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In 2017 things seriously started to shift. This was also in conjunction with a more severe hearing problem. I used to think that his symptoms had psychological underpinnings but now it seems pretty clear that it is neurologically based. I also feel the neurological component has been happening in a milder form for many years but it got worse with having to accept the limitations of aging and his hearing loss. He has no awareness of this issue . He thinks things are fine given the insanity of the world right now. His children live on the East and West coasts and he speaks with them, by phone, 3 to 4 times a year. I don't see them being involved in his care. It also might be difficult to tell them something that he would see as a lie and which they would not be able to discuss with him. He doesn't see a problem and therefore, he is unable to take responsibility for difficult things when they come up. They're always someone else's fault.....me and a former doctor get the brunt of it but it will happen with anyone (including his children) who is too much of a challenge to his "I'm fine/nothing is going on" narrative. I'd like them to know so that they could have a better understand of their father's behavior as a legitimate, neurological issue. My hope would be that could foster a bit more of a connection. I also know that greater connection will not be possible because of the Anosognosia. His children are not psychologically inclined and tend to operate more on the surface. I'd appreciate any thoughts/support you might have on this situation. Either way it feels like a double bind/catch 22. If I say nothing, I'm withholding important information from his children even though no one has asked me. If I say something , I risk alienating my husband and disrupting a newly established balance (right now we are living in separate apartments in the same complex). This balance can easily tip. My intention is to do the best I can for all involved which now, more consciously, includes me. Thanks for listening.

I think you should inform them all at the same time in a group email. If at all possible, include a letter of diagnosis from his doctor, and ask that it include the Anosognia piece as well. Then you can include a layman's description of what it means to have that issue. This way none of them can say, "I didn't know." Do everything important in writing.

You don't tell your husband about the email. In the email you make it clear that his diagnosis cannot be discussed with him because he thinks nothing is wrong and it will upset him.

An important issue in all this is whether you and your husband have assigned PoAs for yourselves? (and hopefully, not each other) If neither of you have this in place, as well as Advance HEalthcare Directives, DNRs and Last Wills, then when he (presumably) passes before you and his children come expecting an inheritance, it will all go smoothly and there won't be any misunderstandings.

Navigating blended family dynamics can have minefields that are only exposed once someone smells money. Protect yourself now and into the future. You need to have a well thought out and financed plan.

I wish you all the best as you prepare with wisdom.
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Reply to Geaton777
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To answer your direct question, yes I think letting his adult children know he has been medically diagnosed with a terminal disease is the right thing to do. In your shoes I wouldn't want to end up being accused of hiding that until it was "too late".

I'm curious about your living in separate apartments, and your initial concerns that his symptoms were mental illness rather than dementia. People can certainly have both, my mom does. How is he handling his day to day life, living somewhat alone with dementia? I'm sure there must have been significant behavioral challenges before his diagnosis for you to decide you needed a separate apartment. I hope you will continue to prioritize your safety as well as his.
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Reply to Slartibartfast
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Has he been diagnosed with dementia? If so, I think his kids would want to know that. It’s a terminal condition. I don’t think this is violating confidentiality. Plus, you are going to need support if not now, then down the road. Even a decision to place him, surely the kids would need to know.

What if you told the kids quite simply “I’ve noticed you dad has been more forgetful/ quicker to anger /more easily confused / [whatever symptoms] in the past few years and it seems to be getting worse. He does not appear to be aware of it however. From what I have read, this is common.”

My dad had frontotemporal dementia and I was the one who had to really urge my mom to get him to a neurologist for a diagnosis. She was in denial even though he was doing crazy and dangerous things and acting totally different from his personality the first 70 years or so of his life.
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Reply to Suzy23
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You are in a tough spot that so many wives who are also caregivers experience.

Here are some facts to help you fulfill the caregiver part:

Key Aspects of Confidentiality:
Legal/Professional Duty: Caregivers must secure records (paper and electronic), protect passwords, and maintain privacy in compliance with regulations.

What to Protect: This includes medical history, diagnoses, medications, Social Security numbers, financial data, and photos.

Information Sharing:
CONSENT
Data can generally be shared with authorized individuals (like family) if the client gives consent or does not object.

When to Disclose: Confidentiality can be broken if there is a legal requirement to report abuse, neglect, or if the client is in imminent danger.

Tips for Security: Do not post about clients on social media, never discuss clients in public, and keep documents locked away. [1, 2, 3, 4, 5, 6, 7, 8]
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Reply to Sendhelp
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So, my first thought was, I don't think it is necessary to say anything about his condition to his kids. They will discover on their own, as you have, when his responses seem to be out of the ordinary.

However, I am considering my relationship with my own father, who is 85, and his wife, who is just 3 years older than me. They live in my neighborhood, so I see them regularly, and talk on the phone weekly. Sometimes I wonder if he is slowing down mentally, or showing any signs of dementia. Obviously, I can see any changes myself when I talk with him. But, I feel that his wife has a better sense of how he's doing, and I hope she would share any of her observations with me.

So, really, you know the kids and how they would respond to this information from you. Just explaining that you see these changes in his behavior, which he is unaware of, and tell them to look up "Anosognosia" so they have a better understanding.
I don't see how that would be upsetting for your husband. You don't have to tell him you shared this information with his kids. And the kids would be insensitive to bring it up or confront him about his failure to recognize his condition. If you think they would, then just don't tell them. Let them form their own opinions from their phone calls with Dad.
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