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Relationships - April 2013

It could be you ....

 

Maggi Stamp, LaterLife's Relationship Counsellor

Every month Maggi Stamp, a qualified and experienced relationship counsellor in private practice after 20yrs with Relate, writes about some of the emotional challenges we meet as we pass our half-way markers. 

For reasons of confidentiality Maggi never writes about a particular person's problems unless you have sent one in to be answered, but all her examples are based on problems raised by clients, family and friends over the years.

You can write to Maggi at maggi@laterlife.com for her to respond in the column.


Facing possible dementia in older parents

Dear Maggi,

I'm not sure what to do about things that are happening with my parents at the moment. I live quite near them with my wife and family and call in once a week to see they are ok and do any jobs that are too much for them. My wife, whose parents are no longer with us, is close to them and helps out with shopping and lifts to the doctor etc.

We both work full time and our son and daughter are in high school now. They don't go round as regularly, but we do have mum and dad to our house for a sunday roast quite often so they see a fair bit of their grandparents.

My daughter asked me why gran had bruises on her wrists the other week after a Sunday visit. I explained how easily older skin bruises and thought no more of it, but yesterday I called in and mum had been crying. She had a bruise on her cheek and she said she had fallen.

Now I'm beginning to worry that either she falls a lot and isn't safe, or that she and dad are not getting on. I know dad, once such a patient man, seems to be less tolerant these days of his own short comings and other people's. He has flown into a temper at the kids being rude, or noisy, at not being able to find the right channel on our remote control and at mum for forgetting to turn the gas off.

I don't know how to bring this up with her or dad without upsetting them and offending their sense of dignity.

What can I do?

What you have described is an alert to many who have elderly parents. You are being vigilant and your children are noticing things and telling you too, which is really helpful. Sometimes, working full time, running a family and keeping an eye on ageing parents is a tall order. Given that there are so many older people now, born just after WW2, this problem is going to be one thousands share.

But you seem to be thinking along the right lines. Either your mum is becoming too frail to be left for long, or the problem lies with your father, who is becoming vulnerable mentally. Once placid and easy-going, he seems to be more angry, a side of his personality that has not been shown until recently. Well, even in the most benign of ageing processes, our physical weaknesses can lead us to huge frustration. The once strong and capable muscles are just not responding to messages from the mind we - wrongly - assume, and certainly feel, is no different to when we were 20yrs old. So, frustration and ageing go together to an extent, when we try to do things in the same way, and at the same pace, as we always did decades ago.

But what you are describing might just be a sign of something a little more worrying. The frustration I've just described doesn't normally extend to grandchildren, though the occasional outburst to a spouse is not unusual. What is unusual however, are signs of physical damage you have noticed on your mother and a marked change of personality in your dad. Mum was obviously upset when you called in and she said she had fallen. Your father didn't contradict this but didn't join her in describing the fall, even though he was there at the time. It is possible she was covering up a distress which sadly, might be a signal to you that more regular visits are becoming necessary. It is possible that either parent might be the one who needs specialised help. Your father could be showing the early stages of changes leading to some type of dementia, or your mother could be behaving oddly, for similar reasons,with your father, leading him to become impatient with her. From what you say, your father is more likely the one needing medical support.

Older people can become very frightened of losing their independence and are likely to make light of the difficulties they have in order to preserve that independence. You, as a loving and caring son, notice change and are doing what you can to support them in their wishes. But it sounds like it is time to start stepping up the support where and when you can. If you feel you cannot broach sensitive matters with your mother it might be your wife who can do it. She is the one who helps with shopping trips and visits to the doctor and is close to your mum.

Ask your wife to spend a little time gently talking to your mum about how things have changed for her lately, not addressing the bruising directly but making an observation about how dad seems to have have changed. Once she been given 'permission' to speak about her worries she might gradually find the words to tell you what is happening.

Occasionally the early signs of dementia can be an unusual change in a person's mood or ability to tolerate ordinary frustrations. Not everyone with a form of dementia is quiet and gentle. Angry outbursts are bad enough but if they are accompanied with physical abuse then it is time to take some action. If this is what you find, you need to encourage or persuade your father to see his GP, after you have first had a quiet word with the doctor. That way, he could be offered some sort of check-up which will asses his risk of dementia. These tests are still not a full diagnosis but they do open the door to a level of care, supervision at a Memory Clinic, support and medication, which can help the sufferer and their carers.

The website www.alzheimers.org.uk has this to say about aggression:

What do we mean by 'aggressive behaviour' in people with dementia?
People with dementia may sometimes behave aggressively in one or more of the following ways:

  • being verbally abusive or threatening
  • being physically threatening, such as kicking or pinching
  • lashing out violently at people or property
  • overreacting to a situation, or becoming very agitated as a result of what seems to be a very minor setback or criticism.

What causes aggressive behaviour?
There are many reasons why a person with dementia may act aggressively, including:

  • feeling frightened or humiliated
  • feeling frustrated at being unable to understand others or make themselves understood
  • the physical effects of dementia, which may have eroded their judgement and self-control
  • loss of inhibitions and decreased awareness of rules about appropriate behaviour learned in early childhood.

Knowing this could be useful for you, your family and your mother. Keep things as ordinary, calm and reassuring for your father as possible, should this turn out to be the root of the problem.

The burden of caring for the elderly is a complex one. For centuries there was no such thing as retirement homes, care homes or nursing homes for old people. One reason was that few reached old age. The family was an inclusive unit and homes often contained 3 or even 4 generations of a family, including at times, a widowed aunt or a single cousin. Everyone contributed what they could to the running of the household.

With the onset of modern transport systems, electronic communication and dispersed families, the elderly have been left to be a separate part of a family for many. Given the pressures of 21st Century life it is very hard to maintain the closeness of the past. Not everyone is in a position to be on hand for their ailing relative, but you have chosen to keep a close eye on your parents and I feel that wherever possible, care at home is the best you can do for a parent. Yet with dementias of all types can mean that there will be a stage at which the sufferer will be better cared for in a specialist residential home. If or when this happens, try to look at it as the best thing for your parent at that stage. Be glad you had close care of them for as long as it was practical, and proud that you chose that way to show your love of them.

Just yesterday a report in America suggested that a worrying 1 in 3 older people now dies with dementia. The statistic is the same for the UK.

Unpaid carers supporting someone with dementia save the economy £8 billion a year.

For more information on symptoms, and ways of warding off or slowing the onset of dementia, go to:
www.alzheimers.org.uk
www.alz.org/what-is-dementia

 

 

 


You can write to Maggi at maggi@laterlife.com for her to respond in the column.


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