August 5, 2004
Elder Rage: What I Know Now
For 11 years. I begged my obstinate elderly father to allow a caregiver to help him with my ailing mother, but he adamantly insisted on taking care of her himself. Every caregiver I hired to help him said, "Jacqueline, I just can't work with your father -- his temper is impossible to handle. I don't think you'll be able to get him to accept help until he's on his knees himself."
My father had always been 90 percent wonderful, but that raging temper was a doozy. He had never turned his temper on me before, but I'd never gone against his wishes either. When my mother nearly died from my father's inability to care for her, I had to step in and risk his wrath to save her life -- having no idea that in the process it would nearly cost me my own.
Jekyll & Hyde
I spent months nursing my mother back to "health," while my father, who was nice to me one minute, would get mad about some trivial thing and throw me out of the house the next. I was stunned to see him get so upset over the most ridiculous things, even running the washing machine could cause a tizzy, and there was no way to reason with him. It was so heart wrenching to have my once-adoring father turn against me.
I took my father to his doctor and was astonished that he could act completely normal when he needed to. I couldn't believe it when the doctor looked at me like I was the crazy one. Much later I found out that my father had told her not to listen to anything I said, because all I wanted was his money. (Boy do I wish he had some.)
My father had never laid a hand on me my whole life, but one day he choked me for adding HBO to his cable package, even though he had eagerly consented to it just a few days before. Terrified and devastated, I frantically called the police who took him to a psychiatric hospital for evaluation. I was stunned when they quickly released him, saying they couldn't find anything wrong with him. Similar incidents occurred four times.
I couldn't leave him alone with my mother, because she'd surely die from his inability to care for her. I couldn't get the doctors to believe me, because he was always so normal in front of them. I couldn't get medication to calm him, and even when I did, he refused to take it and flushed it down the toilet. I couldn't get him to accept a caregiver, and even when I did, no one would put up with him for very long. I couldn't place my mother in a nursing home -- he'd just take her out. I couldn't put him in a home -- he didn't qualify. They both refused any mention of assisted living and, legally, I couldn't force them. I became trapped at my parents' home for nearly a year trying to solve the endless crisis -- crying rivers daily, and infuriated with an unsympathetic medical system that wasn't helping me appropriately.
You don't need a doctorate to know something is wrong, but you do need a doctor who can diagnose and treat it properly. Finally, I stumbled upon a compassionate geriatric dementia specialist who performed a battery of blood, neurological and memory tests, along with PET scans. He ruled out the numerous reversible dementias, and then you should have seen my face drop when he diagnosed stage-one Alzheimer's in both of my parents -- something that all of their other doctors missed entirely.
What I'd been coping with was the beginning of dementia, which is intermittent and appears to come and go. My father was still socially adjusted to never show his "Hyde" side to anyone outside the family. Even with the beginning of dementia, it was amazing that he could still be extremely manipulative and crafty.
Alzheimer's is just one type of dementia, and there's no stopping the progression nor is there yet a cure. However, if identified early, there are medications that can slow the progression and keep a person in stage one longer and delay full-time care.
In addition to slowing the dementia process, the doctor also prescribed anti-depressants, which made a huge difference in my parents' moods. My father also received anti-aggression medication, which smoothed out his damaged impulse control. Once their brain chemistries were properly balanced, I was better able to implement behavioral techniques to manage the changing behaviors. Then, I was finally able to get my father to accept a caregiver, and with the use of adult day health care for them, and a support group for me, everything finally started to fall into place.
One out of every 10 persons by the age of 65 gets Alzheimer's, and nearly one out of every two by age 85. Had I been shown the "10 Warning Signs of Alzheimer's," I would have realized a year earlier what was happening. If this rings true for you about someone you love, I urge you to reach out for help sooner than later.
Ten Warning Signs of Alzheimer's
1. Recent memory loss that affects job skills
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation of time and place
5. Poor or decreased judgment
6. Problems with abstract thinking
7. Misplacing things
8. Changes in mood or behavior
9. Changes in personality
10. Loss of initiative
Jacqueline Marcell is an author, radio host, national speaker and advocate for eldercare awareness and reform. She wrote "Elder Rage, or Take My Father... Please! How to Survive Caring For Aging Parents" (Impressive Press, 2001). Visit www.ElderRage.comfor more information.