Practical problems: lack of insight

Hedgy

Registered User
Aug 7, 2013
33
0
Hello everyone,

I have read through a lot of stories and would like to share mine as well.
Just to give a little background about myself – I am 24 and am doing a very demanding degree in the UK, away from my home country. My parents separated when I was very young, both went their own ways and had different families. I stayed and grew up with my grandparents (my dad’s parents) whom I have always taken as my parents.

My grandparents were coping well when I first got into a good university and went to study abroad… Sadly, however, in early spring this year my grandfather suddenly passed away from a stroke. What is more, soon after he was gone, it appeared that my grandmother had dementia. It was just that while they were together with grandpa her dementia was never that apparent.

As a consequence, this year has been particularly difficult for me. There are a lot of problems at the moment… Gran lives alone. She has lost a lot of weight and doesn’t eat. Even when the meal is prepared for her she would only have a few spoons of it. She is confused between the night time and the daytime. On a number of occasions I have rung her up and stopped from going to the market at around 8-9 pm... What worries me a lot is that she still drives, although occasionally forgets where she parked her car, saying it got stolen... So far we have been unable to persuade her to stop driving, because she wants to be independent (and she is very, very stubborn). Furthermore, changing clothes for sleeping has become an issue. Personal hygiene is also troublesome sometimes… She has a lot of difficulties with speech, finding the words… Occasionally, she switches to her mother-tongue (which I don’t know) without noticing it. I would carry on the conversation in my language, while she would carry on in hers. And she would not admit to it.

But the biggest problem of all is grandma’s complete lack of insight into her condition. She denies that she needs any help or that there is anything unusual. I have suggested a carer, not even that, I said “home help” with cleaning and cooking a couple of times a week for a start (taking little steps, that is). But she said categorically no.

I have tried on numerous occasions to persuade her go and see a doctor. On one occasion, I asked her to draw a clock, indicate the hours and draw the arrows (some of you may have heard of this simple non-specific test for people with suspected dementia) – and she was unable to do that. I then said that I was really worried about her and wanted her to see a specialist. She got extremely angry at me (as if I asked her to do the task in order to just make fun of her, while I was only trying to get her a glimpse of insight…) and I felt so bad about trying to get her to the doctors’... I thought I’d never try again.

My dad is really struggling to look after gran on his own (there aren’t any other relatives or friends who could help), while I am away on my studies… Care homes are not an option in my country (for confidentiality purposes, I wouldn’t like to declare where I come from). While I just don’t know where to start. She still sees me as a child and would not listen to me. Is getting her seen by a doctor a good idea, assuming she did go to one? They could prescribe some medication for her to stop the dementia from progressing for a little while. However, she might as well be beyond the stage where any meds are effective (oh and by the way, she has now decided she won’t take her regular medication – and I cannot convince her to do it). And generally there is so much stigma around Alzheimer’s etc. that I’m not entirely sure it’s a good idea to get the label attached to her.

How do I get her clothes washed without her becoming annoyed at me? She objects to me getting anywhere close to her wardrobe… How do I encourage her to eat more? She gives me back all her food saying that I am a poor student and should eat well… How do I convince her that she does need help? And how do I do all that without taking her anger and annoyance personally (I know it is the disease but that does not really help)?

It would be great if you could give me some tips from your experience… I am on my uni holidays now and would like to try and help both my gran and my dad as much as I can. It’s really sad to see my granny go this way, I’m sure you have felt in a similar way with your loved ones, too... I am young and I have a lot to learn. I am glad to have found this forum, which has been recommended to me by my counsellor.
 

Butter

Registered User
Jan 19, 2012
6,737
0
NeverNeverLand
Welcome Hedgy - this is such a good place, I think. And I hope you find some support here.

You seem to have your head round all the problems your grandma has - and the ones your dad has - and the ones you have. It is a little difficult to give you more practical advice when we don't know where you are - if you are in the western world I would advise you to discuss the situation with your grandma's doctor. If that is not possible, I would advise you to send the doctor a written assessment - very similar to what you have written here. And wait for their response.

If that is not possible I would suggest you visit a doctor you respect, again share the information you have shared with us, and discuss the way forward face to face.

But your own research is keeping you up to speed with much of the picture. If your grandma is denying there is a problem - don't be afraid of agreeing with her. Dirt, in itself, is not the worst thing in the world. And not eating enough - or eating the wrong things - may not be too big a problem.

I wish you all the luck in the world - please keep posting here.
 

FifiMo

Registered User
Feb 10, 2010
4,703
0
Wiltshire
Hiya Hedgy and welcome to Talking Point,

I am sorry to read about your Grandad's passing and how your grandma is showing signs of dementia. It is not unusual when someone's partner dies to start to notice signs of dementia that you hadn't really been aware of before. What can happen is that the partner supports the person and they have various coping strategies between them that can therefore mask the presence of dementia. Like you have noticed, the dementia can be fairly advanced, which, I have to say, is testament to how well your grandad adapted and helped your grandma as things deteriorated over time.

You ask how to get your grandma to see a doctor when she gets agitated at the very suggestion. One approach would be for you and your dad to start keeping a diary of the challenges that your grandma is having on a daily basis. Make a note of any little incidents together with the time of day the happened. Also make a note of whether there were any underlying reasons for things perhaps being worse on that day eg was your grandma particularly tired or had she had a lot of physical activity that day, that kind of thing. You can either make an appointment to see your grandma's dr and take the diary with you or if that is not feasible, write a letter and attach a copy of the diary for their information. The diary will not only show the dr what stage her dementia is probably at but will also over a period of time show the dr how quickly or slowly that things are deteriorating. It could be that the dr might decide to call your grandma in for a general health check or may even decide to visit her at home perhaps.

On the eating side of things, firstly remember that she has probably, for many years always had her meals with your grandfather. When dementia progresses, this is yet another area where he has supported her and she in turn will have been able to take a lead from him on what to do and how. She may even have copied what he did. Now she is on her own she has no one to keep her right or to copy. This could be why she passes food back eg that she is not quite sure what to do with it. So, what to do...if someone is at her place around mealtimes, maybe consider eating with her rather than just giving her something to eat on her own. If she is struggling, consider giving her finger food that she can snack on throughout the day rather than bigger meals. Some people with dementia develop a preference for sweet food rather than savoury. So, you could try giving her sweet things to eat instead. Unless she is diabetic, don't worry about what she eats as what is important is to get calories into her. You will know what kinds of food are eaten where your grandma lives but if you need any suggestions as to what kinds of sweet foods could be offered then let us know and we can give you some suggestions.

Getting clothing for washing can be a challenge! Two things you could try...wait until she is asleep and remove the clothes then, or, could your dad maybe take her out for a walk for say half an hour, during which you can rush round the house collecting any laundry!

Hope this helps but just ask if you need more information,

Fiona
 

IloveNY

Registered User
Jan 22, 2013
14
0
Hello everyone,

I have read through a lot of stories and would like to share mine as well.
Just to give a little background about myself – I am 24 and am doing a very demanding degree in the UK, away from my home country. My parents separated when I was very young, both went their own ways and had different families. I stayed and grew up with my grandparents (my dad’s parents) whom I have always taken as my parents.

My grandparents were coping well when I first got into a good university and went to study abroad… Sadly, however, in early spring this year my grandfather suddenly passed away from a stroke. What is more, soon after he was gone, it appeared that my grandmother had dementia. It was just that while they were together with grandpa her dementia was never that apparent.

As a consequence, this year has been particularly difficult for me. There are a lot of problems at the moment… Gran lives alone. She has lost a lot of weight and doesn’t eat. Even when the meal is prepared for her she would only have a few spoons of it. She is confused between the night time and the daytime. On a number of occasions I have rung her up and stopped from going to the market at around 8-9 pm... What worries me a lot is that she still drives, although occasionally forgets where she parked her car, saying it got stolen... So far we have been unable to persuade her to stop driving, because she wants to be independent (and she is very, very stubborn). Furthermore, changing clothes for sleeping has become an issue. Personal hygiene is also troublesome sometimes… She has a lot of difficulties with speech, finding the words… Occasionally, she switches to her mother-tongue (which I don’t know) without noticing it. I would carry on the conversation in my language, while she would carry on in hers. And she would not admit to it.

But the biggest problem of all is grandma’s complete lack of insight into her condition. She denies that she needs any help or that there is anything unusual. I have suggested a carer, not even that, I said “home help” with cleaning and cooking a couple of times a week for a start (taking little steps, that is). But she said categorically no.

I have tried on numerous occasions to persuade her go and see a doctor. On one occasion, I asked her to draw a clock, indicate the hours and draw the arrows (some of you may have heard of this simple non-specific test for people with suspected dementia) – and she was unable to do that. I then said that I was really worried about her and wanted her to see a specialist. She got extremely angry at me (as if I asked her to do the task in order to just make fun of her, while I was only trying to get her a glimpse of insight…) and I felt so bad about trying to get her to the doctors’... I thought I’d never try again.

My dad is really struggling to look after gran on his own (there aren’t any other relatives or friends who could help), while I am away on my studies… Care homes are not an option in my country (for confidentiality purposes, I wouldn’t like to declare where I come from). While I just don’t know where to start. She still sees me as a child and would not listen to me. Is getting her seen by a doctor a good idea, assuming she did go to one? They could prescribe some medication for her to stop the dementia from progressing for a little while. However, she might as well be beyond the stage where any meds are effective (oh and by the way, she has now decided she won’t take her regular medication – and I cannot convince her to do it). And generally there is so much stigma around Alzheimer’s etc. that I’m not entirely sure it’s a good idea to get the label attached to her.

How do I get her clothes washed without her becoming annoyed at me? She objects to me getting anywhere close to her wardrobe… How do I encourage her to eat more? She gives me back all her food saying that I am a poor student and should eat well… How do I convince her that she does need help? And how do I do all that without taking her anger and annoyance personally (I know it is the disease but that does not really help)?

It would be great if you could give me some tips from your experience… I am on my uni holidays now and would like to try and help both my gran and my dad as much as I can. It’s really sad to see my granny go this way, I’m sure you have felt in a similar way with your loved ones, too... I am young and I have a lot to learn. I am glad to have found this forum, which has been recommended to me by my counsellor.

Hi Hedgy

I was in a somewhat similar situation in that it was obvious to me that my mother had dementia while she insisted it was nothing more than old age forgetfulness. She absolutely refused to have any discusssion about it and just shouted at me.

After another mini stroke, she was admitted to hospital. The doctors confirmed that she had moderate vascular dementia and insisted she have help at home and that she give up driving.

What I'm trying to say is that your grandmother probably realises she is no longer as capable as she was. Understandably this can be terrifying; particularly if somebody always has been independent. I think the advice you have been given about getting doctors involved is spot on. Even my mother couldn't ignore what they said to her. In a funny kind of way, I'm thankful she had her last stroke so that the medical professionals became involved.

Best of luck and will you please keep us updated?
 

Hedgy

Registered User
Aug 7, 2013
33
0
Thank you for yours comments, I really appreciate them. I especially like the diary idea and have already suggested it to my dad! Perhaps we could both work on it and then see a doctor when an opportunity arises.

So far it's been two days since I'm with gran. I am already very exhausted, trying to keep up with her requests and activities. She has a lot of energy! Which is a good thing... Today I was really grumpy in the morning, as there was a massive storm during the night and gran didn't sleep... We only went to bed at around 4 AM, and she woke me up at 8 asking to take her to the market. But otherwise we had a good day. Gran even had three meals today!

I also decided to do the cleaning of the flat in little steps as opposed to trying to clean it all in one go (it's simply impossible). There is an incredible amount of stuff that she has hoarded over weeks and months - and a lot of things that got hidden in the stuff. So far we have found a few pieces of clothing that have been missing for months, as well as a notebook with some important contacts etc. Well done us!

Dad is going away tomorrow so I hope nothing major goes wrong for which I'd need his help... Fingers crossed.

I hope you are all doing alright and taking a little bit of care of yourself, too. Thanks again for your support. This is such a great place to share things.