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Questions & Answers - February 2004



Mary C. Fridley, RN,C is a registered nurse certified in gerontology with more than twenty years in the geriatric health field. She is the owner of Gero-Resources specializing in caregiver, eldercare, and successful aging education and advocacy. Mary is also an author of two caregiver advice columns and contributes articles to various websites. She is available for speaking engagements and would be happy to answer your questions or concerns while maintaining your anonymity.
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Questions & Answerss

Dear Mary,

Your response to the feeding tube dilemma validated my feelings that when Mom is ready to "go", and her body is following the same path, I need to let it happen and a feeding tube isn't the answer unless it will clearly make her more comfortable. I had already decided not to go the route of tube feeding but the conflict was that a friend's grandmother wasn't eating and after two weeks with a feeding tube she was back in good spirits and doing well (in his opinion).

Thank you on behalf of my mother and myself.

Dear Reader,

You are very welcome. Please read on for another point of view.

* * *

Dear Mary,

I really disagree with your response to the person who wrote about the feeding tube. You have no idea how difficult it is to make such a decision. If you decide against a feeding tube, the person will die and you will always wonder if using it would have made a difference. I believe that we should try all means available, just in case, and if they don't work, it wasn't meant to be.

Dear Reader,

I understand how difficult it is to be objective when it is your loved one's life at stake. Caregivers do the best they can and no decision is wrong if done with the highest intent to provide for a loved one's needs and not make decisions in response to their own needs not to lose them.

* * *

Dear Mary,

I have an elderly Uncle who fell and injured his shoulder. He had surgery and just went to a rehabilitation center for therapy. He has some memory problems and other than the shoulder is in reasonably good health. I am told that he will be discharged in three weeks back to the assisted living home. The problem is that my brother, who has Power of Attorney, wants to put him in a nursing home. He is leaving for Florida soon and won't be back until the end of March. He really doesn't want to have to worry about his Uncle while he's away.

We are locked in a power struggle over who is right. As it stands now, my Uncle is weak from being in the hospital but I think he will get stronger with time. I would like to see him go "home" with the help of a companion until he is able to be alone again. The staff says it's up to us. What do you think?

Dear Reader,

It is really too soon to say how much he will rehabilitate, but the Physical Therapist will have a good idea after working with him for a several days. I recommend that you get a level of care from the Adult Evaluation and Review Service shortly before he is to be discharged. This service is usually part of the Health Department but may also be housed in the Area Agency on Aging. Call your local AAA to find out. This assessment will give you an honest opinion of whether he can safely go back to the assisted living or needs a higher level of care. If he is able to go back, with the support of a companion, offer a compromise - let him go back for a trial period and see how it goes. Also, get Power of Attorney while your brother is away so he won't have to be bothered.

* * *

Dear Mary,

My husband has dementia and diabetes and refuses to follow his diet or take his medicine as prescribed. Lately he has been aggressive towards me, something that he has never done before. My friend tells me I should expect this kind of behavior with dementia. How long will it last?

Dear Reader,

I would not assume that his behavior is dementia related until he has had a thorough physical exam. Uncontrolled diabetes can produce this type of behavior, as can other medical problems. Please have him evaluated by his primary care physician as soon as possible.

If it is dementia related, it's hard to say how long it will last. Everyone progresses through stages at their own rate - no two persons are alike. But behaviors are self-limiting meaning they, too, shall pass.


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