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Posted: March 19, 2007

Practical Caregiving

Overcoming Elderly Pride for Their Own Good

A sense of pride -- legitimate or false -- in our elderly loved ones can make your caregiving a nightmare. And it can leave the senior you care for in a physically or mentally desperate state. The only answer is extreme alertness on the part of the caregiver and some aggressive action when a problem is recognized.
The key, of course, is seeing that the sense of pride, which is critical to a long-surviving senior, is not unduly bruised along the way. That's the balancing act faced by Jessica in Kentucky and Betty in Texas. They're caring for close family members, but they're running into issues of pride that turn into defensiveness. Their plan of attack to overcome these injurious feelings is all important.
Jessica and Betty wrote me for my input recently. Let's see what I pulled from my e-mailbag and whether I can help.
Dear Jean:
Mom was living at home, but fell and ended up in the hospital. From there, she came to live in our home. We have someone in to take care of her during the day, then my husband and I take care of her at nights and on weekends. Her wounds are slowly healing.
What concerns me is that all she wants to do is lay there and stare into space. When I turn the TV on, most of the time she wants me to turn it off. There are a couple programs she enjoys. She enjoys CD’s when I put them on, but she never asks me to put one on. She won’t read the newspaper, a magazine or a book. Her mind is sharp, but she seems so withdrawn from everything. Any thoughts?
Jessica M., Louisville, Kentucky
Dear Jessica:
Sometimes when a person ends up in the hospital, the doctors don’t run all the tests for a complete physical examination. How long has it been since she had a good physical exam? Have her eyes been checked, or her hearing? Did they decide what caused the fall? And the likely results of the fall? It may have been a small stroke, which could have some of the lasting effect you mention, but you really need a medical opinion.
When Dad stopped reading, it wasn't because he needed new glasses. He had little strokes we didn't realize and his mind had stopped processing information in a normal manner. He couldn't comprehend what was written on a page. It took him literally an hour to read one page. I had him read aloud to me one time, and it was like a child first learning to read.
He did the same thing your mother is doing. His mind was still sharp, but he couldn't read. The only time he watched TV was when there was a lot of movement on the screen. It seemed he was kind of in a daze, and it sounds like that is what you are seeing in your mother.
Another possible reason for your mother's withdrawal could be her meds. Sometimes they cause this type of "dazed" situation. Perhaps she needs them changed, but again you need to seek the input of a medical doctor.
So, you see that in general, there could be any number of reasons why she is withdrawn. Why don’t you contact her doctor and talk to him about the entire situation, not just what caused her to end up in the hospital. If there's something that can help her, you need to find it, for her sake and for yours.
Please let me know what you find. Our parents deserve the best care, but remember, you can't fix her generally declining health. You need to do everything you can, and then accept the fact that you can not do anything more. She is not going to suddenly raise up and be the person you have known all your life. That is a very hard fact to face.
Dear Jean:
My mother-in-law has forgotten whether she took her meds several times, then gets extremely upset if I tell her about it. I bought her a weekly pill box, but she still doesn't seem to be using it properly. When I explain how to use it, she thinks I am saying she is out of her mind. She is depressed and takes medicine for that. She gets very defensive, if I say anything to the doctor about this. She wants our complete attention 24/7. She lives close to us, but lives alone. Anything we suggest is "wrong" unless it is something she wants to hear. Help!
Betty C., Abilene, Texas
Dear Betty,
Your situation is very difficult and frustrating. Let me explain what might be happening with your mother-in-law.
It could be that her mind is having problems thinking clearly. Not taking her medicines right is one sign of that condition. She probably knows she is having a problem thinking clearly, and this frightens her. She doesn't want anyone else to know it is happening, so she hides it in many ways. When you point out a "mistake," she is very defensive because she has those same thoughts and is afraid she is vulnerable. On the other hand, she is afraid something terrible will happen and you won't be there. That's one reason she wants constant attention.
That happened when Mom first started having problems. She had mini-strokes (TIAs) that caused her mind to not work very well. She knew it was happening and was very frustrated, confused, and at times angry. Mom and Dad both covered this up quite well for a long time. I lived with them when they weren't traveling, so I saw it, but in the end Dad just couldn't face it.
Why don't you call her doctor and explain your concerns? Tell him not to tell her you called, but ask his advice. I feel certain she needs a good check-up for this type of thing.
Try to think of what it would be like to be in her situation. If you can do this, you will have a better understanding of what she is feeling.
There are pill dispensers that will call you on the telephone if she doesn't take her meds on time, and won't let her take the meds early. My column, Pill Dispensers Can Avoid Serious Meds Mixups, tells more about them.
Here are a couple other columns you might find beneficial:
Please write again and let me know how things are going and what you find out.

© 2007 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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