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Elder Care & Elder Rage: Know the EARLY Warning Signs of Alzheimer’s Disease
By Jacqueline Marcell
For eleven years I pleaded with my elderly father to allow a caregiver to help him with my ailing mother, but after 55 years of loving each other, he insisted on taking care of her himself. Every caregiver I hired to help him sighed in exasperation, "Jacqueline, I can't work with your father—his temper is impossible to handle. I don't think he’ll accept help until he's on his knees himself."
My father had always been 90% great, but boy that temper was a doozy. He’d never turned on me before, but then again I'd never gone against his wishes either. When my mother nearly died from an infection caused by his inability to continue to care for her, I flew from southern California to San Francisco to save her life—having no idea that in the process it would nearly cost me my own.
Early Signs of Dementia?
I spent three months nursing my 82-pound mother back to relative health, while my father said he loved me one minute, but then would get furious over some trivial thing, call me nasty names and throw me out of the house the next. I was stunned to see him get so upset, even running the washing machine could cause a tizzy, and there was no way to reason with him. It was so heart wrenching to have my once-adoring father turn against me.
The doctor evaluated my father, but I was flabbergasted he could act so normal when he needed to! I could not believe it when the doctor looked at me as if I was the crazy one. She didn’t even take me seriously when I reported my father had nearly electrocuted my mother. Luckily I'd walked in three seconds before he was about to plug in a huge power strip soaking in a tub of water—along with my mother’s feet! Much later I discovered that my father had instructed his doctor (and everyone) not to listen to anything I said because I was just a (bleep) liar and all I wanted was his money. (I wish he had some.)
Then things got even more serious. My father had never laid a hand on me, but one day he nearly choked me to death for adding HBO to his television, even though he had eagerly consented to it a few days before. Terrified, I dialed 911 and the police took him to a hospital for evaluation. I could not believe they released him, saying they couldn't find anything wrong with him. What is even more astonishing is that similar incidents occurred three more times.
Caregiver Catch 22
I was trapped. I couldn't fly home and leave my mother alone with my father—she'd surely die from his inability to care for her. I couldn't get healthcare professionals to believe me—my father was always so sane in front of them. I couldn't get medication to calm him and even when I finally did—he refused to take it, threw it in my face or flushed it down the toilet. I couldn't get him to accept having a caregiver and even when I did—no one would put up with him very long. I couldn't place my mother in a nursing home—he'd take her out. I couldn't put him in a home—he didn't qualify. They both refused Assisted Living—legally I couldn't force them. I became a prisoner in my parents' home for nearly a year trying to solve crisis after crisis, crying daily, and infuriated with an unsympathetic medical system that wasn't helping me appropriately.
Geriatric Dementia Specialist Makes Diagnosis
You don't need a doctorate degree to know something is wrong, but you do need the right doctor who can diagnose and treat dementia properly. Finally, I stumbled upon a neurologist specialized in dementia who performed a battery of blood, neurological, memory tests, and CT/P.E.T. scans. He reviewed my parents’ medications and ruled out reversible dementias such as a B12 or thyroid deficiency. And then, you should have seen my face drop when he diagnosed Stage One Alzheimer's in both of my parents—something all their other doctors missed entirely.
Trapped in Old Habits
What I'd been coping with was the beginning of Alzheimer’s (just one type of dementia), which begins intermittently and appears to come and go. I didn't understand that my father was addicted and trapped in his own bad behavior of a lifetime and his habit of yelling to get his way was coming out over things that were illogical... at times. I also didn't understand that demented does not mean dumb (a concept not widely appreciated) and that he was still socially adjusted never to show "Hyde" to anyone outside the family. Even with the onset of dementia, it was amazing he could still be so manipulative and crafty. On the other hand, my mother was sweet and lovely like she’d always been.
Balancing Brain Chemistry
I learned that Alzheimer's makes up 60-65% of all dementias and there's no stopping the progression nor is there a cure. However, if identified early there are medications that in most people can mask/slow the symptoms of the disease, keeping a person in the early independent stage longer, delaying full-time supervision and nursing home care. (Ask a Dementia Specialist about: Aricept, Exelon, Razadyne and Namenda.)
After the neurologist treated the dementia and the depression (often present with dementia) in both parents, he prescribed a small dose of anti-aggression medication for my father, which helped his temper without making him sleep all day. It wasn’t easy to get the dosages right and when we did, things were still not perfect -- but at least we didn’t have any more police intervention. Once my parents’ brain chemistries were better balanced, I was able to optimize nutrition, fluid intake, and all their medications with much less resistance.
Creative Behavioral Techniques
Additionally, I was finally able to implement techniques to cope with the bizarre behaviors. Instead of logic and reason—I used distraction, redirection and reminiscence. Instead of arguing the facts—I agreed, validated frustrated feelings and lived in their realities. I learned to just “go with the flow” and let nasty comments roll off. And if none of that worked, a bribe of ice cream worked to get my father in the shower, even as he swore a blue streak he’d just taken one yesterday (it had been a week.
Then finally, I was able to get my father to accept a caregiver (he’d alienated 40 that year—most left after ten minutes), and with the benefit of Adult Day Care five days a week for them and a support group for me, everything started to fall into place. It was so wonderful to hear my father say once again, “We love you so much, sweetheart.”
Expanded Descriptions: www.elderrage.com/
Jacqueline Marcell is a former television executive whose caregiving experience resulted in her book, “Elder Rage”, a Book-of-the-Month Club selection receiving 262 five-star Amazon reviews and being considered for a film. Over 50 endorsements include Hugh Downs, Regis Philbin, John Hopkins Memory Clinic, and the National Adult Day Services Association who bestowed their Media Award. She also received “Advocate of the Year” from the National Association of Women Business Owners at their Remarkable Women Awards. Jacqueline also hosts the “Coping with Caregiving” radio program at www.wsRadio.com/CopingWithCaregiving; writes for AgingCare.com and ThirdAge.com; and is a national speaker including to the National Security Agency and Florida House of Representatives. Jacqueline is also a recent breast cancer survivor who advocates that everyone (especially caregivers) closely monitor their own health.
www.ElderRage.com
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