Feeling suspicious is very common

Dear Jo,

Our neighbor, Jack, often comes over to help out with Dad.  At times, my father gets angry at me or Jack and accuses us of stealing all his money.  No matter how many times I try to explain that we are there to help him, he continues to be angry and yells, “Get out, and never come back!”  I can handle this, but Dad doesn’t understand when I ask him to be nice to our neighbor.  How can I get him to be nicer to Jack?  We really need the help he provides.

Jo Says:

Feeling suspicious is very common for people with memory impairment.  They often put important things in a ‘safe place,’ and when the impaired person can’t find those things, it can be very frustrating for them.  It is logical to blame someone (especially a “stranger”) when things go missing.  It’s also very embarrassing for your dad to be confronted with his memory impairment or mistakes.  Absolute #3 tells us: Never Shame, Instead Distract.  This can be a very useful tool.

Remember that even though his memory is going, your dad’s emotions – those feelings that make us all human, and direct almost all of our actions – are alive and well.  Emotions are all he has to govern his actions by.  When we embarrass someone with Alzheimer’s (or anybody at all, for that matter), it makes them feel ashamed, out of control, and hurts their feelings.  Since your dad may not have a sense of how reasonable his actions are anymore, this can often result in outbursts of frustration and anger.

You and Jack both know something is wrong, and you are truly there to help.  The best way to help is to focus on pleasant things.  You can validate your dad’s feelings about what he’s lost by saying something like, “That must be really difficult for you, Dad.” Then go on to a subject that is pleasant for everyone, such as, “Look what Jack brought over to go with our coffee!  Don’t these cookies look delicious?” This may seem like a form of bribery, but let’s be realistic – bribery works!  So if you come prepared to get your dad involved in something pleasant, like drinking coffee and eating cookies, and then become engaged in that subject, the unpleasant subjects will dissipate. If he starts asking again about his money then you can say something rational and honest like, “Well!  We certainly like to keep most of our money in the bank, but if you need some, I can lend you a few bucks.”  In both of these ways, we steer the situation in a better direction while still letting our loved ones keep their dignity intact.

My husband insists that he is capable of driving

Dear Jo,

Even though the doctor said he shouldn’t drive the car anymore, my husband insists that he is capable of driving.  I tell him over and over that he can’t drive, so now I have to, and he gets furious with me!  I really don’t know what to say anymore.  We argue about this all the time.

Jo Says:

Driving is one of the most difficult issues surrounding this disease process.  For this situation, the best answer comes from the Second Absolute – Never Reason, Instead Divert.  Because of his memory loss and your husband’s inability to consistently store and/or retrieve new information in his brain, he truly won’t remember what the doctor told him.  For that matter, he is going to have difficulty keeping track of the information you are providing him, no matter how many times you tell him.  It is literally going “in one ear and out the other,” because he forgets that new information after a short period of time.

The best thing to do is to change the conversation; he cannot, and will not, be able to respond to reason.  When he starts talking about driving, you can simply divert and change the subject, completely.  Introduce something new like “What kind of ice cream are you going to get?”  It will feel strange at first, and may even make you laugh – which is great!  When you stop feeling so stressed (and he will read it on your face), he won’t be so stressed, and from there you can move forward.  This does not remove the seriousness of the driving issue, but for now it provides relief, and you can move ahead. One of the most difficult things to learn is to keep discussions about issues like these to a minimum – or if you can, totally eliminate them.  However, if you can get your husband to talk and tell you stories, even if you hear the same ones over and over, you will find more enjoyment and less confrontation every day.

I Want to Go Home

Dear Jo,

I recently placed my mother in an assisted living community.  It is really difficult to go and visit her, especially because when she sees me, she tells me she wants to go home.  I don’t know what to say or do.

Jo Says:

“I want to go home” is such a common phrase for a person with Alzheimer’s or related dementia that it has become a chapter title in almost every book about the disease.  In the very first of my Ten Absolutes, we can discover the remedy for this common desire. Absolute #1 says: Never Argue, Instead Agree.

It appears that when they are asking to “go home” it is really their way of saying they want to find a better place in time, in their mind.  After all, Alzheimer’s causes the sufferer to travel back in time to another part of their life.  So when Mom or Dad ask to go “home,” they may not mean the last place they lived.  They may mean their childhood home, or even a moment in time when they felt loved by their own parents.

Meanwhile, as the caregiver, all you can hear are your “guilt tapes.”  You think, I knew I shouldn’t have placed mom here!  She is unhappy – I must have made a mistake.  What am I going to do now? Regardless of your fears, what needs to happen now is that the two of you find a way to face this together.

The best way to do that is to tell the truth.  This is as simple as memorizing 3 little words, made up of 5 simple letters: “So do I.”  And it is, in fact, the truth when the subject of home arises.  As a caregiver, you probably want to go home, or back to a time when the parent-child dynamic was the way you’ve always known it.  Anything feels better than going through the pain and disagreement of dealing with this subject.  After you say “So do I,” you can then change the subject to a more enjoyable one. Go to her room or apartment and talk about her clothes and how pretty she looks in her favorite dress. Make visits as similar as possible to the kind you always had when she was home, and don’t forget to concentrate on enjoying time together.

The Happy Bottom Family Trust

Gladys Kaminski and Diana Law

Gladys Kaminski and Diana Law

Meet Gladys Kaminski, a real sparkler!  My daughter, attorney Diana Law, insisted that I come into the conference room to meet Gladys.  When Gladys enters a room, merriment walks in with her.  We exchanged laugh-filled greetings, and then I asked Gladys why she wanted us to do her estate protection planning.  She quickly responded, “I don’t want to lose everything to long-term care expenses.  Even though I don’t have a lot, I want to make sure that my kids and grandkids can enjoy at least a part of it.”  She was working with Diana to prepare an Estate and Longevity Plan.  Her goal is to never be out of money or quality health care options as long as she lives.  One of the ways that we help clients achieve their goals is the use of very carefully designed trusts.

Most trusts take the name of the trustmaker—so ordinarily Gladys would have named her trust the “Gladys Kaminski Trust”—but she wanted to have it her way!  She wanted to call her new asset protection trust “The Happy Bottom Family Trust.”  Unusual, but legally a trust maker can choose any non-deceptive name for a trust.  I asked Gladys why she wanted a “Happy Bottom Trust.”  Giving me a wink, Gladys flashed a big smile and began her story.

“In 1941 I graduated from eighth grade.  I worked as a salesgirl at the dime store at 31st Street and Halstead in Chicago.  My boss, Mr. Fox, loved to tease me.  One day he came over to me and said loudly, “Gladaaas!  Gladaaaas!  Did you know your name translates as Happy Bottom?”  I laughed and laughed.  And I’ve been telling that story all my life.  Nobody remembers me when just I tell them my name is Gladys.  But everyone remembers me when I tell my name is Gladys and that means Happy Bottom.”

Now both Diane and I were laughing with her, and we agreed that The Happy Bottom Family Trust now made sense to us.  This trust is designed to protect a portion of her assets in the event she ever suffers unending long-term care costs.

Gladys is a model of excellent aging.  Despite knee replacements in 2001 and 2006, she plays golf with “the girlfriends” every week.  They also take an annual golfing trip to Florida or Arizona.  I inquired, “Don’t you girls go to Vegas?”  She looked up at me with a conspiratorial expression and said, “Oh yes!  I need to go to Vegas every year to the bingo convention.  I’m in charge of our parish bingo operation.  I’ve done that for the last 20 years.”  Gladys also serves as treasurer for numerous senior clubs and church organizations.  It’s obvious to everyone that this gal is very confident handling her own money and safeguarding other people’s money, too.

As her estate planning and elder law attorneys, we are honored that Gladys chose us to serve as her trusted guides as she travels the elder care journey.