How do we validate concerns and keep our sanity?

I bet we all do our share of "showtimin". I know I do. Who wants to be a burden? When someone asks "how are things going?", my standard answer is "as good as could be expected". Then unless they start really asking deeper questions, my thought is they are trying to be nice and polite, but they don't really want the nitty gritty details - probably because they don't really know what to do with them. I have one person that I am comfortable "dumping" on. But even within my own family, I know that eventually I will have to say more and ask for more help, but until I hear them say "What can I do to make your burden lighter" or something like "I'm going to make 1/2 a day each week available to you for whatever you need". Only then will I feel like it won't really be a burden but hopefully a blessing to them. It sure would be to me.

For the first time, next week I'll be trying out a local support group for Alzheimers. I'm keeping my fingers crossed that it will be good. Where everybody is in the same boat - we should be able to feel comfortable enough to sharing our true feelings. It's hard to take that time though when you are working full time and then have to rush home to start your "second job" of caregiving.

When I feel an anxiety attack coming on strong, and I know those feelings all too well now. I try to make myself stop everything and find somewhere that I can go for even just 5 minutes. Sit and force yourself to relax your muscles and be "limp" then breathe in deeply through your nose letting the air into your abdomen, hold it for a few seconds and then let it out through your mouth. It's not a cure all, but sometimes it can help you get through the day. Of course, prayer is the best of all.
God Bless Us All.

I think many of us have witnessed this. As you know, the frustration is overwhelming. We leave the doctor's office with nothing gained.

This also can happen when out-of-town relatives come to visit. We - the caregivers - have kept the family up-to-date. We prepare them for the changes they will see. But when they arrive for a short visit, Mom (or Dad or whomever) is so thrilled to see the visitors that they act nearly normal. As soon as the visitors leave, our sick loved one collapses. We look like drama queens and it's all back to normal.

Hang in, friends. It's good to know that others have seen the same thing.
Carol

Yes, that is right.

Jessebelle, is 'showtiming' faking wellness, or faking illness,? I forget .
For others who don't know what the term 'showtiming' means, it's when in front of a doctor or someone else that could help, the patient with, let's say for example, dementia, can maintain an appearance or act that they are perfectly fine, but only for a brief time, then it is back to the dementia behaviors.
Did I get that right, Jessie?

I'm just showtimin', Sendme. :)

Jessebelle, " How do we validate concerns and keep our sanity?"
Keeping our sanity is over-rated. Isn't that similar to the phrase, 'if you love someone, let it go' You can let it go here, share with us. People tell me to 'lighten up'. These phrases are not just cliches, but letting it go has helped me. Even if others quips and quotes sometimes bother me, I later think of them when it comes to mind. Sometimes others offer stuff to say out of meanness. But this comment is offered to you out of a sincere wish to help you not worry about loss of sanity. You seem just fine to me.

This is just my opinion, but from my experience, I have developed some observations. When it comes to the elderly, especially when they have cognitive decline, it's practically impossible to interject any kind of action, communication or treatment at home that makes a lot of difference in the patients behavior. If it makes you feel better to validate, then I would try it. I don't argue with anything that works. I just don't think it really does much to cause a change in the person and I don't think it matters to the patient much of the time when there is mental decline that cannot process what you are trying to accomplish. Long ingrained behavior is difficult to budge. And when there is dementia, it's even more unpredictable.

To me, changing the mood of the patient is more often treated successfully with medication. They can reduce anxiety, lift mood and perhaps allow the person to feel so much better due to the chemicals in the brain, that they may be more pleasant and not as miserable.

Validating implies you are feeling empathy to the patient. You know you have empathy, your mom should know by now that you have empathy and if she doesn't, clearly there is brain damage that prohibits her from knowing this.

I think you both would be better served by the energy being devoted to yourself and your concerns. Be gentle with yourself, take time to treat yourself and accept that some things we cannot change, though we want to. In the end, I would do what I wanted and find peace in it.

I remember a bad stretch when my mother was having nausea and stomach pain. We went from doctor to doctor, but they found nothing. An MRI showed some gassy-ness, but nothing else. Finally I found what the problem was. I counted her pills. She is diabetic and was taking Metformin. She handled her own medicine at that time and was overdosing on the Metformin -- like 2-4 pills, instead of one. No wonder she was sick! She would take the extra drug so she could eat extra snack crackers at night after I went to bed. I was glad I found what the problem was, but miffed at all the time and Medicare money spent on this self-induced sickness.

Jessie Belle I totally understand what you are dealing with. My husband has moderate Alzheimers. He has always been a bit of a hypochrondiac, but now it is constant. He can still be home by himself during the day while I work (no choice financially) and he does almost nothing most days except watch tv. He has constant headaches and stomach pain. The headaches have caused four ER trips. One was necessary - he was dehydrated. But the others found nothing. When asked what his pain level was he said 8, but there was no physical evidence that he was in any pain at all. The stomach pain has been there for more than a decade. In the past year he has seen every possible type of doctor, had every kind of test and yet he still says it is there.

It is so hard to see him focused on himself and his pain whatever it may be. He is not interested in any type of distraction. However, when grandchildren visit or other family he is comfortable with, he perks up and seems to enjoy it.

After working all day and then coming home to the same conversations it is very draining to me. He is a long way from needing in home care or going to a memory care facility. I find I just go through the same motions every day. Which of course includes cooking, cleaning and yard work. It is very lonely and isolating. I know I'm whining. I"m sure you and many others understand, we just don't really have a life anymore.

Some terrific points made here. Validation is often used with redirection. We validate simply by taking them seriously, but we redirect them to something else to take their minds off of whatever the obsession is.

Distracting and redirecting are all part of the mix. The reason that validation gets so much attention is that not so many years back the trend was to "reorient" the person - meaning to make them see our way is right. That doesn't work - never did - for people whose minds don't work like ours. So validating them as people who have opinions and thoughts that are true in their world is important to keep from always telling them that they are wrong. But the solution that many of you have used is redirection. Great discussion!
Carol

Jessie, I know what you mean with regard to "regular" dementis. My mom was diagnosed with Mild Cognitive Impairment (still had decent memory skills but couldn't reason at all and panicked constantly). Then she had a stroke and is now dxed with Vascular Dementia. Mom was probably depressed and anxious her whole life. Wouldn't take antidepressants while at home or in Independent Living, but they put her on them after she had the stroke (when we were in charge). They've made a world of difference in her general outlook and calmness.

My husband, who is 62, had really big heart surgery 10 years ago (aortic aneurysm , valve and aorta needed to be replaced). His car I ac team put him on an SSRI as part of their protocol, and the psychiatrist who follows him added Abilify a couple of years ago, to good effect. So you can see why I'm a fan.

I think seeking out a psychiatrist your mom can work with is well worth a try. Even if she doesn't cooperate at being interviewed, a good psych can tell an awful lot in a couple of minutes. And her untoward reactions to her previous meds are important. I hope this works out. Take care of you!

I've learned not to engage in the details of my mothers never ending complaints. If I do that she becomes more and more obsessed. I do as Cmagnum said, I validate her feelings and move on. My Mom does not have dementia and she has always been like this.

Babalou, she doesn't have the classic type of dementia. It is one reason I would love for her to have an MRI, if nothing but to give me a clue to what is going on in her brain. I would not be surprised at all to find that she has bipolar disorder with associated memory loss and loss of reasoning. Doctors have her as "dementia" and she is on palliative care. This is why I am interested in a good geri psych evaluation. What if she lives another 10 years? Would a mild mood stabilizer make her feel better? Thoughts of valproic acid or Abilify are a bit spooky to me, since I have seen the harm prescriptions can do in my life. But if something helped her feel better, it would be worth a try.

As it is now, she is okay most of the time. And she would notice the disappearance of the sheets right away. And she would remember, since she still has very good memory for the things that she pays attention to.

Jessie, what would happen those twin sheets dissappeared one night? Would she obsess for a day or two and then move on?

"Sorry mom, that's not one of the choices"

Are you talking about MY mother??? or yours?? This is SO familiar. My Mom is home alone with Alzheimer's. She has caregivers 6-7 hours/day....but she thinks she needs no help. Problems with new caregiver yesterday, so she wanted no one today. I said, OK...as long as you plan to stay home, because you are not supposed to drive'. Well....by 1pm she's called 4 times, and called my daughter twice.....too quiet....she's bored....too tired to do anything. Thinks she might go to bed cause there's nothing interesting to do and nothing on TV. I finally said, "Well sounds like you have better days when someone comes..." NO she says, what I need is family around to do something with. We have, for years, gone around and around about this....since I live 5 hr away and our daughter lives two hours away, and we both have husbands and families. Our other daughter and hubby and kids live up in WA state. They've offered to have her move in with them so she would be near family....but OH NO....Mom doesn't want to be around 6 kids and doesn't like how this daughter keeps up her home! Doesn't even matter that Mom could have a MIL suite all her own.....OH NO....she's NOT leaving her house until she dies! But she doesn't want caregivers and she only wants family around her, and there's no family in her town. Her friends have all either died or are moving into AL, because Mom is 89 now. One has invited her to go to AL with her...OH NO!! She's never going to live in one of THOSE places!! Well....what IS the answer?? Nothing, because she cannot be reasonable. Cannot move in with me. My husband has Parkinson's and I am still trying, at 71, to run a home business too...to boost our Soc. Security. I cannot have two 'patients' who do not like each other under the same roof! Daughter in Phoenix has husband and son, and health problems of her own ...AND home schools her son. Her hubby has POA for his own parents....that he may have to take in at a future point. So....there's no good answers for those who cannot be realistic. Today, am cleaning and found a calendar of Mom's from 1960. She wrote little diary type notes as a summary of each day. She WAS THE SAME WAY THEN!! 'dull day, tired all day long, stuck home without the car..." "worked all day long....7.5 hours straight....washing, ironing, waxing floors...then stuck here all evening..." UGH....who focuses on stuff like that? Rarely a note about a nice day or a good time. Sometimes notes about going out to dinner....and ALWAYS...." I had thus and so, but it was NOT good....not going back there again...." AND...she's been on an antidepressant drug since April with no improvements. I think it's so ingrained in her personality there is no changing her. Who wants to socialize with someone like this, or even be her friend? No wonder she is alone.....and unhappy. Maybe your mom has the same type of history? And with me, there is no talking about fixing anything she complains about, because she wants it fixed for free too.... as soon as something is going to cost money, after all the investigation into getting it done....she's NOT spending that kind of money on it....she cannot afford THAT MUCH!! There must be some volunteers that we (which means always....I.....) can find who will do it for free.... So I have given up. I go to the dementia instructions of diversion; changing the subject; ignoring what she says, and refusing to comment to it..... I feel bad for her to have to be so unhappy at the end of her life....but I didn't do it to her and I do not know how to fix it for her when she seems to have no desire to even TRY to find the good moments in her day.

I went a step further and told her that I wasn't going to do it. I didn't tell her that she couldn't do it, but she will need to order the mattress and have someone come in to move the beds. To me, of course, it makes sense to get rid of the old sheets. Most of them are not in the best shape. My parents slept in two single beds the last 50 years of their marriage. They bought a lot of sheets, but never got rid of the old ones. Sheets are one of my mother's remaining hoarding strongholds. She won't let me get rid of even the threadbare ones because, according to her, they are still good.

I admit they are still good -- for tearing into pieces to make hamster beds.

Jessie, I think you hit the nail on the head! If only....then everything will be better. I do believe that this behavior is fine when one lives alone, but when this behavior impacts upon the person helping you live "independently" I think it's a different matter. Boundaries are important in caregiving, and I'm wondering if putting her off for a few days ( I strained my back mom) might not work.

My understanding of "validation" is not so much actually doing what your LO wants, but acknowledgment and repetition of their concern. Many cases that is really what is wanted. Someone with dementia is not going to remember whether or not any actual action is taken.

I guess what you might call it is magical thinking. "If only I had this, then I would be happy," never realizing that happiness comes from the inside, instead of anything outside ourselves. We can sleep on a bed of rocks and be happy if we feel it inside.

That's what Jeanne was suggesting doing. It seems a good idea when someone is frightened or angry about something. I don't know if would work so well with switching beds or chopping up moss.

GGsGirl, your suggestion about having her sleep in the small bed would be a good one. The only troubles with that one is that the bed needs new mattresses and is in one of my two rooms. It is in my rabbits' room, so probably has fur all over the old mattresses by now. The only thing it has been used for is to hold my shipping supplies, which the bed is stacked with. Moving the bed would be expensive and would upset everyone... and believe me I know it wouldn't make my mother happy in the end. In a few weeks she would be asking for the big bed again, but this time with a different headboard or something. It is what she does.

I wonder if it is possible to validate the emotion behind the complaint without having to validate the content of the complaint itself?

It would seem to me that validating the emotion would let the person know they've been heard?

However, it would also see that to validate the content would lead the person to think that we are going to do something about it or agree with what they want to do about it?

Though I am not as far along in this journey as most, I have already found if I validate my Aunt's complaints, they grow bigger, larger, and impenetrable. So, I try to point her in a different direction.....I gave you a pill for that earlier. I've already talked to the doctor and they said...... Admittedly I do not call the doc every time something is wrong unless it is something new or different for me and I don't know what to do. When she got a UTI and was ready to head to doc (and I know how serious UTIs are) a phone call to doc for meds was sufficient. Or, I've already called them to come out and fix this. And I can answer the same question the same way the next time she asks cause she won't remember. Or, I'm so sorry, I can't afford to have that done right now. Even with the Doc visits, I can tell her we were just there because she has no since of time. Of course, with my Aunt, her eye site is so poor it is easier for me to convince her of things outside. Even inside she has trouble. And her hearing is almost gone so I can tell her what she heard is something else. Anything to get her to focus on something else. Don't know if anything like this will work for you but it sometimes helps in my situation.

JessieBelle, we all walk a tightrope, whether our mothers are Drama Queens or not. I can relate to the irritability being on my part - plans derailed or whatever gets my blood boiling - and I so do not like me or my reactions to my mother then. (You are not alone in this; but keep in mind it wouldn't bother you if you didn't care). I apologize and she has often forgotten what it was for! The blessings of short term memory loss.

Question (not knowing your whole house situation): could your mother just sleep in the other room for a bit to use those #!*@ sheets? She might recall on her own why she wanted the bigger bed. Too disruptive? Better than hauling mattresses back & forth! But I understand how hard it is to find the fine balance between validation and catering to every minor worry/desire.

And, yes, elder crush is great! I felt bad when my mother's rehab was done at the NH and she came home, leaving behind her gent friend. Never too old! LOL

I have found it helpful to attend a caregivers group for the last year, because you can also find validation.These are available through your local area on aging, & they are free. You will meet other wonderful folks. It's really about validating your self as well as your loved one. She may die at any time, so do the best you can, but remember to also take care of yourself.

Being through this with my mother, I think they are trying to replace what used to make them happy and you're the only one around to absorb their 'energy' (be it bad or good.... which is draining). You're the good daughter (in this case... like me) who has tried to bring some kind of normal/content/happiness into this chapter of there life... If you're like me and others here, you want things to end on a good note with you're mom so you can find some solace/peace in your life as well. It's a fine balance... A tightrope walk (not a cake walk). I found that only getting away from the house and getting good rest (removing the parental atmosphere a of chaotic energy field) can bring us back to ourselves to recharge... So we can charge forward again when need be). I found they don't change, so it's up to us to continually change our 'world'... Our autonomy that is our birth right... I watched a movie this past weekend with Alan Alda called The Longest Ride where he answered the question "what gives me the right to be happy?"... He said "What makes you the right to be unhappy?" ... Im finding out that if you don't do everything to take of yourself your health is majorly at risk. Don't get sick... Another movie I'd like to recommend to everyone is "Like Sunday, Like Rain". We need diversions to get out minds away from the day-in day-out grinds, especially in caregiving.

Elder love is a wonderful antidepressant, JessieBelle!

And I agree - as far as any treatment goes much depends on age and life expectancy. In my opinion, I wouldn't want to put a person of any age through something that will likely cause anxiety and discomfort and little benefit.

Even the use of antidepressants can be a roller coaster ride. While some people respond positively to the first one tired, many don't and can even become more depressed. It often takes experimentation, and quite frankly, the antidepressants on the market aren't targeting the right chemicals for many.

I'm not against trying them by any means and I do know that many benefit. I'm simply making the point that, depending on age and other factors, how far you take this can vary.

You've got great instincts, Jessiebelle. In the end that's often our best guide. Whether to validate something or "shoo away the monsters" (which is a form of validation, anyway), we know our loved one and have some idea of how he or she will respond. Caregivers need to be listened to for many reasons but one is that we know our loved ones in ways that others don't.

Take care all of you fantastic people. I learn so much from all of you!
Carol

She has a physical each year and blood monitoring three times a year. Her only below-the-neck ailments (beyond the spinal stenosis, hypertension, and diabetes) has been a UTI every other year. I would like her to see a neurologist, Carol, and have an MRI to see if we can get an answer for her symptoms. This late in life it might not be useful, but if she were to live another 10 years it would be helpful to know if a mood stabilizer could make her feel better... and make life easier for the people around her.

Justa, I know what you're talking about. I feel better about me if I stay kind. I feel bad about me when I get irritable. Sometimes I catch myself being pissy and know that it's me, not her, when that happens.

Today's Sunday and she is happy about going to church. It's raining, so me, I'm not so happy. She has a fellow that she is interested in there, though, so it's kind of endearing. So off in the weather we go. And no, I don't mind. "Elder love" is a wonderful antidepressant.

Validation is over-rated. When The Spouse, who is in assisted living, was obsessing over whatever it was last week—broken belt buckle, phone not charging, lost button—I just told him to stop obsessing over it and go take a walk in the hall. I also said I would see what I could do next time I came. My take on his situation is that he has a sense of something wrong, is feeling uneasy about it, and these concerns aren't what it's about. My response is a lot like when one of my daughters had a monster under the bed, and I took it by the scruff of the neck and threw them down the stairs. When you're lost at sea, what you need is a good navigator, not someone who agrees it's scary to be lost at sea.

Just some clarification on relating, etc. A psychiatrist mom can relate to is better. But a psychiatrist who is a cold fish but a good psychopharmacologist is better than someone who is just trying random drugs.

I've never heard of "working with the drugs" Does that mean that you have to want the meds to work? Never heard that said, but I'd be interested to read about it.