Ask Dr. Barb: Mom's accidents may be early signs of dementia

Dr. Barbara Rosenberg

Dear Dr. Barb:

My mother has been forgetting food on the stove until it burns. She seriously scaled her hand while washing dishes, and she stepped on the accelerator instead of the brake while parking and crashed into her house. She seems of sound mind and fine otherwise, but I worry that these are early signs of mental decline. My brother and sister think we should start looking for a nursing home. But I’m against it. My mother always says how much she loves her house and her garden. I know she wouldn’t want to move — not even to live with one of us. I’ve read so much about problems in nursing homes, and of instances where older people who seem healthy die shortly after moving to one. Is it possible that negative emotions around being removed from one’s home could shorten someone’s life? I think it would be better for my mother to live with my family than in a facility. What can we do to make the right choice?   

Dear Reader:

The dangerous accidents your mother recently has had may be more than normal forgetfulness, and more possibly early signs of diagnosable conditions, such as Alzheimer’s or other forms of dementia. It is understandable that you and your siblings are concerned. Having your mother live with you would be very loving on your part and, undoubtedly, you would try to provide the care, safety and attention that she would need. Having your mother in your home also would let family members hang out with her or help as much as they could or would want to.

However, your mother still might miss the privacy and familiar routines of her own home. Furthermore, her living with you might also become stressful for you and your family, as your routines would be disrupted. You also would be taking on an added caregiver role in addition to other family and/or work responsibilities. Also, it could happen that your siblings may not help out very much, and you’d end up feeling resentful. Having a family meeting to devise a plan for your mother’s safety can be a way to get other family members on board. Teamwork will be essential around issues pertaining to food shopping, bill paying, doctor visits as well as coordinating any hired caregiving your mother may need. In time, this teamwork also may bring stronger family bonds.

Emphasize to your mother that accepting some form of assistance will be the best way for her to continue to live in her own home. From childhood on, we all strive for control over our own lives. So it is not easy for an individual who has been living independently to suddenly become dependent on others who are trying to be loving and protective.

However, with ongoing physical and mental deterioration, older adults can become increasingly challenged in daily living, resulting in others wanting or needing to take over.

Losing the choice to drive to get where she wants, or not being able to safely prepare her own meals can leave an older person with low self-esteem and a loss of self-confidence.

A more extreme and depressing loss of independence would be moving into a nursing home. Yes, there can be safety problems with such facilities. Some may be overcrowded with people of all kinds of physical disabilities, which can limit the amount of attention and care the staff can provide.

Also, older persons have lower immunity to infections and more easily can contract illnesses in close living quarters. Getting sick and feeling lonely and abandoned, one’s will to survive can be drastically lowered.

An assisted living facility is an alternative setting that can provide varying levels of care and emotional independence with physical safety. These facilities typically offer options for meals, transportation, recreation and others to socialize with. However, most are expensive and often beyond the means of older individuals and their families.

Older persons with mental challenges also might find these settings disorienting, with changes in sleep and meal routines and the absence of favorite hobbies and a familiar setting. With nursing homes and assisted living, visitation may be regulated. This may contribute to feelings of homesickness.

Ultimately, there are several advantages, both emotionally and financially, for your mother to “age in place” within the comforts of her own home. The first step in her doing so will be to convince her that she needs help.  Having lived independently for so long, she may deny that she needs it and plainly refuse.

This is another area where a family meeting can help. Decide who should have the initial conversation with your mother. She may be more likely to listen to one than others.

When talking with your mother, be sure to address her fears and concerns. Ask her what would help her feel less anxious about accepting some form of caregiving. Also, start slowly with any hired caregiving, even if many more hours are necessary. Even with help from family members, changes cannot fall into place immediately after everyone’s responsibilities have been agreed upon.

Tell your mother that any help will be on a trial basis. Inform hired caregivers in advance  about your mother’s likes or dislikes, as well as her possible resistance to having a stranger in her home. Hiring a caregiver who is a good match and able to communicate well with your mother will be essential.

Commitment to your plan and patience with trial and error will make these new arrangements more workable. You and your siblings can get information about Alzheimer’s, dementia and ways to make a home safer for those with age-related disabilities from the National Institute on Aging website.

Barbara L. Rosenberg, Ph.D, is a licensed psychologist whose Summit practice serves individuals of all ages, as well as couples and families. She previously chaired educational and social programs for the Essex-Union County Association of Psychologists. Contact her through BarbaraRosenberg.com.