Alzheimer`s Disease/Caregiver stress

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QUESTION: My son-in-law's father has alzheimer's and is about Stage 5. He can dress and bathe himself, fine with toileting. His son and wife order from the menu for him, tell him where to sit, etc. His personality is still there - he's still the kind, gentle and caring man he's always been. He can carry on entire conversations that make no sense. I noticed when they were bossing him around over the weekend he did get somewhat rebellious. More importantly, I've noticed with my son-in-law a meanness toward my daughter and grandkids and general attitude of being an arse. I know this must be tearing him up inside. Is there anything I can do or recommend that can help before he destroys his marriage and relationship with his kids? He thinks counseling is stupid and for the weak. He does like to read.

ANSWER: Hi Shelly-
I would suggest a few things.  Try to get your son-in-law to attend some Alzheimer support groups.  Encourage him to attend by stressing that he will meet others going through the same difficulties with their loved ones and he will learn more about what to expect as the disease progresses.  If he won't attend,go to the Alzheimer's Society website and find books that are aimed at family members of those with AD.  Maybe you can buy him one or two.  
Your also mentioned that your son-in-law's father is getting "somewhat rebellious".  It is rather common for those with AD to become argumentative and sometimes even combative.  Encourage his caretakers to discuss his behavior with the doctor treating him and encourage them to ask about medications that will keep him more calm.
From what your write, your son-in-law is stressed out over his father's condition.  Often the children of those with AD fear that they will suffer a similar fate in years to come. I think your best approach is to be as supportive as you can toward him and try not to over-react when he gets testy.

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QUESTION: Is the combative behavior inevitable? Seems to me that using kind persuasion would get more support from the man. For example, instead of saying "Get over here and sit down!" - I think something like "Hey, come over and sit with us!" would garner more cooperation. Even though he has AD, he's still an adult and I would think, doesn't like to be bossed around.

Answer
Hi Shelly-
In general, when you deal with someone with AD it is best to go with the flow and avoid getting into arguments.  Ordering around a person who has AD often results in in a non-productive situation.  No, all AD patients don't go through this argumentative stage, but it is not uncommon.  
You are certainly correct in your feeling that those with AD should be treated like adults; with respect and dignity.  Try to find some literature on effective communication with AD patients and show it to your son-in-law.  Of course, the way you present it to him will also be important.

Alzheimer`s Disease

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Peter Winkler

Expertise

I can answer questions regarding the care of persons with Alzheimer's Disease. I have no medical degree and I am not qualified to answer questions of a medical nature.

Experience

I was the spouse and primary caretaker of my wife, who was diagnosed with dementia at the age of 53. I initially cared for her at home, but after her illness progressed, I placed her in a long term care facility. A year later, I found a nursing home for her and she spent almost 10 years there before she passed away.

Education/Credentials
I have an MSW (Master's in Social Work) degree.

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