How does a family member convince someone that they are not capable of “being more mindful” when they have Alzheimer’s disease?
I am becoming more concerned for my younger brother.
He has been diagnosed with Alzheimer’s disease. I am starting to hear more confusion when my brother is talking to me on the phone. We don’t see each other often because he lives in D.C.
He called me a minute ago saying that he has to be “more mindful” about his finances. He was attempting to pay a doctor bill and he accidentally sent the money to someone else. Geeeeez!
I told him that he is going to have to appoint someone else to start handling important things for him. He agreed but went back to saying that he needs to be “more mindful.”
I suppose that this is a form of denial on his part.
I went through this sort of thing with my mom when she developed dementia along with her Parkinson’s disease.
I would tell mom not to reach for things on the top shelf of her closet because I didn’t want her to fall. She would say, “Okay, honey.” Then she would think that she was capable of doing more than she could actually do.
The Parkinson’s made it more complicated because Mom said that her brain sent the signal to move, but her body couldn’t follow the signal.
I took everything off the top shelf in mom’s closet to avoid accidents.
I certainly hope my brother will find someone to help him. He doesn’t have a wife or kids. He has friends. They lead busy lives like he used to.
It’s hard to see him confused and somewhat unaware of the total situation that he’s dealing with. I don’t know how common that is. I am not sure how most people deal with this. I would appreciate hearing about your experiences with your family members.
Thanks.
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Prayers for your brother.
What a tragedy! I’m so sorry about your sister in law’s accident.
Yeah, I really hate that my brother feels like he can still drive. It’s very worrisome to me that he could kill others and himself.
AD and the dementias are frustrating for the person when they're still cognizant enough to know something is off with them. Ask him how YOU can help him, either with the bills or by setting up a simpler system to pay them. Maybe you can hire someone to go over during the first week of the month and get his bills together for him, in envelopes with stamps on them. Or set up a dry erase board with bills he owes, due dates, and a box to check off when they are paid. An aide to help him with whatever he needs help with. Maybe fly down for a few days to see what's going on and get a helper on board?
This is tough stuff, I know. Good luck and Godspeed, dear one.
He knows that he has received an Alzheimer’s diagnosis and it’s extremely difficult for him to accept.
He has worked hard all of his life and certainly didn’t plan on spending his retirement figuring out how to manage as best that he can with Alzheimer’s disease.
I know that he is becoming depressed and anxious. He is incredibly embarrassed about his diagnosis. He asked me, “How did this happen to me?”
Honestly, Lea…
I was so taken aback by his question that I couldn’t even think of a good response. There were a couple of moments of awkward silence for both of us.
You are not able to 'convince' the person. What you need to do is learn 'how' to communicate with a person who doesn't have their mental facilities / due to their brain chemistry changing and cells dying.
This will get worse. The 'best' you can do is educate yourself by reading, buying a book or two, going to / contacting an Alzheimer's Association for support and information. When a person has dementia, it IS like learning a new language.
Contact TEEPA SNOW.
This is not easy and most people are 'thrown' into this situation without any knowledge or training of what to do and how to communicate with the inflicted person.
In part, Alzheimer's / dementia means:
Alzheimer's disease is a brain disorder that slowly destroys memory and thinking skills, and eventually, the ability to carry out the simplest tasks. In most people with Alzheimer's, symptoms first appear later in life.
Alzheimer's disrupts processes vital to neurons and their networks, including communication, metabolism, and repair. At first, Alzheimer's usually damages the connections among neurons in parts of the brain involved in memory, including the entorhinal cortex and hippocampus.
Visit this site:
https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease#:~:text=Alzheimer%27s%20disrupts%20processes%20vital%20to,the%20entorhinal%20cortex%20and%20hippocampus.
This is about brain science and what happens, i.e., (part of the link above):
What Happens to the Brain in Alzheimer's Disease?
Key biological processes in the brain
How does Alzheimer’s affect the brain?
What are the main characteristics of the brain with Alzheimer’s?
How do changes in the brain affect people with Alzheimer’s?
The healthy human brain contains tens of billions of neurons, which are specialized cells that process and transmit information via electrical and chemical signals. These cells send messages between different parts of the brain, and from the brain to the muscles and organs of the body. Alzheimer's disease disrupts this communication, resulting in widespread loss of brain function as many neurons stop working properly and eventually die
Key biological processes in the brain
Most neurons have three basic parts: a cell body, multiple dendrites, and an axon.
The cell body contains the nucleus, which houses the genetic blueprint that directs and regulates the cell’s activities.
Dendrites are branch-like structures that extend from the cell body and collect information from other neurons.
The axon is a cable-like structure at the end of the cell body opposite the dendrites that transmits messages to other neurons.
The function and survival of neurons depend on several key biological processes:
Communication. Neurons are constantly in touch with neighboring brain cells. When a neuron receives signals from other neurons, it generates an electrical charge that travels down the length of its axon and releases neurotransmitter chemicals across a tiny gap called a synapse. Like a key fitting into a lock, each neurotransmitter molecule then binds to specific receptor sites on a dendrite of a nearby neuron.
This process triggers chemical or electrical signals that either stimulate or inhibit activity in the neuron receiving the signal. Communication often occurs across networks of brain cells. In fact, scientists estimate that in the brain’s communications network, one neuron may have as many as 7,000 synaptic connections with other neurons. The early loss of synaptic connections is one of the main hallmarks of cognitive decline associated with Alzheimer's.
Gena's comments: Stay calm, do not argue, set limits (on phone or in person) as this will drain you if you do not take control. First, you need to understand what you are dealing with and how to manage. The above referrals will help you.
Gena / Touch Matters
I was upset after speaking to my brother on the phone when I posted this question.
I agree with you that his denial isn’t intentional. He doesn’t know what he doesn’t know, which is so very sad to witness.
It may help him if you can be there in person. Having you there, it will be harder for him to hide his condition. Being aware that you see him and his mistakes could help him to acknowledge the deficits brought on by his condition and seek help.
You would think that since he has a background in business that he would have done preparation years ago.
I suppose that it’s like the contractors doesn’t get around to renovating his own house because they are so busy with other projects at work.
If you are close to your brother, I would suggest a visit and see for yourself what is going on.
You might be able to suggest some things to him that make his financials more error-proof. For instance, the doctor bill could have been paid by credit card so that he can dispute the charge...or if he has time, he pays the doctor bill in person instead of electronically.
He needs to not use Paypal or Zelle for anything, money sent that way, is non-recoverable.
If he needs to be more mindful, does this mean that he might turn on the stove and forget that he turned it on?
At this stage, he could easily fall for a financial scam.
I have a feeling that I can’t rely upon his words over the telephone or text messages.
My sister gave up driving and sold her car . Now she does not remember doing that and keeps talking about buying a car . She lives with her son. She had bad compression fractures of her spine and had surgery for it last Fall . She is still in pain and walks slowly with a walker . So my nephew keeps using that as an excuse . She has had a definite step down cognitively since that back surgery .
My dad's doctor told me that smart people can hide dementia for a long time, I imagine that really smart people, such as your brother, can hide it even longer.
May The Lord be with both of you during this new season in life.
I think that’s exactly what it is. He still thinks he’s capable. I’m not sure how long he’s been able to disguise what he’s been going through.
Hell, he even confuses me at times when I speak to him. Some days he sounds perfectly fine and other days he says things that I can’t follow.
Yet, ironically he knows that something is wrong. He will start a sentence and forget what he is saying. Then say, “Oh, my memory or I have to be more mindful of things.”
He has faith. He prays and is comforted by his faith. I just want him to take the proper steps to live the best life that he can considering all that he is dealing with.
I do think that denial is something that people go through when they receive news that they don’t know how to cope with.
They've ruled out other stuff, yes?
They were concerned about him having Parkinson’s disease at one point. He is having issues with his hands and is going to start doing physical and occupational therapy specifically for hands. He can’t hold onto things without dropping them.
He said that they gave him an Alzheimer’s diagnosis. He dealt with the long covid symptoms too. So they sent him to NYU to participate in a study. Some people feel that is related to Alzheimer’s disease now.
I wish I had some good advice.
It’s hard for me to describe how I feel because the only personal affiliation that I have with Alzheimer’s disease is with my godmother.
I would go to visit my parents, then swing by the nursing home to see my godmother before going home.
I visited weekly for years, eventually she stopped recognizing who I was.
One of her sons lived in San Diego and only visited once a year. Her other son didn’t visit her at all.
I didn’t see any point in continuing my visits because they were no longer bringing her joy. She was completely gone as far as having any cognitive ability.
When the residents of the home were evacuated for hurricane Katrina, she thought the home was taking them all on a road trip! She was completely oblivious to the storm.
She went blind due to her macular degeneration. The whole thing was so sad.
I prefer to remember her as the godmother I knew before she was placed in her nursing home.
My godmother was quite old when she was placed in the nursing home.
Dealing with my brother’s situation at his age (60) is entirely different for me. I don’t think he wants to believe that his doctor has given him an Alzheimer’s diagnosis.
I hate to think about my brother getting to the point where my godmother was.
Unpleasant thoughts enter our minds when we are faced with a situation like this.
Definitely take TIME to think. To plan. Don't go booking a flight just yet.
If you do start to plan a visit, who could go with you?
Who is or could be in your Brother's support team?
Did you mention a best friend?
Is there any other siblings? (I know you have sadly lost some).
I think that's what I'd do. Visit when the best friend or another close relative could also be there. Have a nice meal out.
Then have a casual lunch at your Brother's home & discuss 'paperwork'. Who would your Brother like to help him going forward?
Alternatively, it may be that due to his living far away, you decide this cannot fall to you. That's OK too!
Many ((hugs))
I can’t be certain because he has never discussed anything in depth. Many years ago I noticed that he was wearing a wedding band and I asked him if he got married and didn’t tell us! LOL 😆
He gave me a flip answer, saying that he wanted to wear a wedding ring so that women wouldn’t go after him for his money!
I was like, What????? Reading between the lines, I have suspected that he is gay, but for whatever reasons, he doesn’t want to talk about it.
It’s funny, because my parents would ask me if I thought that he was gay. They said, if he is he doesn’t have to hide it. We wouldn’t care if he was. He’s our son and we love him.
None of us would care if he was gay or not. He is aware that we wouldn’t care but who knows why some people keep their identities hidden?
He has women who are friends but he has never been in a relationship with a woman.
Yes, I have another brother. Two brothers are deceased.
Maybe my husband or my daughter would go with me to D.C.
I sent money to the wrong person by accident recently.. luckily to my daughter who said Thanks!!! Why?? (She returned it 😁)
Modern online banking can be hard - does take concentration. You are right to see this as a big red flag. It can open the gate to mistakes, fraud & scammers.
Has your Brother nominated a POA?
This will be the first important step.
The next will be that awful time the POA needs to financially take over.
That’s when he said, “I have to be more mindful.”
I told him that he wasn’t capable of being mindful and that he needed to start planning for his days ahead.
Just really frustrated because I asked him not to come to our brother’s end of life celebration and that we understood that he shouldn’t be traveling. He didn’t listen and came home anyway.
I am pissed off that he is still driving. He rented an expensive car when he came home and wrecked it in the Windsor Court parking lot! He thinks that he can do everything like he did before. Flying on a plane, checking into hotels and so on. He acts like his accident is no big deal because insurance covered the damage.
It’s not just the Alzheimer’s disease, when he got shingles somehow it affected his eye, so he is seeing an ophthalmologist too. He mentioned something about his cornea. It’s just too much to deal with and he isn’t listening to anything that I tell him.
I am upset with myself for not being able to get through to him but I know that I am not to blame for his behavior.
I will take some time to think everything over while I am sitting in PJ’s. Will catch up with y’all later. Thanks again for letting me vent.
Can you set up "auto pay" for routine bills?
For bills like the doctor could you set up a portal so that you could see pending bills?
There are Care Managers that might be able to do these things as well.
Things like this are difficult enough when you live in the same house or the same area I would think it is way more problematic when you are far away.
Mom lived in our home for 14 years. I really don’t know how I feel about taking on the responsibility of starting all over. Does that sound unkind? I love my brother with all of my heart but I just don’t know what I want to do.
Something definitely needs to be done about his bills. You’re right about that!
Somehow, I pictured him as much older.
Do you think that when you visit, he would be open to making an appt with a Neurologist?
Or, maybe even make the appt now, and you could go with him when he actually goes?
Do you think he's capable of making those kinds of future procedural plans?
My heart breaks for you.
He has a ton of doctors that he sees for all of his various medical issues. He has his primary doctor, his cardiologist, the gastroenterologist, oncologist, and what’s the lung specialist? Oh, a pulmonologist due to lung issues that occurred after he nearly died from Covid. He was on a ventilator for a long time. He was asked to participate in the Long Covid study at NYU and he did.
Most of his doctors are in D.C. but he does travel to NY to see other doctors. He lived in Manhattan for years. He loves NY.
I don’t know what he is or isn’t capable of right now. That’s why I am concerned.
He’s super smart, but his memory is slipping. Throw denial in and it’s concerning.
Denial comes in very, very quickly for most.
When my brother, living in Palm Spring in SoCal while I lived in SF in NoCal was first getting symptoms of dementia he KNEW something was wrong.
I on the other hand had no clue.
We were having these long conversations by phone and suddenly I was speaking to dead space. He was gone.
He claimed it was the phone and had the company out often but nothing wrong. Then there was the hallucinations which started at night, when he got up to use the bathroom. Said they weren't dreams and in fact they weren't but neither of us could figure whether waking dreams of what. His balance, poor over the years, became awful and when I visited for my yearly month with him the weight was falling off, I noticed he wasn't using deoderant and had lost his sense of smell, not understanding his tshirts DID smell. He was then 84.
I went home knowing something was wrong, but not what. And then got the call he was in the hospital after a single vehicle (his) accident in which his head was banged up badly. Lay in his neighbors arms saying "I KNEW something was wrong; I KNEW it".
He was diagnosed by symptoms with probable early Lewy's dementia, and together we got all the scans done, the neuro-psych evals, negotiated the system, chose an ALF, he made me his POA and the Trustee of his Trust and we set up an "allowance" account for him, transferring all bills and etc to me.
He KNEW what was coming, and feared the going out of control or not recognizing he was no longer capable. So he insured everything while he could.
While we both feared what was coming, and he hoped to die before it happened I told him that wasn't really in our control. It turned out he did die of a sepsis from a wound in his shin he hid and ignored. He was not unhappy about that. A week of treatment that didn't touch it and only made him hideously ill, a week of hospice and he was gone from me. An incredibly brave and sensivle man, as always he had been.
If your brother isn't willing now to act for himself and ensure things, it is almost certain he will leave it too long, and will be prey to every catastophy that can happen financially.
I don't know how you can convince him other than to make a trip and go though full diagnostic, help him get a Licensed Fiduciary on board who works through the courts, and get protected. You are too far away to do this for him, and it was TOUGH and the steepest learning curve I ever went through . I don't recommend it to anyone.
I sure wish you the best.
My brother is aware of everything but he thinks that he is capable of “being more mindful.” Of course, he isn’t going to be able to be in control.
I do live too far away from him to be able to handle everything for him.
He’s having a hard time dealing with everything. He was so independent before all of this and he isn’t going to adjust well.
He left New Orleans for New York right after graduating from Tulane University. He lived in Manhattan for years. Then, onto D.C. Working 60 - 80 hours a week as an investment banker. He couldn’t do that line of work here because New Orleans doesn’t have the abundance of wealth that NY and D.C has.
We only have one billionaire in our city. That’s Gayle Benson, the New Orleans Saints football team owner. When she sells it, she knows that she will have to sell the team to someone who is living out of the city because no one here could afford to buy the team.
My brother had no interest in settling down, marrying or having kids. So, he’s in this on his own. His best friend works long hours and travels extensively so, I can’t really discuss this with him.
The sweet woman who sits for his cats when he is at the hospital told him that she will be glad to take his cats.
My brother told his cat sitter that he has money allocated for his cats’ care and that she would be paid for her time and effort.
The woman said, “You don’t have to pay me. I love your cats!” She’s a sweetheart. My brother said that he would leave her money anyway, whether she wanted it or not.
It’s hard to fathom dealing with this because he is so young.
I know his financial situation is complicated. As an investment banker some of his assets are tied up with business partners. He owns properties all over the world.
He’s going to need help with getting his affairs in order. I am not sure how involved that I want to be in all of this. He can’t do this by himself though.
He nearly died from colon cancer years ago, has had several heart surgeries, survived a life threatening stroke. He has diabetes.
He nearly died from Covid. He got it before the vaccine came out. D.C. was a hot spot for Covid. He was on a ventilator and in the hospital for a while.
He was mugged and beaten so badly that he was taken to the hospital. He has been through a lot. Not to mention that he’s already had a couple of driving accidents as well.
Now this, Alzheimer’s disease to deal with. It’s heartbreaking.
I think for your peace of mind you will have to take the trip to DC, or you will never sleep.
Keep us posted, please
I’m so sorry .
I never thought that my brother would be in this situation.
You can only make a case to convince someone of something if they are capable of memory recall, and the use of reason and logic. Your brother is losing his, and he knows it but that won't help him "be more mindful". He's got mind-fail. You can no longer engage with him in the way you are used to in the past. It won't work.
Unless someone chooses to step in help your brother -- you know what the outcome will be since you've been on this forum for a while -- "someone" will need to go there in person for at least a week or (preferably) more to help him get his legal and personal ducks in a row, and set future solutions in place.
You also know that you can't get an uncooperative person to do anything against their will. So the change and decisions will need to come from the LOs around your brother. Your brother fits into a category called "Elder Orphan", of which there are many. Every family has at least one. This is how I wound up being PoA for my 2 Aunts (single, no kids of their own).
May you receive clarity and wisdom and peace in your heart on this journey. (((hugs)))
I am sorry about your cousin too.
My brother isn’t old 😞. He’s only 60!
Sometimes, he seems just fine. I know that he isn’t fine but he acts like he is.
Other times, he’s very forgetful and confused.
I have begged him not to drive anymore. He told me today that he is only driving during the day and no longer drives at night.
Same thing with flying. His doctor told him not to travel alone anymore because he was going lost in the airport.
He used to travel all over the world with his job and he thinks he still can.
I suppose I should go to D. C. to get a better picture of his situation. I don’t know how this will work out for him.
I was trying to rephrase my statement by asking for the best way to explain to a person that they are losing their capacity to “be mindful.”