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How do I deal with overbearing Alzheimer's care?

A fellow caregiver asked...

I am a social worker at a senior community with independent living, assisted living, Alzheimer's and dementia, and a nursing home. We have a doctor who lives in the independent living and his wife is at the Alzheimer's/dementia building, both are in their eighties.

Everyday he comes over to see his wife very early in the morning and wants to say the rosary with her and get her up. He spends most of his day with her, refusing to let her join any of the activities at or outside of the building. He tries to control her every move and she becomes very anxious.

The family has tried to speak to him regarding this issue and well as all of the staff. I am currently working with him on this issue, however, it seems that nothing I say seems to sink in. He is her legal guardian, and makes all decisions regarding her care. I realize that he means well, but it is becoming a problem for her and the staff. I have tried to talk to him about how important it is that she continue to do things for herself, or she will lose the ability. He will agree and be good for a few days, then start feeding her and doing everything for her. The family is very frustrated and I have racked my brain trying to find different ways to help him understand he cannot be that controlling and forceful with her. Does anyone have any suggestions on how to best deal with this type of problem?

Expert Answer

A social worker and geriatric consultant who specializes in dementia care, Joyce Simard is based in Land O' Lakes, Florida, and in Prague. She is a well-known speaker and has written two books, one focusing on end-of-life care and the other, entitled The Magic Tape Recorder, explaining aging, memory loss, and how children can be helpers to their elders.

This behavior is not uncommon.  The well spouse trying to have some "control" over a situation where he has no control because of the disease is a difficult situation.  No magic answer but here are some suggestions. 

Ask her physician to become involved.  Try to get him to attend a support group.  Perhaps have someone take him so you know he really goes!   See if he will agree in writing to a certain schedule for her so he can be reminded what he has agreed to.  If only you could get him involved in his own activities but from experience i know that is tough.  When she slips into the advanced stage of dementia he may want medical interventions that are more of a burden than a benefit.   He is fortunate to have such a caring social worker!