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For eleven years I pleaded with my elderly father to allow a caregiver to
help him with my ailing mother, but after 55 years of loving each other–he
adamantly insisted on taking care of her himself. Every caregiver I hired to
help him sighed in exasperation, “Jacqueline, I just can’t work with your
father–his temper is impossible to handle. I don’t think you’ll be able to
get him to accept help until he’s on his knees himself.”

My father had always been 90% great, but boy-oh-boy that temper was a doozy.
He’d never turned it on me before, but then again–I’d never gone against
his wishes either. When my mother nearly died from an infection caused by
his inability to continue to care for her, I immediately flew from Southern
California to San Francisco to save her life–having no idea that in the
process it would nearly cost me my own.

EARLY SIGNS OF DEMENTIA?
I spent three months nursing my 82-pound mother back to relative health,
while my father said he loved me one minute but then get furious over some
trivial little thing and call me horrible names and throw me out of the
house the next. I was stunned to see him get so upset, even running the
washing machine could cause a tizzy, and there was no way to reason with
him. It was so heart wrenching to have my once-adoring father turn against
me.

I immediately had the doctor evaluate my father, only to be flabbergasted
that he could act completely normal when he needed to! I could not believe
it when the doctor looked at me as if I was crazy. She didn’t even take me
seriously when I reported that my father had left the gas stove on without
it lighting, or that he had nearly electrocuted my mother. Luckily, I walked
into the bathroom just three seconds before he plugged in a huge power
strip, which was in a tub of water–along with my mother’s soaking feet!

Much later, I was furious to find out that my father had instructed his
doctor (and everyone he came into contact with) not to listen to anything I
said because I was “just a (bleep bleep) liar”–and all I wanted was his
money! (Boy, I wish he had some.)

Then things got serious. My father had never laid a hand on me my whole
life, but one day he nearly choked me to death for adding HBO to his
television–even though he had eagerly consented to it just a few days
before. Terrified and shaking, I dialed 911 for the first time in my life.
The police came and took him to a psychiatric hospital for evaluation, but I
just could not believe it when they released him saying they couldn’t find
anything wrong with him. What is even more astonishing is that similar
horrifying incidents occurred three more times.

CAREGIVER CATCH 22
I was trapped. I couldn’t fly home and leave my mother alone with my
father–because she’d surely die from his inability to care for her. I
couldn’t get healthcare professionals to believe me–because my father was
always so darling and sane in front of them. I couldn’t get medication to
calm him, and even when I finally did–he refused to take it, threw it in my
face, or flushed it down the toilet. I couldn’t get him to accept a
caregiver in their home, and even when I did–no one would put up with him
for very long. I couldn’t place my mother in a nursing home–he’d just take
her out. I couldn’t put him in a home–he didn’t qualify. They both refused
any mention of Assisted Living–and legally I couldn’t force them. I became
a prisoner in my parents’ home for nearly a year trying to solve crisis
after crisis, crying rivers daily, and infuriated with an unsympathetic
medical system that wasn’t helping me appropriately.

GERIATRIC DEMENTIA SPECIALIST MAKES RIGHT DIAGNOSIS
You don’t need a doctorate degree to know something is wrong, but you do
need the right doctor who can diagnose and treat properly. Finally, I
stumbled upon a compassionate neurologist specialized in dementia, who
performed a battery of blood, neurological and memory tests, along with CT
and P.E.T. scans. He reviewed all of my parents’ many medications and also
ruled out all the many reversible dementias. And then, you should have seen
my face drop when he diagnosed Stage One Alzheimer’s in both of my
parents–something that all of their other doctors had missed entirely.

TRAPPED IN OLD HABITS
What I’d been coping with was the beginning of Alzheimer’s, which starts
intermittently and appears to come and go. I didn’t understand that my
father was addicted and trapped in his own bad behavior of a lifetime and
that his habit of yelling and pounding the table to get his way was now
coming out over things that were illogical and irrational… at times. I
also didn’t understand that demented does not mean dumb (a concept that is
not widely appreciated) and that he was still socially adjusted never to
show his “Hyde” side to anyone outside the family. Even with the onset of
dementia, it was amazing he could be so manipulative and crafty. On the
other hand, my mother was as sweet and lovely as she’d always been.

BALANCING BRAIN CHEMISTRY
I learned that Alzheimer’s is just one type of dementia (making up 65% of
all dementias) and there’s no stopping the progression nor is there yet a
cure. However, if identified early there are medications that in most people
can mask/slow the progression of the disease, keeping a person in the early
independent stage longer–delaying full-time supervision and nursing home
care. (Ask a Dementia Specialist about the FDA approved medications:
Aricept, Exelon, Razadyne and Namenda.)

After the neurologist treated the dementia and then the depression
(often-present in dementia patients) in both of my parents, he prescribed a
small dose of anti-aggression medication for my father, which helped smooth
out his volatile temper without making him sleep all day. (Boy I wish we’d
had that fifty years ago!) It wasn’t easy to get the dosages right and not
perfect, but at least we didn’t have to have police intervention anymore!
And once my parents’ brain chemistries were better balanced, I was able to
optimize nutrition, fluid intake, and all their medications with much less
resistance.

CREATIVE BEHAVIORAL TECHNIQUES
As soon as the medications started working, I was able to implement some
creative behavioral techniques to cope with all the bizarre behaviors.
Instead of logic and reason–I learned to use distraction, redirection and
reminiscence. Instead of arguing the facts–I simply agreed, validated their
frustrated feelings, and lived in their reality of the moment. I finally
learned to just “go with the flow”. And, if none of that worked, a bribe of
vanilla ice cream worked the best to get my obstinate father into the
shower, even as he swore a blue streak at me that he’d just taken one
yesterday (over a week ago)!

Then finally, I was able to get my father to accept a caregiver in their
home (he’d only alienated 40 that year-most only there for about ten
minutes), and with the tremendous help of Adult Day Health Care five days a
week for them, and a weekly support group for me, everything started to fall
into place. It was so wonderful to hear my father say once again, “We love
you so much, sweetheart.”

ALZHEIMER’S / DEMENTIA OFTEN OVERLOOKED
What is so shocking is that no one ever discussed the possibility of
Alzheimer’s with me that first year. I was told their “senior moments” and
intermittently odd behaviors were just old age, senility, stress, and a
“normal part of aging”. Since one out of every eight persons by the age of
65, and nearly half by the age of 85, get Alzheimer’s Disease–I should have
been alerted to the possibility. Had I simply been shown the “Ten Warning
Signs of Alzheimer’s”, I would have realized a year sooner what was
happening and known how to get my parents the help they so desperately
needed.

If any of this rings true for you or someone you love, I urge you to seek
early evaluation from a Dementia Specialist-immediately!

TEN WARNING SIGNS OF ALZHEIMER’S
(Reprinted with permission of the Alzheimer’s Association)

1.   Memory loss
2.   Difficulty performing familiar tasks
3.   Problems with language
4.   Disorientation of time and place
5.   Poor or decreased judgment
6.   Problems with abstract thinking
7.   Misplacing things
8.   Changes in mood or behavior
9.   Changes in personality
10.  Loss of initiative

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jacqueline marcell

Last Modified May 29, 2009 @ 9:49 pm
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