Just because you re senile doesn{t mean you re stupid

[TerryJ2]

So, I got some advice from a therapist several wks ago in reg. to my cousin. I{m supposed to gloss over talking about her apartment, change the subject, etc. There is no use reasoning with someone who is only using emotion. Period.

Today I visited her. She of course brought up the subject of not wanting to lose her apt in NY because she would have no place to go to live. We ve been through this so many times during therapy I cannot even begin to tell you ... She can NOT live there, not alone, not with an entire crew of hospital personnel.

This time, I just nodded and put a concerned look on my face.
P. didn{t fall for it.
She said You are nodding in agreement but I can see that you don{t really understand. I will have NO PLACE TO LIVE WHEN I GO HOME. What will I DO_

So much for that approach ...

 

[Shari]

How about "We'll find you a new place when you're ready?" Or "we have something else lined up and waiting?" or "you can live with us" (assuming she won't be....)

 

[rlsnights]

I didn't go back and read your previous threads so I may be totally off base. If so please forgive me. But we are in a continual struggle with this issue ourselves with not one but two extended family members.

If she's not conserved then she does indeed legally have the right to go live anywhere she likes - whether it's smart or not, whether she has the money or not, whether it's dangerous or not. If it is not safe, etc then a petition for conservatorship needs to be filed and the matter heard in court or at the minimum brought to the attention of Adult Protective Services.

If she is not conserved and you do not agree with her plan, then you can tell her that you feel very strongly that it is not safe for her to return to her apt. If it was me, I would also tell her that my conscience would not allow me to help her do something that I thought was dangerous and I wouldn't discuss it anymore. Then you have to hold to that. If necessary I would tell her that I would have to leave if she insisted on continuing to talk about it. And then I would do it.

If she is conserved then that is another matter. If the conservator has determined that it is not safe for her to return to her home then the decision is out of her hands.

That either needs to be made clear to her or not depending on her cognitive/psychiatric condition. If she is suffering from dementia or psychosis to the extent that she is delusional then there is no point in any kind of rational discussion with her at all. She is not rational and not capable of being rational. You might as well hit your head against a brick wall.

To argue with her is to participate in the delusion that she has the power to decide this.

If no one has told her where she will live once she is well enough to leave her current placement then that should be done if it seems appropriate. If it's not certain she will leave where she's at then I would tell her that - again if it seems appropriate.

If it's not appropriate to be straightforward with her due to agitation, etc. then I would tell her whatever she wants to hear and let her talk all she wants about her plans for going back to her apt. I would also try to get her to talk about other things that are less (for you) uncomfortable subjects and reminiscences.

I do not think this is cruel. It is the only rational response in this situation.

Patricia

 

[Hound dog]

Patricia has many good points.

However..........I'm wondering. Have you just flat out told her she is NOT going home, period, that she has no say so in the matter? That it is too dangerous, so it will not be considered an option?

To stop arguing with mother in law, we had no choice but to finally do this to her. I hated it because I was the one for years who had been coaching her on patient's rights ect, especially for the elderly. The arguing, though, had her anxiety kicked up into high gear and kept her agitation up high. Putting out foot down put a stop to both. Since we had medical power of attorney and doctor backed us up 100 percent that "home" was not a safe environment anymore.....that was that. We did it as nicely as possible, but we had to be firm and really stress the safety issue. However mother in law was far from being even slightly "confused" at that point. She didn't even really have memory issues.

 

[DammitJanet]

My mom was senile with Alzheimers and she was still convinced most days that she was going home. Now on any given day that could be many different homes. LOL. It varied from her last home in Myrtle Beach to my family home where she lived for years raising me to her homes in MA where she was raised. I never quite knew exactly which one she meant until she got to really talking.

I just kept telling her she was home and that there wasnt any other home she was ever going back to. This was it. She never was quite happy with that answer but she had to make due because we didnt give her a choice. Normally she tended to forget what she was talking about in short order anyway. If I could find something on TV that caught her interest, politics for example, I could redirect her for awhile. Fox News, CNN and CSPAN were my friends back then...lol. She would argue with them for hours.

One thing I did learn is that you cannot convince a delusional person anything. Nothing. If they believe it, you have to let them. It is their reality. I would simply go along with whatever she says and just smile and nod even though you know good and well its not happening. Same as when I was pregnant with twins. No one could tell me different when I was convinced I was. Everyone just played along until I came to the point when I figured it out on my own. I would have thought they were lying to me. There were many things they told me that I got furious at people for telling me. Like telling me that I couldnt walk. I was convinced I had been walking all the time while I was still in ICU but of course I wasnt but in my coma I had delusions that I was walking all over the place. I kept telling people that I needed to get up to go to the bathroom even though I had a foley in. They kept telling me I couldnt. I was furious. I could hardly move but in order to prove to me after I had fits, they tried to sit me up and of course, I couldnt even put weight on my feet. I was so confused. It made no sense to me since I was convinced I had been walking all over. Its really hard.

 

[DaisyFace]

Terry--

Like you, I have spent some time in the Alzheimers/Dementia wards interacting with patients....and it seems to me that many of them have "reality test questions".

Let me explain - most of the patients were not 'completely gone'. Most of them drifted in and out of lucidity. [In fact, we had only one woman who was completely out of it and she was the easiest to deal with because we could just go along with anything she said and she was happy as a clam.]

But for the rest - they did seem to realize that they were losing touch. I would notice that they would ask questions. "Where is my wife?", "Where is my house?", "Where are my children?", "Where are my things?", "Who is taking care of my dog?". For each person, the question they would ask was different....but they would ask me the same question each time they were feeling unsure. It was as though they were testing their sense of reality. What is real? What has happened to me? What is my life now?

As hard as it is - I would answer their questions...over and over and over. The simple truth.
"I'm sorry - your wife has passed.",
"I'm sorry - your house has been sold. You live here now.",
"Your children are grown. They stop by every Saturday. Would you like to see the pictures from their last visit?",
"Some of your things are right here. See? Here is your recliner. Some of your things are with your children."
"I'm sorry - your dog has passed. His puppies live with your grandchildren. Do you want to see their pictures?"

And there would be a moment of sadness. They would nod. They would look me in the eye and tell me "Thank you".

You are right - your cousin is not stupid. She has a "sense" that something is not right.
If you can...give it to her straight.

"I'm sorry your apartment has been rented. You live here now. See? Here are your things."

 

[tawnya]

My Pop is the same way. Every day he asks my Grandma if she has "paperwork", meaning bank statements, etc. Now, he can't understand one of them. Every time she tells him the same thing about the finances. He can't now, and will never again be able to understand. Sometimes he gets really angry at her, and sometimes he just nods his head.

It's very hard.

((HUGS))

 

[DammitJanet]

DF....My mom was in and out of lucidity when we got her but the main problem was she didnt have the slightest clue who I was from almost the moment I got on the scene. She only had probably one clear hour or so and it was in the attorney's office when she signed her POA. Thankfully her attorney had known both of us for years and knew I was the only child and she had no one else to take care of her or things would probably have never gone as easily but he really looked the other way on her functioning and when they asked her who I was...she answered correctly...so that POA was signed. WHEW!...

I think that was the last time she knew who I was. She remembered Billy the longest. She remembered Tony too even though most of our lives she hated him but at the end she adored him...lol. Me? She had no use for. I would get out baby pictures and tell her that was her baby and she would be adamant that she had never had a baby...lol. Oh well...I tried.

 

[Star*]

This may or may NOT have anything to do with anything -

But the other day I ran into a woman who was an alzheimers counselor. Meaning she counseled family of people who had alz. I asked a few questions about myself mostly because there are days when I literally feel like the cheeze is sliding. I feel much better knowing that I'm not in the beginning stages of alzheimers, and just suffering from every day stress situations and could use a good glass of sugar-free wine and a hot soak etc., etc., etc.

However she did say that people like yourself can benefit greatly from seeing people like her because there are situations that come up, and questions that need to be addressed, just like dealing with difficult child's and if you do not deal with ALZ people every day how would you know how to deal? She was a wealth of information and resources not only for ALZ but elderly and aging people and was able to separate for me what is basically aging and what is ALZ signs.

Just a little 411. Your Aunt? She's a pistol to begin with - I wouldn't want to spar with her on a GOOD day let alone her trying to fight ALZ.

Hugs

 

[TerryJ2]

Thank you all.
She is not that far gone ... or at least, she wasn't yesterday. Except that she told me that her nephew from Alaska called to say that he was visiting on the 14th and I thought, WTH? He could have emailed me.
So I emailed him and he wrote back, "JUNE 14. Don't worry, I planned to email you before then."
Sigh.
We have an appointment with the talk therapist on the 13th.
In the meantime, the neuropsychologist at the retirement center is working on a "conservatorship" form, which is called, sadly enough, having her "declared incompetent." She has turned away the Alzheimer's testing psychologist twice now and they cannot complete the testing in one sitting because she cannot focus her attention that long.

I will certainly tell her in therapy that this is the end of the line, and she will absolutely blow up. No matter how many times I've told her, she refuses to accept it and says, "I have the right."
Well, by the time that appointment comes, she will no longer have the right.
I have to call the therapist and ask whether we should tell her that. I don't know which will agitate her less.
Also, she is in close touch with a person she allowed to rent her apt but who is no longer paying anything. That person is adding to her agitation by freaking out and saying that she doesn't have a job and nowhere to live, thus, echoing P's sentiments. I am going to have to block her calls.

Yesterday, to test the waters, I told P that when we were in NY, easy child accidentally packed some memorabilia things such as framed photos, knick knacks and ceramics, in the boxes I packed, which were only to contain fabric, clothing and photo albums, just to see what P's reaction would be. She blew up and said, "I told you I didn't want anyone else touching my things! Even easy child!"
I responded that she was right there and knew that easy child was helping me and she simply repeated herself.

And by the way, this is going to be my last therapy session with-her. The neuropsychologist said that there is absolutely no point to using cognitive therapy on someone like her. I am going to tell the therapist that and tell her that I am only going to this one last session, and that's it for me. If she wants to waste P's money and her own time, then P has to find her own transportation.
Hey, the therapist told me to draw boundaries. So I will.

Anyway, since P fades in and out, but is totally, totally fixated on this, there is no way she'll let up on it. She will fall into a huge depression and blame it on me.
No way around it.
I'll just have to live through it.

 

[TerryJ2]

Star, hmm, maybe I'll google local Alzheimer's family counselors. Good idea.

Love your expression about the cheese sliding, LOL!

I was told that the difference in OUR memories is that if we forget something, we'll eventually remember it, say, when we open the fridge, try to start the car, or look on the calendar. It's when we do those things and still have no idea what we're doing that it's a more serious issue.

Yes, P was a pistol. And still is.
I found out she used to dance in Reno. She has the most bizarre stories. I never know what to believe and then I find a photo or a news clipping and I go, "Oh, s**t! it really happened!" Or at least, the people met or something happened but it may not have been quite as exaggerated, Know what I mean?? She's an actress and a storyteller and will do anything to take center stage.

husband said that she won't die unless she's able to fall face down, screaming and shouting out a line to the audience. Any audience.

 

[Star*]

I can actually see her as kind of a Fried Green Tomato kind of gal......

 

[TerryJ2]

I have to rent that movie. Haven't seen it in yrs. You aren't the first one to tell me that. I'll let you know ...

 

[Hound dog]

I can actually see her as kind of a Fried Green Tomato kind of gal......

LOL That's how I picture her too.

The Alz counselor is a very good idea. Your aunt just isn't the type of woman to give up her freedom without a fight for sure. mother in law's aunt Kate was that way too. Whew.....now that was a battle and a half and the woman was 98 yrs old at the time. She was a southern lady who could cut you down with barbed wire and it took you quite a while to realize she'd done it, she could do it so sweetly........but when the temper flew, you ducked.

My memory is just plain swiss cheese. Only new holes appear at random. lol

 

[DammitJanet]

I had the alzheimer people tell me that too when I started to get really worried I was losing my mind completely. I think its common for caregivers of these patients to start to think that either its so genetic or its catching that they have signs of early onset dementia. Every single time I would misplace my keys or go blank about something I was practically frantic thinking...omg...its started already! The nice woman on the end of the phone calmed me down by telling me if I realized I had lost something or knew I was missing something, I was just fine...lol.

 

[Star*]

Terry,

Actually I see her as a mink coat, very coiffed, bejewelled - Northern - Izzy......A dame with attitude. But all the Snark of Izzy.

 

[TerryJ2]

LOL!
She has bright red hair, long and straight, past her shoulders. She is 5 ft-1", used to weigh 90 lbs but now weighs about 115, partly due to actually eating since she's been here,, and partly due to the medications she's on, making her stomach swell.
She loves fluffy, romantic clothing and lots of floral patterns. Very English. Oh, and she loves big hats, too.
She wears lots of necklaces at once, nothing chunky, all dainty. The more colors, the better--bright dark red hair, fuschia sun hat, pink lace blouse, bright blue pants.
She has given me many outfits over the yrs. OMG, not my taste. I'm into Land's End, LLBean, Ann Taylor.

Oh, and when she wants to share food, she insists you eat it. She will shove it in your mouth.