Dear Carol: My dad, 79, was getting confused about normal things around his house, so when COVID began in March, we convinced him to move in with us. We gave him a bedroom/bathroom suite and it worked fine for a time, but his cognition is deteriorating badly. His doctor diagnosed him with Alzheimer’s, and he’s had some medications, but they haven’t helped.
I’ve told Dad that with an Alzheimer’s diagnosis, he’ll need help with finances and that we should move his bank accounts online, but he says he doesn’t have Alzheimer’s and he doesn’t need help and doesn’t want that “computer stuff.” Then he threatens to move out to “show us.” Should we keep telling him he has Alzheimer’s, or should we just pretend that he’s fine and wait for a disaster? — TG.
Dear TG: A hard fact is that while denial like your dad’s denial presents a significant challenge, it’s not unusual and is likely a normal response to loss.
It seems that you are doing what's possible medically. Your assignment will be to learn to understand his disease in a way that helps you work with your dad's altered brain. Many people who live with dementia don’t understand that they have a brain disease because, well, their brain won’t let them understand it, so not mentioning his dementia is a start.
RELATED COLUMNS: Elder-friendly tech to stay connected during COVID| A good relationship with your parent is worth more than cleaning differences | Did I make the right decision with Mom's end-of-life care? | Bursack: Empty chairs at holiday dinners are more prevalent during COVID
If you learn to work around his resistance by asking him to contribute in some way, he might feel less defensive. That could mean giving him some easy projects like fixing something that’s not too tricky if household upkeep is an interest of his. If he likes to cook, ask him for help in the kitchen. If he is OK with chores, ask him to fold laundry or some other uncomplicated task. Helping around the house might make him feel better about himself.
One caveat: It’s easy to come across as patronizing, so work on making requests casual but respectful. Yes, this is hard, because if you ask for help with things he can no longer do, he'll be frustrated.
Alert: Being a dementia caregiver is anything but easy, and you will make mistakes, so forgive yourself if something backfires and try again later.
For his finances, why not take advantage of our current isolation by telling him that the banks are suggesting that everyone who hasn’t set up their accounts online do so now? Once that’s done, you can tell him that the current advice is that it’s safer to pay bills online, too. This is all true. If he resists having his accounts online where you can monitor them, you could provide him with a shadow checkbook while you keep the real one.
Try to make changes slowly, remembering that every change that you want to make could take multiple tries. If you ask for his input and let him talk out his anger and frustration, you should gradually make progress.
The Alzheimer’s Association, available online at alz.org, is helpful for learning more about interacting with people with dementia.
Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached through the contact form on her website.