Medical Forum / Diseases and Disorders / Alzheimer's / October 2008
strong-willed/ self-destructive...
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-a- - 17 Oct 2008 19:33 GMT ...My (81 yo) mother has been diagnosed with a series of vascular strokes and a likelihood of symptoms of Alzheimers. It's obvious that's what's going on.
My father died of Alzheimers complications about 8 years ago (at 82) and now we're facing a similar situation with my mother...who is also very aware of this diagnosis, and the memories of what happened with my father.
She is -- and always has been -- strong-willed to the point of self-destructive. At times we had to quietly intercede in some of her efforts on behalf of my father during his decline (although she is now claiming none of us lifted a finger to help). She is now OBSESSED with the belief that her neighbors are trying to steal her home of over 50 years and has spent vast amounts of time (and money) photographing NOTHING as proof, having locks changed, having the property surveyed, hiring lawyeres to write threatening letters, etc. She resists all discussion on this subject. Meanwhile, she refuses all offers of care, determined she live out her life at her home. We are all determined that this desire be honored since it means so much to her. We have the resources to provide care for her on an increasing basis --i.e., a driver on a part-time basis with an eye to long-term care, but she steadfastly refuses to accept it, thus putting her children in the position of becoming someting neither she nor our father ever intended -- caregivers. Beyond failing short-term memory, this is her only real symptom -- she is very aware of the current political, financial situations (completely of the belief however that she is now broke -- she isn't), can go out to a meal and has voluntarily stopped driving and reported to her insurance company that she does not intend to drive anymore, and boy, when she blows up, is a master of sarcasm, memory and well-placed verbal lashings. Much as we experienced with my father, unfortunately, the most irritating personality traits seem to remain as the more human, lovable and memorable traits seem to fade into oblivion.
Meanwhile, in a sudden rage, she has refused all contact with me (and another of my two siblings -- we suspect this has to do with her increasing paranoia that we're all in on the plot; "the next you hear from me, my lawyer will call to tell you I'm dead") -- I had been shopping with her weekly, taking her to her doctor's appointments, accompanying her to the theatre, paying her bills, etc.; the third sibling has had to step in these past two weeks who is already overwhelmed by the burden (I've been into this since the beginning of this year when a friend of her's called to tell me her behavior suddenly changed, probably the result of a stroke -- I got her right to the doctor, then to a neurologist and did all the testing with her; I'd not missed a single appointment despite the fact that she is not always pleasant; I'm not ashamed to admit that my banishment is not entirely unpleasant). She has adamantly refused psychiatric evaluation, and while acknowledging her illness, is becoming increasingly isolated and paranoid without yielding an inch to the realities incumbent in the progression which we've all been through.. The three siblings are in constant touch through e-mail, phone calls etc, and are trying to come up with a game plan. She is refusing contact with all but the reluctant third sibling who is ready to go postal, since she is totally consumed with anger now..
Short of mounting a legal battle for conservatorship, which myself and siblings are reluctantly planning in order to help her since she's resisting all efforts, does anyone have suggestions as to how to intervene with a wilful parent (who now refuses to speak to me), hell-bent on an increasingly self-destructive, isolating behavior prior to having to do it with lawyers? (My father was a lawyer, the other banished sib is a lawyer, so it's not lawyer aversion, it's conflict aversion)...
thanks.
Dennis P. Harris - 18 Oct 2008 05:42 GMT > Short of mounting a legal battle for conservatorship, which myself and > siblings are reluctantly planning in order to help her since she's resisting [quoted text clipped - 3 lines] > (My father was a lawyer, the other banished sib is a lawyer, so it's not > lawyer aversion, it's conflict aversion)... sadly, there is no way to avoid either the conflict or the necessary step of intervening with a conservatorship or guardianship.
be sure to document EVERY occurence that demonstrates her inability to handle her own affairs; if you can videotape incidents without her being aware of it, that would help. be sure to get her docs on your side.
the court should order at least a cognitive skills test which will demonstrate her cognitive deficiencies, and preferably a full physical and neuropsych exam.
good luck. the hardest thing you will ever have to do is to parent your parent. like others in this group, i have had to do just that, over parental protest, in order to keep my mother safe and at home as long as possible.
if you are lucky, your father will have made sure that both of them executed durable powers of attorney --- that will help make it easier for the court to appoint that person, rather than some court appointed stranger, as the conservator.
find a good elder law attorney and work with her/him. you don't want a lawyer who is inexperienced in this area. your local alzheimer's association chapter can offer referrals and a support group --- find them through www.alz.org
Evelyn - 18 Oct 2008 13:22 GMT Hi A,
I read your posting with some trepidation because my father is very much like your mother. He is always angry at one of us.... myself or my two siblings. He suffers from vascular insufficiency to his brain, and sometimes he is as clear as can be and others he is difficult and irascible. All this is complicated by the fact he is willful beyond words and takes no suggestions of any kind in a good spirit. What is worse, whenever he is in one of his moods, he moves money around from this account to that, according to which child he is currently angry at. (he has accounts that are "payable upon death" which gives him a the means to make us miserable, with and to threaten us with)
We too probably need to get to a lawyer to discuss things sometime soon ourselves. Dennis gave you good advice. I am replying to let you know that I sympathize with you more than I can say. He is 95 yrs old and in basically pretty good health other than the clogged arteries to the brain and glaucoma. Having a difficult personality alone would be tough, but with his vascular problems it is much worse. His blood pressure is excellent, his heart health is good, and he could outlive us all. None of us, myself or my siblings are in good health however, so his outliving us is a distinct possibility.
So having no real solutions to offer (other than to develop nearly super-human patience) this post only offers sympathy for what you are going through.
 Signature -- Best Regards, Evelyn
(Our) enemies are not man. They are intolerance, fanaticism, dictatorship, cupidity, hatred and discrimination, which lie within the heart of man." -- Thich Nhat Hanh
> ...My (81 yo) mother has been diagnosed with a series of vascular strokes > and a likelihood of symptoms of Alzheimers. It's obvious that's what's [quoted text clipped - 59 lines] > > thanks. -a- - 18 Oct 2008 20:51 GMT Well, that's why we're here. I'm grateful for Dennis' response and for your solidarity in sharing this experience. Although I wash it hadn't gone down that way, I'm at least prepared for some of what's going in in terms of the progression..
Fortunately because one of the sibs is co-executor of my father's estate, my mother is in no position to carry out threats she may make and I've already told her that my motivation is her care and nothing else, that I love her because she's my mother but she's an extremely difficult person, nonetheless.
The three sibs are trying to figure out whether we need to proceed with a conservatorship or at least advise our mother of our adamance that she start to accept outside help which has been provided for.
It's difficult, because even though Az has made things worse, as mentioned previously, her personality is somewhat constant in her determination to be controlling of all things. What's difficult is the things she's trying to control are things which are both unreal and uncontrollable.
> Hi A, > [quoted text clipped - 87 lines] >> >> thanks. Evelyn - 18 Oct 2008 21:15 GMT > Well, that's why we're here. I'm grateful for Dennis' response and for > your solidarity in sharing this experience. Although I wash it hadn't [quoted text clipped - 15 lines] > be controlling of all things. What's difficult is the things she's trying > to control are things which are both unreal and uncontrollable. I can totally relate. They imagine things, misinterpret things, and even sometimes totally invent things willfully. My father is quite a master at it. It is very difficult to deal with. Unfortunately the only thing I know of that honestly works is antidepressant or antipsychotic drugs. But you need a doctor who understands and appreciates what is going on, and will help to keep her happy and comfortable in her world. And of course that depends on what exactly is going on in her mind.
In the case of my mother in law who is now deceased, she was deeply depressed. Antidepressants worked very well for her and kept her happy and relaxed a great deal of the time. It worked very well for years. When she no longer responded to the antidepressants and paranoid delusions began to trouble her greatly, an anti psychotic drug helped.
But they don't work for everyone. It depends what part of the brain is deteriorating and also different kinds of dementia are notorious for not responding to drugs at all, or even making their behavior much worse. You can only know if you try. But first of all you may need to have a good chat with her doctor. You might make an appointment for yourself and then sit down and chat with him about her delusions.
Oh.... very important.... Use the right words. Delusions are when they imagine situations that are not real. My mother in law imagined quite a few wild ones that tended to recur and upset her greatly. It was only when we got her on the antipsychotic medication that the delusions calmed down a bit.
Another thing....Don't blame her for it. Remember she has a progressive, organic, disease of her brain. She isn't the mother you grew up with and have known all along. It is hard not to, I know. But as my sister always tells me when my father gets out of hand....."remember, he only is operating on half a brain"...... somehow it brings me back to reality.
 Signature -- Best Regards, Evelyn
(Our) enemies are not man. They are intolerance, fanaticism, dictatorship, cupidity, hatred and discrimination, which lie within the heart of man." -- Thich Nhat Hanh
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