My mom dementia is worse since my dad has died, what can I do?

A fellow caregiver asked...

She sees him at night and goes as far as to cook for him and stays up all night for him to come home. She even imagines there is a consiparcy in heaven to keep him from coming home. I just don't know how to handle it. I promise dad no nursing home. What is the best thing I can do to help her?

Expert Answer

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

Dear Anonymous:

My sympathy over the loss of your dad, and the challenges you now face with your mom. Her stress over the death of her husband may have contributed to her accelerated decline in mental status.

The best thing you can do to help your mom is first, keep her safe. The fact that she has dementia, is cooking and staying up all night waiting for dad set off immediate alarm bells for me.

First I'm concerned because of her memory issues combined with your statement that she is not sleeping - this is clearly a problem involving her safety in the kitchen with the potential for a fire.

Her lack of sleep will, over time, impact her health and further contribute to her increasing dementia. It may also increase her risk for a fall in the middle of the night.

There are a few steps I suggest you consider taking. Talk with her neurologist about her behavior and habit of remaining awake at nights. He may prescribe a sleeping aid that assures her nights are spent resting. You can also consider hiring a caregiver to be with your mom in the evenings to be sure that she takes any medicines she supposed to consume, is in bed, and not spending her nights sleepless and cooking.

As for the problem of convincing your mom that her husband is gone and is happy in his new home in "heaven," I suggest you talk with the Alzheimer's Association. They have experience and staff or can refer you to professionals to help you deal with this issue.

Mom's dementia is likely to prevent her from rationally adjusting to the realities of her loss, or her concern that dad is being held hostage in heaven.

You are justified in these types of situations in creating "white lies" that help to resolve the problems. One such "story" can be that you received a message from you dad, and he said to tell your mom that everything is okay. He's doing well, he's happy, and he's going to wait to see her some day in the future when she can rejoin him.

If she asks why dad didn't "contact" her, you can say something to the effect that he can only do that at night when you're sleeping, and if your up, cooking and waiting for him, he can't reach you.

Based on your mom's dementia, doing this is not unlike telling a young child a fairytale about how some day her Prince will come on a white horse etc. And if it helps mom realize that dad is in heaven, and that he wants her not to wait up for him, can resolve that problem.

One last thing about promises made to aging parents. There are times when those promises were made with the best of intentions. But circumstances change, and the meaningfulness of that promise is compromised by the facts and conditions surrounding, in this case your mom, take precedence.

While I'm sure your dad would be delighted to know that your mom was never placed in a nursing facility if things were different, I'm equally certain that he'd never forgive himself if by holding you to that promise, his wife, your mother was injured or her care and quality of life compromised just to keep that promise.

As part of your talk with mom's neurologist, ask him/her at what point in her decline might it be best to move mom to a safe, caring environment where her needs can be addressed and met 24/7 for the balance of her life.

Your task isn't easy, but the proper care of your mother, based on her needs exceeds the desire you may have to keep the promise you made to your dad.

Best of luck.