Expert: Paula Damgaard - 9/19/2008

Question
QUESTION: My wife's father, soon to turn 91, he appears to be around the 5th level. The doctor recommended to us today to bring him into our home since he can't remember to go to his meals or properly take his medications, and his mobility is very poor. He's been at a senior living complex since 1989.
We have 4 of our 5 children at home. Ages 27, 18, 16, and 11 (all girls). I'm concerned primarily out our 11 year old. What are your thoughts on how to handle the potential of her watching her grandfather degress and possibly die in our house? Any suggestions woould be appreciated. Thanks for participating in this valuable forum.

ANSWER: Frank, This is going to change your household a huge amount.  He is going to bring a huge amount of responsibility to you and your wife.  As the disease progresses he is going to become an invalid.  Unable to do anything, eat, drink, toilet, bath, all activities of daily living.  Are you sure you are ready for this?

As for your 11 year old, it will be hard for her.  She will no longer be the "special baby child" as granddad will now take that spot.  When my mom was going through the disease we rotated her between my house and my sister's.  I have two daughters who were during that time 11 and 14 at the start.  I know that at times it was not easy for them and there were times they resented her and my time that was spent caring for her.  But I also know that they both were really close to my mother and cherish the time that they had her near.  We placed my mother in a nursing home where she lived for the next 8 months.  When she died she was still able to care for herself to some degree and knew all of us.  

These are hard questions and harder decisions!  I hope this helps you.  Please let me know how you make out.  Paula

---------- FOLLOW-UP ----------

QUESTION: I did see it coming and tried to prepare most of the family. Of course one never knows how well we'll handle this situation but my wife isn't having it any other way. My wife is a stay at home mom, still takes kids to school and things of that nature. She does have a flexible schedule. My son is married (32 yrs old) and will take him in from time to time for a weekend visit. Eldest daughter is single , 27, part time teacher who still lives at home andhas a lot of flexibility.
Although he has no short term memory (i.e. can't remember if he ate breakfast when I call at 9 AM) he does remember the distant past fairly well and most of the family's names and specific recent events. He can carry on an intelligent conversation when he's not complaining about being confused or saying he doesn't know what he's supposed to be doing. Also he eats well, quick and with relish (when he remembers to eat). The mobility is a big problem. Can't get around without a seat type of walker. Our house is 2 story with all baths and showers on the 2nd floor. Not sure how to handle bathing. Downstairs I have a living room with minimal furniture that can be made up for him. He'll have little privacy after living alone since 1987 when his wife passed, but there's enough room for him to have kind of a single's apt set up in the living room. The den where the family spends it's time is on the other side of the house, so he could be somewhat alone  in his "room" periodically during the day. Still I'm truly unsure about how well we'll do as he digresses.


Answer
I wish you lots of success with this.  I encourage all of you to make sure that you make time for yourselves.  It is very easy to get caught up in the caring and forget yourself.  I would also encourage you to enroll him in a daycare setting where he will be able to interact with people who are in the same shape as him.  This will also allow for him to have activity during the day and provide a safe haven for him while your wife goes about doing her normal daily routines.  She will not be able to just "put him in the car" and take him with her as I am sure she is envisioning.  As he progresses he will need more and more of her time and that will take away from her ability to care for your youngest child.

As for the bathing, my mother hated taking a bath, not sure why, so I improvised.  I bought flushable wipes so that she would always have a clean butt and did sponge baths everyday to clean the other parts.  She was always used to having her hair washed in the kitchen sink cause that is the way she did it as a child.  She never was one that worked up a smelly sweat so we were lucky.  If you call the Alzheimer's Association they will have other helpful hints on how to bath an AD patient that can no longer get into the tub.  

I hope this is a rewarding experience for all of you, cause it can be, as long as you remember to take care of all the parts!  Good luck and let me know how it goes.  Paula