DM and DF are becoming toxic as they age. Tips for coping please

[WhatdidIdoyesterday]

Parents are in their early 70s, been married almost 50 years, and both have health issues.

DF is on his 3rd course of chemo having been diagnosed with prostate cancer 4 years ago. He's doing ok at the moment but its taken a toll on his physical health and lots of ups and downs along the way. Mentally he's sharp but becoming increasingly short tempered, I'm not sure if its the steroids/chemo drugs or something else. He doesn't like discussing his diagnosis although I've tried to get as much info out as I can.

DM is showing a lot of warning signs of dementia. Her short term memory is terrible and has gotten much worse in the last year, but she refuses to see the GP and seems to think its normal for her age (72) because her mother was also forgetful in her older age. She comes out with utterly daft suggestions and opinions about things that make no sense to me, repeats herself constantly and can't remember things from the same day. She has taken to writing copious notes about her day and is now getting obsessive about her notebooks as she relies on them as her "memory" each day. Her physical health is ok but she has poor personal hygiene. She seems to have stopped washing her hair and wears the same clothes for days at a time.

Together their relationship seems to be deteriorating, my DF has no patience for my DMs forgetfulness and my DM seems to expect my DF to be able to do all the things he could do prior to chemo including taking her on long trips by car, and organising everything relating to their house and finances.

I feel totally caught in the middle, I've been taking my DF to all his hospital appointments and will soon have POA (waiting for it to be registered) for their finances but I can't stand they way they treat each other. I really don't like spending time with them together, although on their own is fine and mostly enjoyable. When they're at home they constantly bicker and snipe like children and their conversations go round in circles, or they just sit in silence. It makes me feel like an awkward teenager. I know I'll need to spend more time caring for them in future so trying to be as prepared as I can now to protect my own mental health. I do genuinely want to help them as they've been good to me over the years, but unless things change with how they treat each other I am going to find it a struggle. Its so unpleasant seeing the contempt and lack of respect they have for each other.

So as not to drip feed I also have 2 DC and a full time job so life is busy anyway without this. I live 10mins drive from my parents house and see them twice a week plus we go on holiday with them once or twice a year. I have a sibling but he lives 6 hours away so unable to help day to day and it has all fallen on me for the last few years.

Sorry for the epic post, I guess I really needed to get this off my chest.

Slightly different scenario here, PIL are together in a care home and have been there for 18 months after bouts of illness which meant they were unable to keep themselves safe (falls, eating the wrong food, not monitoring blood sugars etc). MIL has dementia and other health issues including diabetes, FIL has Parkinsons and his mobility is poor. Recently FIL has been resenting MIL spending time with other residents, having her meals with them etc and is becoming extremely rude with staff and then phoning us saying that they are separating/splitting up and that the staff are ganging up on him. MIL talks a lot of nonsense a lot of the time, her family home was up for sale for £450 and that we should buy it as it hasn't changed (since she left as a child) and that she is planning a holiday as they have not had one for a while (not a viable option). Visits to the care home are difficult, we cannot take treats due to her diabetes and we get lots of requests for random items which are not needed which they ask the staff to phone us for (we had to empty their house which was bordering on hoarding). We visited last weekend and advised that husband was away this weekend, he phoned earlier and said that they had phoned him eight times today. It is hard and we limit visits to less than an hour for our own sanity. It is good that you have to POA sorted, make sure that they have wills in place and please do take care of your own wellbeing, limit your visits to short ones if possible, reconsider the family holidays and perhaps arrange for visits to a day centre or similar and have important conversations about changes which may be required in the future such as carers, cleaners, DNR orders etc, talk about keeping them safe and also consider getting a formal dementia diagnosis for your Mum. It is a really difficult time but really important that you do what is right for you and your children

Ring the GP, tell them that you do not want to discuss your mum as you know they can’t, but ask for a memory assessment.
You can also ask SS for an assessment.

Thank you and @Diversion sorry to hear what you're going through.

Sadly based on my mum's current viewpoint she would be very unlikely to go to any GP appointment I made for her. Whenever I bring up her memory loss she says its just old age and she doesn't need to see the doctor. I think deep down she knows its not normal but she's not willing to accept the reality or ask for help. She's clinging on to her notebooks as a way to retain control but its an illusion, she's kidding herself.

I have also suggested they get a cleaner but she doesn't want a stranger in the house. If she won't even allow a cleaner I don't know what other help I can arrange.

It does sound as if your mum could be on her way to dementia. If she is then it will gradually get worse, and the moment will come when it can’t be denied.

Regarding the bickering, just tell them straight. Their bickering is horrible and if they are going to bicker you are going home. Relationships with adult dependent parents can be weird - they can start behaving like tweenagers but still expect to be treated like revered grownups, and we still treat them like revered grownups not to be questioned.

@WhatdidIdoyesterday Your parents are in a dreadful situation. Your mum will be only too aware that it’s a one-way street and she will lose everything that is important to her, her ability to do what she wants, go where she wants, eat the food she chooses, make a drink when she wants, wake up when she wants. If your dad is on his 3rd chemo, his prognosis isn’t good, and a lot of his last 4 years he will have been feeling dreadful. Both of them need the support of a fully fit and healthy partner. It’s not surprising their relationship is suffering.

But you don’t have to be in the middle of it. Try to see them separately if you can. Leave if they start to bicker. Don’t get drawn in emotionally, say cheerfully “well I’ll leave you to your arguing, goodbye”.

In practical terms, google prostate cancer and look up the treatment, and that will give you a good idea of what to expect. My DH started the same route 18months ago. Find out why your mother isn’t washing her hair - is she having difficulty keeping her arms above her head? Is she changing her underclothes? - wearing the same outer clothes several days running isn’t a problem. Does she smell?

Limit what you do for them. Make it clear they have to outsource. The things I would do are the things that can’t be outsourced - helping with decision making, attending medical appointments at which information is to be given. Blood tests, scans can be dealt with by taxi.

It’s more important for you to be a daughter than to be a carer.

Been there, as an only child. Such a difficult road to walk.

1. A social services assessment may be useful. Theres a long waiting list so starting the process could be useful. Tell your mum it's for your dad and make sure you that he has an occupational health assessment. They may offer him equipment and once you are on their books it's then easier to access extra help.
2. Accept that you can't solve everything. You can't force her to change her clothes but IME you wait until your moment to step in. Perhaps offer to help her put on a load of washing whilst you are there and then as an afterthought suggest you could wash the cardigan/clothes she is wearing.
3. Try not to criticize. It's sooooo hard but criticism - even the word no - will make her more defensive. So if she's asking your Dad to do something he can't for example try to deflect. "Tell you what Mum. I'll do that whilst dad has a rest," or "Can we watch telly/go in the garden whilst Dad thinks about that."
4. Don't discourage the notebook. It's enabling her to stay semi independent. She will give up on it eventually or you can swap it for a simpler one. I made a calendar on my computer with all the key moments in the week/month on for them that they needed to remember eg. Phone X at 1pm put a pretty picture underneath and gave it them as a present.
5. Be oblivious to how they speak to each other. It's the stress speaking and you won't change it. Put yourself in the middle and chat to one or the other and keep it cheerful.
6. Look after yourself. Don't feel guilty about feeling frustrated/angry/whatever. It's the illness talking, not her but it can still really get under your skin.
7. Buy them a dementia clock for Christmas. It has a nice clear face and shows the day of the week, the date and has the word Morning or Afternoon on. If they don't need it now,they will and that gives them time to get used to the digital clock too.
8. Hang on in there and know that whatever they say now, they do love you, and each other and do appreciate what you are doing. After 10 years of dementia, many frustrations and nearly 4 years without speech my mum looked at me, held my hand and whispered 'Thank you, Love you," in her old voice. It was as if in those v final days some of the confusion and anxiety and fear left her and I found that she really was still in there.

Sympathy OP, one pair of my parents (divorced and remarried when I was v young) would bicker All. The. Time. And it made things so unpleasant. So grateful they never needed my care!
Even so. I would ask them to save it for after I went, and repeat (in very civil tones) if needed.
I have mixed good and bad news - after my Dad died, visits got much less stressful, as StepM's new chap was an all round pleasant person, and everyone acted like normal people! Dad had had a bit of a traumatic childhood so I could kind of see why he might have been like that. Couldn't change it tho, more's the pity.

Thanks, all good advice. Its depressing thinking its going to get gradually harder over the next 10-20 years. My DGM lived to 98 so theoretically could be 25 or more years of my mum needing care and its only going to get worse.

I feel like my dad is already on borrowed time. At best I think we'll have another 5 years with him being reasonably independent. The current round of chemo seems to have gone well and he is fatigued but coping quite well except for dealing with my mum. After he finishes this round its just the uncertainty of if/when it comes back. Last time he finished chemo we thought he was going to be well for a good few years so its been hard going back to square 1 and seeing how much pain he has been in again.

My main concern is my mum's total refusal to discuss or accept her memory loss is not typical for her age. I don't know how to get outside help if she won't admit it. She is so reliant on my dad and me, and its not fair on either of them or me. She can't live independently alone, so if he ends up in hospital or worse she'll only have me and I can't be in two places at once.

I know I'll need to spend more time caring for them in future

of all the things you’ve told us about your parents, the above is pretty much the only thing you have any control over. So think hard about what level and type of involvement you can sustain here, given you have your own family as well. You are not responsible for your parents, unless you choose to be.

what does your dad think about your mums deterioration? can you talk to him en route to appointments? Have they always bickered like this?

The short answer is that at this stage there is no way to get her outside help or a diagnosis of anything unless she is willing to engage. If neither you nor your DF can persuade her to go to the GP, she will carry on until a crisis of some sort happens, and then it will all come out.

are you able to tell her that her hair isn’t clean or that she smells bad? How does she react to being told this?

7. Buy them a dementia clock for Christmas. It has a nice clear face and shows the day of the week, the date and has the word Morning or Afternoon on. But for goodness sake put it into a different box before you give it them - don’t give it them in a box labelled “dementia clock “! Go for the plain sober type, not the type with dark blue/moon face alternating with light blue/sun face - that really does look like “second childhood”.

Its depressing thinking its going to get gradually harder over the next 10-20 years. Needs will increase, it won’t necessarily get harder. More help will become available, there’ll be less fighting against it. My dad is now in a happy place, he’s warm, well fed and comfortable, and no longer needs anything else. It’s a lot easier than when he was maintaining his independence.

My main concern is my mum's total refusal to discuss or accept her memory loss is not typical for her age. It’s difficult, but very normal. My dad did accept his short term memory was going, but didn’t accept, still doesn’t, that his decision making skills were failing. You just have to wait. Or see if the GP will give her a memory test under the guise of a routine check up, though the “pass mark” is something like 75-85%, so even with cognitive impairment she can feel she’s done well.

Thank you. I'll see how the next couple of months go and will suggest again that DM gets a GP appointment. My dad's next hospital appointment is coming up in a few days so I'll be able to speak to him alone about how we can get my mum to accept reality.