the usual. She is going downhill pretty fast though, after an excellent period of stability during a drug trial she was in.
Yes, she does have Alzheimer's behaviors - repeats herself, confabulates, and after about 10 minutes cannot carry on a conversation.
I understand for some people this is a drag or makes them uncomfortable. I and my siblings don't push expectations on others to visit with her - but when visitation comes up, the comments are grating. Things like "seeing my sister like that is so sad" or "I don't have the patience for her and I wouldn't want to hurt her feelings" or "we'd invite her to lunch but it is too much, you understand right?" It goes on - like theses folks are asking my permission to not see her. It is tiring - and I need all of my energy to care for mom, not them. In a few more months she may not know anyone.
What brought this to a head is that my aunts and mom for decades have gone on a sisters' weekend trip. This year they told me about if after it was planned (OK), that the place they rented was small so no room for mom (really?), that she wouldn't like the activities planned (not accurate), that she is hard to be around (Yes, her behaviours are annoying) etc. Yet they know mom would be sad at being excluded (though she'd forget about it after a couple of days). I'd prefer they just tell me they are excluding her because it's too much for them and wouldn't be fun. It's true, it would not be fun for them. No hard feelings, really. Some days I don't want to be around her either.
Can anyone offer a short, polite response I can rehearse for these situations?
In that case I think I would acknowledge what they're saying is true, but follow up with a clarifying statement.
I have a similar situation with my sister who has early Alzheimer's and is now end stage. Some close friends and relatives have done this exact thing. I don't need enemies after this, but I'm also not the person to forgive them.
I have said something like, " I realize that it's really difficult but we only have a small window left with her being able to even communicate THIS well, So, while I don't expect you to take her away for a weekend or anything like that, it would be really nice If you could spend some shorter times and come see her. I don't want you to regret it later on when she's not able to communicate or recognize us anymore or when she's gone. But that's totally up to you and what you're comfortable with. But I have to tell you, it's really uncomfortable for me when you say things like 'you understand right?' I do understand, but it's really hard for me too, and asking me THAT makes it harder."
Maybe you could condense it somehow if you think that's helpful. It's pretty longwinded! Sometimes when I'm trying to be tactful I get a little too wordy!
Move on from them and focus on Mom. Keep her happy, motivated, and laughing. Take her on outings and into the sunshine. Do things she loves doing. Love and enjoy her. She'll say some pretty funny things. Just enjoy her. My mom said things that had me giggling for days. I still laugh about them.
Blessings to you on this journey.
I understand it is hard, but no, I don't understand why you are choosing to exclude her when her time that she can spend with you is coming to an end. It is your choice, but please understand it is not my responsibility to make you feel better about those choices. I am choosing to spend as much time with Mum as I can and even though it is very hard for me, I won't make excuses . She deserves our love and support. Please stop asking for my approval,
Maybe long winded and not as polite but that is what I would say.
While the word excluding may be accurate, to describe not inviting someone out - I've found it just does get too hard to always include someone with special needs. That's the honest truth. I've been asked to take out LOs that lack ability to get into my car, lack continence, & cannot walk! Also cannot manage well or are uncomfortable in certain environments, eg a noisy cafe or cannot abide being outside due to heat, cold, wind intolerance. Avoiding triggers for panic, avoiding embarressing toileting accidents, avoiding physical injury to myself - that all takes it's toll.
I have zero regrets for excluding. Because what I was sometimes asked to do was completely unreasonable.
BUT! Activities & outings can be changed. Arranging a smaller group, different location (stay in rather than go out).
To set an event up for SUCCESS has been my aim. To make compromises where possible that do not cause harm to anyone.
Things just get separated out. The able can still go on trips & lunch out.
This does not prevent them visiting those who could not go at other times.
I found myself unable to keep up with her needs and my own life at one point and that is when we hired caregivers. They do a better job at doing things for and with her than I did no matter how hard I tried. At times I do feel inadequate but I remind myself that we each have our skills and weaknesses. They can handle her day to day needs and doing things with her better than I can and I can handle visiting her, managing her schedule, listening to her complaints and fears and such better than my brother. My brother can’t handle as much of the personal interactions as I can so he manages what he is best at. I would rather not have people trying to take on more than they feel comfortable with. Some of my mother’s friends call her once in a while but often I have updated them on how she’s doing beforehand, just as I do when her friends visit. They can choose to go through with it or not. I don’t mention the possibility to her until they feel comfortable with making plans.
As for things that my mother doesn’t want to do but has to, or things she wants to do but can’t, one of her caregivers, who is really good at that, and I work as a team. Just as you can’t expect everyone to be able to handle seeing her “that way” you also can’t let her do whatever she wants. She is basically the child and you are the parent now. I doubt she let you choose where the family lived or other important decisions when you were a kid and you can’t let her dictate your families lives now. None of us can always get what we want! That is life. It may be hard for seniors with cognitive issues to understand just as it is for young children to understand. I don’t know about you but when I was a kid I complained about things but it didn’t mean that I then got my way! My mother doesn’t like things enforced but we have to stand firm. It will be interesting when she needs 24/7 care and that time is approaching. We will give her a choice between more in home caregivers (if that is still reasonable) or moving to a facility. That’s it, one or the other, no choosing door #3! If she got to dictate the options then it would result in serious health issues and accidents.
Good luck, it is hard to see a loved one decline. Not everyone can handle everything and it is probably best that those most uncomfortable and who get most upset not be put in those positions. (I apologize for all the rambling!)
I found myself unable to keep up with her needs and my own life at one point and that is when we hired caregivers. They do a better job at doing things for and with her than I did no matter how hard I tried. At times I do feel inadequate but I remind myself that we each have our skills and weaknesses. They can handle her day to day needs and doing things with her better than I can and I can handle visiting her, managing her schedule, listening to her complaints and fears and such better than my brother. My brother can’t handle as much of the personal interactions as I can so he manages what he is best at. I would rather not have people trying to take on more than they feel comfortable with. Some of my mother’s friends call her once in a while but often I have updated them on how she’s doing beforehand, just as I do when her friends visit. They can choose to go through with it or not. I don’t mention the possibility to her until they feel comfortable with making plans.
As for things that my mother doesn’t want to do but has to, or things she wants to do but can’t, one of her caregivers, who is really good at that, and I work as a team. Just as you can’t expect everyone to be able to handle seeing her “that way” you also can’t let her do whatever she wants. She is basically the child and you are the parent now. I doubt she let you choose where the family lived or other important decisions when you were a kid and you can’t let her dictate your families lives now. None of us can always get what we want! That is life. It may be hard for seniors with cognitive issues to understand just as it is for young children to understand. I don’t know about you but when I was a kid I complained about things but it didn’t mean that I then got my way! My mother doesn’t like things enforced but we have to stand firm. It will be interesting when she needs 24/7 care and that time is approaching. We will give her a choice between more in home caregivers (if that is still reasonable) or moving to a facility. That’s it, one or the other, no choosing door #3! If she got to dictate the options then it would result in serious health issues and accidents.
Good luck, it is hard to see a loved one decline. Not everyone can handle everything and it is probably best that those most uncomfortable and who get most upset not be put in those positions. (I apologize for all the rambling!)
As far as travel—that’s a problem. It’s very confusing. My niece and hospice took him to a pizza pub to hear a duo play. As a guitarist he loved it. But when they brought him back to the nursing home he’d insist he didn’t live there. It wasn’t his apartment. My 22 year old niece had to soothe her dad and convince him he was in the right place. I don’t think people realize how disorienting travel can be for people with brain problems.
You say you'd prefer they just tell you they are excluding her because she's too much. And that there's no hard feelings. Can you say that directly to them?
Otherwise, you don't owe anyone any lengthy response. Simply reply, "That's fine." and leave it at that.
Maybe if you tell friends and family one time that you are not in charge of your mother's social calendar, and they can contact her directly if they wish.
Hopefully they will get the message that they are selfishly wasting your time and energy on their needs.
All you can / could do is offer (as below)
or
Encourage them to consider:
1-a short visit would be appreciated. I KNOW this is hard.
2-Ask them to focus on holding her hand and smiling (not talking or setting up a situation wherein she needs to 'think' of how to answer a question...when she cannot remember or know how.
3-Make simple statements "The weather is lovely today... the flowers are blooming" ... "It is nice to see you today"
Help make communication easier
-The first step is to understand that the disease causes changes in communication skills. The second step is to try some tips that may make communication easier:
-Make eye contact and call the person by name.
-Be aware of your tone, how loud your voice is, how you look at the person, and your body language.
-Encourage a two-way conversation for as long as possible.
-Use other methods besides speaking, such as gentle touching.
-Try distracting the person if communication creates problems.
-To encourage the person to communicate with you:
-Show a warm, loving, matter-of-fact manner.
-Hold the person’s hand while you talk.
-Be open to the person’s concerns, even if he or she is hard to understand.
-Let him or her make some decisions and stay involved.
-Be patient with angry outbursts. Remember, it’s the illness “talking.”
To speak effectively with a person who has Alzheimer’s:
Offer simple, step-by-step instructions.
-Repeat instructions and allow more time for a response. Try not to interrupt.
-Don’t talk about the person as if he or she isn’t there.
-Don’t talk to the person using “baby talk” or a “baby voice.”
-Be direct, specific, and positive
Here are some examples of what you can say:
-“Please do this,” instead of “Don’t do this.”
-“Thanks for helping,” even if the results aren’t perfect. You also can:
Ask questions that require a YES or NO answer. i.e, say: “Are you tired?” instead of “How do you feel?” Limit the number of choices. i.e, “Would you like a hamburger or chicken for dinner?” instead of “What would you like for dinner?”
-Use different words if he or she doesn't understand the first time. For example, if you ask the person whether he or she is hungry and you don’t get a response, you could say, “Dinner is ready now. Let’s eat.”
-Do not say, “Don’t you remember?” or “I told you.”
-If you become frustrated, take a timeout for yourself.
-Communicate clearly and calmly.
-Use short, simple sentences.
-Don't talk to the person as you would to a child – be patient and have respect for them.
-Try to communicate with the person in a conversational way, rather than asking question after question which may feel quite tiring or intimidating.
* I've been working with dementia inflicted individuals for 10-15 years now.
* The key is being able to put myself in their shoes (many people cannot do that).
* Realizing that communicating with a person inflicted with dementia is like learning a new language; most people will not know how nor take the time to learn how.
* I've learned w a client speaking gibberish (2 yrs) visiting / working with her):
1) She always remembered who I am (altho I didn't expect this over 2 yrs)
2) She'd would respond to affection me saying: "I love you M" ...
3) I'd smile-be energized to see her;
4) agreed with her (I couldn't understand);
5) saying "that is a good question, I'll think about it ...
6) watch for her cues.
Important: Know the visit is important; even if not many words spoken.
Give family-friends a book: "How to communicate with a person inflicted with dementia" - they may - or may not - appreciate your efforts although your intentions are heart centered, wanting the best for your mom.
Gena / Touch Matters
He is now, at 72, beginning to progress again (now adding actual dementia, I believe?) to an already damaged mind.
Your information may help me more effectively manage our future conversations. Thank you.
Initially, I sense that you would 'do better' to accept how others respond for your own well being to be as present with your mom as possible. People shunning her or not wanting to see / be around her will likely not change. You have to change how you 'hold' the situation (which is heartbreaking).
I believe:
1) "Most" people either:
(a) do not understand what dementia is nor how to communicate/connect with a person inflicted;
(b) they do not know how to extend their self / project how another person feels (i.e., confused, dealing with a changing brain, fears);
(c) they haven't developed the ability to feel / be compassionate - although they could feel that way and still not know what to do.
(d) "Faulting" a person for their abilities or decisions won't make the situation better nor meet your objective (connection with family/friends for your mom).
Understand, with compassion (it is asking a lot from you, I know):
2) People are uncomfortable with themselves - and based on emotional maturity (not age), they will either make excuses to you (why they won't visit/interact) because they may feel embarrassed and / or simply cannot own up "I am uncomfortable" and/or "I feel anxious / anxiety around her."
People do not like being uncomfortable.
- As you say "feisty' over the word Alzhemzer's' - tells me that you are wanting to / have / trying to explain what is happening to your mom. Explaining to her doesn't help her at all - it will frighten, confuse, and trigger fears.
What I would say: "Everyone's brain changes... we do the best with what we have." And stop.
Using logic and facts will not help her 'feel better'. What you want to focus on is keeping her as calm and emotionally even as possible.
What I would do:
1) Read / google Teepa Snow "how to interact with a person inflicted with dementia" - webinars, You Tubes, books
2) solicit / find volunteers (through local churches, high school / colleges. People that do not have an established relationship with your mom.
See this website: https://alzheimer.ca/en/help-support/i-have-friend-or-family-member-who-lives-dementia/understanding-how-your-relationship
In part, it says:
It is important to remember that different people react to the same situation in different ways. Some people will not be helpful at all and will put distance between them and the family. This is often because they feel that cannot cope with the changes. However, some people who care for a family member with dementia find that their families experience a new kind of closeness, as they work together to deal with stressful situations. Some people even show strengths that they never knew they had.
Everyone has a need for companionship and physical intimacy. People with Alzheimer's disease or other dementia are no different. They may fill this need through family, friends. Changes to the need for closeness and physical intimacy brought on by the disease will affect any relationship.
See the next response I wrote. Gena / Touch Matters
People do what they want to do and they don't do what they don't want to do.
My response would be no response.
You’re a wise woman, Southie
These are my sentiments as well.
I agree. I am not in favor of taking people with Alzheimer's/dementia on trips or putting them in party situations. They do not enjoy this kind of activity and will ruin these activities for everyone else.
Visiting one or two people at a time. Or even lunch date at a nice, quiet restaurant if the person is still well enough to be taken out on public.
Sure, it's hard to see a LO declining. It's supposed to be hard. It's supposed to be sad too. It can be awkward to be around a person with dementia. Most people don't know what to say. So don't say anything. Just be there. Just being there is something so many people just don't understand.
Say to them:
These may be the last months you can spend time with her.
You may be in this situation someday.
Wouldn't you want your family to spend time with you if you had dementia?
No need to be so polite.
Gives u something to do
writing on a clip board
It opened up their vocabulary
You are interacting with your mom on a regular basis, you notice the changes, you know the changes and I am sure you are reading and talking with her Dr's, care givers and other relatives of residents to know what is next, others might not.
Best of luck to you as you will need it.
@MDJones
Guilt-tripping or attempting to guilt-trip has never helped anything or anyone.
@Deb4Mom
Some people are cowards. They're afraid to be around a sick person or someone with dementia so they come up with all kinds of excuses.
In my line of work I've dealt with many, many people who were afraid to be around a sick LO or one with dementia. They'd call to "check" on them but would not come in person. I'd often ask with total sincerity, the one question no one asks and that they're often afraid to ask themselves.
What are you afraid of?
Most of them couldn't answer this. I'd tell them the best I could that they don't have anything to be afraid of. Granted, visiting a person with dementia can be an awkward experience, but it's not nearly as bad as what people convince themselves it will be.
my friend took her Alzheimer’s mother on a cruise
her mother complained the whole time
Would not get involved with anything
actually she even had issues with eating any of the food
these holidays and occasions may be nice to include old parents to but they really just are not practical
my friends holiday was more than 100% ruined and a waste of money
its hard as you are caring fur your mother and want her included etc
you can feel her pain more being with her
your relatives/friends see the reality of the situation
your mother is no
longer in a position for these trips
I would have thought a conversation to say mother is still in tact a good amount if the time and aware when she is being left out and you would appreciate their support in a day trip
now and again or a one day get together to include her
and leave it at that.
if they choose not to include her any further in anything small and it upsets you then maybe tell them you think it is a bit selfish and you’d prefer not to hear about it all, but be prepared you may wish later you were included.
your mother requires looking after and events can’t always cater fir tvat point
as per my friend she had no holiday end of and actually came back more stressed when the whole purpose of the trip was to chill out.
Everyone has a point here but everyone can compromise and agree something small
your mother can’t cope with anything more than small anyway
maybe that’s the path to take
you all have valid points
Having those weekends with the girls was your moms life before dementia. Im sure many things fall into this category now. I know it is sad, but just let it go. If her sisters need this to be a vacation and not a caregiving weekend....that is their prerogative. Focus on you and your mom.
Frankly it was the biggest challenge I had with end of life care for my Mom and Dad. Though heartbreaking to observe as my dad (who was left alone when Mom passed 18 months earlier) said things like 'they think I'm an old fool' and 'I'm sure they're busy with their own lives', nothing I said or did was going to change my older brothers.
Make no mistake though, when Dad passed I certainly made a point of reminding them their traveling to see him would have been within the same country and 1/2 my travel time but somehow, magically, I found a way to cross a border, self isolate then stay in town for a week to visit (287 days over a 2 year period but who's counting)
People who chose not to visit will have to live with their own consciences and I feel sorry for them. I was there when he took his last breath and wouldn't have missed it for the world.
I also reminded them all that I had to muster the strength every day so they could suck it up for one short visit!
I have no sympathy for the adults who can't bring themselves to visit.