How can I get my mother an in home aide without offending her?

Sarao asked...

My mom has dementia, and is headed towards Alzheimer's. She is getting less and less lucid each day, but is still functioning well (driving, some cooking) although she can't keep her own schedule and has forgotten how to do many basic things. She also falls -- a lot. She has also picked up smoking again. We feel an in-home care person is going to be important soon, but she is still too aware for her not to notice and be offended by this. How should I handle this sort of transition to getting daily care for her without offending her?

Expert Answer

As Founder and Director of Circles of Care, Ann Cason provides caregiving, consulting, and training services to individuals and public and private organizations involved in eldercare. She is the author of Circles of Care: How to Set Up Quality Home Care for Our Elders.

Thank you for asking this question. Many adult children fear offending their parents. I picture your mother standing on the edge of a cliff,  shaking her fist..  She is shouting, I will drive, I will smoke, I won't go to the doctor. She struggles to maintain independence while you struggle for her safety.

The time is approaching when you must say to your mother,  "Mother, I love you.  I have to keep to safe."  Then you have to tell her that it is not safe to drive anymore.  " We have to get someone to drive for you and cook a meal." 

But don't go alone to tell your mother.  Do you have a sibling?  Do you have a partner?  Do you have a friend that your mother trusts. Or do you have a minister?    With this other person, create a supportive environment.   Sit, drink tea, relax, then speak directly.  "Mother your memory is not so good."  When she gets angry, sit quietly.  Don't lose your temper or get into a shouting match.  Let her anger rise and fall.   Be warm and relentless in your insistence.   "Mother, you are falling down. I am afraid you will break a hip.  I don't want you to suffer"

You will have to do this more than once. She has to get used to the idea.  With dementia in home aides may need to be taken to meet your mother more than once. You may have to go with the caregiver several times as she begins to work with your mother. She has to gradually see the value for her. I suggest you watch the old movie, Driving Miss Daisy.  Also, my book, Circles of Care, has many examples of how others worked with dementia.

  It does sound as if your mother needs more medical attention.  Dementia going into Alzheimer's does not sound like a medical diagnosis. Also, why is she falling? After a complete check-up, it might also be decided that she needs a geriatric psychiatrist. 

Sometimes people who suffer from dementia may take up smoking as a comfort. Your mother may feel terribly lonely.  Take her to lunch or shopping or to an art showl. Maybe you could go out for coffee.  Spend time with her without an agenda so that she can enjoy your company. 

Also, I would suggest a Professional Geriatric Care Manager who has experience with dementia and  knows the services in your part of the country. If you can't find a care manager, go to your Area Agency on Aging or the Visting Nurse.  You will need quite alot of support during the last years of your dear mother's life.