As I do geriatric house calls around the Bay Area, adult children and other relatives of my patients often say, “He’s just not the way he used to be. Why can’t he be the way he used to be?”
Children and other family members often struggle to accept that an elder has dementia.
• Sometimes the patient has been difficult, even mean, in earlier years. It’s difficult for family members to accept that the person that may have driven them crazy a decade ago is now very needy. Try to accept that the elder your dealing with now is fundamentally different because of their dementia
• One upside is that patients sometimes actually improve their relationships with their family after dementia sets in. As one daughter told me, “My Mom is so much easier now: She’s forgotten all the reasons she was mad at me. Now she’s just glad that I’m here.” Hope for that kind of resolution, and even if it doesn’t come, recognize that dementia, not the intention, drives the behavior of most patients.
• Accept that relatives go through a very real grieving process when an elder gets dementia. You may grieve the loss of a beloved relative. Or you may grieve the fact that a difficult elder will now never really understand you. If you’re suddenly responsible for caring for your elder, you may grieve the loss of an independent life. Expect this grief. Accept it, and try to work through it.
• Try to acknowledge your fear. Dementia holds up a very scary possibility of what may come with old age. You may be terrified that because you have relatives with dementia, you may get it too. Remember that while there is some genetic link to dementia, that is far from the whole story. Try to focus on the present, not a problem that may, or may not, come decades from now.
• Consider joining a support group. Your local Administration on Aging or your local chapter of the Alzheimer’s Association has a list of local support groups for family members. If your elder lives in assisted living, or in a nursing home, those institutions also sponsor support groups for family members.
Especially during the upcoming Holidays, compassion, acceptance, and acknowledgment all go a long way when interacting with family, with or without dementia.
Elizabeth (Dr Liz) has over twenty years of experience in providing medical care to the elders. She is board-certified in Internal Medicine, Geriatric Medicine and Palliative Care Medicine. Dr Landsverk founded ElderConsult Geriatric Medicine, a house calls practice, to address the challenging medical and behavioral issues often facing older patients and their families.