Annie's Mailbox: Elder Care

[madripoor_rose]

Dear Annie: My mom is in her 70s. She always has had trouble controlling what comes out of her mouth, but it seems to be getting worse.

Mom often insults others by making offensive comments or asking rude questions. When they attempt to respond, she laughs in their face. I have heard Dad rebuke her on occasion for this behavior, but it doesn't seem to make any difference. She goes on to offend or tease the next person.

Mom monopolizes every conversation. She answers every question, even those not directed at her. She chatters nonstop and will not allow for any silence in a conversation. Simply being around her is exhausting.

I worry that Mom is severely limiting her options in terms of who would be willing to care for her in the future. She is so abrasive that no one wants to be around her. She doesn't seem to realize that the more words she carelessly speaks the greater the likelihood that something regrettable will come out. Is there anything I can do or say to her that might make a difference? — Can't Think Before Speaking

Dear Can't: Has your mother had a complete checkup lately? Sometimes these problems are the result of small strokes or other physical or neurological problems. On occasion, troublesome behavior that has been annoying but tolerable becomes less filtered and less controllable over time, especially if there is underlying depression or anxiety. Suggest your mother see her doctor, and offer to go with her so you can discuss this directly. You also can leave a message at the doctor's office with your concerns.

Comments

[madripoor_rose]

The advice isn't as bad, as far as it goes, but drawing on my own experience as a parental caregiver....anyone who'd be put off by 'offensive remarks' and being a chatterbox isn't going to have what it takes to do the job anyway.

[recessional]

Mostly this, although knowing that "offensive remarks" can cover a huge range of behaviour depending on the person (one person's "offensive remark" is another person's "vicious emotional abuse" and "getting worse" is equally subjective), I can understand it helping to know that that part, at least, is mostly the result of neurological crap.

But yeah, if you can't handle constant chatter . . .

[torachan]

What are you imagining under "offensive remarks"? Because when I see that, I think this lady is making racist or homophobic comments, etc. and I certainly don't think being intolerant of that has anything to do with whether or not someone is capable of being a caregiver.

[madripoor_rose]

You can be intolerant of racism and homophobia, yes. But if that's the kind of thing that makes you want to spend less time with the elderly but lucid bigoted parent because it's so 'abrasive'....you are in no way prepared for the hell on earth being the primary caregiver for someone with stroke-related dementia can bring.

[torachan]

LOL Okay. Fuck that shit.

[cereta]

I don't think she's saying what you're reacting to, here. Specifically, I think the two of you are using two different definitions of "tolerant."

No one is arguing that people have to be tolerant of bigotry as a general principle. However, it is true that many of the results of aging (stroke, dementia, etc) not only remove people's filters, but make them more aggressive, rude, and frankly offensive than they were previously. We can argue about whether those attitudes were there before the stroke/dementia are are simply now being given free reign (and it's worth remembering generational issues), or whether the stroke/dementia actually created them (I know my grandmother expressed attitudes that I highly doubt she held before her decline, albeit on less inflammatory topics), but it remains that a mentally declining elderly person is possibly going to say some really offensive shit.

What I think madripoor_rose is saying is that a person who is a primary caregiver, whether family or paid, of an elderly person must be able to hear those things without reacting in the moment. They can think less of the person; they can disagree vehemently in other forums, but for the most part, there is little to no use taking the person to task for it. And as a matter of practicality, a caregiver has to be able to hear those things without reacting in the moment and without it eating away at them too much. The former is neither productive nor, in a professional setting, acceptable, and the latter is a good way to end up with an ulcer.

[madripoor_rose]

Yeah, I was thinking more along the lines of oh...my mother screaming that she was going to kill me for four hours because I tried to get her to eat her breakfast, and finally throwing the food at me and trying to stab me with a fork.

People who want to spend less time with a woman because she's monopolizing the conversation, and asking rude questions aren't going to be there for the hair-pulling and adult diapers. (and yeah, I didn't automatically think racism and homophobia because there are plenty of ways to be offensive, unfortunately.)

[madripoor_rose]

I honestly hope you never have to deal with it.

[vass]

I'm so sorry you had to go through that. Dementia sucks.

[madripoor_rose]

Thank you. It does, for everyone involved.

I know elder care doesn't always get that bad, but it can and literally without warning and overnight. And the sad fact is, unless you're rich enough and lucky enough to be able to hire a home health aide or pay for a good nursing home, someone in the family is going to have to do it all.

So I'm reading this letter by this naive child, shaking my head. I'd've given anything to have had fifteen more years of an 'abrasive' mother instead of the hell she was trapped in.

The letter writer needs to start looking at the worst case scenarios now and start planning.