Carol Bradley Bursack, CDSGF
Author, speaker, columnist and eldercare consultant
Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.
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Question
Is vascular dementia progressive like Alzheimers?
People can have what are called mini-strokes or silent strokes which can be, as the terms would imply, virtually unnoticed. Also, lack of... People can have what are called mini-strokes or silent strokes which can be, as the terms would imply, virtually unnoticed. Also, lack of blood flow to the brain can cause dementia symptoms. It sounds like your mom is a candidate for the second, if not the first.
To answer your question about whether or not vascular dementia can worsen, the answer is likely yes. Most dementia will worsen over time.
Your mom probably needs more than one specialist since a doctor who is treating her spinal stenosis - likely a rheumatologist - may not be qualified to treat her vascular dementia.
Spinal stenosis can be painful, and people who have dementia can often have trouble expressing pain, so you'll have to stay well tuned in to her need for pain relief.
Please keep checking back with us so we know how you are doing,
Carol see more
To answer your question about whether or not vascular dementia can worsen, the answer is likely yes. Most dementia will worsen over time.
Your mom probably needs more than one specialist since a doctor who is treating her spinal stenosis - likely a rheumatologist - may not be qualified to treat her vascular dementia.
Spinal stenosis can be painful, and people who have dementia can often have trouble expressing pain, so you'll have to stay well tuned in to her need for pain relief.
Please keep checking back with us so we know how you are doing,
Carol see more
Question
How do you take control of your parents finances when they won't let you and won't talk to you about it?
This sounds like a matter for the police, though if you don't know where she is it may be hard to prosecute. It would seem that someone... This sounds like a matter for the police, though if you don't know where she is it may be hard to prosecute. It would seem that someone her age could be proven incompetent by these actions. I hate to sound like this is a mystery novel, but could a private detective do some online followup to track her? What worries me is that she may be in danger.
Please keep us posted!
Carol see more
Please keep us posted!
Carol see more
Question
How do I stop my Dad from losing his patience with my Mom?
It sounds to me that your parents need to be in a professional care situation. You can't do this alone. Your dad's frustration is... It sounds to me that your parents need to be in a professional care situation. You can't do this alone. Your dad's frustration is understandable but not good for your mom (or you). You can't control how he acts. Do they both qualify for nursing home care? Or does one qualify and the other qualify for in-home care?
The situation as it is can't continue if for no other reason than it will take your health down along with theirs.
Please keep looking for outside help and let us know how you are doing.
Carol see more
The situation as it is can't continue if for no other reason than it will take your health down along with theirs.
Please keep looking for outside help and let us know how you are doing.
Carol see more
Question
Does dementia come and go?
I agree with Lindaz that dementia doesn't come and go, but symptoms can be different from one day to the next or even one moment to the... I agree with Lindaz that dementia doesn't come and go, but symptoms can be different from one day to the next or even one moment to the next. Diagnosis is best, of course. Then you have a place to start.
Please keep reading the advice from the wonderful community. People do understand what you're going through.
Carol see more
Please keep reading the advice from the wonderful community. People do understand what you're going through.
Carol see more
Question
How can my Mom qualify for Hospice?
Alzheimer's is a terminal disease but it goes on for years. If a doctor determines that your mother has six months or left to live,... Alzheimer's is a terminal disease but it goes on for years. If a doctor determines that your mother has six months or left to live, then she would qualify for hospice. As the others said, hospice isn't for financial relief. It's for the terminally ill.
I have seen people get better on hospice and go off of the care for a time. I've seen people live many months on hospice and have a good quality of life without the pain that they've been enduring. However, no one qualifies until it looks, medically, like they are entering the end of life. Talk with her doctor and see what he or she says.
Good luck,
Carol see more
I have seen people get better on hospice and go off of the care for a time. I've seen people live many months on hospice and have a good quality of life without the pain that they've been enduring. However, no one qualifies until it looks, medically, like they are entering the end of life. Talk with her doctor and see what he or she says.
Good luck,
Carol see more
Question
Does dementia come and go?
Great answers from everyone here so I won't add much but to say that yes, this is not an uncommon occurrence. Anything from a UTI,... Great answers from everyone here so I won't add much but to say that yes, this is not an uncommon occurrence. Anything from a UTI, sleep meds, anxiety meds, B12 deficiency (not watched for often enough so you should ask about that) or dementia could be causing this. She should be examined by a gerontologist is you can get her into one. If not, an internal medicine doctor can check for a UTI and other things. A neurologist will check for dementia. If it's a type of dementia, then you'll know what to watch for. Information will help you cope with whatever this is.
Please keep reading here and also let us know how you are doing.
Carol see more
Please keep reading here and also let us know how you are doing.
Carol see more
Question
How do I detach from my narcissistic Mom?
I'd suggest a support group for caregivers. Our community here has many people who have coped with (or are coping with) this issue.... I'd suggest a support group for caregivers. Our community here has many people who have coped with (or are coping with) this issue. Stay alert for updates since you'll be hearing from some of them. Also, an in person support group may help.
Finding a good counselor to help you cope with this difficult issue would also be a good idea.
Please keep us posted on how you are doing.
Carol see more
Finding a good counselor to help you cope with this difficult issue would also be a good idea.
Please keep us posted on how you are doing.
Carol see more
Question
Any life insurance available for someone with dementia/Alzheimer's?
This is a tough issue for many so my heart goes out to you. It's not likely that you'll be able to get a *good* life insurance... This is a tough issue for many so my heart goes out to you.
It's not likely that you'll be able to get a *good* life insurance policy at this point since Alzheimer's is a terminal disease. If you found one, the premiums would be high. If you still want to look, find an insurance broker in your community who works with several companies since then you aren't likely to get so much pressure to buy a certain one and ask for references.
Take care,
Carol see more
It's not likely that you'll be able to get a *good* life insurance policy at this point since Alzheimer's is a terminal disease. If you found one, the premiums would be high. If you still want to look, find an insurance broker in your community who works with several companies since then you aren't likely to get so much pressure to buy a certain one and ask for references.
Take care,
Carol see more
Question
Will we be able to get Medicaid?
Normally, when there are assets above a certain amount people don't qualify for Medicaid, but your circumstances are complicated.... Normally, when there are assets above a certain amount people don't qualify for Medicaid, but your circumstances are complicated.
States differ on what they allow and don't allow. Since your husband is awaiting a disability appeal hearing, you are likely dealing with an attorney for that. If this attorney can't advise you on what you can do as far as your assets and Medicaid, he or she should be able to suggest someone.
Good luck. Please let us know how it works out for you.
Carol see more
States differ on what they allow and don't allow. Since your husband is awaiting a disability appeal hearing, you are likely dealing with an attorney for that. If this attorney can't advise you on what you can do as far as your assets and Medicaid, he or she should be able to suggest someone.
Good luck. Please let us know how it works out for you.
Carol see more
Question
I feel like my life is at a standstill except for what is important to my Mom. Any advice?
I agree with the majority of the comments here. When we are at a standstill, a therapist can help sort things out. We need to set... I agree with the majority of the comments here. When we are at a standstill, a therapist can help sort things out. We need to set boundaries but it's very hard to do with aging parents who are controlling. Yet, without that - where are you? Please do find someone to discuss the details of your life and your relationship with your mother so that you can figure out appropriate boundaries or alternative care for her, if needed.
Please check back often and let us know how your are doing.
Carol see more
Please check back often and let us know how your are doing.
Carol see more
Question
Does someone with dementia know they have a problem?
So much depends on the stage a person is. In the early stages of dementia many people know that something is wrong. Later stages, often... So much depends on the stage a person is. In the early stages of dementia many people know that something is wrong. Later stages, often not.
And then, as you say, Java2012, there are what I call "moments of clarity" with many types of dementia. It's a brief time when they seem to "come back" before fading back into their dementia-destroyed existence.
Please keep checking back!
Carol see more
And then, as you say, Java2012, there are what I call "moments of clarity" with many types of dementia. It's a brief time when they seem to "come back" before fading back into their dementia-destroyed existence.
Please keep checking back!
Carol see more
Question
Can my Dad change his POA to me if his wife has put him in a care home and left him there after having him dee...
Babalou gave you good advice. You'll need the assistance of an elder law attorney if you want to fight this. However, make sure that... Babalou gave you good advice. You'll need the assistance of an elder law attorney if you want to fight this. However, make sure that you know all the facts. Yes, medications can do everything you say. However, dementia can also make a person do and say exactly what your dad is doing and saying.
A neurologist is the best person to check out your dad. He or she could adjust the medications to see what is helping and what is hurting. Then, a proper diagnosis can be made. Perhaps a brain scan will show deterioration - or not. If you are going to fight this legally, you'll need all of the facts.
I hope that this can be settled so that everyone's best interest is addressed.
Take care,
Carol see more
A neurologist is the best person to check out your dad. He or she could adjust the medications to see what is helping and what is hurting. Then, a proper diagnosis can be made. Perhaps a brain scan will show deterioration - or not. If you are going to fight this legally, you'll need all of the facts.
I hope that this can be settled so that everyone's best interest is addressed.
Take care,
Carol see more
Question
Wrong medication. Do I chalk it up to human error?
That's what I would do. There's so much good going on here that it's a shame to spoil things since they owned up to the mistake... That's what I would do. There's so much good going on here that it's a shame to spoil things since they owned up to the mistake and took the correct steps. I hope that his BP comes back quickly and everything evens out. Please do keep us posted.
Carol see more
Carol see more
Question
Wrong medication. Do I chalk it up to human error?
I think that the home has handled this admirably. Unfortunately, human error is part of life. As you said, they could easily have hidden... I think that the home has handled this admirably. Unfortunately, human error is part of life. As you said, they could easily have hidden this but they didn't so I'm assuming that they've taken all of the steps that they are required to take. Since their care is overall high quality, I'd be satisfied with things as they are.
If you do want to take more action, you can contact your ombudsman for the home. That is your choice.
Take care,
Carol see more
If you do want to take more action, you can contact your ombudsman for the home. That is your choice.
Take care,
Carol see more
Question
Is the end of life pain like if you have a heart attack?
Hi Smithy1968, You sound as if you are concerned that someone you love will feel pain upon death. Generally, the organs shut down gradually... Hi Smithy1968,
You sound as if you are concerned that someone you love will feel pain upon death. Generally, the organs shut down gradually since death under the circumstance I assume you are watching is gradual.
Both of my parents were on hospice care for months and were kept comfortable during that time. When they died, they died peacefully. No pain.
I was holding my dad when he died and I felt the release of what I would term his spirit, but no struggle or pain.
Mom's heart took a long time to stop even though her limbs were mottling and she was showing signs of other organs shutting down. When her heart stopped it was simply one more peaceful step.
I don't think you'll have to worry about the heart attack pain. This is different.
Take care,
Carol see more
You sound as if you are concerned that someone you love will feel pain upon death. Generally, the organs shut down gradually since death under the circumstance I assume you are watching is gradual.
Both of my parents were on hospice care for months and were kept comfortable during that time. When they died, they died peacefully. No pain.
I was holding my dad when he died and I felt the release of what I would term his spirit, but no struggle or pain.
Mom's heart took a long time to stop even though her limbs were mottling and she was showing signs of other organs shutting down. When her heart stopped it was simply one more peaceful step.
I don't think you'll have to worry about the heart attack pain. This is different.
Take care,
Carol see more
Question
What services are involved with an individual who has had a stroke but suffers from Alzheimer's also?
This depends on where you live. Someone who has had a stroke may be more physically impaired than someone with Alzheimer's. When they... This depends on where you live. Someone who has had a stroke may be more physically impaired than someone with Alzheimer's. When they happen together (and with a stroke there is also the possibility of vascular dementia which complicates things even further) you'd need someone who has the understanding and muscle to help the person with the stroke and perhaps give physical therapy, plus you need someone used to working with people who have dementia.
A nursing home may be needed if the person needs a great deal of physical care. Check your state's website by typing aging into the browser along side your state's name. You should see a long list of links that will lead you to services.
Take care,
Carol see more
A nursing home may be needed if the person needs a great deal of physical care. Check your state's website by typing aging into the browser along side your state's name. You should see a long list of links that will lead you to services.
Take care,
Carol see more
Question
How should salary be determined when being a caregiver for one parent?
Since your mom has substantial income, I would think this could be a family decision. However, if that income isn't substantial enough... Since your mom has substantial income, I would think this could be a family decision. However, if that income isn't substantial enough to pay her way for years of care - meaning if she could even need Medicaid - there may be limitations.
Either way, I'd suggest going through an elder care attorney to determine the amount paid as well as whether or not you need to pay taxes, etc.
I know that just paying for hours spent doesn't come close to compensating you for leaving a job. You will be losing Social Security among other things. Take that into consideration when you make your decision.
Good luck,
Carol see more
Either way, I'd suggest going through an elder care attorney to determine the amount paid as well as whether or not you need to pay taxes, etc.
I know that just paying for hours spent doesn't come close to compensating you for leaving a job. You will be losing Social Security among other things. Take that into consideration when you make your decision.
Good luck,
Carol see more
Question
My Mom needs a couple of teeth removed. Her communication is severely limited, Novocaine, or Anesthesia?
I was going to suggest Nitrous oxide gas as well. I agree with ferris1 that if the stage of dementia is advanced and pain isn't the... I was going to suggest Nitrous oxide gas as well. I agree with ferris1 that if the stage of dementia is advanced and pain isn't the issue it's best just to leave it alone. However, abscesses can be a problem. My mother-in-law needed surgery for that reason. They used a combination of local anesthetics and nitrous. Good luck making this decision. It's a tough one.
Carol see more
Carol see more
Question
How do you get over the trauma of watching someone when they die?
Parysia, thanks for telling us the full story. Your friend is very wise. You did everything that you could. So many things are out of our... Parysia, thanks for telling us the full story. Your friend is very wise. You did everything that you could. So many things are out of our control. Please keep letting us know how you are doing.
Carol see more
Carol see more
Mom has become a recluse. Any advice?
If she is not getting decent care, then a move may be in order. However, moves can be very stressful (you've indicated that you already know that). She could suffer even more of a setback.
I think that I'd agree with the majority here right now. Yes, a smaller facility may have worked before or could work now, but there's no way to know.
Whatever you decide, don't wallow in guilt. You are trying your best. We can't make others happy, and people your mom's age often have many things to be unhappy about. They are legitimate. Her only way to express this may be to complain.
Please keep us posed on how you are doing.
Carol see more