My mother is 89 years old with onset of dementia. She lives alone in a large house and my and I sister drop by several times a week to visit and check on her. She forgets to take her medications and does not eat like she should yet she refused help from anyone who is not family. Denial is her favorite defense. Any suggestions? Jon G., Miami, FL

It's always difficult to know what to do when a parent resists help they clearly need. Your mother's behavior will likely become even more challenging as her dementia progresses.  That's why it's so important for you and your sister perservere to put a plan in place that will ensure that your mother takes her medications regularly, eats well, and has the additional support that she needs so that she will remain healthy and safe.

I contacted Dr. Bonnie Levin, the Director of the Division of Neuropsychology, at the University Of Miami and relayed your question. She offered two strategies. 

"First screen potential caregivers and then ask your mother to select the one that she most comfortable with. It will help her to feel that she's is part of the process. Keep it simple and give her a choice between two individuals," Dr. Levin explained.

"Then, once you have identified a potential caregiver, spend time with your mother and the caregiver together, so your mother pairs a family member with an outside caregiver.”

Dr. Levin also suggested a way to make this transition easier for your mother. 'Identify some activities, at home and outside of the home that she can do with the caregiver. That way your mother views this individual not as an intruder but a source of fun and support. "that will help make this transition easier. That way your mother view this individual not as an intruder but a source of fun and support."

How you communicate with your mother will be a critical part of implementing your plan. Several of my previous Ask Nancy columns  address this issue, and you may find them relevant and helpful to your particular situation. 

 
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Category: Care Planning, Caregiving, Family Relationships, Memory Disorders/Dementia/Alzheimer's Disease, Lifestyle