2 Oct 2008
Dear Mary,
My father is taking care of my mother who is disabled from Parkinson’s disease. The problem is he has major memory and judgment problems. He forgets to give her medicine sometimes and she is spending more time in bed. I have tried to get him to see the doctor but he does not think anything is wrong. I have also suggested hiring someone to help, but he says they are managing just fine. My brothers live out of state and call our parents once a month. Of course Dad sounds great on the phone so they think I am exaggerating. What can I do?
Dear Reader,
Sometimes a professional can be more successful in getting things done. I recommend you call the Department of Aging and Disabilities (410-222-4464) and schedule a home evaluation. A nurse or social worker will make recommendations for care and provide you with information about valuable community resources. Send your brothers a copy of the recommendations and elicit their help with your father.
Hiring a geriatric care manager is another idea. This person will establish a rapport with your parents, access services as needed, and keep a watchful eye on the situation. You can find one by contacting the National Association of Professional Geriatric Care Managers at 520-881-8808 or www.caremanager.org.
Dear Mary,
My mother’s has Alzheimer’s dementia and has started to experience urinary incontinence. She also is more hostile and refuses to wear adult diapers. She swears and swings at me when I insist she put them on. All the reading I have done has prepared me to expect incontinence but it did not prepare me to manage it. Can you please give me some advice?
Dear Reader,
Although incontinence is inevitable the initial occurrence should not be assumed a progression of the disease. Since your mother is also experiencing a behavior change, she may have a urinary tract infection. This needs to be ruled out before she is truly deemed incontinent. Please have her seen by her primary care provider as soon as possible.
If indeed she is incontinent, prevention is the key to successful management. Through reminders and guidance she should be toileted every two hours while awake. Be sure there is a clear path to the bathroom and the area well lit. If she has trouble finding the bathroom, post the sign “toilet” on the door (or whatever word she is familiar with). A picture of toilet may also work. As for getting her to wear incontinent under garments, the cardinal rule is never referring to them as diapers. Buy the pull-up kind and replace all her current underwear in her drawer with them. The hoped for outcome is that she will automatically put them on when getting dressed. Though she is wearing incontinent garments, she must still be toileted frequently to keep her comfortable and free from infection.
Dear Mary,
Can someone live on a supplemental food drink forever? A neighbor says her mother refuses solid food so she gives her only Ensure® to drink. She says the doctor told her to do it.
Dear Reader,
Ensure® is designed to add calories, protein, and essential nutrients to a person’s diet. People who cannot chew, swallow, or digest solid food for whatever reason use it under medical guidance as their main source of food.
| 