How do you help someone who won't even admit that they have Alzheimer's disease?

A fellow caregiver asked...

I am a live-in caregiver for a 75 yr old woman who has been diagnosed with Alzheimer's. She is in complete denial. Feels there is nothing wrong with her, will not take her prescribed medications, because she says she's not a child and she knows when and how to take them, although I put her medications in a small cup each AM & PM, I order the medication and pick it up. SHe argues about everything, she very controlling & manipulating, makes constant calls to everyone numerous times a day. If it is not her idea or done her way forget about it, she makes your life miserable. She has a husband in a rehab. hospital with heart problems (not a candidate for surgery) given 1 yr. to live it's now been 14 months, I take her to see him everyday & she drives the nurses crazy, sometimes her husband gets fed up with her constant complaining and idol chatter and yells at her to leave. My question is "How in the world do you handle a person like this?"? It seems that one day she will be in one stage of Alzheimer's. only to slide back into an earlier stage then get worse a week later. There is not a subject that she doesn't find something to argue about with me. On the good side she's still capable of eating & bathing by herself. Getting her to change clothes is like pulling teeth.Lately she wants to go for a walk everyday she swears it's once a day, I know for a fact it's 3 times a day. Once she forgot what street she was on, (she lives in a mobile home park has been here for 30 years). People call and beg me to please get rid of their phone numbers so she can't call them anymore. I need some advice!

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

What a dilemma. You sound like a wonderful professional caregiver trying to do all the right things to make this experience as positive as possible. The problem is - it is not always possible! The denial of her diagnosis certainly compounds things for both of you. I is not unusual for a person with Alzheimer's disease (AD), who has always been in control, to adopt denial as a way of coping with the loss of control. As long as she does not admit to being unable to function as she once did, then she doesn't have to change the way of life she has lived for many years. She convinces herself she has control over things she knows she is losing control over in order to remain powerful in a world that is leaving her powerless. She demonstrates her power to others including the staff at her husband's rehab center...and you! Unfortunately denial leads to delay. To delay facing the diagnosis and actively talking about it leads to great frustration both for the AD person and for those around her. It also puts off appropriate and solid medical attention such as AD-specific medications that might make her more 'pleasant' and it makes social interventions considerably more difficult to introduce. An important question is related to Power of Attorney or Guardianship and whether or not anyone has it. One of these may be of value to you in changing phone numbers and phone systems - making frequent calls impossible. I encourage you to talk to whomever is in charge of legal and financial matters and openly discuss her negative behaviors. Perhaps you could suggest to those folks who are complaining about her frequent calls to get caller ID and NOT answer her calls...they will diminish in time. I know it is not easy but try to agree with her as often as possible no matter how ridiculous it may seem. She cannot come into the current world of reality but you can enter hers by attemting to agree wih all her irrational thoughts. You cannot try to reason with someone who has already lost the power to reason. Remember it is very difficult to be argumentative with someone who refuses to disagree! Make sure you are taking good care of yourself as you stuggle to take care of your AD-person.