 | | | Linda Fodrini-Johnson, MA, MFT, CMC is a Licensed Family Therapist and Certified Care Manager. She has been practicing professional care management (now called Aging Life Care(tm)) since 1984. | | | | | | You may notice that a close family member or friend is having more and more challenges with memory or making sound decisions. What do you do and how should you approach this sensitive subject?
Recently, I was asked to do a podcast interview with a geriatrician. She asked me if there were any books for families dealing with this beginning stage of a dementia that brings on worry and concern. Sadly, my answer is that I could think of none that just addressed this issue.
When my mother first started to exhibit some lapses of judgment or memory I didn't want to confront it head on for two reasons: 1) I did not wish to see this fiercely independent woman (who was driving all over San Francisco with friends a decade younger than her) lose her independence. I needed her to be my strong role model even at 86. This is called denial. 2) My clinical background said I just needed to gather more information before jumping to conclusions. So, I started a log of times she forgot to take the keys out of her garage door as she drove away, or repeated the same story to me five times, or going to see six different doctors with vague symptoms.
I had been providing my mother a personal assistant once a week since she was about 80 years old. She just needed someone to help her with organizing paperwork and following up on the telephone for her when she had questions regarding a bill or an upcoming medical appointment because her hearing was impaired and phone calls were challenging. The personal assistant came for just two hours a week and was amazed at how well my mother was. She was my gatekeeper as mom's memory and judgment started to fail. Her dementia, we determined, was from small strokes.
Not everyone has this type of information and monitoring of a parent at a distance or even nearby. Often those with dementia like Alzheimer's disease are socially appropriate for a long time into the illness, and even the family doctor might miss it on routine appointments. But, when you have the "red-flags" that safety is at risk, it is time, or probably past time, to jump in. When bringing in a personal assistant, start slowly.
If you jump in and say, "Mom your memory is failing" you most likely will be faced with resistance and denial. How each of us approaches a parent can make all the difference in the success of the intervention.
The best way to design a good plan is to bring in a third-party expert, Aging Life Care Manager (formerly called Care Managers), that will give you the best chance of success with your intervention. You might have a hard time with being entirely honest with a parent, but a professional care manager can help you to design "therapeutic fiblets." These are sometimes called "white lies" that are to be used to reduce stress for everyone and most of all, protect the self-esteem of the person with the early stage dementia.
If an evaluation has not been done, the care manager will help you make that happen and connect you with the best dementia screening clinic in your area.
At Eldercare Services, we have classes and support groups for families dealing with the early stages of dementia - it is challenging to do this without some good advice and support. These classes are free and open to everyone - friends and family.
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Lamorinda Weekly, Moraga CA