Expert Answers to Caregivers Questions

As a family caregiver, I have grief over my mom being in a nursing home.

Question About: Caregiver Grief

Last updated: 06-Jul-2009

By Caring.com Community Member, wkcsouthward4

I have been taking care of my mom since last March 2008. When Mom found out she had colon cancer, she lived with me for ten months and she decided to go on hospice in June 2008. She did have some treatments but could not have surgery due to her having severe COPD (chronic obstructive pulmonary disease). The treatments seemed to have worked and stopping her bleeding, but when she moved into a nursing home in March 2009, she has started to bleed again.

She has been bedridden since March 2008 and it began to be hard on me and she was tired of the same four walls and we all decided on her going to a nursing home. Now I just feel so bad. I felt like I was prepared last year when she went into hospice that she would pass away soon, but now since it has been this long I have felt like she was doing OK. Now all those emotions are back. I feel so sad for my mom because she is scared again and I don’t know really how to help. I visit her almost daily and do the things that I have done all this time for her but I now think about her passing day in and day out and I know I shouldn’t, but how do I stop these emotions? It has been an emotional roller coaster for over a year now. I have been her primary caregiver and she calls on me rather than anyone and that is OK but I feel helpless to help her. Any help will be really appreciated!

Expert Answer by Dr. Mikol Davis

Mikol Davis, PhD received his doctorate in Psychology from the University of San Francisco in 1980. He has worked in community hospitals with geriatric patients suffering from dementia, depression, and other psychiatric problems. Dr. Davis has provided psychological counseling for people in crisis, suicide attempts, drug dependency, and emotional problems due to failing health. He has assisted many individuals to resolve conflicts with other members of their families. Dr. Davis has been in private practice in Marin County, California since 1976 and is co-founder, with his wife, Carolyn Rosenblatt of AgingParents.com.

Caregiver grief is truely a very lonely place to be. We often dont age or die gracefully. So how do we deal with the challenges of being a caregiver of our aging parents when the final relief of suffering won’t just come soon enough? We can’t just do it alone, we need help, and must force ourselves to reach out to others. It is clear that you have reached your own personal emotional threshold, when you no longer have the inner resources to offer hope and are felling quite helpless. This is an very important sign that our spirit is revealing to us that our personal responsibility and burden is clearly reducing the quality of our own lives. So, now it’s time ask for the help and support you need as a caregiver. The grieving process is quite different for everyone. Often grieving becomes protracted, and when that happens we are challenged to do everything in our power to take better care of our mental and emotional needs. Sometimes caring for your aging parent requires that you get professional support to ensure that you don’t get stuck by your own hopeless and helplessness. Please don’t wait to contact you family doctor and get a referral to a professional psychologist or mental health practioner that has traveled the grieving road. For mental health links and resources contact your local mental health association. I hope my words help you move forward to both better help yourself, mom would truely want you to do that for her. For additional resources on cargiving check out Carolyn Rosenblatt’s latest book, “The Boomers Guide to Aging Parents, The Complete Guide.”

How can I keep my husband, who has dementia, and teenage daughter from fighting and avoid family conflict?

Question About: Avoiding Family Conflict

Last updated: 04-Jul-2009

By Anonymous Caring.com community member

My husband has mild dementia and is suffering from depression because he forgets many things. Sometimes he is very aggressive when things are not his way. He is 78 years old and is going worse. We also have a daughter who is 15 years old and they are fighting most the time. I think that he is hiding his dementia with aggressive attitude. What I can do? Many thanks for your help, Dora.

— Question from Anonymous Caring.com community member

Expert Answer by Dr. Mikol Davis

Mikol Davis, PhD received his doctorate in Psychology from the University of San Francisco in 1980. He has worked in community hospitals with geriatric patients suffering from dementia, depression, and other psychiatric problems. Dr. Davis has provided psychological counseling for people in crisis, suicide attempts, drug dependency, and emotional problems due to failing health. He has assisted many individuals to resolve conflicts with other members of their families. Dr. Davis has been in private practice in Marin County, California since 1976 and is co-founder, with his wife, Carolyn Rosenblatt of AgingParents.com.

Let me start by saying how important it is while dealing in family conflict with a teenager, to get some immediate professional help. Ask you family doctor for a referral to a psychologist that works with families and specializes in inter-generational counseling. Your husband who is suffering from dementia and depression can not “consciously” use agressive behavior to cover up his medical condition. Often agressive behavior is a symptom of depression. However most parents are challenged by dealing with a family conflict teenager. Unfortunately your daughter must be suffering from watching her one and only father slowly become incompetent and dependent. The very best advice I can give you is to immediately have your husbands medication levels for depression be re-evaluated. Next get a referral for a family psychologist. Third reach out to your family or community and arrange for a “safe place” where your daughter can go for the night or weekend to get away from family. An additional resource you might check out is ourfree articles written by me and my wife Carolyn Rosenblatt at AgingParents.com. I hope this helps you situation.

Is it wrong to want to make my sister help?

Question About: Sibling Unwilling to Help With Caregiving

Last updated: 10-Jul-2009

By Anonymous Caring.com community member

My mother passed away from cancer a couple of years ago. While she was dying, I was going through chemo for cancer. I got absolutely no support from my sister or father, as they were only concerned with my mom. I did everything myself, such as driving myself home after a six-hour chemo session. It also was emotionally devastating to not be healthy enough to be by my mother’s side in the final months.

My mother’s death devastated my father. He is so alone now. My mother was his whole life. Since then, my sister, who lives in a different part of the country, visits for a week or two about twice a year. I work full-time and try to visit my dad a couple times a week after work. I’ve done shopping and errands for him, and I always make time to visit him on weekends.

I recently got engaged to a man who lives a couple hours away from my father (I live in between). My sister makes me feel like her little visits are more than I ever do for my father in a whole year. I have tried to get her to move here to help out, but she refuses. She says I shouldn’t ask her to give up her current life (which consists of no friends and no significant other).

I am engaged and I want to be able to spend time with my fiance. I feel bad just taking a long weekend with him. I worry about my dad. My jealous sister gets angry at me for spending time with my fiance instead of my dad. She’s very good at making me feel guilty.

To top it all off, she has borderline personality disorder and can goes off in an over-the-top screaming rage at any time over the smallest thing. It’s frightening. It all makes me think of packing up and moving far away with my fiance to force my sister to help out with my dad. (But I would never do that.)

I adore my dad, but I am incredibly burnt out and need help/backup in caring for my dad. I am a cancer survivor who still takes cancer meds on a daily basis. And my blood pressure is too high. I just want to enjoy life for a while. I don’t know what to do.

— Question from Anonymous Caring.com community member

Expert Answer by Dr. Mikol Davis

Mikol Davis, PhD received his doctorate in Psychology from the University of San Francisco in 1980. He has worked in community hospitals with geriatric patients suffering from dementia, depression, and other psychiatric problems. Dr. Davis has provided psychological counseling for people in crisis, suicide attempts, drug dependency, and emotional problems due to failing health. He has assisted many individuals to resolve conflicts with other members of their families. Dr. Davis has been in private practice in Marin County, California since 1976 and is co-founder, with his wife, Carolyn Rosenblatt of AgingParents.com.

You are an amazing survivor in spite of your sibling being unwilling to help with the caregiving of dad. If is unfortunate that your sisters mental illness has become so toxic to you. It is unlikely that she will ever truly appreciate all that your did for mom and all that you continue to do for dad. The only way your marriage to be will work is if your make your on life priority number ONE. Your guilt is getting in the way of your own healing from chemotherapy. Be realistic about what you can do to help dad. Get volunteers to supplement what you are not able to provide dad. Get supportive counseling to help you with setting limits with your sister and focus on your own priorities. Counseling maybe available at no or low cost through community mental health services. Feel free to read more about how to maintain mental wellness at our website AgingParents.com

How do I deal with caregiver anger from my brother?

Question About: Caregiver Anger

Last updated: 30-Jul-2009

By Anonymous Caring.com community member

My brother has been living with my mom since my dad died five years ago. She is legally blind, with advanced Parkinson’s and back pain. He has done a wonderful job of taking care of her. He stopped working, but has returned to graduate school. I live about ten miles away, and have a full time job 40 miles away. I come home each weekend to help out as best I can, but he treats me with intense hostility. I’m afraid of him. He’ll blow up at me, or just refuse to talk to me. He is very sweet to our mother, but I’m really hurt by his behavior. I buy him presents because I know he can’t afford them on his own, but he just hates me. I can’t talk to him…I’m too afraid to. My mom says he’s depressed, but she doesn’t say anything else to him because he’ll get angry at her. Before Dad died, we were very close…I considered him my best friend. Even back then, he would have flares of anger, but I’ve always been very protective of him and would back him up in fights. He hasn’t really talked to me for about a year and a half now. I love him dearly, but like I said, he terrifies me because he seems to hate me so much. It just seems like one day he decided he didn’t care about me anymore, and that I’m the worst person in the world. I just don’t know what to do…because I spend all of my free time with them, my social life is compromised. Neither of us are dating, as far as I know…it would upset my mother if I didn’t come home each weekend and at least pretend to get along with him. I feel like all I can do is try to be patient and work within the system he’s established, but I just want to know if there isn’t something else I could be doing. I feel like I’m grieving the loss of my brother as well as my dad.

— Question from Anonymous Caring.com community member

Expert Answer by Dr. Mikol Davis

Mikol Davis, PhD received his doctorate in Psychology from the University of San Francisco in 1980. He has worked in community hospitals with geriatric patients suffering from dementia, depression, and other psychiatric problems. Dr. Davis has provided psychological counseling for people in crisis, suicide attempts, drug dependency, and emotional problems due to failing health. He has assisted many individuals to resolve conflicts with other members of their families. Dr. Davis has been in private practice in Marin County, California since 1976 and is co-founder, with his wife, Carolyn Rosenblatt of AgingParents.com.

Thank you so much for describing how your brother’s anger is affecting both you and your mother for whom he is her caregiver. The resentment from your brother is not uncommon. He has taken over the 24/7 responsibilities for your mother’s daily needs and most likely resents your having an outside life. My experience as a psychologist with over thirty-five years of experience treating families and caregivers, has often revealed the long term resentments we often carry as adults. Dr. Mom’s diagnosis that your brother is depressed is likely right on target. Often when people are depressed their symptoms are increased irritability, anger, and often quick to rage at others. My first suggestion is that you hire a caregiver from an agency to give your brother some time either during the week or weekend. Your brother is likely burned out or close to it. Secondly, you need to get some emotional support to learn how to stand up for yourself and stop being intimidated. Give yourself permission to take a weekend off from your family responsibility to do something nice for yourself. Right now it sounds like mom has two loving kids who are stressed being around each other because they have many unmet personal needs that are critically affecting the quality of their lives. Thirdly, I suggest that you find a neutral family friend, clergy, or professional mediator that can assist you and your brother begin to look at how the stresses between you is directly reducing mom’s present quality of life. My wife Carolyn Rosenblatt is a nurse -lawyer who recently wrote a book that directly deals with the most difficult emotional subject of “How to handle family conflicts about elders.” Please check her book out: “The Boomers Guide to Aging Parents, The Complete Guide.” I hope this helps you begin the needed peace and family healing.

Dr. Mikol Davis

Is it unrealistic to expect my father-in-law to help contribute to household expenses?

Question About: Contribute Household Expenses

Last updated: 17-Jul-2009

By Anonymous Caring.com community member

Hello, My father-in-law has been living with us for six years. He is now 81 years old. After his wife died, he was lonely so he sold his home after we renovated our garden style basement into a three room “apartment” for him. The finished space is about 1000sf. He has his own kitchenette, bathroom with large shower, bedroom and living room. He reimbursed us for most of the renovation cost which was about 45K. He is a lovely man whom we all love and appreciate. He still drives and although he gets a little bored once in a while, he enjoys his life. We include him in all visits (family or non-family)which he enjoys. There is just one issue that I find I am a little resentful of. In our initial arrangement, it was agreed that after 2 years of living here, Dad would start paying rent. He sold his house when he moved in and has multiple hundred-thousands in the bank collecting interest. After 2 years, he made a comment about how our arrangement had been to contribute after 3 years and how he already contributes by taking us out for dinner (maybe twice a month). He also brings up things that he bought for us on our birthdays. We just let it go at first since we were in such a new situation and didn’t know how to navigate it. It has been six years now, and Dad has never offered to contribute on a regular or any other type of basis. Although I don’t think our own finances have anything to do with the appropriateness of him contributing financially, we have paid out of pocket for all three girls college tuitions. We have just finished paying double tuition for our second daughter and are still paying for our third daughter. In all my searches on the web, I have never seen anyone talking about elderly parents contributing to the household expenses. Am I being unrealistic? Are there any rules to follow here?

— Question from Anonymous Caring.com community member

Expert Answer by Dr. Mikol Davis

Mikol Davis, PhD received his doctorate in Psychology from the University of San Francisco in 1980. He has worked in community hospitals with geriatric patients suffering from dementia, depression, and other psychiatric problems. Dr. Davis has provided psychological counseling for people in crisis, suicide attempts, drug dependency, and emotional problems due to failing health. He has assisted many individuals to resolve conflicts with other members of their families. Dr. Davis has been in private practice in Marin County, California since 1976 and is co-founder, with his wife, Carolyn Rosenblatt of AgingParents.com.

Here is my short answer based on my professionally consulting with hundreds of families that are caring for their aging parents. Answer “YES” demand that Dad contribute to the household expenses.

By Anonymous AgingCare.com community member

My mom has been very depressed, saying that she just wanted to die. I try to help her, but she lashes out and can be so mean. How do I handle this?

Expert Answer by Dr. Mikol Davis

Depression is often presented to others not as sadness and apathy, but as anger or rage. Seniors who are depressed have lost purpose in their lives and often lash out at others, mostly at their loved ones. When anyone expresses their desire to die, it is most important to NOT take this comment Lightly. If you are caring for your Mom please get her seen by her physician right away. This is the type of responsibility to NOT delegate the others! Go to the appointment with your Mom and if she asks that you not attend the doctor’s examination, make sure to speak with the doctor yourself. You will be most effective if you prepare your observations of her mood and behavior. Depression in the elderly if often not treated due to age discrimination. Many new medications directly increase in quality of an elders life. Positive change is often quite dramatic when elders are properly treated with anti-depressant medications sometimes referred as “S.S.R.I’s”. S.S.R.I’s are anti-depression medications which fist came on the market with Prozac. Theses medications have been safely used for many years in treating seniors. Most importantly the lashing out and anger can disappear very quickly after two to four weeks on medication. After the evaluation by her family doctor, it is also appropriate for you to ask for a referral to a psychologist or psychiatrist. This may be in order to better get to the real root of her unhappiness. Medications often work best when talk therapy is used in addition to the medication. Don’t wait to do what is right for Mom.

Question for Caring.com

I’m 57 years old and recently became critically ill, brought to the ER, and underwent several procedures that I always thought needed a family member or designee to agree or approve, like dyalsis, heart catheter, etc. Apparently the ER doctors went ahead and did these things to me since I was not awake and none of my family or friends were available. I guess my question is: Is this standard procedure to just go ahead or is there an Ethics Board or something similar to do the deciding? Thank you for your responses.

Expert Answer

When you arrive at the emergency room unconscious, and there is no one to give consent to a procedure, the doctors must do what they can to save your life. It is presumed, legally, that you would want what is best for you if you were able to give consent. When you can’t the doctor uses his or her own judgment in place of yours, to treat your emergency condition. Even if an ethics committee exists, there is no time to have a committee meeting when there is a pending emergency condition. It is legally appropriate and ethical for the doctor to do what is thought to be safest for you. If you have a healthcare directive (also called “power of attorney for health care or medical”, your own doctor should have a copy. However, even with that, your own doctor may not be the one who first sees you in the emergency room.
Carolyn Rosenblatt, R.N. and Attorney has over 40 years of combined experience in her two professions. As a nurse, she has extensive experience with geriatrics, chronic illness, pain management, dementias, disability, family dynamics, and death and dying. As a trial attorney, she advocated for for the rights of injured individuals and neglected elders. She is also co-founder of AgingParents.com and author of The Boomer’s Guide to Aging Parents.

Last Updated March 19, 2010 Question from Caring.com

Reader:
My father was given a PICC line during a hospital stay, and then he died from a blood clot. He was never prescribed any blood thinners, and then I found out it’s usually mandatory to take these medications if you have a PICC line. Could someone have made a mistake – is this negligence on their part?

Answer from nurse-attorney, Carolyn Rosenblatt:

Your question asks about the issue of medical negligence. As a former litigator for 27 years, I can say that it is a very complex question, and one that cannot be answered without a review of all the relevant medical records by a competent attorney who is experienced in handling this kind of case, as well as possible review by a medical expert. The issue of negligence has multiple dimensions, and is influenced by what lawyers call the “standard of care”. That is a measure against which the facts of your particular situation are viewed. Experts for one side may have one opinion as to the standard of care in a particular case, while the opposing side or sides may have differing opinions.
If you are concerned about this and want to have your matter reviewed for a lawyer’s opinion on it, be sure you find the right kind of lawyer. I discuss the specifics of how to find one and how to tell if the one you are thinking of retaining for the job is right for this special kind of matter in a booklet, “How to Find A Good Lawyer For Mom or Dad”, available on my website (search Products). If you need legal advice, and I recommend that you get it, be a good consumer and shop carefully for the right lawyer. Bear in mind that every state has laws regarding how long you have to make a claim or file a case for medical negligence in court. These are called statutes of limitations. Because there are a lot of legal rules about timing and they are quite rigid, you should get legal advice right away. If you miss the time limits on any part of the claim, any rights that you have can be lost for good. So, in summary, address your concerns by getting proper legal advice to find out if there was medical negligence, and do it promptly.