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Question: My mother-in-law (76) and father-in-law (80)had long stopped sex in their late 50's however, since early this year, she keeps going to his room 2/3 times during the night seeking sex. Whenever her request for sex is turned down by him,she would start a big "fight" and accuses him of having an affair with one of their female friends. She also has other symptoms of AD such as loss of memory and ask same questions repeatedly. Although we'd like to separate them, she insists that she would follow him wherever he goes as she wouldn't allow him to meet his "girl friend". If they go on living together, we're afraid that he may be tortured to death both mentally and physically (she has hit him a few times). What should we do to help the couple? Your timely answer is much appreciated.

Answer:Her behavior of frequently attempting sexual relations, and the delusion of your father-in-law having an affair are symptoms of the disease and are likely related to brain damage.  She may not have an understanding that sex ceased 20 years ago.  Instead, her reality could be that she is currently living in a time when she and her husband were sexually active. 

Dealing with these sexual advances is often a matter of trial and error.   It is
best to try to avoid arguing with her when she seeks sex.  If possible, have your father-in-law redirect her onto another activity or topic.  Sometimes, the request for sex signals the need for attention, reassurance, and closeness, instead of the need for sexual gratification.  Touching, hugging, and other forms of affection may help meet this need.  It may be helpful to seek the advice of a professional.  Ask her doctor if there are any medications available that can be used short term to assist with this sexual behavior.

If this problem persists, it may be necessary to seek other living arrangements for your mother-in-law.  Care facilities, such as an assisted living home or nursing home can offer the skills required to deal with this type of behavior.  Her doctor may be able to provide some insight as to the level of care that is needed.

Dottie Lyvers
Family Caregiver Support Specialist
Northwest Piedmont Area Agency on Aging

 

Question: My Mother has Dementia caused by alcohol abuse and she was also addicted to nicorete gum. She has been put on different meds for blood clots and high blood pressure . She has very little short term memor and I noticed one of the meds side effects is confusion. Could that be stoping her short term memory from coming back , and with het S.T. memory coming and going is that a good sgn?
— Jeff

Answer: I would suggest that you speak with your Mother's doctor regarding your concerns about the medication and her confusion.  It is difficult to say what could be causing her confusion – the dementia or the medications, or both.  It may be that she has some confusion as part of her dementia, but possibly the medications are causing it to increase.

Many people who have a form of dementia experience confusion and the "in and out" of their short term memory.  It is common for a person with dementia to have good days and bad days, or good moments and bad moments.  For example – in the morning, your Mother may be able to remember a story that she saw on the news, but by that evening, she may not be able to remember a conversation you had 5 minutes prior.  It doesn't necessarily mean she is improving when she remembers, it could just mean that her brain is working more effectively at that moment.

 

Dottie Lyvers
Family Caregiver Support Specialist
Northwest Piedmont Area Agency on Aging

 

Question: My Mom is using her fingers and spoon at the same time to eat and put very large amounts of food into her mouth at a very fast pace. My response is to cut the food in small pieces, give her a small spoon and just take the plate away for a few seconds to slow her down. Why is she doing this and what should I be doing? Thanks.

Answer: Eating can be very confusing for someone with Alzheimer's disease or dementia.  Because of the disease, she may be overwhelmed with too many items on the table and/or too may food choices.  Cutting her food into small pieces, as you mentioned, is a good idea.

There are some things you can try to help simplify eating for your Mother.

  •  
    • Create a calm environment for eating.  Limiting noise & other distractions may help her focus on the meal.
    • Keep the table setting simple.  Remove centerpieces, flowers, condiments.
    • Serve smaller portions of the meal.  Give her a small amount at a time on the plate.  When she is done with that, fill up her plate again with a small portion.
    • Present one item to eat at a time.
    • Serve small meals throughout the day in place of three large ones.
    • Try finger foods, and eliminate the utensils.
    • Cue her to use the spoon, if needed.  It may be necessary to verbally guide her step by step through the eating process. 
    • Model how she should use the spoon or other utensil, if she doesn't understand.

Dottie Lyvers
Family Caregiver Support Specialist
Northwest Piedmont Area Agency on Aging


Question:
My husband is 68 and was diagnosed with AD at age 59.  He was lucky to get on medications early and we both have been fortunate that up until just lately he has had what (in the scheme of things) is small.  In the last couple of years his symptoms have escalated.  He owns his own business and is lucky to have wonderful managers who are good with him each day when he goes in. Tonight my husband told me he just isn't happy. It seems like all I do, day in and day out, is work to keep him happy.  I read everything I can about AD to make certain he has the best medicines.  I exercise regularly and try and keep myself in good health.  I arrange my entire life around his steadily increasing needs.  I do this because I love him.  To hear him say he "isn't happy" breaks my heart. I know it's the disease talking but it still hurts me deeply.  I know this is only the beginning of the bad part to come.  I am questioning my ability to do everything that is expected of me.

After a full day of chauffering him, doing mountains of laundry from 'accidents', struggling to find things that will keep him interested in life I probably am not as attentive as I once was in the evenings when he came home.  I am ready for a rest and don't feel like resting in front of the FOX TV news with newscasters yelling at each other.  I retreat to my office many times and read quietly with my dog at my feet.  Now he is upset about this quiet time I have struggled to keep for myself.  He is long past the reasoning stage and everytime I leave the house to run a minor errand he goes ballistic when I come home, wanting to know where I was …. why going to the grocery took so long, etc.  Up until this point, I have tried to just sit down and explain to him patiently exactly what I have done every minute I am not by his side.  Honestly though, tonight when he said he 'wasn't happy' … I about blew my stack and said things I am glad I didn't.

Instead I walked out of the room until I could get myself back together and then tried to go back to talk with him about it.  By that time, he was smoking a cigar and probably had not given it one further thought — never realized how he had hurt me.  I don't know if I am tough enough to do this.

HELP!
–Jane


Answer:
As you've experienced, caring for someone with AD can leave you worse off than your husband.  While he forgets about what just occurred, you are left with all the frustrations and emotions that go along with the situation.  This can be very hard on the caregiver.  It is so imperative that you find ways to take care of yourself and relieve stress.  Certainly reading
and exercising are good starts.

Here are some other suggestions:

  •  
    • Consider finding a support group to join to help your cope
    • Seek a counselor to help you deal with your emotions
    • Do anything you enjoy to relieve stress and take a break
    • Get a break by asking family or friends to stay with your husband
    • Investigate local community resources to help with home care
    • Seek out volunteer programs that may exist in your community that offer volunteer respite programs.
    • Take your husband to an Adult Day Care Center, if one exists in your community.

Most importantly – just keep telling yourself that you are doing the best that you can do!

 

Dottie Lyvers
Family Caregiver Support Specialist
Northwest Piedmont Area Agency on Aging

Question: Is it wrong to keep the fact that my mother has Alzheimer’s from her? Whenever a doctor or someone mentions the word, she gets angry and denies that there is anything wrong with her. Is there any benefit to telling her?

Rebecca in Tennessee

Answer: I don't think it is helpful to upset your mother with the word Alzheimer's. She may not be able to accept or understand what the diagnosis means or how it is impacting her life. Sometimes using the phrase memory problems or difficulties is less threatening. Whatever she is comfortable with is how I would describe the problem.


Question: Sometimes I really need a break, but my husband is not comfortable around many people. He does not realize there is anything wrong with him so he does not understand why I want to be away from him? He asks me if he did something wrong and it just breaks my heart. We have been married 44 years.

Sarah in Toronto, Canada

Answer: Your husband is unable to realize that you need a break because of the cognitive impairment. You are his main support person and this is the very reason you need to schedule a break. You will return refreshed and renewed and better able to provide care for him. Even though he is not going to be as comfortable with another care provider right away, hopefully he can find an activity that will be enjoyable. Try adult day centers in your area or a trusted friend. Good luck!

This Month's Expert is:

Tamara Goetz

Caregiving Core/DMAC Research Coordinator
University Memory & Aging Center
Case Western Reserve University
12200 Fairhill Road
Cleveland, Ohio 44120