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Caregiving Questions

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My mother-in-law is 73 years old, and an Alzheimer’s patient. She had been bedridden for the last 8 months and I feed her semisolid food using baby bottles. She does not have complete bladder or bowel control, and speaks incoherently all the time when she is awake. This is becoming a problem as my children's studies are getting impacted due to her loud voice. How long will this stage continue? [ 09/24/10 ]

Taking care of a loved one who has Alzheimer's disease can be quite challenging. Taking in your mother-on-law to care for her in your home places demands not only on you as the primary caregiver, but also on your entire household. You may feel exhausted from constantly having to balance your mother-in-law' needs against those of your family's, and for this you may even resent the disease. Upsetting as this is, it is all quite common.

First of all, congratulate yourself for the selfless act you are undertaking. You may never get the recognition you deserve from your caregiving work, but you should realize that you are performing an invaluable service for your mother-in-law. Secondly, although your parental instincts may want to protect your children from your mother-in-law's disturbing behaviors, the reality of the matter is that your children are learning valuable life lessons: we take care of our loved ones because family is important; and death and disease are just as much a part of life as are birth and wellness. If you try to stay compassionate in your attitude toward your mother-in-law and set an example for your children, hopefully they will take away something more from this whole experience than “grandma is loud and acts strangely.”

Based upon the description of your mother-in-law's condition, it sounds as if she is in the final stage of the disease, which might last anywhere from a few months to a year or more. In the meantime, if your children are old enough and it is not too inconvenient, perhaps they could study at the local library or at a friend's house a few nights a week. Remind them that their grandmother does not do these things to purposely annoy or upset them, but that her behaviors are part of her disease. A bit of empathy and understanding can go a long way toward developing a tolerance toward obnoxious behaviors such that they become less of a distraction.


Doctors advised my 75-year-old husband today that he would no longer benefit from Aricept or Namenda. He is close to the final stage of the disease, but he still sleeps pretty well at night, goes to bathroom on his own (he has had a couple of mishaps but nothing major) and eats regularly; however, he does not appear to know if he is hungry or not. How long will this stage last? [ 08/30/10 ]

Based on your description, your husband still seems to be doing fairly well overall. He is still mobile and can go to the toilet on his own, has as good sleep schedule, and accepts food—all of which are good things and would argue that he is not yet in the final stages of the disease. Therefore, it is very difficult to say how much longer this current stage will last: it could be months or it could be years. The rate of disease progression varies considerably with each patient, and is not even consistent for any given patient (that is, a person may have stable symptoms for several months only to have a rapid decline over the course of a few days). So try to make the most of this time with your husband if or before he should become completely incapacitated.

Also, be aware that the medications your husband is taking may still be helping, albeit much less effectively than previously. Therefore, you may notice an increase in functional or behavioral symptoms once the medications are discontinued, which may make your job as a caregiver more challenging. You should weigh the potential advantages (lowered expenses due to not having to purchase the medications, no possibility of drug side effects) and disadvantages (possible increase in the severity of symptoms, more difficulty for you as the caregiver) of discontinuing your husband's medication with his doctors before making any final decisions.


My father-in-law, who is 69 years old, has some sort of dementia, but refuses to see a doctor. He still plays golf three times a week, but his former partners no longer play with him, due to his behavior. He is obsessed with time and is early for everything (sometimes hours early). He talks constantly, does not listen to anyone when they are trying to tell him what is going on and he taps or sings all of the time. When my mother-in-law tries to remind him of things, he gets angry and sometimes becomes aggressive. I am concerned that he may cross the line with his aggression and hurt someone. I believe that he is anxious, fearful and shows signs of OCD. What are our options if he won't see a doctor? [ 08/27/10 ]

There are numerous medical conditions that have symptoms mimicking those of dementia; many of these conditions may be treatable. But it takes a trained clinician to determine what might be the cause of your father-in-law's recent behaviors. The sooner a diagnosis is obtained, the more potential for treatment may be available.

Your father-in-law is probably aware of his declining cognitive abilities and therefore is in denial and/or is very defensive when it comes to people criticizing his behavior (which may be yet another reason why he no longer plays golf with his friends). This, unfortunately, may make it even more difficult to get him to see a doctor.

You can start by getting your mother-in-law to contact her husband's primary care physician to relay your (and her) concerns. The doctor will probably want to see your father-in-law for an exam, such as a memory screening exam. You and your family will have to be a bit creative here, but it may be possible to bribe, guilt or even trick your father-in-law into seeing the doctor. Some tactics you might use include:

  • Tell him that his doctor's office requires him to come in for a check-up before they will renew one or more of his existing prescriptions.
  • Put the focus on you. Tell him that you (or your spouse) are concerned about his health and that it would make you feel better if he got checked out. If you have children, say that your child is concerned about “granddad” because she wants to be sure granddad will be around for her birthday/graduation/etc. Guilt sometimes helps get a patient to the doctor.
  • Enlist the help of his wife. Get her to say that she has a medical problem and that she would feel better if he accompanied her to her doctor's appointment (technically the appointment will be for him, and you will have to let the doctor's office know of your plans in advance). Once there, the forewarned doctor can just examine him too, since he's already there.
  • Enlist the help of his friends or a person he respects. A former boss or co-worker, a clergy person, an attorney, etc. Get this person to suggest to you father-in-law to visit the doctor for a check-up. Better still if the person is around the same age as your father-in-law, that way he or she can say that it's just something everyone does when they reach a certain age.
  • If your father-in-law does indeed have dementia, don't think that you will necessarily be able to reason with him because his sense of rational will be distorted or absent. But you can still talk to him and explain how even though it is frightening to have to face, early diagnosis of a health issue is a good thing, because early medical intervention can usually forestall the problem from advancing.

My mother, who has early Alzheimer’s disease, was placed in a “care home” 1 year ago. Is it harmful or dangerous for me to take her out of the home for the day (or perhaps a day and a night) as long as she is constantly supervised by my family? I feel very sad for her being in a virtual prison as she is still a very lively character who holds a good conversation. All I am trying to achieve is to bring some light and joy into her life, but I am meeting resistance from other family members. [ 08/26/10 ]

It is fine to take your mother on outings so long as you try to adhere to a general schedule. Alzheimer's disease patients do best when there is a regular routine or schedule that they follow each day, such as for meals, waking, nap or bedtimes, bathing, toileting, and other activities. Check with your mother's care home to determine the schedule they have her on, and if you should take her out for the day, try to do the things she would normally do within the scheduled times. Better still, with the help of her care facility you can build in a short outing as part of regular schedule. For example, you could arrange to take her for a 1-4 hour outing a few times a week.

Overnight outings may still be feasible while your mother is in the early stages of the disease so long as the care facility does not have a strong objection to the idea. Talk to the facility first to find out if she is sleeping well at night—that is, does she have insomnia, does she wander at night, etc. If you should choose to have your mother overnight at your home, pay close attention to her behavior for signs of agitation. Again, stick to whatever routine the facility uses for dinner and bedtime. Even with a routine, your mother may become disorientated in the evening and become anxious and upset. If she has a tendency to get up in the middle of the night and wander, this could also pose a safety problem. As the disease progresses, however, it would probably be best for her to stay in her own bed at the facility each night. Too much disruption in a dementia patient's schedule can cause unnecessary anxiety and stress.


My wife is bedridden and cannot communicate with family members. We have to move her from the bed to a geriatric chair because she is no longer able to stand up. Is this related to the progression of Alzheimer’s disease? Sometimes she calls out my name and other times she does not. I just wonder if she hears us when we tell her that we love her and pray out loud for her. [ 08/02/10 ]

In the later stages of Alzheimer's disease, a person can become immobile. Your wife's inability to stand may therefore be directly related to the progression of the disease, or it could be caused by another unrelated condition altogether. Unfortunately, in these neurodegenerative diseases, it is sometimes impossible to clearly pinpoint which disease causes which ailment. Regardless, it is important that her position (be it sitting or lying down) is changed regularly to prevent sores from developing. Also, to the best of her ability, try to encourage your wife to do some stretches and arm and leg lifts from a seated position. You will have to help guide her in the movements, but just go slowly and let her try to do as much as she can on her own. The goal is to keep her muscles active to slow muscle deterioration. Any physical activity is good—it does not need to be rigorous and it is actually better if she does not overexert herself.

When an Alzheimer's patient becomes unable to communicate, it is essential to continue to provide him or her with human contact in any form. Even though it may seem as if your wife cannot hear or respond to you, you presence near her is likely a calming influence. Many caregivers are certain that some of what they say in the presence of their non-communicative loved ones gets through. So continue to talk to her and tell her you love her. Also, don't forget about non-verbal communication. Touch is very important too, so hold her hand, gently stroke her arm or brush her hair, or give her a gentle shoulder massage. It may not seem like much to you, but these little things can improve her mood and affect her overall well-being.


My mother-in-law has Alzheimer’s disease. She is in the mild-to-moderate stage of the disease. When we go to family functions, (weddings, for example), she may wish people a happy Easter. Sometimes, after arriving at an event, she just wants to go home. Should she stop going to these type of gatherings or is it better for her to go so that she will have some social interaction and brain stimulation. [ 07/30/10 ]

Social gatherings, even if there are only a handful of people, can be overwhelming and sometimes frightening for a person with Alzheimer's disease. The person can become confused and over-stimulated by the noise and commotion, which can lead to anxiety and agitation. While social interaction in general is good, it is best to try to tailor the interaction to suit your mother-in-law's condition. Therefore, perhaps going to fewer such events would be warranted, or only attending those events with smaller gatherings. Before you accept an invitation on behalf of your mother-in-law, make sure the event is at a time that is good for her (i.e., it does not interfere with naps, or is too late at night). Typically, Alzheimer's patients are better in the morning and early afternoon, so an evening event may be more challenging for them.

When you arrive at the event, find a quiet place where you can take your mother-in-law. This will be her little sanctuary away from the noise and confusion of the party, particularly if there are children present. If the event is at someone's home, for example, ask in advance if a separate room or secluded area can be made available for your mother-in-law to sit in. If people want to visit with your mother-in-law, bring them to her a few at a time. Even if you think that your mother-in-law will know who these visitors are, be sure to introduce each one and provide some details or a brief description of who they are. For example, you can say “This is Cathy, your niece. We stayed at her house last summer and had a good time swimming in the lake.” Not only will this help to jog your mother-in-law's memory about who the person is, but it can also make for an easy conversation starter.


Lately, my 84-year-old mother, who lives in an Alzheimer’s disease center, will rest her head on the table for very long periods of time, but she is not sleeping. Her head is resting on the table for such a long time that she gets lines in her forehead. Why does she do this? [ 07/29/10 ]

Alzheimer's disease can often cause a person to become apathetic or depressed, which can also lead to the person becoming lethargic and easily tired. It is possible, for instance, that your mother is mildly depressed, and therefore prefers to sit in this position. It is equally possible that your mother simply finds this position peaceful or calming, and may rest her head on the table as a way to relax or even “meditate,” sort of like a coping mechanism. Maybe if there are people or commotion around her and she does not feel like being social, she may just put her head down as a way to communicate her desire to be left alone. Sometimes, however, Alzheimer's disease simply causes people to have odd behaviors that they did not have before the disease—this may be one of those unexplained behaviors.

Try talking to your mother when she is in the head-on-table position. Does she communicate with you readily or is she non-responsive? Does she keep her head on the table or pick it up when you start talking? Ask her about it. Is it something that is enjoyable to her (the smoothness or coolness of the table) or is it because she is bored, tired, afraid, etc.? She may not tell you directly, but there may be some emotion underlying her response which can help you determine why she does this.

If you think that she seems depressed or apathetic, speak to her primary care physician. A doctor's evaluation could help to determine whether or not she is truly depressed, and whether she could benefit from anti-depressant or anti-anxiety medication.


My father-in-law is in the early stages of Alzheimer’s disease. He and my mother-in-law are in their mid-seventies and currently live in a beautiful condo, but are now thinking of purchasing a home. Their children are concerned that a change of residence and all the added responsibilities of owning a house again will only aggravate the disease. What do you think? [ 07/28/10 ]

The condo is probably better for an older couple who do not need the added responsibilities of maintaining a home and yard. However, is there a reason why they do not think the condo is appropriate for them anymore? Are they worried about noise issues (from them or from their neighbors)? Is it a safety issue (e.g., too many stairs or balconies, too close to a busy highway, etc.)? Do they want something more aesthetically pleasing (e.g., a garden and small yard of their own)? Or do they want to be closer to family? Try to determine what the true reason is for their desire to move. There may be a way to fix their concerns without them having to move homes.

If there is no real way to fix the issue, or if they are determined to move out of their current condo, you may want to suggest an alternative: an assisted living community. Residences in these communities come with the piece of mind that there is always someone around to help out with your father-in-law if your mother-in-law is unavailable or if he requires more care than she can reasonably provide (particularly as the disease progresses). Plus, there is the added benefit of having many of their peers around to socialize with.

If they are going to move, it is best that they do so sooner rather than later, while your father-in-law is still in the early stages. While it is possible to move someone in the later stages of the disease, it is certainly more challenging and upsetting to the individual.


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Disclaimer: The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for the advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product or therapy. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.

Last Review: 04/29/13


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