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
If someone with dementia hates one close to them so you move them to another relatives house is she soon going...
The comments here are absolutely right. Your mother hates her situation, her disease, her loss of independence. It has nothing to do with... The comments here are absolutely right. Your mother hates her situation, her disease, her loss of independence. It has nothing to do with you. For a short period of time, she may be happier, but it won't last because nothing will change about her disease.
Training and education in caring for someone who has dementia can help to a degree, but that often comes down to acceptance of the disease on the part of the caregiver. If your sister's personality is such that she can do this, the arrangement may work out better, but this still doesn't mean that she is a better daughter or that your mother really hates you. Most likely, after the first days or weeks, nothing will be different.
That being said, it sounds like you've taken your turn and it's time to let your sister do the caregiving for now. You deserve a life of your own and you don't deserve abuse. I'd go along with your sister if you think she can do a fairly decent job of caring for your mother.
Eventually, your mother may need professional help. Then, it may come down to which state provides the best services for their aging seniors. It wouldn't hurt for you and your sister to compare these services early on so that decisions can be made when help is needed.
Good luck, my friend. Please don't be hard on yourself. You didn't fail. It's time to pass the torch to someone fresh.
Carol see more
Training and education in caring for someone who has dementia can help to a degree, but that often comes down to acceptance of the disease on the part of the caregiver. If your sister's personality is such that she can do this, the arrangement may work out better, but this still doesn't mean that she is a better daughter or that your mother really hates you. Most likely, after the first days or weeks, nothing will be different.
That being said, it sounds like you've taken your turn and it's time to let your sister do the caregiving for now. You deserve a life of your own and you don't deserve abuse. I'd go along with your sister if you think she can do a fairly decent job of caring for your mother.
Eventually, your mother may need professional help. Then, it may come down to which state provides the best services for their aging seniors. It wouldn't hurt for you and your sister to compare these services early on so that decisions can be made when help is needed.
Good luck, my friend. Please don't be hard on yourself. You didn't fail. It's time to pass the torch to someone fresh.
Carol see more
Question
What would be the cause of the ongoing urinary tract infection in an elderly female?
I'm assuming, if I read your note right, that your wife’s always had a temper. A UTI could be causing the other symptoms or she could... I'm assuming, if I read your note right, that your wife’s always had a temper. A UTI could be causing the other symptoms or she could be developing dementia.
She definitely needs a physical exam. It's generally easier to convince someone to see a doctor for a physical problem than a mental or cognitive one. Could you convince her to see a doctor about an antibiotic for a common urinary infection if you avoid mentioning her temper or accusations? If she will go, then you could contact the doctor's office ahead of time and let them know that you suspect dementia (if that's the case).
You definitely need to do something here, for your sake if not hers. Do you two have children? Close friends? Someone who can talk your wife into a simple urinalysis?
If she does have a UTI and nothing is done, she is likely to develop worse symptoms and may need to go to the ER as these can travel to the kidneys. Do your best to get her help. If she won't budge, watch for signs that she's spiking a fever or having kidney pain. I hope you don't have to wait for that. Do try to get someone else in to help you convince her to see a doctor.
Good luck. Please check back and let us know how you're doing.
Carol see more
She definitely needs a physical exam. It's generally easier to convince someone to see a doctor for a physical problem than a mental or cognitive one. Could you convince her to see a doctor about an antibiotic for a common urinary infection if you avoid mentioning her temper or accusations? If she will go, then you could contact the doctor's office ahead of time and let them know that you suspect dementia (if that's the case).
You definitely need to do something here, for your sake if not hers. Do you two have children? Close friends? Someone who can talk your wife into a simple urinalysis?
If she does have a UTI and nothing is done, she is likely to develop worse symptoms and may need to go to the ER as these can travel to the kidneys. Do your best to get her help. If she won't budge, watch for signs that she's spiking a fever or having kidney pain. I hope you don't have to wait for that. Do try to get someone else in to help you convince her to see a doctor.
Good luck. Please check back and let us know how you're doing.
Carol see more
Question
My husband has dementia and sometimes gets up at 2 or 3 a.m. What should I say to get him back to bed?
I read about a forward looking care home that used a snack technique. They would say to the night wanderer, "let's sit and have a... I read about a forward looking care home that used a snack technique. They would say to the night wanderer, "let's sit and have a snack." The caregiver would share a quick light snack with the wanderer and then the caregiver would say something like, "I think it's about bedtime now." The person nearly always had forgotten the "errand" that was so necessary and would go back to bed. It's another form or distraction and redirection.
Pointing out it's night and not the time to be up is generally unproductive simply because logic doesn't work on someone with dementia.
It never hurts to check with the doctor in case there's an underlying cause. However, this is not unusual behavior with people who have dementia, so if the doctor doesn't have suggestions try the snack approach. I know that having a snack at that time isn't likely your idea of a good time, but it's easier than fighting a losing battle.
Please keep checking back to let us know how you're doing.
Carol see more
Pointing out it's night and not the time to be up is generally unproductive simply because logic doesn't work on someone with dementia.
It never hurts to check with the doctor in case there's an underlying cause. However, this is not unusual behavior with people who have dementia, so if the doctor doesn't have suggestions try the snack approach. I know that having a snack at that time isn't likely your idea of a good time, but it's easier than fighting a losing battle.
Please keep checking back to let us know how you're doing.
Carol see more
Question
How do you tell one parent it's time for the other to go into a nursing home?
You could start with letting her know that she takes wonderful care of your dad but some in-home help could make it work longer. Stress... You could start with letting her know that she takes wonderful care of your dad but some in-home help could make it work longer. Stress that if her health goes downhill she may not be able to help him at all.
If she tries in-home care but doesn't like it or won't try it at all, the idea of them moving to assisted living together is another good idea. Also, many new living arrangements have "graduated" care so that if they moved into the same home or group of homes, they may eventually have to separate to different care units but she'd still be close to him. That gradual change may help her adjust.
She married him until "death do us part" and many of the older generation can't separate out that this promise sometimes means that what is best for the spouse may be hiring help in caring for him or her. If need be, ask for help from both of their doctors.
Work with her your mom. Lend your support as suggested. This is a very difficult decision for her so give her time if this isn't an emergency. Stressing your dad's needs and her own health may eventually help her make this decision.
Take care,
Carol see more
If she tries in-home care but doesn't like it or won't try it at all, the idea of them moving to assisted living together is another good idea. Also, many new living arrangements have "graduated" care so that if they moved into the same home or group of homes, they may eventually have to separate to different care units but she'd still be close to him. That gradual change may help her adjust.
She married him until "death do us part" and many of the older generation can't separate out that this promise sometimes means that what is best for the spouse may be hiring help in caring for him or her. If need be, ask for help from both of their doctors.
Work with her your mom. Lend your support as suggested. This is a very difficult decision for her so give her time if this isn't an emergency. Stressing your dad's needs and her own health may eventually help her make this decision.
Take care,
Carol see more
Question
What do you do when elderly parent refuses needed care or legal considerations?
Hi Seattleite, I've been thinking a lot lately about the rights of elders vs. worried adult children. The dignity of the elder should... Hi Seattleite,
I've been thinking a lot lately about the rights of elders vs. worried adult children.
The dignity of the elder should be considered no matter where he or she lives, and cognitively sound elders should be able to make decisions.
While we have wonderful facility care in my community and many people choose the safety and social environment of a quality assisted living facility or even nursing home, that isn't the right place for everyone.
As you mentioned, sometimes adult children would far rather have their parent "well cared for" and in a situation where they didn't have to worry so much. That's understandable. However, that may not be what the elder wants.
We all die. Your mother knew what she wanted and how she wanted that to play out. Bless her heart and her spirit. I'd have liked to have met her.
Carol see more
I've been thinking a lot lately about the rights of elders vs. worried adult children.
The dignity of the elder should be considered no matter where he or she lives, and cognitively sound elders should be able to make decisions.
While we have wonderful facility care in my community and many people choose the safety and social environment of a quality assisted living facility or even nursing home, that isn't the right place for everyone.
As you mentioned, sometimes adult children would far rather have their parent "well cared for" and in a situation where they didn't have to worry so much. That's understandable. However, that may not be what the elder wants.
We all die. Your mother knew what she wanted and how she wanted that to play out. Bless her heart and her spirit. I'd have liked to have met her.
Carol see more
Question
Do you need a Medicare Supplement after being accepted for Medicaid?
Since Medicaid is state run, I'd check with your mom's social worker. There's a "spend down" on Medicaid (generally).... Since Medicaid is state run, I'd check with your mom's social worker. There's a "spend down" on Medicaid (generally). How that is handled is not the same in all states. Likely, the Medicare supplement isn't the best choice financially, but I'd keep it until you talk to the Medicaid people in your state. Sometimes, Medicaid would rather your kept the supplement. They'll help you decide what is best.
Good luck,
Carol see more
Good luck,
Carol see more
Question
My Mom has a reverse mortgage. How does this effect the sell of her home?
Hi Kathy, I agree with Angel. Reverse mortgages can be very difficult to fully understand. If your sister doesn't understand it she can... Hi Kathy,
I agree with Angel. Reverse mortgages can be very difficult to fully understand. If your sister doesn't understand it she can (as she nearly did) cause some big problems for your mom. It wouldn't hurt to see an attorney to have the contract looked over so that you know your options.
Good luck,
Carol see more
I agree with Angel. Reverse mortgages can be very difficult to fully understand. If your sister doesn't understand it she can (as she nearly did) cause some big problems for your mom. It wouldn't hurt to see an attorney to have the contract looked over so that you know your options.
Good luck,
Carol see more
Question
My Dad died and had a car, Mom's on Medicaid and cannot drive. Can she gift the car to one of the kids?
Hi KC, I think you can trust the attorney. Since Medicaid laws are different in every state, you were truly wise to discuss this with a... Hi KC,
I think you can trust the attorney. Since Medicaid laws are different in every state, you were truly wise to discuss this with a qualified professional in the field. Now that you've done that, there shouldn't be anything to worry about. If the attorney suggests any special type of paperwork, do it the way he or she suggests.
Take care and please check back with any questions. We can support you even if we recommend seeking legal help.
Carol see more
I think you can trust the attorney. Since Medicaid laws are different in every state, you were truly wise to discuss this with a qualified professional in the field. Now that you've done that, there shouldn't be anything to worry about. If the attorney suggests any special type of paperwork, do it the way he or she suggests.
Take care and please check back with any questions. We can support you even if we recommend seeking legal help.
Carol see more
Question
Where does the strength and will to continue caring come from when Mom refuses to care for herself?
Hi Dixielicious, I'm so glad you wrote. You weren't rambling - you were just telling us your feelings. Your situation isn't... Hi Dixielicious,
I'm so glad you wrote. You weren't rambling - you were just telling us your feelings. Your situation isn't good for your or your mother. Of course you love her, but her depression is keeping her from doing what is good for her. You understand that but are frustrated at the same time. That is only human.
She's used to you doing it all, and you have disabilities yourself. Have you checked with social services to see what options exist in your state? Could you ask for a social worker to come to your home to help you sort things out?
Your mother may qualify for assisted living or a nursing home. You should be able to take care of your own disability issues without worrying every minute about your mother.
ou do need outside help. There is no shame in that. Please call your local social services or your Area Agency on Aging and see what help is available.
Keep us posted on how you are doing. We are pulling for you.
Carol see more
I'm so glad you wrote. You weren't rambling - you were just telling us your feelings. Your situation isn't good for your or your mother. Of course you love her, but her depression is keeping her from doing what is good for her. You understand that but are frustrated at the same time. That is only human.
She's used to you doing it all, and you have disabilities yourself. Have you checked with social services to see what options exist in your state? Could you ask for a social worker to come to your home to help you sort things out?
Your mother may qualify for assisted living or a nursing home. You should be able to take care of your own disability issues without worrying every minute about your mother.
ou do need outside help. There is no shame in that. Please call your local social services or your Area Agency on Aging and see what help is available.
Keep us posted on how you are doing. We are pulling for you.
Carol see more
Question
What do we do when the elderly break house safety rules?
If she has dementia, she can't follow rules, but even if she doesn't have dementia she's likely to resent being told there are... If she has dementia, she can't follow rules, but even if she doesn't have dementia she's likely to resent being told there are "rules" in her own house.
The idea of a gate is a good one. She won't like it, but if there is nothing she really needs upstairs, she may not try to unlock it. Make the lock strong. If dementia is the issue, you may have to re-evaluate where she should be alone. Some houses are much easier for "aging in place" than others.
Please keep us posted on how you and she are doing.
Carol see more
The idea of a gate is a good one. She won't like it, but if there is nothing she really needs upstairs, she may not try to unlock it. Make the lock strong. If dementia is the issue, you may have to re-evaluate where she should be alone. Some houses are much easier for "aging in place" than others.
Please keep us posted on how you and she are doing.
Carol see more
Question
Getting wife with dementia to agree to have help. Any advice?
I agree with Jeannegibbs and several others, too. Logic and facts won't work with this woman since her reality is her reality. However,... I agree with Jeannegibbs and several others, too. Logic and facts won't work with this woman since her reality is her reality. However, taking care of her husband with help doing chores so she has more time for the "important things" may help her make the decision to accept help for his sake. If it's her decision then it's okay. Naturally, this help will be there for both of them.
If this doesn't work, the suggestion that you call in social services may be the only answer. Your patient needs care. However, I would try Jeanne's suggestion first as it may give them more time as a family.
Good luck. You are facing the dilemma that is Alzheimer's. The clash of our world and theirs. It's often an agonizing journey.
Carol see more
If this doesn't work, the suggestion that you call in social services may be the only answer. Your patient needs care. However, I would try Jeanne's suggestion first as it may give them more time as a family.
Good luck. You are facing the dilemma that is Alzheimer's. The clash of our world and theirs. It's often an agonizing journey.
Carol see more
Question
ALF is not helping Dad with CPAP at night as they agreed. Any suggestions?
If the AL agrees that they will check every two hours, they should, however, I'd say that's an unusual for an ALF unless you are... If the AL agrees that they will check every two hours, they should, however, I'd say that's an unusual for an ALF unless you are paying more for that service. Still, if they agree and aren't following through, you could try the ombudsman. This person is there for ltc disagreements. Go to www.ltcombudsman.org and type in the Zip code of the home. If this doesn't get you a contact, you can try your state website. I'd only do this if you've tried all other more direct routes such as talking with the administrator.
Good luck,
Carol see more
Good luck,
Carol see more
Question
Are metabolizing drugs harder on Alzheimer's patient?
Good point, Wendala, about pharmacists. I generally recommend that they be consulted on any medication questions since that is their... Good point, Wendala, about pharmacists. I generally recommend that they be consulted on any medication questions since that is their specialty. It nothing else, their input helps educate us and gives us more information when we ask the doctor questions.
Carol see more
Carol see more
Question
Are metabolizing drugs harder on Alzheimer's patient?
It's harder for all of us to metabolize drugs as we age. That's why older people should, under many circumstances, be prescribed... It's harder for all of us to metabolize drugs as we age. That's why older people should, under many circumstances, be prescribed lower dosages of drugs.
Sleeping pills can be very tricky for older people. Some even cause more memory issues. I agree with staystrong that melatonin may be a good option, but check with her doctor.
Please keep us posted. We help each other.
Carol see more
Sleeping pills can be very tricky for older people. Some even cause more memory issues. I agree with staystrong that melatonin may be a good option, but check with her doctor.
Please keep us posted. We help each other.
Carol see more
Question
As a caregiver, how are you managing to take care of your own health?
GrammyM, I'm so proud of you! Please keep sharing this message. You take very good care of your husband. As a matter of fact, I'd... GrammyM, I'm so proud of you! Please keep sharing this message.
You take very good care of your husband. As a matter of fact, I'd guess that your renewed self is perceived as a happier self by your husband, which helps him, too.
I loved your words: "This is NOT me, this has never been me. Where has the pride, the self-assurance gone! If no one else cares, I must care."
No one but another caregiver - nearly all of us on this site - can really understand. But we do. You have it figured out. Thank you for sharing this positive message.
Carol see more
You take very good care of your husband. As a matter of fact, I'd guess that your renewed self is perceived as a happier self by your husband, which helps him, too.
I loved your words: "This is NOT me, this has never been me. Where has the pride, the self-assurance gone! If no one else cares, I must care."
No one but another caregiver - nearly all of us on this site - can really understand. But we do. You have it figured out. Thank you for sharing this positive message.
Carol see more
Question
We are moving out of my grandma's house, is this a selfish decision?
Hannah, you and your mother are not selfish. It's beyond time for someone else to take over your grandma's care. Underneath the... Hannah, you and your mother are not selfish. It's beyond time for someone else to take over your grandma's care. Underneath the dementia, she knows that you love her, so don't ever let that though go.
If your relatives can't handle the situation, then someone needs to call adult protective services and let them know that your grandma is alone (if there's no social worker involved yet). It's their job to figure something out. If need be, you can explain your health and that of your mother. It's time for outside care.
If your mental illness doesn't allow you to keep in contact, that's okay. The extra stress may make your own health deteriorate. You'll have to decide that on a day to day basis. Perhaps if social services can get your grandma settled in a nursing home and she begins to do okay, you could visit, but in this case your own health must come first.
You and your mom need to take care of yourselves. That's the bottom line. You've done far more, already, than most people could under these circumstance. Don't back down.
Please keep in touch and let us know how you are doing.
Carol see more
If your relatives can't handle the situation, then someone needs to call adult protective services and let them know that your grandma is alone (if there's no social worker involved yet). It's their job to figure something out. If need be, you can explain your health and that of your mother. It's time for outside care.
If your mental illness doesn't allow you to keep in contact, that's okay. The extra stress may make your own health deteriorate. You'll have to decide that on a day to day basis. Perhaps if social services can get your grandma settled in a nursing home and she begins to do okay, you could visit, but in this case your own health must come first.
You and your mom need to take care of yourselves. That's the bottom line. You've done far more, already, than most people could under these circumstance. Don't back down.
Please keep in touch and let us know how you are doing.
Carol see more
Question
How can I deal with anger and depression associated with Caregiver burnout?
Hi JessieBelle, I'm just guessing, but I think that the many layers of clothing it can take to keep some elderly people warm are... Hi JessieBelle,
I'm just guessing, but I think that the many layers of clothing it can take to keep some elderly people warm are uncomfortable to wear.
I know that the temperature issue is a big one. The heat can be stifling to younger people. So, as you say, compromise is best, but that can be difficult to make happen. This is just one of many issues that can make living together hard.
Take care,
Carol see more
I'm just guessing, but I think that the many layers of clothing it can take to keep some elderly people warm are uncomfortable to wear.
I know that the temperature issue is a big one. The heat can be stifling to younger people. So, as you say, compromise is best, but that can be difficult to make happen. This is just one of many issues that can make living together hard.
Take care,
Carol see more
Question
My parent's want me and my wife to move in with them. What are my legal options?
With this kind of relationship, it can work. There is a movement - not huge, but it's there - toward multi-generational households.... With this kind of relationship, it can work. There is a movement - not huge, but it's there - toward multi-generational households. When everything is worked out legally (which should be done, anyway since everyone should have a POA for health, one for finances and a will) and personalities are compatible, it can be delightful.
Many people have regretted this set up, but many others have found it works. It's very individual. Your family sounds ideal for this setup if anyone's is. Communication will be key.
Please keep us posted as you move forward on your journey.
Carol see more
Many people have regretted this set up, but many others have found it works. It's very individual. Your family sounds ideal for this setup if anyone's is. Communication will be key.
Please keep us posted as you move forward on your journey.
Carol see more
Question
How to get husband to quit pulling on his catheter?
It sounds as if you've done nearly everything possible. I think that if his urologist doesn't have any ideas that can help you it may be time to seek a second opinion. That doesn't mean that his doctor isn't good. It simply means that another urologist may have learned of a solution that the current doctor hasn't heard of.
I wish I had a brilliant solution, but I don't. Please let us know if you learn something new. We'd like to know how you are doing and whatever you learn may help others.
Meanwhile, we're empathizing with your exhaustion and frustration over this issue.
Carol see more