12 Tips When Caring for an Elderly Loved
by Jacqueline Marcell
How Do I Handle My Elderly Loved One Who:
1. Wants all my time and attention?
Set reasonable but strict limits of when you can be
available and when you can’t. Never allow yourself to be manipulated. If
you never give in to demands, your parent will learn that moaning and
groaning doesn’t work and will eventually stop trying. If you give in to
extreme begging, they will continue to push harder and harder, knowing
that you will eventually cave in.
Always use an answering machine to screen your calls and
never pick up and respond if your parent is being nasty or negative. When
they ask for your help in a more reasonable way, respond positively to
reinforce the good behavior, telling them how proud of them you are, and
how much you appreciate the way they have approached you this time.
Reinforce good behavior.
Getting your loved one involved in activities will be
the best thing for both of you. Call the nearest “Area Agency on Aging”
to find the Senior Centers and Senior Day Care Centers nearby, and learn
about enrollment and schedules. It may take a lot of coaxing and
compassion to get your parent to step out of their comfort zone of being
at home and to consent to go to Day Care where they don’t know anyone.
Remember that any type of change can be extremely frightening for elders.
The Day Care professionals are very familiar with this problem and will
help you. Ask one of the administrators to call and talk to your parent a
few times to develop a relationship before going.
Take your parent out for lunch and when they are in a
good mood, casually stop by the Day Care to say hello to that
administrator. Have an appointment set up so you can take a tour, meet the
other seniors and staff, and reduce some of the anxiety. Encourage your
loved one to attend no matter how much they protest. They may hate it at
first, saying that everyone is too old, it’s too much effort, or they
just don’t like it-but don’t give up. Eventually they’ll make new
friends and look forward to all the activities. The pressure on you to
entertain them will be drastically reduced.
If they cannot physically attend a Senior Center, you
can hire a companion to come in and visit with them on a regular basis.
This person can read to them, watch a movie, take them out for a walk or a
ride, play a game, or talk about the old days, etc.
Call your local public libraries to find out about their
volunteer programs. These volunteers can be very helpful by bringing
printed books, audio books, movies and travel videos to the home
regularly. These deliveries also provide a visitor whom your parent may
enjoy talking with. Call the Eldercare Locator (800-677-1116) to find
other programs for the elderly in your area.
2. Makes constant unreasonable demands?
Focus on the positive things you can do for your parent
and don’t emphasize the things that you can’t. If you continue to
eventually give in to their extreme demands these behaviors will get
worse. Assertively set your boundaries of what you will and won’t do
ahead of time and stand firm, giving sympathy and empathy where
appropriate. Don’t let your better judgment be swayed by your sense of
responsibility. If their demand strikes you as illogical or irrational,
BIG FLAG-it is! Call the Alzheimer’s Association to find out where your
loved one can be tested for dementia. If the bad behavior stops, give
positive reinforcement by acknowledging their ability to control their
conduct. You may want to give a specific reward to further encourage them.
If the negative behavior continues, give three warnings, use the silent
treatment, then walk away.
3. Is inflexible, critical and negative?
First, use empathy and sympathy within reasonable
limits. Your parent may just need a hug or kiss at the moment and be too
embarrassed to ask for the affection they crave. Instead of arguing, agree
with them about how terrible something is for a short moaning session.
Practice using positive phrases like, “I’m sorry you’re feeling
so lousy... What can we do to cheer you up?... Let’s put on some
uplifting music and talk about good things.” Resolve within yourself
not to let their negative energy and insulting comments get to you. Focus
on anything positive that they say, redirecting their attention to change
If the negativity continues after you’ve tried
repeatedly to change the subject, tell them that you will not engage in
any more negative conversation for the day. Their “negativity quotient”
is used up. If you allow it to go on, giving too much sympathy, you are
teaching them that the more they complain, the more attention they will
get. Don’t be an enabler.
Never respond positively to any negative
behavior. For example, if your loved one screams at you to hand them
something, do not do it until you are asked properly. Never respond to any
demanding orders, telling them that you will be happy to accommodate their
request if asked nicely. If the bad behavior continues, give three
warnings, use the silent treatment, and then walk away.
4. Complains about real or imagined physical symptoms?
Set a time limit for these health “complaint”
sessions. Listen, be sympathetic, and offer solutions. Then, declare the
complaint time over and divert their attention to a different topic or
activity. If the moaning and groaning doesn’t stop, give three warnings,
use the silent treatment, then walk away.
Try a simple test to see if their symptoms might be
psychosomatic or just for attention. The next time they complain of a
minor ache or pain, quickly put a vitamin pill in their mouth, pretending
the pill is an aspirin. See if the mysterious pain immediately goes away.
Don’t tell them that their pains are not real, but privately let their
doctor know what you discover.
Together, write down their symptoms in order of what
bothers them the most. When you go to the doctor, see which symptoms they
actually end up complaining about. Have the doctor address each issue,
take notes, and cross each item off the list as they are reviewed. If your
loved one is embarrassed to complain to the doctor, take charge and make
sure the doctor knows all symptoms including: sleep, appetite, energy
changes, memory problems, alterations in mood, inability to do basic
things, incontinence, depression, anxiety and anger. Speak with the doctor
in private if necessary.
Frequently bring all medications (prescriptions and all
over the counter vitamins, etc.) to the doctor’s to make sure there are
no interactions. When a new medicine is prescribed, ask if any specific
foods and alcohol should be avoided while taking this drug. Should this
drug be taken with or without food? Should this drug be taken at a certain
time of day? Is it all right to continue normal activities, such as
driving? All drugs have side effects, and can interact with each other and
produce further complications.
Get a lock box for their medications if you have any
suspicions that they are not being taking appropriately. Hide a spare key
someplace in their home in case you forget or lose your key, or if someone
else has to give the medications if you cannot get there.
5. Exhibits bizarre behavior and uses inappropriate/foul
Bizarre or unusual behavior that is out of character is
one of the first signs of dementia. Be aware and don’t dismiss these
early warnings signals. Seeking help at this early stage will greatly help
your loved one and reduce your frustrations.
You can still set your limits of acceptable behavior.
Correct them every time inappropriate behavior occurs and when foul or
embarrassing language is used. Never resort to bad language yourself as
that just perpetuates it. Keep your temper under control, or walk away
until you can regain it.
Role-playing can be used to teach appropriate behavior.
Make it simple with specific dialogue showing them the proper way to ask
for your help. “I’d appreciate it if you
could hand me the television remote... I’m glad you came to see me
today... Could I please have a glass of milk?”
If you are being verbally abused (“I hate you... I
never want to see you again.”) never respond. Don’t let your
emotions get the better of you. Change your perception and don’t
escalate the problem into a screaming match or expect a rational
discussion. When you are being called offensive names, do not respond.
Acknowledge them only when you are being called by you correct name. Give
three warnings, use the silent treatment, walk away immediately if the
behavior does not stop.
6. Has become suspicious and paranoid?
Don’t make light of it, argue, or tell them that their
fears are irrational. Calmly acknowledge how awful it must be to feel that
way and assure them you don’t think they are crazy. Make them feel safe,
loved, and assured of your continued support. Report these symptoms with
examples to their doctor. If you get an unconcerned attitude from their
doctor that it’s just part of the aging process, insist on taking
them to a geriatric psychiatrist for evaluation. With the proper
medication, these fears may be greatly reduced.
7. Is experiencing increasing levels of memory loss?
Call the Alzheimer’s Association and find out where
you can take your loved one for evaluation right away. They are the
experts at this-don’t waste time with doctors who are not. Inquire about
the drugs: Aricept, Exelon and Reminyl, and Vitamin E therapy.
Display large “direction” signs with easy-to-follow
instructions. “Brush Your Teeth... Turn off Stove... Keep Door
Locked.” Get a large wall calendar so that they can check off the
days. To help insure that medications are not forgotten or doubled, make a
chart that they can check off each time they take their pills. An erasable
board can work well too. It will help them remember people if you label
pictures of everyone they know and put them up where they will see them.
(The larger the better.) For their telephone, get one that has one-button
dialing with a photo and name of the person next to the number. The use of
lists, tape recorders, crossword puzzles, trivia and computer games can
help exercise the memory also.
8. Makes up silly lies, exaggerates and cries wolf?
These may all be efforts to get attention and sympathy.
Understand that these actions are desperate attempts to hold onto control
or a need for assurance of your continued support. They may also be
craving physical affection and don’t know how to ask for it. When you
recognize an obvious lie, carefully evaluate the motive behind it. Don’t
get hooked into confronting them on unimportant issues. Instead, switch
your perspective and let these tall tales roll off your back. Even though
they are exasperating, you don’t want to become a victim yourself. It
takes two to play a game, so just don’t play it.
There are times, however, when some of their attempts to
control the situation cannot be overlooked. When these behaviors are
constant and disruptive try behavior modification. Never respond with
positive action to what you know is a manipulative lie or the lying will
persist. Calmly let them know that you’re aware that they are just
trying to get more attention and that you will not let it upset you. Set
strict limits of what you will and won’t tolerate and let them know that
you cannot be manipulated.
9. Prefers to stay in bed or do nothing-”waiting to
This could be an ulterior motive to get more attention,
or it may be a sign of depression. Carefully evaluate what’s going on.
Drop in unexpectedly a few times and observe their level of activity. If
you suspect depression, ask their doctor to consider prescribing an
anti-depressant. There is such a wide range of effective medications
available today that there may be no need for them to suffer.
Then, get your parent enrolled in Senior Day Care to
create a life outside of lying in bed all day. They have to have something
to look forward to, friends to see, varied activities to do. You cannot
supply all this stimulation yourself day after day. Go with them a few
times, have lunch and introduce them to everyone to encourage the making
of new friends. Additionally, many centers have a shuttle service to pick
them up and bring them home.
If your parent is a “Sundowner” who wants to sleep
all day and be up all night, there are a few things you can do to alter
this pattern. In the morning, open all the windows and drapes to let in
fresh air and sunlight; make lots of noise by turning on the radio and
television, running the vacuum cleaner, dishwasher, etc.; plan activities,
exercise and visitors. Getting an hour or two of sunlight daily can help
regulate their circadian rhythm. Ask your doctor about Melatonin that may
help them sleep at night. Make sure they are not getting any caffeine from
coffee or chocolate in the evening. Also, have their doctor regularly
review all of their medications to see if any may be causing
daytime drowsiness. If possible, switch them to be taken at night.
10. Refuses to allow a cleaning person into their home?
If you arrive to find their home in a deplorable
condition, don’t rush to clean it. First, call Adult Protective Services
and have them “drop in” to examine the condition of the home. Their
report will automatically go to the local police department, so you will
be visited by a police officer soon. This puts you on record with them in
case you need to prove that your parent can no longer take proper care of
things. Have APS say that the home must be cleaned immediately for health
and safety reasons. This way, you aren’t the bad guy making changes your
loved one doesn’t want.
11. Gets furious if something doesn’t happen at a
Avoid telling them a definite time of when you will do
something, or when something will happen. Give a broad window, be vague,
and say that you will try to handle their request soon. Never commit to a
specific time because they may tend to obsess over it. This way, it will
be a pleasant thing to tell them that you have accomplished what they
asked for, rather than disappointing them that you didn’t have time. Don’t
lock yourself into a time frame that you may not be able to meet. You will
build their trust if you don’t have to disappoint them.
12. Gets mad when told “No” they can’t do
Avoid responding with a flat-out “No” to their
request. Let them know that you have considered the issue and understand
their viewpoint, but explain that it’s not a good idea right now.
Indicate that maybe next time, or at a later date, you will be able to
handle their request. Cheerfully distract their attention to something
else more positive. Most of the time, they will completely forget about
this request and have a different one by the next day.
Just like some children, the more some elders are told
“No” they can’t do something, the more they will keep fighting to do
it. It can become a test of wills for power and control. In some
instances, it may be best to just let them have their way (if there is no
danger). Usually they will come to the conclusion on their own that it
really wasn’t such a good idea after all.
From Elder Rage-or-Take My Father... Please! by
Jacqueline Marcell. Copyright © 2001 by Jacqueline Marcell. Excerpted by
arrangement with Jacqueline Marcell. $19.95. Available in local bookstores
or call 949-975-1012 or click here.