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What to do when extended family member shows signs of dementia?

I have an Aunt who has no kids and lives 1500 miles away. Lives independently in a big home. What do I do when she shows what appears to be signs of dementia? She is withdrawing from her social circles (completely, though she claims she hangs out with them often... she has not), she seems at times disoriented at best, and disheveled at times to the worst to the community when they do see her.

This is a woman who has always been extremely active in church, very organized, used to being in control and having a very solid upper middle class life. She is old school southern, and with that comes a lot of dignity and grace that she is used to walking with. In addition, she watched her Dad fall apart in his final years in this way, and has seen her sister plummet over the course of several weeks from coherent to nearly completely gone.

She appears to not eat a lot, and when we talk on the phone she forgets that we've already spoken about things she asks about in the same conversation, not seven minutes apart. She also at times sounds like she takes notes to remember things, and sometimes I think she is being cordial to me but not recognizing it is me.

When I've brought my concerns up, she is adamant and angry and says she is fit as a fiddle and the doctor gave her a clean bill of health (like three or four years ago). Any concerns her friends on the ground there have expressed she replies with, "They should mind their own business."

If I lived nearby, I would simply visit often, and try to get her to sign up for life alert, or a cleaning lady or all of the above. And if it got bad, make attempts at bringing her into our home. But we live far away, have limited resources, and I am so unsure. What kind of options are out there, without having to call authorities and go overboard in having her abilities completely questioned at best or taken away at worst?
Status: Open    Mar 09, 2016 - 01:41 PM


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APFM Staff Answers

Mar 09, 2016 - 01:40 PM

Hi - I'm sorry for the delay in answering your question - you don't mention what state you or your aunt are in and rules can very state by state. If you would like to give us a call at 866-568-2989 we could put you in touch with a Senior Living Advisor in your area who could discuss options in your area, give you suggestions on having productive conversations about senior living with your aunt and give you guidance on additional resources.


Mar 08, 2016 - 05:21 PM

I read your questions and I really felt your pain and concern for your aunt. I find it disheartening that you have not received an "Expert" answer to your questions. You have truly valid concerns and there must be people in the state where your aunt resides who could offer you help and/or counsel. Perhaps you could add that information to your post.

Even though you (and your family) do not have the means/resources to care for your aunt at such a distance, perhaps a like-minded group of relatives (and close friends) could band together and try to convince her to at least consider a "Respite Stay" in an Assisted Living Facilty, just to try one out. Plenty of ALFs offer them. Unfortunately, the window of opportunity for "reasoning" with the person in this type of situation just gets shorter. As an elderly person slips towards dementia, his/her ability to have rational conversations becomes virtually impossible. And I am not even talking about a clinical diagnosis of Alzheimer's. I am just talking about the plain garden variety of old-age dementia, that lots of people end up with. Has your aunt signed a healthcare PoA? It would be great if she would do that for you, to give you some level of comfort that she recognizes she will not always be her own best advocate.

My mom, who is 91, could argue with someone until she was/is blue in the face about why she should still be able to live on her own, alone, in her own home. Luckily I spotted an opportunity to move her into an ALF one year ago this week and she has been basically thriving there ever since...knock on wood. Don't get me wrong. She doesn't really like being there in that she doesn't like the idea of using her savings to pay for it. (If it were free to her, that would be a totally different story! Then she would rave about it.)

My mom's daily needs are met by kind and caring staff. And I am not worrying about her constantly anymore. (I did not live nearby when I moved her into the ALF and I still don't live close enough for even weekly visits.) In the year leading up to her move into the ALF, which we agreed would be "on a trial basis", she had been in and out of the hospital multiple times, had two surgeries (back and hip) and rehab stays totaling more time than she had lived in her own home. I think she spent a total of maybe 3 out of those 12 prior months living alone. And, even then she needed help with everything from bill-paying to laundry to grocery shopping, etc., but to hear her tell it, she was perfectly fine and capable and drove herself everywhere, etc. Many of our elderly (my mom included) just get to a point where they aren't capable of taking good care of themselves anymore, don't want to admit it to themselves or anyone else and they basically try to conceal it as best as they can. I think that is just human nature. But, they are only going to decline from that point....not get miraculously and substantially better.

Based on the points you made in your post, I believe your aunt really does need assistance and you are acting in her best interests to try and sort out what can be done. I think you are a blessing in her life and she is lucky you are trying to look out for her. I hope you get some "Expert" answers soon. Keep seeking help and guidance in what to do and the next steps to take. It sounds like you may be the only person in her life with enough sense to recognize that she needs help and that she needs it NOW.

Take care.

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