For most of my life, one of my mother’s outstanding traits was her ability to socialize with others.  She had an ability to start, or add to, a lively conversation on most any subject and a way of making every stranger feel welcome, every person feel important.

Alzheimer’s changed that wonderful behavior and recently she has begun to just chatter, maybe for attention or maybe as an attempt to be her old self.  However, she now interrupts conversations with nonsensical, repetitive, often irrelevant chatter.  Or in the car, she will just talk non-stop about nothing and everything.  It can be very irritating, so my family tried humor and found that it often works… at least temporarily.

When my mother is chattering non-stop in the car, my brother tells her that he has an Eject-o-Mom installed in the passenger seat and if she continues to chatter he will press it.  She giggles and the chatter subsides!  Ten minutes later, she may be chattering again and he may have to say it again, but she giggles again and is quiet for another few minutes.

When she chatters non-stop at home, Steve tells her that the chair she is in only has a 100-word capacity and if she says more than 100 words, it and she will melt into the carpet.  And she stops to think about that and forgets to chatter for a few minutes.

While this may sound silly, it actually works.  Those with Alzheimer’s have a different reality.  You cannot teach them to modify their behavior – they will forget your teaching.  You cannot effectively punish them, for they often do things unconsciously; they react without ‘thinking’.  Nor will they long remember a punishment or what it was for.

So when I need to reprimand my mom (which can be often), I try to find a funny, nonsensical way to do it instead of using anger (which only makes the matters worse).   And with each activity that I do with my mom, I try to make her laugh at least once.  And as I try to find things to make her laugh, I find myself relaxing and finding more joy in my time with her.

There are lots of things in life to make you laugh or smile, if you only take the time to notice.  That’s one good lesson I have (re)learned while caring for my mom; and one I hope to carry with me for the rest of my life!

There comes a time, if people live long enough, that hospital admission should be avoided. My mother struggled to maintain her independence into her 90s, tolerating walkers and assisted living only when necessary. Once her life was reduced to a wheelchair and skilled nursing care, she did not consider her life worth living.

While my mother was in assisted living, she appeared happy and mentally alert. After a family reunion for Thanksgiving, she developed a urinary tract infection that sent her to the hospital. She was there for two weeks, then released to a skilled nursing facility, with the goal of returning to her assisted living apartment.

The two-week stay in the hospital took more out of my mother than she could recover from. The time with no mobility exaggerated her arthritic condition to the point where walking again was impossible, even with assistance from a physical therapist. She returned to the hospital twice more with urinary tract infections, but never recovered the strength that she had prior to those admissions either. I now believe that the repeated hospital stays caused her to lose her ability to walk, and eventually the desire to live.

It was only through hospice care that we were able to stop the hospital admissions, which were counterproductive in her case. I would strongly recommend that anyone in a similar situation utilize hospice care to avoid hospital admissions for elderly relatives.

In our situation, we were able to move my parents into a guest home on my brother’s upstate New York property and hire a full-time live-in to care for my mom.   This change gave my mom the attention she needed, but also, critically, relieved my father of the burden of being the primary caregiver which was literally killing him, physically and emotionally.

As the plans progressed, my family decided not to tell my mother that she was moving, only that she was going to visit my brother for “a while”.  All of us helped with the move.  My two sisters flew with my mother and their two cats to be greeted in Albany by my brother.  The same day I flew to Chicago to help my dad pack, oversee the movers and say good bye to our family home for over 25 years.

When we arrived in New York four days later, my mother was just happy to see us… especially my dad, her life partner.  When her bed, dresser, piano, sofa and other items arrived a few days later, she was confused but took it in stride.  After all, all her loved possessions – my father, her cats, piano, bed and dresser were there, so this must be where she lives.  She still gets confused once in a while about where she lived, but I do believe we saved her the confusion and emotion of saying good bye to her friends, very good friends.  I don’t believe she would have understood why she needed to say good bye, that she might not ever see them again.  I think, in our situation, that we choose wisely.

I would love to hear your story about moving your parents.  It is never easy.  But I have to say that my father has gotten younger since the move.  At 87, he is much happier and healthier than he was with the full burden of the main care giver for my mom.   My mom, at 82, is still my loving mom…

Submitted by Lisa Cochrane

Our caregiver was not born in the US, but had worked as a caregiver for over 7 years assisting several other families prior to joining our family.  The way she acts and reacts to my mother is sometimes an issue as she is much more aggressive and hard on her than any of us can be.  But she often gets positive results when we cannot, so we have learned not to judge her actions until we see what happens.

Case in point… Recently, my mother has taken to swearing like a sailor whenever she was upset.  It started with “Oh God!” but then progressed to even nastier language.  It was getting difficult to take her out in public because we never knew when she would spout off with inappropriate language… and we didn’t want to stop taking her out as it was a good way to entertain her and pass the day. 

My family tried all sorts of creative things to curb this behavior, but to no avail.  Our caregiver had been on vacation as this was occurring and when she returned she simply said to my Mom “I will bite your tongue off if you swear again.”  Now, I could never say that and probably won’t even think it, but it worked.  When I first heard what she said I felt it was too strong and too nasty, not the sort of thing that should be said to my wonderful, loving mom.  Then I saw the results and realized it had been effective. 

This experience made me realize that the best care-giving solution is often a combination of loving family and an outside care-giver.   Family may have the love but often don’t have the experience and outside care givers are more detached so they often can employ different methods.  Our caregiver’s relationship with my mom is more like a teacher and a student… she keeps her distance so that she can play the disciplinarian when needed.

While I cannot imagine saying to my mom (or anyone for that matter) that I will “bite your tongue off if you say that again”, I do appreciate that it worked to curb a behavior that was unsettling to my family.  I learn from our caregiver every time I visit.  I may chose not to employ some of her techniques but that does not mean that I don’t appreciate the results.

If you are playing a part in caring for an aging parent, try to share that responsibility with an experienced care-giver.  Not only will get some time away, but you may also find that you learn from them and/or find solutions to some of your ongoing challenges.

Submitted by Lisa Cochrane

There really isn’t much a caregiver can do to stop this trait of Alzheimer’s. It is a recognized symptom of the disease, and like most aspects is basically incurable. But there are ways to cope. As my friend discovered, responding with an alternate phrase may be enough to make the change stick. Her mother would call out in public, “My God! My God!” Each time she did, my friend responded with, “My goodness. My goodness.” Eventually Mom started saying, “My goodness” instead. But this only worked for a while, since at home the rest of the family didn’t reinforce the change.

Another coping device that might limit the shock and embarrassment of such outbursts is to be prepared when they occur. Compile a list of similar-sounding words and keep them in mind when the Alzheimer’s sufferer is in a public setting. When a choice four-letter word is delivered, quickly respond with its sound-alike. Duck? I don’t see a duck, Mom. Silly, but that’s the idea—try to turn it into a little bit of humor. Most people around you will probably understand what’s going on right away.

Just remember that cursing, unfortunately, is a typical symptom of Alzheimer’s. If you don’t let it become an embarrassment, it won’t seem as shocking.

When the level of care for your aging parent must be increased, it’s important for caregivers to take a more active role in how that care is delivered.

When my mother moved to the Chicago area, she stayed in an assisted living facility with which we were extremely pleased. But after a stay in the hospital, she was required to move to the rehab facility on the same campus.  Since we were so happy with the assisted living facility, I made the mistake of assuming that she would be well cared for in the rehab facility.

They had made no effort to compare treatment plans from the adjacent building. For example, they had every pain medicine labeled “PRN” (Latin: pro re nata, which means taken as needed).  That meant that she would receive no pain medicine unless she asked for it, but she had been on a pain management regiment for years so never had to ask before, and now did not realize the change.  Once I saw the intense pain that she was in, I had to act, to get the facility to resume her pain management regiment, but it was a difficult process.

Most facilities have a certain level of care that they are prepared to offer, and sometimes do not recognize when residents require greater care.  It’s important for children and caregivers to get involved and stay involved in the decision making process before a parent is moved.

I first discovered that since my Mom’s physician wasn’t associated with the hospital she was in, they assign an internal doctor called a “hospitalist” to manage her treatment. And if I didn’t catch him in the morning when he did his rounds, trying to get information from anyone else on the staff was nearly impossible! Shortly after she got out, we changed physicians to one that was associated with this hospital. Now she will manage her care if and when Mom has to go in again.

One morning when I walked into her room, a caring hospital worker told me that my mother needed more supervision. He said that she had gotten up early in the morning and walked over to sit down on a chair across the room! When I begged her not to do that again – we didn’t even know if she had a hip fracture yet – she calmly exclaimed, “Well, at least we know I can still walk!” 

It was then I noticed that only three of the four rails on the bed were up.  Her nurse informed me that I’d need to get orders from the doctor to put all four rails up. This totally baffled me, but I got the orders and put them up when I left that night. The next morning I found out that Mom had tried to climb over the side rails and fell out of bed in the process! Fortunately she wasn’t hurt. It was only then I discovered the reason for not putting all up at the same time – apparently it’s been proven that more people get hurt trying to crawl over the rails than if they actually get out of bed without them! The only thing left to keep her safe was to put her in wrist restraints at night.  I struggled with this one, but there was no other choice.

I also learned that if your parent suffers from dementia, it’s likely to get worse in the hospital, simply due to confusion that comes from being in such a different environment.  During the day, my mother’s manifested itself in a very sweet and humorous way. At one point she told me that the surgery (which she didn’t have) had gone well and they worked on her breasts while mending her hip and she couldn’t wait to get the bandages off to see the results! At night, she would become agitated and paranoid. I discovered that this is called “sundowner’s syndrome.” She refused to eat one evening, because she was sure that her food had been poisoned. It wasn’t until one of the nurses told me that this was very common, that I stopped wondering what was going on and accepted this as a temporary problem.

Ultimately it was determined that Mom hadn’t broken her hip and they were able to get her blood pressure back to normal so she went back to her assisted living home. Had I been armed with more knowledge on hospital procedure and the effects of a hospital stay on the elderly, it would have made a difficult situation much less difficult.

Many of us with senior parents have moved far enough away from our folks that the only time we see them each year is during the holidays. That’s the case with me—we’ll be seeing my mom over Thanksgiving and my wife’s mom during Christmas.

It’s great to get together, of course, but now that our moms are aging, it’s also a good opportunity to assess their mental and physical health. It’s certainly better than trying to do it over the phone and asking questions, since parents may not be completely truthful about health issues in order to keep from becoming a burden to their children.

Obviously I won’t be sitting at the Thanksgiving table, staring at mom. But over the course of our visit, I’ll be checking for indications that she may be having trouble performing functions that weren’t a worry before.

For example, my mom has always been someone who takes regular walks and never has any trouble with stairs, and I’ll want to make sure that is still the case. She wears a hearing aid and lately we’ve had some trouble over the phone, so I’ll be looking to see if there is a bigger problem than she admits when we talk.

If the opportunity arises, and you can sit down with your parent one-on-one, the personal setting may give you a chance to ask about such things as financial or legal issues, to make sure his or her affairs are in good order. If you are visiting at your parent’s home, you might also ask to see such things as bank statements or insurance policies, to make sure they are in order. Ask also about new purchases or agreements they may have entered into—as we’ve noted in previous posts, seniors are often the target of unscrupulous sales pitches. You can also check on medications—how many and whether they’re taken as prescribed.

And if you have a suspicion your aging parent is developing dementia or Alzheimer’s, here are a few signs to look for, courtesy of the Alzheimer’s Association (alz.org).

• Memory loss that disrupts daily life
• Challenges in planning or solving problems
• Difficulty completing familiar tasks
• Confusion with time or place
• Trouble understanding visual images and spatial relationships
• New problems with words in speaking or writing
• Misplacing things and losing the ability to retrace steps
• Decreased or poor judgment
• Withdrawal from work or social activities
• Changes in mood and personality

The holidays are a great time to relax and renew family bonds, but don’t pass up the chance to make sure your aging parent is in as good shape as you think s/he is.

I am certainly not an expert on the extremely trying experience of dealing with dementia, but I can share what I have learned. In the last six months of my mother’s life she showed significant dementia, but she was under hospice care at that time. I had visited her at her lunch time, and she was insistent that she had to call her husband immediately. Since she had been a widow for 24 years, I had no idea how to respond.

In panic I found her hospice nurse and asked her assistance. The nurse came with me and we calmly explained that her husband could not be called right now. The nurse then asked who else my mother could call. Mother said she could call her son, to which I replied that I was here. Somehow the need to call someone got transferred to my son. We were able to reach him in California, and my mother talked to him for a half hour. After that my mother was calm. The lesson learned is that, no matter how irrational the request, you never deny the request. The effort needs to be to redirect the request until the need is satisfied.

Through research, I found out that dementia is a term used to describe a group of brain disorders that includes Alzheimer’s. These brain disorders generally cause memory loss and make it harder to carry out daily tasks.

Alzheimer’s disease is the most common form of dementia. According to the Alzheimer’s  Association, as many as 5.2 million people in the U.S. have the disease. Alzheimer’s attacks the brain, slowly killing different parts until it finally affects a crucial body function that results in death.  It affects each person differently, attacking different parts of the brain in different ways and on a different schedule.

More than memory loss, my family first noticed a change in my mother’s behavior.  Yes, she forgot things, but more importantly she stopped doing the things she took pride in and loved to do.  She stopped gardening and cooking, two of her most extraordinary talents.  She stopped cleaning the house and washing clothes, as though she could no longer see when something needed attention.   She lost her thirst for knowledge, stopped reading the paper and lost her ability to have a good conversation.  So to us, the fact that she forgot what happened yesterday became secondary to the dramatic changes in her habits, hobbies and love of life.

She was a gourmet chef, yet she quickly deteriorated to not even pouring herself a glass of milk.  Her garden was spectacular but she lost all interest.  She used to be the life of the party and made everyone feel at home, but she became scared of the unknown and people she didn’t recognize.  Where she used to exercise and pride herself on being 5’2”, 105 pounds and a size 6, she is now 5’2”, a size 14 and forgets that she used to swim or walk up to five miles a day.

Again, this debilitating disease affects each person differently and my family still has a few things to be thankful for… Mom still remembers all of us (children and grandchildren), loves to be loved and continues to play the piano with gusto.  On the downside, she still corrects our grammar, pronunciation and now swears like a sailor!