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Posted April 24, 2009

Ask An Expert

Elderly Behavior: Stubbornness May Indicate Dementia, Depression

Q.  My Dad is 86 years old and lives alone in Texas. He has one daughter (my sister) living within a mile who cares for him most of the time. I try to visit both at least once a year. On my last visit (March-April 2009), I helped my sister care for him following a hospital stay for pneumonia. He was also diagnosed with diabetes a couple years ago. 

Following his hospital stay, he was going through extreme highs/lows with sugar. He tends to eat the wrong things. We started him on a diet designed for diabetics, allowing him snacks that would be okay. However, he would sneak other snacks that weren't so good, resulting in the swings in sugar. We finally got him leveled out and he was doing okay as long as I was around.  

Also, he's a sucker for buying junk that's advertised in junk mail. He spends thousands on this junk. We talked to him about it, hoping to help him understand that it is junk. He says he's buying it for the great grandkids but he just packs it away. He also said that it's his money and he can spend it as he wants (which is true). We suggested that instead he do something for the grandkids like a savings bond.  

Now to the problem. I sat down with him before leaving and had a talk, explaining how important it was for him to cooperate with his daughter regarding his eating and spending. I got a call from my sister one day after returning home. She said that he had purposely been eating high-sugar items, drove his car (which the doctor ordered him not to do), and refused to take some of his pills. He's been very outspoken and blatant about it. He’s acting very childish.  

My husband says he might be back-lashing from my visit because I made him toe the line. The question: Is this typical behavior for someone in his position? In order to protect his health we have to do something. What is our next step? We don't want to put him in assisted living, but it's something we're considering. He can't live alone, he doesn't take care of himself and won't take his medicine. Is there some way we should try to get through to him? My sister can't continue dealing with him with his behavior like it is.  

Your help is appreciated.

Jan S., Kenai, Alaska.

A. It sounds like your father may have depression or possibly even an early form of dementia. My advice to you is to have your sister take him to see his doctor and if you can find a geriatrician have him formally evaluated. 

This answer is provided by Dr. Vivian Argento, a trained geriatrician and member of the geriatric medical team at Bridgeport Hospital in Bridgeport, Connecticut.  Dr. Argento is an expert in memory and medical problems affecting the elderly and serves as a clinical instructor at the Yale School of Medicine at Yale University in New Haven, Connecticut. She’s also a consultant both in and out of hospitals and cares for patients in various locations, including nursing homes, assisted living facilities, and in their homes via a house calls program. Dr. Argento can be reached at pvarge@bpthosp.org

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