Ruminations About Caring for Elderly Folks--
Things You Should Know

22 December, 2008
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I am having a most educational experience these days. Living next door to my husband's adoptive parents isteaching me things which I never knew about.

Both parents are living, my FIL (father-in-law) is 90. I love him dearly. [I love his wife dearly, too!] His moods are always changing, much more than one might expect of an adult. Sometimes, he is the person I remember, and other times, he shows a different side of himself which wasn't as apparent before. I can say the same for my MIL (yes,that means mother-in-law). I recently learned that manyelderly people can seem quite rational and normal but actually be victims of what is called "spotted senility". Sometimes their minds work close to normally for periods of time, and then other times their minds don't.
Folks who don't live with them or see them often would find it hard to believe that they have problems and cause problems because of mental incapacity. But I am finding out from first hand experience that this is the case. If you don't know about this disease which many elderly people suffer from, you can easily think that-- relatives might make what appears to be extreme decisions concerning their aging parents. Relatives may seem to be motivated by all of the wrong kinds of things and that relatives are in cahoots to usurp everything from the aging parents. Reality is that this is not necessarily the case (though, of course, sometimes that might be so).

Spotted senility is a very real condition and can be a cause of a lot of tension and conflict between family members who don't live in the immediate vicinity. This not only causes misunderstandings among family members about what kind of situation the elderly are dealing with, it also is a source of extreme stress for caretakers and for the persons who are victims of this disease.

Though not the same thing as spotted demential, there are other problems that might well manifest themselves.

Elderly people can hallucinate if they get a fever. They can hallucinate if they become dehydrated. They can hallucinate if they become constipated. So, their daily routine becomes very critical to helping them to keep their facilities close to normal. I was very surprised that elderly people often experience hallucinations as a result of dehydration. I was very surprised to learn that constipation is also a real source of this problem of hallucinations. I knew that high fever can cause anyone to hallucinate I didn't know that even a slight fever, a low-grade fever, can cause this. And hallucinating is something different from spotted senility.

Probably the most well known problem we usually hear about is alzheimer's disease. I am not experiencing this kind of problem with my elderly in-laws so won't write about it.

I had it explained to me recently that as we age, we begin losing things. Our hearing might begin to go. We loose our excellent, sharp eyesight. We begin having difficulties moving around and doing all the things we are used to doing, little by little, and in some cases, not so little by little. We lose control of our bowels and/or our urinary system. We find our minds don't work the way they used to, they are not as sharp as they used to be and we cannot remember things or think as clearly and quickly as we usedto. For a lot of elderly people, this is extremely frustrating. Not only that, but, as we age, many of us seem to loose the ability to suppress or control our emotions and our selfishness. We loose mental and emotional flexibility and are less able to think about the situations of those around us. Just doing and being comes to take all of one's effort and energy, leaving little room to be able to see or hear or consider what someone else might be digesting. For people who are stubborn and have a lot of pride, this is even more painful. Because it is so painful, when we make errors, instead of being able to accept it and take things in stride, we may tend to get angry at others and fault them for our problems. Or we may deny that we ever said or did such and such a thing or that we changed what we said last month. We may really not remember some circumstances and situations or things and so, we may take a completely different stance. When folks around us don't understand or become bewildered or disagree, we may well become angry. Many proud elderly people cannot admit their loses and difficulties well and I learned that the reason is because it is painful for them, extremely painful. So rather than hurt their own heart, they will unconsciously deny the situation and then they need to lash out at or blame someone else.

I realized that this is NOT a personal attack, it is not me or even about me and my lackings, usually. (I must be honest and say that there sometimes are situations where I was lacking and it is about me, though.) Any person who might stand in the same position will face the same things. The reactions most often are really about being unable to digest things because of deterioration in the person's brain, which affects their emotions, their judgement, etc.

Not only that, but, when our physical condition is good, we tend to be more clear minded and normal and in better spirits. Then, when our condition is not so good (relatively speaking), the opposite is true. The physical condition of elderly people changes much more rapidly and often, then that of younger people. This means swings happenin temperment much more than they used to. A caretaker told me that elderly people have wave-like cycles and it is difficult for someone who doesn't know about this or understand about this to deal with the changes in mood, thoughts, actions, judgments of our family members.

This summer, my FIL was hospitalized suddenly because of pnuemonia. Pnuemonia caused by food going into his lungs rather than into his esophagus. He very suddenly became seriously ill and the doctor said he didn't know whether FIL would be able to weather this and get well and live or not. Elderly people can suddenly get ill and it gets worse much more quickly and unexpectedly than for a younger person who might get ill.

During the period that FIL was in the hospital, MIL asked my husband to take care of the property, especially the area which neighbors use to park their cars in. They had been paying FIL monthly for parking on his property. FIL cannot take care about the area anymore. He cannot cut the grass or tree branches or clean up that area. Since this means needing time from work and needing tools and gasoline for the grass cutter, MIL told my husband he could have the small income from the parking. It doesn't fully cover for the costs for him, but that helps some.

A couple of weeks ago, FIL noticed that this money is no longer going into his bank account. He was upset and thought that the neighbors were cheating him or something strange was going on. My husband was called over because FIL wanted help to contact and deal with the neighbors. My husband explained things. My mother-in-law got really angry and swore she had said no such thing about the money for parking and was sure my husband was trying to steal from them. She had no memory whatsoever about their discussion, which she had initiated out of her worries. She forgot that she ever asked my husband to assume responsibility and offered him that bit of income.This made things very difficult for my husband. Shortly after that, she could not find 500 yen that she thought had been on the table and accused my husband of stealing it. In reality, she doesn't remember where she puts many, many things, and most likely she had put the money in her change purse but had forgotten. She could only think that someone around her took advantage and stole her change. Grand father also has often shown the same kind of problem, swearing that someone came into the house and stole something he couldn't find. Of course, it usually was some small thing which was not so valuable that a theif would take it, should they come in the house. There are other things more likely to be taken. But at such a time, rationality is not present and reasoning doesn't help. We have begun to learn, that things will often calm down with time and space (though not always), and that moods and ways of thinking change, moment by moment, depending on how their physical condition is.

At the moment, we are going through a period where my FIL is refusing to go to the nursing home for day care. MIL is not really fit to take care of him by herself. But that is not something FIL can grasp. MIL, herself can only partly grasp this, too.

She has recently burned a towel by accident at the kitchen stove because of forgetfulness and when the smoke detector went off, she panicked. Fortunately nothing serious happened. A couple of weeks later, she was sitting next to the kerosene stove, watching tv. She was sitting on a rattan stool. She dozed off and fell. She got bruized and is having more difficulty than before with her back and legs again. Fortunately, no fire resulted. Then again, a couple of weeks later, today, actually, she was grilling rice cakes on top of the kerosene stove and she forgot. The rice cakes burned and the caretaker who came to take MIL and FIL for day service noticed the smell and told her something was burning.

Today, FIL and MIL didn't go for day care. IF FIL doesn't go, MIL will not go. Reality is that she and he both NEED to go for a variety of reasons. But they cannot understand this or accept it. MIL has been persuaded to go because FIL gets difficult with the staff when she doesn't go. This is partially true that when she goes, her presence there reduces FIL's contrary and complaining outbursts, but it is the ostensible reason, not the real reason she needs to go. FIL complains and is contrary anyways some days. He is difficult to persuade to go every day. But some days, when he leaves and comes home, he is in such high spirits and talks about what a good time he had or the like.Then next day, he doesn't  recall and refuses to go.

I am not doing constant care of FIL and MIL. At least not now. But it is a big worry for my husband and I, especially since we both MUST work to cover living expenses and even so, are not keeping our heads above water in that area. God has been helping us tremdously, and I am grateful. But nevertheless, we feel the stress about finances and how to balance time and energy and make sound decisions in just about every area of our lives. I believe God will help us in caring for FIL and MIL, and will help us make ends meet, somehow, if we don't succumb to small thinking and negative emotions, and we really make effort to live as wisely as possible.

I have been taking MIL to rehabilitation and usually use 1/2 a day or more helping her a couple of times a week. Sometimes it is very trying because I want to do other things which I need to get to but those things have to be pushed aside for the sake of FIL and MIL and harmony. I have to go over my emotions and small mindedness and irritability at the inconveniences I sometimes face. I remind myself that God is giving me an opportunity to make a closer and better relationship with my FIL and MIL through putting me in a position to serve them without expecting anything in return. We have no idea whether our time together will be long or short. We don't know if we will have tomorrow. God is teaching me that I need a bigger heart and mind than I really have towards others. Some days it is easier to digest things than others. And we add to that other things which need to be digested, too, and it can be very stressful and discouraging at times. So I am trying to remember that a lot of what is going on is not personal or because I am a bad person or failed miserably. Well, there ARE areas where the stress comes as a result of seeds I have sown coming to bear less than healthy fruits, but this is another matter and I am trying to deal with THAT by sincere repentance, prayer, and effort to try to improve my attitude and serve.

Got to close for now. But I thought that sharing what I am learning might help others know about things which they might need to deal with later on in caring for family members. Without knowing about these things, it is more difficult to digest things and deal with them well, with a loving attitude. Having these things explained to me by caretakers has helped me tremendously.