How Do I Convince My Father to Seek Help?
Posted to alt.support.alzheimers by Mary Gordon, March 27, 2001

Consider that your father may have a progressive neurological disease that causes brain damage - so he may not be capable of understanding that he is not himself, or be able to recognize the problems he is having. Don't expect him to ever accept he has a problem, or cooperate - all the reasoning and logic on the planet may have no effect on his understanding of the situation or his emotional reactions. Take action anyway.

A couple of ideas.
1. You and your mother should write out what you are seeing and what your concerns are - be as specific as you can - what areas is he having problems in - memory, trouble with numbers, behavioral changes, emotional changes - whatever. Either mail or fax the information to your father's doctor, so he is aware of what is going on. Do this in writing, to give yourself a chance to really organize your thoughts on an upsetting subject - the doctor will get a clearer picture than with just verbal communication where you may not remember to bring up everything you are noticing. Follow up with a phone call to the doctor and get some support and advice - it may be possible for the doctor to come up with some ideas for ways to get your dad in there. This is serious stuff - he needs to be seen so various things can be ruled out. In a case like this, I would not hesitate to use some Loving Deception to get him in there (i.e. saying he needs to see the doctor to maintain insurance coverage or for a routine check up or whatever).

2. Enlist the help of your pastor, relatives, family friends, former co-workers, anyone you think he might listen to. Don't stress his failings so he gets defensive, stress how worried people who care about him are, and how much better they would feel if he would do this helpful thing of seeing a doctor just to reassure them.

3. If all else fails, take the bull by the horns and make the appointment with the doctor. Don't make a big deal about it, or tell your dad long in advance so he can get all stirred up brooding. Take the afternoon off work, go over there, pick up him and your mother, and take him to the appointment.   Bribe him with the promise of a nice lunch or a ball game afterwards - whatever it takes to mollify him. We had to do this with my mother in law. We were really matter of fact, we didn't get into emotional arguments. We just went and got her and took her there because she would absolutely NOT have gone otherwise. She wasn't happy, but in effect we just steam rolled over her objections.

You will never forgive yourself if this is something that could have been helped with early treatment. Your mother really needs help with this. Also, if your father is driving, I'd be quite alarmed for his safety and for your mother's safety. Something is quite clearly wrong with his abilities. You know your dad better than anyone. I know its hard to overcome an adult child's reticence to interfere with a parents life, but if this is Alzheimer's, you need a diagnosis so your mother and the rest of the family can have some idea of what to expect next and start to plan for the future NOW, while your father is still able to sign legal documents etc.

10 warning signs of Alzheimer's (from the Alzheimer's Association)
Has memory loss or the inability to concentrate affected job skills?
Is performing familiar tasks, like setting the table, becoming difficult?
Are there problems with not finding the right word or substituting inappropriate words?
Is there disorientation to time and place, even in familiar surroundings?
Has poor or decreased judgment been exhibited?
Are there problems with abstract thinking, for example, in performing basic calculations or thinking a problem through?
Are things being misplaced more often, then found in odd places?
Are changes in mood or behavior rapid and without apparent cause?
Have there been dramatic changes in personality?
Is there a loss of initiative and disinterest in normal activities?

Reality Sets In
Posted to alt.support.alzheimers by Mary Gordon, April 30, 2001

Evelyn, you and your husband have yet to make the big mental shift that all caregivers have to make - and believe me, I sympathise, because the day you make the shift and the full meaning of what is happening comes home to you is like getting hoofed in the guts. As hard as it is for you, it will be even harder for your husband - he will desperately want to believe that the mother he loves is still "in" there intact if only he could find the right words to find her. He will not want to believe that the person he knew is gone already in a very real way.

It is really hard to come to terms with the fact that this looks like the woman you knew, it sounds and dresses and walks like the woman you knew, it even has her mannerisms - but this is NOT her anymore. You absolutely cannot treat her the same way you used to treat her - she has a damaged brain, and YOU have to change the way you look at everything she does. You have to totally change your expectations of her, your interpretations of what she does and why she does it, and the way you deal with her.

The old "rules" for relating to her have changed - you have to throw out all your old assumptions and beliefs about her motivations, the standards of behaviour you hold her to, and how you interpret what she does. Things that would be formerly interpreted as being unreasonable, stubborn, malicious, hurtful, irrational, rude, deliberately annoying, paranoid - these apply to a person with an intact brain who is in full command of themselves. You have to get to the place where you really "get" that she is not doing this on purpose. She is doing the best she has with what her brain will allow her to do.

I look back at our own frustration and annoyance with my mother in law in that stage, and wow, I know we were still treating her like she was herself in there, and that if we only explained things better, she would suddenly say, "Oh yes, you are right, I see your point now, I've been unreasonable!". It ain't gonna happen.

The epiphany happened for me because we had very small kids while my mother in law was going down hill (3 born during the time the disease was taking her from us). I remember watching our oldest as a toddler pitching a fit about something, and realized that in an adult, his behaviour would be interpreted as totally bizarre and unreasonable. He was worse when he was tired or hungry or over wrought. No amount of reasoning would snap him out of it. He couldn't understand my perfectly sensible explanations. He had no comprehension of dangers or ability to assess his own capabilities. He couldn't control his emotions. He couldn't see how his behaviour affected others. He wanted what he wanted when he wanted it, and lived in the now (me telling him we could go somewhere next week didn't help, since he had no sense of time).

When you look at a toddler and evaluate their behaviour, you are using your adult filter of what is reasonable for the state of the person's brain. You easily say to yourself, he can't help it, his brain is only capable of certain things, so we can't expect him to behave like an adult or have the capabilities of an adult - so we don't apply those "rules" to him, or we'd go bananas with frustration. You ask yourself, as the grown up, what else can I do? Getting upset with him doesn't help, and neither does arguing...it just tends to escalate things. Hmmm, we can keep him busy, we can distract and divert him, we can love him, we can keep him away from things that might be harmful to him, we can make sure he gets enough food and rest, is kept clean, provided chances for social interaction.......sound familiar??  The kid doubtless still drives you nuts at times, but you are philosophical about
what they do because you know it is not aimed at you personally.  I can tell you, the day I started applying that same thinking to my mother in law was a sad one, but after that, what I had to do seemed much clearer and I agonized much less.

You and your husband have to shut the door on your old relationship with her and accept the mantle of caregiver - and it is painful when you first really put it on, because no one wants to accept that day has come. You will have to make the decisions for her, and you can't base them on the way she was before she got the disease in terms of what she would have liked or disliked - you are going to have to do things that she doesn't like - that's a given - for her own good and protection, the way the guardians of the toddler have to do things to him he may not like. You have a new reality, so wishful thinking has to be banished.

There is NO point to continue to have conversations and arguments about her returning to her old home. She cannot go back there. Period. Get rid of her place - get rid of her excess stuff, sell the house, and do it now, so you can rid of the idea that "going home" is even on the list of maybes. Take action now to do whatever you have to do to shut that door permanently and MOVE ON to consider options that you DO have for the future. I am presuming your husband has power of attorney for his mother. Don't try to do it all yourself. Go over there with a U-haul, boxes and some relatives and pick out the items of value, heirlooms and family pictures and papers, and be ruthless with the rest.  Hire someone to help you with the overwhelming task, not only of disposing the junk, but cleaning and painting or whatever is required. You will feel much better once that monkey is off your back. 

My heart absolutely goes out to you. I know how horrible this is - my husband is an only child and his father was long gone when his mother got Alzheimer's (she was in her early 70's when it hit). For us, once we really "got" Alzheimer's and what it meant, my husband and I were able to work together as a united team to deal with my poor mother in law - but I won't tell you the transition was an easy one. My husband just didn't want to believe or accept what was happening for a long time.

Ultimately, I was usually the "bad cop" and my husband was the "good cop". I was the one who had to be cool and practical and tell her in kind but assertive terms what was going to happen...and my husband tended to be the one who put his arms around her and tell her he agreed it was all so unfair and rotten but couldn't be helped.

Anyway, I've rambled on a lot - I feel so, so sorry that you are going through this. It is absolutely hell on earth, and I totally understand how awful it is.

Hang in there.
Mary G.