Families keeping elderly relatives with dementia at home alone when they can’t look after themselves!

• Dealing with elderly, frail parents who are unwell with memory impairment can be a major challenge.

• Dementia is the commonest cause of older people not manage at home alone!

• This is even worse when they lose their insight into their physical, cognitive impairments and care needs. Then they simply cannot consent.

• Many families are unwilling to confront their frail elderly parents to try and get them some more help, to try and get them into hospital for appropriate care or to get them into appropriate Residential Aged Care.

• Many families are obsessed with not upsetting their elderly parents by just not dealing with their problems managing at home even when their elderly parents are starving, falling, getting more confused, drinking excess alcohol, forgetting to take their pills and self-neglecting at home.

• This lack of action usually results in a crisis, crossing the “Thin Red Line” and ending up in the public Hospital Emergency Department.

• The reasons why sons and daughters are reluctant to confront their frail, elderly parents or get them further assistance include:

  ·       Confronting their parents to try and make them see reason will threaten their relationship.

  ·       Unresolved, unreconciled relationship issues including unresolved guilt, conflict and lack of love in the relationship.

  ·       Just want to keep Mum “happy”, no matter what.

  ·       Watching their elderly mother or father fade and struggle at home because they simply just don’t want to “upset them”.

  ·       Not taking executive action in getting the help that they need just because of the threat of anger and retribution from their elderly parents.

  ·       Just unable to cope with mother being angry with them.

  ·       In complete denial about their physical and cognitive decline, saying it is just “old age” when mother is actually quite unwell and could be treated successfully to resurrect her independence.

• I PROMISED NEVER TO PUT MUM IN A NURSING HOME

  This is a fascinating statement as nearly 100% of sons and daughters who have promised this, almost guarantee that their mother will end up in a Nursing Home!  It is a real paradox in life.

• So watching mother or father “fade away” at home from self-neglect is not a sensible option. First of all families need to be able to” recognise the physical and cognitive decline in mother and that she needs help. Many do not recognise this but simple blame the myth of “old age”! thus denying them proper medical care.

• They just can’t cope with confronting mother about the reality of the difficult home situation and are petrified of her response and anger in refusing hospital admission, extra help at home or Nursing Home placement. 

• This obsession about keeping mother at home commonly resides from family guilt when nursing home is mentioned but is clearly the safer option then.

• This situation commonly borders on elder abuse through elder neglect even though the family thinks they are helping and pleasing their mother.

• When elderly parents are no longer unable to initiate and maintain their nutrition and hydration, forgetting to eat and drink, wandering, falling, poor hygiene with incontinence, unable to manage pills and socially isolated which makes dementia worse anyway, then the time has come for nursing home unless there are reversible and treatable conditions.

• We wouldn’t lock a 3 year old child up all day at home alone, so why do families insist on keeping a frail very demented person at home alone when they are unsafe to be there anymore?

• Many children are petrified of their older parents and refuse to discuss their mother or father’s medical problems with them for fear of anger, retribution and negative outcomes. This is much worse with dementia.

• Some of the reasons for this great fear of their elderly parents include-

  -lifelong controlling and aggressive personality disorder.

  -worsening paranoid tendencies blaming children for everything going wrong.

  -“gaslighting”, a form of emotional abuse by manipulating their children and forcing them to question their own memories, beliefs and undermining them by denying facts and reality.

  -“guilt trip” and emotional blackmail by tormenting children to control them with statements such as “you just want to put me in a Nursing Home”, “after all I have done for you”, “you never phone me or visit me” when they already receive regular visits and phone calls.

• However, retained capacity to consent to life affairs, place of living and medical treatment means that we cannot go against the will of what our elderly parents want, even if it then means that they will continue to struggle alone at home. Then all we can do is to wait for the crisis, for them to cross the “Thin Red Line” and end up in the public hospital Emergency Department.

• How to deal with elderly parents in denial, denial about dementia and elderly in denial about health- they need be referred to a Geriatrician for a comprehenisve medical assessment and diagnosis.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.