How can we communicate and keep up a meaningful heart-to-heart connection with my aging mother as her mental condition deteriorates? She's past eighty now, and symptoms of dementia are becoming more and more pronounced in her behavior. Her short-term memory is so poor that she can't remember what she said to me ten minutes ago. It's as if we're already losing her. Do you have any advice?
Caring for a loved one with dementia may be difficult, but it also has its meaningful moments. Stay open to the possibility of connecting with your mom in simple ways - for instance, by sitting with her in the twilight, holding her hand, brushing her hair and witnessing her contented smile. Some caregivers have been thrilled to watch the spiritual aspects of their elder's life continue to blossom despite the loss of mental faculties. As one woman said, "Even when my mother could no longer put sentences together, she had no problem praying the Lord's Prayer." Caregivers may also find a deep and poignant sense of fulfillment in the reversal of the parent-child relationship, cherishing the opportunity to nurture their aging loved one.
While you can expect to be surprised by times of joy, living with someone who is afflicted by dementia can take a severe toll on the caregiver and their family. As you move through this phase in your relationship with your mother, make sure that you're taking care of yourself. Watch for signs of over-stress and burnout - fatigue, stomach distress, headaches, and difficulty sleeping. Be aware that the frustration and confusion you're encountering can leave you feeling angry, guilty, depressed and overwhelmed. If your loved one lashes out at you or no longer recognizes you, you may experience emotions of grief and sadness. It's important, then, to protect your own mental and emotional health. If you don't take care of yourself, you won't be able to care for your mother effectively.
In dealing with this challenge, you may find it helpful to educate yourself on the various causes of dementia. They fall into two general categories: reversible and irreversible. Reversible causes include depression, confusion and delirium (which can sometimes be the result of physical illnesses such as pneumonia, urinary tract infection, or heart attack). Among the more common forms of irreversible or progressive dementia are senile dementia or organicbrainsyndrome, which results from persistent physical or neurological damage to the brain. Contributing conditions can include: vascular or multi-infarct dementia, which is caused by multiple minor strokes and reduced blood flow to the brain; mild cognitive impairment (MCI), a state of memory loss somewhere between that of normal aging and Alzheimer's disease; and Alzheimer's disease. For more detailed information about these conditions we suggest you consult with your mother's physician.
It's worth adding that there are several prescription drugs currently being used to treat age-related memory loss, including donezepil (Aricept), rivastigmine (Exelon), and memantine (Namenda). Your mom's doctor can tell you whether it might be worth giving one of these drugs a try. Keep in mind that they are relatively costly, and that the potential side-effects, such as gastrointestinal upset, need to be balanced against the benefits.
On the practical level, it's important to have a plan of action to help you manage the needs of your loved one and still reserve some time for yourself. Here are some suggested steps to take:
- Get a diagnosis. The sooner you know whether your mother has dementia that is treatable or untreatable, the better you will be able to manage the situation.
- Write a daily schedule. A structured day of planned activities will help promote a sense of routine and stability for your aging loved one.
- Locate available resources. Take advantage of the services and information available from county and state health or social-service agencies. For more information, see the website of the National Association of Area Agencies on Aging.
- Seek financial and legal advice. Prepare for the future by discussing your mother's needs, such as wills, trusts and durable power of attorney, with a professional financial adviser or an attorney.
- Be realistic about your loved one's changing capabilities. Try to concentrate on your mother's remaining strengths to help her feel loved and valued. In addition, having realistic expectations about your mother's situation will minimize disappointment and frustration for everyone.
- Ask your pastor to visit your aging loved one. Church members who personally share hymns, prayers and communion can be deeply meaningful to an elder in your mom's situation. Your pastor may be able to recruit others to visit as well.
- Cope with change. Realize what you can and cannot do, and don't be afraid to ask for help. Others are often willing to assist, especially if the requests are very specific and time-limited.
For additional help and information on this topic, we'd encourage you to consult the resources and referrals highlighted below. Or if you have relationship concerns and challenges associated with this situation, please don't hesitate to give our Counseling department a call.
Caring for Your Aging Loved Ones