problems with the old folks - sorry long

Nurses General Nursing

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First off, I'm not asking for medical advice. I'm having a real bad time dealing with some grandparent issues and really just need someone to vent to. Also, I'd love to have some support from others who've gone through this.

I've done quite a bit of my clinicals at LTC, and I've spent time on Alzheimer's & Advanced Alzheimer's units. I know what the disease looks like & I know what I'll be dealing with in the future.

It appears that my grandfather, who has basically been father to me, is at the beginning stages of dementia. My grandmother is still living, but she refuses to make any decisions about his future. My father was their only child and he passed away 14 years ago. This leaves my sister & I to decide what to do.

Ideally, I want to keep him at home as long as possible. As long as my grandmother is able to take care of him, he can stay. However, if she feels she can't do it any longer, he can't take care of himself. Both my sister & I MUST work, so we can't just stay with him all the time.

The big problem now is that he is obsessed with marital problems that occured 50 to 60 years ago. Over the years, he's picked fights over this ancient problem. However, more recently he's started bringing it up daily & now it's several times a day. He's become mean & nasty to my grandmother about these perceived slights from half a century ago. She ,herself, isn't well & this constant turmoil is really wearing her down.

Monday morning, I'm taking him to the Doc to see about putting him on Risperdal. I'm hoping that might make it possible for her to tolerate him & allow him to stay home a little while longer. I know, sooner than later, I'll have to have him put away & it's breaking my heart.

I feel like no matter what one of them is getting the shaft. If he stays at home a while longer, her health will probably suffer. Yet, I hate to put him away when the only crazy thing he does is this compulsion to dredge up an old grievance & harrass her with it. Other than doing that, he is perfectly sane. He forgets nothing, he's up to date on all the latest news, he keeps track of what my kids are doing at school, & he knows all the latest goings on at our church. He just can't stop himself from picking these fights with my grandma.

Has anyone around here had to make the horrible decision to put a parent or grandparent away? How to you cope with the guilt? Did you have a decision making process that helped you? My nerves are totally shot. I had to take 2 Klonopin today, which is totally unusual for me. My chest keeps feeling tight & then I can't breath, next thing I'm sick to my stomach, then it's nervous diarrhea. I've had a massive H/A for 2 solid days. I just want to fix everything & get on with my life.

Specializes in Home Health, Case Management, OR.

Is there the possibility of them getting an assisted living type apartment together? If you grandmother is starting to decline as well perhaps that would be an option. I worked for 3 years with Alzheimers/Dementia and I know that it is always a hard choice for the families, but they do what is best overrall. I feel for you, you are very young to have to deal with this issue.

My advice is to find a place for your grandfather to live. Preferably somewhere close enough for your grandmother and you to be able to visit often, if not daily. Think of your decision not as "putting them away", but placing them in an environment where they will have the caring and the support to maximize their lives as they change. It is a transition for this stage in their lives and yours. All of you will have the opportunity to just enjoy each other.

It has been my experience as a nurse that people with dementia become comfortable with routine and familiar things. I worked in a unit that had been designed specifically for the wanderings and behaviors of dementia to allow maximum freedom and safety within the structure of the unit. Staff was handpicked, trained, and educated on the natures of dementia. Activities are planned for the residents daily and personalized for them while participating within a group setting. Not all nursing home/memory care units are the stuff of nightmares. The best ones encourage and support continuing family relationships and participation, including meals together.

Caring for a loved one with dementia is a noble task at best. The reality often results in caregiver burnout, among other things. What is your support system like?

Another point that may come up is the legal one. The familial responsibility for caregiving may be clear among the family members, but if it hasn't legally been clarified, there could likely be issues down the road when you will least be able to deal with them. Especially if money or real property is present.

I understand your position as I, too, have been in a similar position. On a personal level I learned the hard way that one person cannot do it all for another person. Sometimes stepping back and letting go while letting others step in to share in the caring can be a more loving act for both yourself and those who love the person with dementia. Sometimes as caregivers, we forget we need TLC, too.

So good luck with your decision! :icon_hug:

It is really hard to watch our family members get older and decline. I think seeing the doctor is a great idea. Make sure that all the medical aspects are ruled out before he is labeled as having dementia. Too often other things impact the decline in function. Make sure the doctor is aware of the specific issue of rude behavior. Perhaps Resperdal is the correct medication but don't place blinders on for other options.

I like the idea of an AL apartment. I hope that is a possibility.

Lastly, try to rethink your language about having them live in another atmosphere. You are not "putting them away". You are looking at options that will provide a safe and comfortable environment that you and your sister cannot realistically provide. It is not uncommon for elders to appreciate moving to a facility where they do not have to do as much work as living on their own. No worries of home maintenance, heating empty rooms, cleaning a large area. The ability to do this starts with a positive image of the new environment from you. This does not mean you have to sell it to them. Just don't sabotage the possibility of moving, especially if he really does have dementia. He will recognize your non-verbals more easily than what you say.

Best of luck. I hope that did not sound too lecturing. I went through this with my husband's grandparents. It is not easy. Keep loving them.

:typing

Specializes in LTC, Hospice, Case Management.

It bothers me that you refer to it as "putting him away". Now I'm sure that I am being overly sensitive, but to me this sounds like a toy that no one wants to play with anymore.

How does he respond when spoken to about his actions towards Grandma? Does he acknowledge that this is all "old history" or does he become defensive? Has Grandma tried apoligizing (even if she doesn't need to) just to see if this would pacify him?

No matter how this goes, you are in a tough situation and unfortunately will probably only become tougher. You can only do the best you can do and don't beat yourself up about the hard choices. Good luck to you

Specializes in LTC.

*hugs* I can only imagine how hard this is to go through.

Have you considered having him go to an adult daycare a couple of days a week to give your grandmother a much needed break? And have you sat down with your Grandmother and had a heart to heart about what she feels needs to happen. She may believe that it's time for him to move someplace that is safer and les stressful.

dementia with paranoid features can sometime be vit B12 def...common with age esp amongst caucasians......northern europeans......unfortunately the blood test is not particularly accurate and the 'normal" low in this country is very low.....

also, has anyone considered depression?

agitation is a very common symptom.

and depression is so pervasive amongst the elderly, yet grossly underdx'd.

he needs a thorough checkup before recommending risperdal or anything else.

let us know what happens?

many hugs to you and yours.

leslie

My advice is to find a place for your grandfather to live. Preferably somewhere close enough for your grandmother and you to be able to visit often, if not daily. Think of your decision not as "putting them away", but placing them in an environment where they will have the caring and the support to maximize their lives as they change. It is a transition for this stage in their lives and yours. All of you will have the opportunity to just enjoy each other.

It has been my experience as a nurse that people with dementia become comfortable with routine and familiar things. I worked in a unit that had been designed specifically for the wanderings and behaviors of dementia to allow maximum freedom and safety within the structure of the unit. Staff was handpicked, trained, and educated on the natures of dementia. Activities are planned for the residents daily and personalized for them while participating within a group setting. Not all nursing home/memory care units are the stuff of nightmares. The best ones encourage and support continuing family relationships and participation, including meals together.

Caring for a loved one with dementia is a noble task at best. The reality often results in caregiver burnout, among other things. What is your support system like?

Another point that may come up is the legal one. The familial responsibility for caregiving may be clear among the family members, but if it hasn't legally been clarified, there could likely be issues down the road when you will least be able to deal with them. Especially if money or real property is present.

I understand your position as I, too, have been in a similar position. On a personal level I learned the hard way that one person cannot do it all for another person. Sometimes stepping back and letting go while letting others step in to share in the caring can be a more loving act for both yourself and those who love the person with dementia. Sometimes as caregivers, we forget we need TLC, too.

So good luck with your decision! :icon_hug:

I agree with this or if both have to be placed somewhere get them separate rooms where the wife can have her own privacy and unviolated space.

Why should she have to be subjected to his harrassment, emotional and verbal abuse?

Good luck to all of you.

How does he respond when spoken to about his actions towards Grandma? Does he acknowledge that this is all "old history" or does he become defensive? Has Grandma tried apoligizing (even if she doesn't need to) just to see if this would pacify him?

She won't admit to doing anything wrong, because she says she didn't do the things he's accusing her of. This makes him incredibly angry & now he wants her to leave him alone. Unfortunately, she just can't seem to do that. She is constantly "checking on him", which infuriates him because, right now, he doesn't even want to hear her voice. She wants my sister & I to "make him be nice and care about her". Obviously, that is not something that's within our power to grant. It's starting to seem like they are both part of the problem!

Also, I say "putting him away" because I feel like that's what I'm doing. Every previous generation in our family has died at home with loved ones handling their care. We just don't have the resources to do that this time. All my grandad wants is to sit in the swing under the shade tree with his little dog on his lap & I can't do that for him. I really feel like I'm letting him down & he deserves so much better. :(

ii agree with the others that when you think 'PUTTING HIM AWAY' this will make it more difficult for you make well thought out decision

people in this stage [esp men] get aggressive toward their care-giver and your g-mother is probably not able to handle this

accept reality, you can not quit your job and provide one on one care, your g-mother is losing this battle, and your g-father wil need more and more care not less and less

what did or did not happen decades ago is not reveleant[sp]

ltc placement may not be the easiest decision because you will have to be giving both of them emotional support in two different places but it might be the best thing to do

See if you have an organization in your area that helps families who are needing to make these decisions...some type of Senior Resource center or Counsel on Aging. I am glad you are taking him to the Dr. It sounds like a thorough check up is in order. Good Luck!

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