Dear Family Advisor

My Cousin Refuses to Believe That His Mother is Facing Worse Problems Than Just "Old Age."

Last updated:

January 10, 2012
122406819

I live with my aunt, who's 82. After she totaled her car, she needed me to drive her wherever she needed to go. Then I began to notice that she would forget simple things, such as whether she'd taken her medicine. She'll forget a conversation five minutes after having it. She accused me of stealing the spoons, until we found that she'd hidden them in a drawer. I've mentioned this to her son (my cousin), who is emotionally close to his mother. He doesn't think it means anything. Even her doctor pushes it off as "old age." But I'm sure there's more going on.

My cousin is in charge of all things legal and does help with doctor appointments. But he believes her memory is fine. I live with her and know that it's in fact increasingly worse. I have some health issues of my own, and it's stressful to try to make sure my aunt is OK all the time. What can I say to my cousin to get him to understand the magnitude of the problem? This isn't just "old age," and I need help caring for her.

There are basically two ways to get your cousin to recognize that his mother has memory issues and needs proper medication and additional help. The first way is to work on documenting her condition -- by taking videos, by taking notes, by getting other people to observe it. The other way is to step back a bit so that your cousin will be forced to get more involved and experience your aunt's physical and cognitive decline for himself.

You also have to come to the realization that he may never fully acknowledge his mother's situation. Why is he in denial? Many people don't want to identify with Alzheimer's and other memory-loss disorders. It scares them. They fear it's genetic, and that they could face a similar journey. In addition, once they acknowledge the condition -- where a person is now and where it might lead -- they usually realize they'll have to change aspects of their own lives to help with caregiving. Your cousin might need to do more for his mother, and eventually she won't be able to live on her own. Accepting these changes can be daunting. It's likely that your cousin doesn't mean to shove his head deep in the sand -- he probably doesn't realize he's doing it. For him, as for many people, it's just a natural reaction to all these frightening changes.

It will take patience and perseverance to help your cousin recognize and reconcile with his mother's condition. Your aunt needs you to be her advocate. She's going to need more and more supervision, and she needs her family to rally around her and begin to make solid short- and long-term plans for her care. Be vigilant and try various tactics to get through. It will become more and more obvious in time, and you shouldn't have to shoulder this alone. Your family might not like what you have to say, but you have to try to make them face reality, for everyone's sake.

Start keeping a journal. Take note of when your aunt puts her keys in the fridge, when she doesn't recognize you, when she tries to take her meds for the third time in one day. Note what time of day is worse, what the doctor says at appointments, and anything else that pertains to her care. If you have the technology (using a smart phone, for example), go ahead and record a few interactions. It might not be proof to your cousin (it's amazing what we can justify when we just don't want to face a scary truth), but it validates your experience -- and that's important, because caregivers can start to think maybe they're the loony ones! Ultimately the mounting evidence should pay off, not only with your cousin but also with your aunt's doctor.

In the meantime, start treating your aunt as you would someone with memory impairment. Be careful if she tries to cook (because of fire dangers) and when she gets in the shower (hot water can scald an older person easily); note when she takes her medications; realize that she might begin to wander. Educate yourself about behavior changes that may arise so that you can be proactive and not always reactive. Start checking into in-hoe care aides, community and volunteer care, and even care facilities for when or if that time comes. Join a caregiver support group, so you don't feel alone; it helps to interact with others who are facing similar challenges.

Most Alzheimer's and memory disorders are diagnosed by symptoms, and those you mention can lead to this conclusion (though you shouldn't rule out possible effects from medications or other causes). You might as well state the obvious when your cousin is around. If he gets upset, then kindly and firmly share that this is your aunt's reality -- and yours -- and that if you're going to do the bulk of the care, you have to honestly face what she and you are dealing with.

And while you're dealing with all that, have a life of your own! I say that almost facetiously, because I know from experience how difficult that can be. Nonetheless: Fight for your aunt, but also fight for yourself. Accept right now that you can't fix all of this and that you need help, lots of help. Know also that, yes, some things will slip between the caregiving cracks. Do the best you can, but don't put yourself last. See your friends, exercise, take a class, make personal and career goals and keep them. Don't turn into a caregiver superhero. See your role as a care coordinator, not a DIY-er (do it yourselfer). You deserve to have a vibrant, love-filled life -- but you have to create the space for it, expect it, and, at times, even work for it.