Expert: Paula Damgaard - 9/26/2008

Question
Mom has Alzheimer. She chokes on any thing she tries to eat or drink. Dad has her at home and is about to fall out from exhaustion. My sister & brother help with mom. i live 6 hours away. Dad refuses any out side help.  He won't say but i think from the way he talks she has been aggressive with him. She sleeps less & less.How much worse can this get? What stage is Mom in? I am beside myself and suffer from panic attacks from mom's illness. when will i know when to go home? i want to be at home when the end comes. Please help me!

Answer
Dear MJ, I wish I could tell you exactly when to go home!  I am sorry that your dad won't accept outside help, because he surely sounds like he could use it!  There are medications that she could be given to make her less combative and easier for him to handle.  As for the choking, I would suggest that instead of him giving her pure liquids to give her foods similar to the consistency of baby cereal.  They seem to be able to swallow that easier.  

While I have no idea when your mom's end will come, do you think your dad would let Hospice in?  Many of the Hospice programs have a transition program for people, like your mom, who are trained to help with dementia patients.  Perhaps he would let them in?  

As for what stage you are asking is she in?  I can only guess not seeing your mom and from the little that you describe, I would have to say that she is probably in stage 6-7/ severe stage.  

I think that your dad needs to know that when your mom is aggressive, it isn't your mom that is driving this aggression it is the disease and he shouldn't feel bad about asking for medicine to help her.  I think he feels like he is "doing something wrong" which is why she is acting this way and that is NOT the case.  This is totally disease driven and he needs to recognize this and medicate her.  He is no good to her dead, and unfortunatly studies have shown that 50% of caregivers get really sick or die before the patients because of the stress of caregiving.  Please urge him to use the resources that are available!  Hospice is provided by his Medicare.  

I hope this helps and I am sorry you are so far away, I know that is difficult, but perhaps you could find a way to help him, like paying for a house cleaner or someone to do the laundry?  Take care and let me know how it goes.  I wish you luck in getting your dad to get the help that HE needs.  Paula