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October 2011

Mom with Alzheimer's wants to see her young sons

Dear Carol: Mom is 93 with mid-level dementia. She is constantly asking for her sons, but when she sees them, she says they are not her sons and she gets upset. She thinks something has happened to her children. Needless to say, this frustrates us all, mostly because we hate to see her so confused and in emotional pain. How on earth do people handle this? - Angel

Dear Angel: As hard as your mother’s confusion and anger are to accept, her behavior is very normal for people in certain stages of Alzheimer’s.

As you’ve seen, explaining repeatedly that these grown men are her sons doesn’t help. Arguing just upsets people with AD because in their mind they are right. And they are – they are just mentally in the wrong moment of their history. Being told they are wrong only makes them more confused and anxious. Therefore, it’s likely time for some “therapeutic fibbing.” Don’t think of it as lying. You are telling her “fibs” out of compassion, not out of malice. You are being kind by not insisting she join you in your reality when she is unable to do so.

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What to do if you aren't happy with nursing home care

Family members have ways to address caregiving issues with nursing homes. Attitude and the chain of command are both important, but every caregiver has someone on their side if they need more assistance. That person is your ombudsman.

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Assisted living combines help and social life

Assisted living centers are attractive to many people who are isolated in older homes, with neighbors they no longer know and yards that are too much work. Not everyone wants to make this move, but many do it anyway, if only because they must have help at hand for emergencies. Often, once a period of adjustment has been endured, elders thrive in these communities.

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Depression among caregivers high: get help

Numerous studies have shown that depression is a huge risk for many caregivers. People generally go into caregiving out of love, giving no thought to the fact that caregiving for an elder could go on for years. Quality of life for both caregiver and care receiver can erode as the elders' mental and physical health deteriorate and the caregiver isolates. That's when depression can set in. The remedy for this depression generally rests on some sort of regular break for the caregiver. Often, the care receiver enjoys a change of pace as well.

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Coping with outsiders who criticize your caregiving choices

One of the saddest letters I've gotten from readers was from a woman who had cared for her Parkinson's stricken husband for over a decade. Her whole life revolved around his needs. Eventually, it became too much for her. He froze up when she tried to physically move him. His memory was affected. His sheer size became too much for her. She couldn't handle it, and his needs became too complicated even for in-home help. She had to resign herself to putting him in a nursing home.

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Loneliness can cause some elders to turn to alcohol

Many an elder who only drank socially, or with a spouse, finds that a nice glass of wine at the end of the day helps ease loneliness. The once concrete rule that only alcoholics drink alone is rationalized away. When aren't they alone? The death of a long-time spouse leaves a huge hole in an elder's life. Could your elder be filling that hole with alcohol? If so, how much? What can you do to help?

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When insurance stops physical therapy what are the options?

Dear Carol: What can you do when insurance discontinues physical therapy because a patient is not making enough progress? My 66-year-old sister suffered a massive stroke and was in physical therapy for several weeks. Because she was not making enough progress in her physical therapy, they discontinued her sessions. The insurance company states that there is no point in continuing the discomfort, effort, and expense of physical therapy if it is not helping, but her husband thinks she could benefit from more. Amelia

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Being a caregiver when you have breast cancer

A mentally and physically sharp woman in her early 70s, was caring for her husband of many decades who was suffering from Alzheimer's disease. The wife was coping as well as could be expected. She also was doing what many caregivers do. She was ignoring her own health needs.

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On Oct. 25, PBS will air Bill Moyers’ exploration of end-of –life issues “On Our Own Terms”

Emmy and Peabody Award-winning journalist Bill Moyers interviewed dozens of terminally ill patients to create a four-part exploration of end-of-life issues that span thoughts about everything from health care to cultural attitudes.

A press release that I received from PBS notes quotes of high praise:

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Dementia caregiver's "survival guide" useful companion

AlzDiseaseA new book titled “Alzheimer’s Disease and Other Dementias: The Caregiver’s Complete Survival Guide,” by  Nataly Rubinstein, social worker who has also has been a long-term caregiver for a family member who suffered from Alzheimer’s disease, is a winner. Her book speaks with the authority of a trained professional as well as the heart of a caregiver.

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