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It's A Family Affair

Families are complicated. It may be clear to you than an adult day program is appropriate, but other family members may disagree. In fact, this is happens a lot. Sometimes it's an honest difference of opinion. Other times more distant family members do not have a realistic picture of how dangerous a situation is, how much care is required, or how much work is involved in caregiving.

You might get some flack - or even a lot of flack - from siblings who are sure they know better. Or, you may have a spouse who is not aware of the physical and emotional toll on your health that results from caring for him/her.

Sometimes a neutral third party can be brought in to provide an assessment of the situation and discuss long-term care options with everyone concerned. Family Caregiver Alliance provides this service, at no cost, on a case-by-case basis. They offer a variety of support services to caregivers, including counseling and support groups. You can reach them at (415) 434-3388.

If the person you're concerned about has dementia, things can get even more complicated, as they may be unable to make good decisions independently. Perhaps some of the following exchanges will help you to form your own constructive responses when dementia is part of the big picture.

Talking to Someone With Dementia About Going to an Adult Day Program

When I talk about visiting the center, Mom refuses to go. What should I do?

Don't invite resistance by insisting on talking about it. Wait until the morning of your visit, get up, get dressed and ready, and go. Be upbeat and relaxed, and talk about the drive. This will help to defuse the fear of going to a new place.

When I try to talk about it, we get into an argument.

Don't argue. Try changing the subject and starting over later.

My wife says she doesn't need to go, that she is happy just being at home with me. What should I say?

You can say "I love having you here, but I think you need more activities and things to look forward to. I see how bored you get here at home. Also, I need to have time to shop and meet my friends. It is important for me to be able to do these things."

My husband says, "Quit work and take care of me." What do I say?

Say, "I wish it were possible. I also know how bored you would get with just me everyday. I know that they have lots of exciting activities and projects for you at the program."

Talking to Siblings About Sending a Parent to an Adult Day Program

She's doing pretty well right now; does she really need an adult day program?

It is important to integrate her into an adult day program while she is still receptive to change, able to recall faces and has communication skills. People with dementia become more fearful of change in the later stages.

What can he get out of it if he can't remember anything?

Being with friends, busy and engaged, improves his quality of life, and will help him feel contented. This feeling can outlast memory.

I'm sure you do need a break, but it doesn't seem right to dump Dad there for the day.

It will definitely be a big relief for me. But more importantly, Dad will benefit from a change of perspective, meeting new people, and trying new things. I've checked the place out, and met the staff, and talked to their references. I really think they'll do a great job. He won't like it at first, probably, but he can survive part of a day without me.

If Mom wants to stay home, then I think that is what you should let her do.

Look, I don't relish the opportunity to discuss this with her again. But I think we have to. I'm worried about her falling, leaving the water on, starting a kitchen fire, wandering down the street and getting lost, buying a time-share in Florida over the phone. All of those things are possible when she's home alone. She needs to be in a safe environment. And she needs to be around other people. At some point her safety has to come first.

You're always complaining that he sleeps so poorly at night. How will he have the energy to go to a program during the day?

They tell me that the activity and socialization at a program will very likely improve or eliminate his sleep problems. I think it's worth a try. I know I feel better when I get some exercise.

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