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Questions & Answers - February 2002

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.

About Mary
Mary's Column Archives: Caregivers'
Questions & Answers

Dear Mary,

My father is now in a nursing home. It was a difficult decision to make but it became impossible to manage his medical needs at home any longer. Needless to say, I am racked with guilt. When I call or visit he sounds so depressed. I know he is not eating well and he says he just wants to die. He begs to come home and it breaks my heart. How can I help him?

Placing your loved one in a nursing home is never easy and guilt is part of the package. Your father is going through a period of grief, just as you are. You are both grieving for days gone by and aware that life will never be the same again. Your father's depression is justified and may lift once he becomes acclimated to his new environment. However, it is wise to pay attention to his symptoms and expressed desire to die. A major life change or illness can throw him into a clinical depression that will not resolve by itself. Discuss your concerns with the nurse manager and his physician. A low dose antidepressant may be appropriate.

As for you, you may indulge in guilt but only for a short time. Your father needs your courage and strength. When you visit or call, allow him to vent his feelings while you sympathize, then change the subject. Give him things to look forward to like a visit from you, a trip home for dinner, or a special outing if his medical condition allows. Try to remain upbeat in his presence without making light of his feelings. Decorate his room with family pictures and memorabilia, a favorite lamp and blanket, and anything else familiar to him. Continue to visit and call frequently but most of all tell him you love him and that he is still your "Dad".

Dear Mary,

My husband "Jim" had a stroke six months ago. We had been married for 46 years. He is now paralyzed on the left side and has many bruises from bumping into things. It is like he does not know his left side exists. His eyesight is poor and his moods change without warning. I have hired a girl to help him bathe and dress, but I am still exhausted by day's end. I have been thinking about adult day care but am concerned about the cost. What do you think?

Adult day care can be costly but is a blessing to caregivers and I highly recommend it. The staff is educated to manage the problems you describe and rehabilitative services may be available on-site. He is exhibiting signs of "left neglect" which is not uncommon from a stroke.

Call the adult day services in your area and get as much information as possible such as cost per day, mode of transportation, staff/client ratio, and activities provided. Be sure to ask about grant money. Some day centers have grant money available to help with the cost. There may be a waiting list, but if your husband qualifies, it is best to get on the list as soon as possible. You can also contact the local Area Agency on Aging to inquire about financial assistance for this kind of care. Good luck.

Dear Mary,

Recently I had to bring my 78 year old Dad to live with me so I could care for him. There are a few problems that I have. He doesn't change his clothes everyday, doesn't bathe regularly, and he's wetting himself and hiding his soiled underwear. He goes out just about every day to his sister's club and drinks beer, but the doctor told him he had to stop drinking. When he drinks he wets himself more.

I don't know how to manage these problems without hurting his feelings or making him angry. If you could suggest some way to approach him I would be truly grateful.

Honesty is the best approach. Apparently he is aware that he is wetting himself and is trouble by it enough to hide his soiled underwear. Talk candidly with him before he has his beer. Let him know that you love him and are concerned about his health and his hygiene. Talk to him about wearing male incontinent underwear; they are disposable and made specifically for men. Most medical supply stores have them or can order them for you.

You may have to insist that he bathe every day, even if it is at the sink. Set out fresh clothes for him and take the soiled ones away.

As for his beer drinking, that is more difficult. If it's been a life long pattern, it will be hard to stop. The doctor is your best ally. Scare tactics regarding his health may work. I would also encourage you to contact Al-Anon for support and advice. This group is dedicated to helping families of alcohol abusers. They can be reached at the toll free number: 888-4AL-ANON. Good Luck.

Dear Mary,

I hope you can help me. My husband had coronary by-pass surgery two years ago and suffered a stroke while in the hospital. He is only 64 but is now in a wheel chair. He can transfer to a bed by himself and is also able to help himself with his personal care. The problem is, he doesn't want to. He is very negative, angry, and has no motivation to do anything. Frequently, our children will visit or invite us over, but he stays in his room or refuses to go out. There is nothing wrong with his mind. He just seems to have given up. He is on blood pressure medicine, but even refuses to take that sometimes. He has stopped going to the doctor because he says the doctor can't help him. I am heart broken and tired. My husband was an active, happy man who liked to fish, boat, and hunt. I don't know how to help him. Can you give me any advice?

It sounds like your husband is suffering from depression. It needs to be addressed immediately. If he will not go to the doctor with you, enlist the aid of your children to get him to go. Call his physician and tell him what you have told me. Depression is a mental illness that is commonly seen in people who have suffered a stroke. It is just as real as diabetes or heart disease and should be treated as aggressively. Your husband's mental suffering is no less than his physical suffering; it can be treated. He is still a young man and may have many years ahead of him. It would be tragic for him and you to exist in this state any longer. Please call his physician today, time is wasting. Let me know how you make out.

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