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Oct 24

What I know now: Caring for my dad who has Alzheimers

Sun 24 Oct 2010 16:25:50 | 19 comments

For the past couple years my Dad has been slowly slipping into the grasp of Alzheimer's. The neurologist diagnosed him in the first stage. An unexpected bowel obstruction and subsequent surgery this past August catapulted Dad into the end stages of Alzheimer's. Here was an independent man now unable to relate to us or express or care for himself.  


After months in several hospitals, the prayer and hope by his doctors and family was that Dad was experiencing postoperative delirium from the effects of the anesthesia from which recovery was possible.  


It was not to be.  


Today, my Dad is in an Alzheimer unit in a nursing home.  He never recovered his faculties after surgery. 

 

What I Know Now:    


*My dad and mom were each in their own crisis.


Whereas, it was a seesaw on where my siblings should focus our attention, it was clear that two lives who had been joined for 55 years were now separate with individual needs. 


Dad's most immediate need was to find a home with a long term bed to place him in. My mom's need was to shop for a nursing home with us.  But in the end, she was unable to make the decision for placement.  As she was going back and forth, clearly indecisive,  my brother finally asked my mom if she would like her four children to decide together on dad's placement. "Yes," could not have come out of her quicker. 

 

*Looking for a home is a very sad shopping trip.


After all the years the three of my sisters and I spent shopping with my mom, this trip paled in comparison. What do we look for in a nursing home? As in most situations that we find ourselves thrown into that bare so much emotional weight, we felt helpless.


However there are some excellent resources online on scores etc for nursing homes. After tossing out a few on our list, mom and I settled on four. This was enough to look at for one afternoon. We tried to laugh about much and also to be honest in an attempt to dilute the reality that we were finding a new home for my dad in… an institution. Two out of the four did not have “locked facilities” (my dad needed his facility to be locked because he is a "wanderer.") We also needed a bed immediately and we also needed it to be a Medicaid bed.


That left only one viable option. 

 

*Yes, you will be developing a whole new vocabulary as each disease has its own set of familiar terms you wished you never had to speak.


You will also have to remember security codes, room numbers, meal times, staff and roommates names. Enough new things to absorb that I often felt like I needed a room too. Yes, I also found out that Alzheimer's, especially early onset, is hereditary. Expect to be exhausted. 

 

*We waited too long to delve into my parent's financial matters.


Since dad was in early stage we thought we had time and so did mom. Dad took care of all of this for all their married years. Now, we were left at the kitchen table with mom in a puddle of tears amongst a pile of file folders and bills and insurance statement from the two months dad had been hospitalized.


Take charge early. As our situation proved you just never really know when it's too late. 

 

*Mom had to apply for Medicaid.


Did you know there are attorneys who handle getting your finances in line for the official meeting? At this point with so many to-dos on our list, we decided to split them between the four of us kids. Yes, as callous as it sounds, this is one of the biggest projects a family will have before them, and unlike our day jobs, one that has an emotional component that bubbles over often.


My brother spent the last two months going to attorney meetings, combing through all the finances.  And just this week, taking mom to her appointment. The process to apply for Medicaid is tedious and long and gripping but in the end, it will allow my mom to pay for my dad's care and will give her an allowance for expenses. Since their house is not paid for, mom will have to sell and either find a small apartment to live in or live with one of her children.


Many times mom during the Medicaid application process, she had to be encouraged to keep going along because the thought of being uprooted from her home was overwhelming to her.  (And us, too, really.)   

 

*Your siblings will take back the roles you’ve all had when you lived under one roof.


The bossy one, the absent one, the one who has THE right answers, the one who sits in indecision. Accept one another all over again.


You need each other more than ever. 

 

*The independent spouse, in my case my mom, will be depressed, sad and either need to share this or hide out in denial for a bit.


Allow both extremes. Denial is a good friend for my mom as it is a temporary pause for her in the midst of all the life changing decisions and work she has before her. It is clearly not helpful for any of us kids to push mom when she is courting those dreaded questions: Why me?  What's next? Where am I going to live? How am I going to do this? Where is God?


There are no answers, really.  Spend time listening. Because if I’m perfectly honest with myself, I have the same questions. 

 

*We all are grieving dad as if he has died.


This is a very awkward feeling as you wander the halls in the locked unit walking beside him. Yet that is exactly what it feels like.

 

*It is okay to ask for God to take him.


A prayer was shared with us by another family experiencing the same. "Dear God since he can't come home with us please take him home with you". 

 

*Expect a wide variety of personalities of nursing home staff, just as you would in a restaurant or business or in your memories of teachers.


Some will be caring, loving and kind; others will be irritated with any requests and some will seem to take on the personality of the patients they deal with all day and night. Get over the disappointing staff as soon as possible. This is life inside an institution.


I am still learning.


What I do know is to make friends with the staff.  Being grateful for persons who would work in these homes helps a lot. 

 

*It's okay to laugh, and it feels good.


My mom is amazing to me.  She has kept her humor most days.


The other day she told me she had a great idea:  Weight Watchers should hold its weekly meetings in the dining rooms of nursing homes surrounded by the residents dining. A fail proof way to lose your appetite. I know it curbs my appetite every time I join them. 

 

*If you are still raising your own children expect to be surprised at the tenderness and creativity they have when visiting the nursing home.


Let your children in on the pain and be available for questions. Also, expect you will also feel you are carrying their load of grief. My youngest daughter had to run out to the courtyard and hide behind a climbing vine. I followed her and found her sobbing uncontrollably. She still sits behind me if we are talking to dad in bed.   And that’s ok. 


Allow your children to do it their way! 

 

*Read whatever you can on how to visit an Alzheimer patient.


Although, right now all my family needs is a good pair of sneakers to keep up with dad's wandering. There are many helpful sights and associations with information. If research and reading is just too much on top of everything else, do it anyway. 


Expect to feel like you have no idea what to do or say with your loved one. Dad has said so many things to me that don't make any sense. The words are all strung together and sometimes he is happy to just have a monologue. Yet, sometimes he will stop and look at me waiting for my response or answer.  “Ummm, ummm, good luck,” is all I have to say. 

 

*Spend as much time with your aging parents as possible, bring the kids and the pets.  Tomorrow is not guaranteed.


Because we knew dad was starting to slip, we spent most of the summer with him.  That was a blessing.  You will never regret the time you spend with your parent(s).   

 

*Be ready to be discouraged and motivated to do something to raise the awareness of the plight of the elderly in our country.


This world of institutional care I have been invited to be part of will prick your heart. Are we keeping people alive for this? Many have strong physical bodies but their minds have gone. God's doing or man's?


Hard deep questions but each time I enter the home and drive away I wrestle with this. 

 

*On my good days with dad I swear that he still knows me.


However, on most visits I am not sure he knows who I am. I am familiar to him. What is missing is the way he used to look at me, the "you’re my daughter and I love you so much look."


Cry and cry some more and dig up the notes and birthday cards he wrote to you that you kept for just this moment.  Cry some more. It helps me to look at pictures of dad when he was alive and aware. He had a full and a productive life and that is what I cling to whenever I get discouraged and sad. 

 

Margaret Furnas is married and the mother of four daughters.  She lives with her family in Chagrin Falls, Ohio. 

 

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Comments

What a wonderful, thoughtful analysis of the process, Peg! Thank you for sharing your heart with those of us who may be facing this in the not-so-distant future.
I posted some comments on main video but that they'd be appropriate under Margaret's column too: I made sure to write down funny and sweet things they did, because that disease often takes a much different turn - to mean spirited people. The personality of one with Alzheimer's can be very different from moment to moment.

One time my dad told me to get rid of all the worms on the floor. I thought he might be seeing things since it was berber carpeting with a swirl design. He said, "No Cindi, they are on the wall, too." (There were no worms anywhere...but he often saw and heard things that were not there or real.) So I went to the closet, got a rag, and PRETENDED to be cleaning up the walls and the floor of the worms he saw. I had not water, no water bucket, just the rag. After a few minutes, I asked him if he felt that was clean enough. He said, "Yes, Cindi, that is much better, thank you." Of course I thought when I was done he might laugh and say, "YOU are the one whose mind is going-I gotcha!" But he did not. I think we need to "go with it" rather that fight it...because if they see it...it's there.
Thanks for your encouragement Hallie. When I keep my humor it reminds me of your writing! Cindi, lol, i am learning to go with it and to forgo a reality check. Just last night Dad was talking about something on his wall in the nursing home that was black and white and all I said is I don't see it. He said it is there and back and forth. Next time I will just go with it because I have to admit I am very curious about what he saw.
Yes, Margaret...it's so hard to "go with it"...sometimes I felt like I was lying...but had to get over it. We have a son with special needs...he's gave us many opportunities to "practice" at this sort of thing!
The book THE 36 HOUR DAY is a great help in all the "steps" in dealing with Alzheimers....the care, the medical issues, the family, etc.
Here is a time that was a little trickier.....dad told me, "Don't go into the other room...the man with the gun is here to kill us. I see Eleanor (his deceased sister) and John (my deceased brother) in there. We have to get them out." I just sat with him. I had NO idea how to handle that one, I just knew I didn't want him to flip out if I went in the other room. It's interesting the way the mind works (or doesn't work) with that awful disease.
This is so difficult . . . you showed such love, honor and patience.
What a moving post! Having gone through the process with my beloved father-in-law last year, I can relate. I think a lot of us ask God to take our loved one, but I remember feeling guilty about that even though it's probably the most natural thing in the world to wish for. Something that helped me was reaching out to other people who had experienced dealing with Alzheimer's. Talking about it can really help!
You are doing a beautiful job of modeling to your kids how you would like them to take care of you...
Beautiful. Absolutely beautiful!
Thank you for sharing your sorrow and experience. As you watch your father's departing journey from this llife into the full presence of God, where God is not to be missed, may you find comfort that your dad is not alone, now. May your dad sense the nearness of the God he has loved all these years. Romans 8:38-39
I just read your blog and am sitting here at work crying. You write with such a beautiful depth of honestly, sincerity, sensitivity and emotion.
Thanks for sharing this, Margaret. Can hear you talking and feel your heart wrenching. Interesting title: What I know now. Retrosepct is always so wise so thanks for our reminders for us who are not quite where you are yet. I think you could do a sequel: What I still don't know.
I cried right along with you...especially when I read about the prayer and about your daughter crying. Thank you for sharing your painful journey. Trust me when I say it WILL get better...as you go through the painful acceptance process and begin to love who your dad is now, as opposed to who he used to be, you will find yourself calmer and more able to focus on the increasingly few bright spots. I truly believe that somewhere inside, they DO know us...lor they feel a feeling of familiarity and comfort with us, even if for a brief moment. And just because he might not remember that moment 5 minutes from now, don't think he didn't enjoy that moment when it was there.

Have you found a support group yet? The lessons I learned there, particularly about end of life, were invaluable. God bless you.
I just read your blog for the 3rd time and could even write to you after the first reading because I didn't have the words to say how moved I was. Just forwarded it to our friends because it is the most truthful summary of what a family Alzheimer's journey is about. So many Alzheimer's articles are so clinical. Yours is reality.
Love it! You are such a talented writer and you spoke the words of a family strugging with Alzheimer's so eloquently. I sure am struggling and you gave me another chance to just cry.
I just read this. You are amazing in your ability to write. Somehow you captured everything...beautifully yet impactfully. Thank you.
It is my Dad's birthday tomorrow. My mom and sibs and I have been trying to decide how to best celebrate his day. How to celebrate when Dad does not know it is his birthday? Trying to honor him where he is today. He is very overwhelmed with many visitors at once. He does not sit long outside of his room requesting to go back "home" now. "Home" we thought meant his lakeside home in Vermilion. After 10 months in the nursing home, he now refers to his room as home. Another twinge of loss for us all as Dad is more and more institutionalized. After scaling back suggested celebrations which included taking Dad to the nearest beach on the Lake or to the local ice cream parlor my Mom has decided on what would be best for Dad. We will bring in balloons, cake and party plates for all the residents at lunch time. Dad is best at around noon in the cafeteria at lunch. What will register for my Dad as we celebrate his life will only be known to my Dad. He is mostly nonverbal and confused, My heart tells me that even still he will know that something is special about June 28th, that he is surrounded by faces that he can't quite place, but yet will feel the love that we long to share deep in his soul and his mind.
Wow, that's a tough one! Is there anything that he still enjoys, whether it's something new or something from his past? Maybe it's food or music or even a scent? I am reaching here because I don't know your Dad, but I'm just thinking of how challenging this can be when their tastes have changed, as a result of the Alzheimer's. I think of my late father-in-law, John, who I loved so much, and how he used to love steak and red wine and how none of the things from his past held any appeal toward the end. I think it's great that you're acknowledging your loss and trying to make it a comfortable celebration for your Dad. Whether he knows it's his birthday or not, you know, and it is obviously something you want to commemorate. Your Dad is very blessed to have you in his life ....



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