How do I deal with overbearing Alzheimer's care?

5 answers | Last updated: Nov 09, 2016
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 Answers

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!

Community Answers

Lindasd answered...

Very insightful post. Yes, what a caring social worker. It makes me think that this is probably an issue for a lot of healthcare workers, even in a normal patient setting in a hospital, especially when dealing with the very elderly patients. In reality it is possible for both husband and wife to have diminished mental capacity when only one is being treated.

Would there be a good healthcare, professional support group - if not maybe worth forming some network that offers help.

As a caregiver to my mother who has Alzheimer's, I will keep in mind my demands on staff when in these situations. I remember when my dad went into the nursing home for late stage Alzheimer's, I was not always patient with the social worker there. It is a very stressful time for family.

I guess I would ask, in the end, even though you feel the wife is not getting the care she needs, maybe, just maybe this is "their" end of life experience and you are along for the ride. Maybe as hard as it is for you and staff, you can find a way to support him different than normal. Is there a way to have a staff member be part of his visits and bring the activity to both of them? Just thinking outloud from a non professional point of view.

You are a very kind and caring person. What a tough job. Thanks for caring so much.

A fellow caregiver answered...

What is the difference, if any, between Primary Progressive Apshia and Alzheimer's. Does the first always lead into the other & how can you tell what the patient is really suffering from?

The caregiver's voice answered...

I am curious as to the outcome of this particular situation as it was posted a couple years ago. We can all learn.

However, because similar behavior will surface among other couples and family members, THE KEY IS for the social worker to LEARN AS MUCH AS POSSIBLE ABOUT THE doctor and his FAMILY dynamics from family members.

One never knows the reasons why people do things--

-- the doctor feels guilt for his wife's Alzheimer's and this is the price he pays. -- he perceives she is not receiving the kind of care he is able to provide (whether or not this is true, this may be his perception).

On the positive side, this could also be his remaining loving act of grace for his beloved.

A fellow caregiver answered...

He could have always been a very controlling individual and never allowed her make her own decisions. So this is just who he is.