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Dealing with Dementia

58-year old Margaret Chen lived with her husband Tom. But Tom, who worked full time, was increasingly unable to meet all her care needs. Margaret was losing weight steadily, eating or drinking only when Tom reminded her to, and forgetting to take her blood pressure pills. Her legs were becoming weak from lack of exercise, and she had fallen several times. She was beginning to have problems getting to the bathroom, sometimes soiling herself and remaining wet until Tom got there. Worst of all, she sometimes became disoriented, even agitated, and would wander out of the house saying "I'm going my sister's house. " (Her sister had passed away some time ago.)

Tom would phone his wife from work throughout the day. Many times Margaret wouldn't answer, and Tom would have to leave work to check on her. Each day he arrived at work exhausted, because Margaret had kept him awake rummaging around in their room all night. With this constant stress and worry, Tom's work performance deteriorated, and soon he was in jeopardy of losing his job. He was in conflict about what to do. He desperately needed help meeting his wife's needs, yet he knew he did not want to put her in a nursing home. At this point his employee assistance coordinator referred him to an Adult Day Services program.

At first Tom was skeptical about how well his wife would do in a day setting, but after he and Margaret visited the center they decided to give it a try. Working with Tom, a team of social workers, nurses and therapists first developed a plan for meeting Margaret's health needs. This included monitoring her blood pressure, along with her food and liquid intake (to help her regain weight); managing her medication; and making sure she was brought to the bathroom regularly. Then they thought of ways to get her involved in activities she would enjoy. She joined a cooking group to improve her arm strength and motor skills, and she began working with one of the physical therapy aides to help build back her leg strength and balance.

Several mornings during the first weeks, Margaret told Tom, "I don't feel like going anywhere today." With gentle encouragement, Tom got her to the center. After a month in the program, Margaret no longer hesitates in coming. In the morning she announces to her husband, "It's time to go to work." Tom says his wife is sleeping much better now, "And I am, too. I'm feeling less stressed because I know my wife is safe at the center."

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