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I have a client who is a lovely woman with Alzheimer’s Disease.
I see her 4 hours a day 4 days a weeK.



The family is very well educated about Alzheimer’s Disease but they all are having a hard time dealing with her recent mind altering thoughts that just are not true.



her husband was going out to pick up some dinner and he asked her 3 times if she was sure that was what she wanted, she said yes. After he left during the daytime, she had a panic attack that she had been left alone and that he was going to the daughters house to celebrate Christmas without her! She was in tears according to the husband.



Then she has been avoiding the very nicely prepared dinners that he has always done for her and she walks right by the dinner grabs some almonds and a banana and goes and sits on the couch!



when she is with me, I get none of that behavior, we go out and walk trails, walk in parks, anywhere we can go we walk. That is what she loves to do.



is she being rude to the husband by not taking his nicely prepared dinner? She treats him very coldly and will not allow him to help her in anyway.



he is trying his best and needs to know how to deal with all of this rejection.



Again, she is never this way with me, and I am with her 16 hours a week. She is very pleasant and kind.

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Often times People with Alzheimers Lose taste and smell and are not hungry for a big dinner . My Dad Has done that - I cook a nice meal and he says " he isn't hungry " I wrap it up and Place in the fridge . Sometimes I dont cook and Just Buy a Burrito or Sub . Often times he Likes to be Independent and make a sandwich for himself . Many times The People who get the Most abused are the Ones closest to them because its Like a naughty child - they Know they can get away with it - where as your Like the baby sitter who takes them Out for enjoyable walks so they have to be nice to you .
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Alzheimer's patients are most often most difficult for family members and act out worse around them than others with disinhibition behavior. This isn't at all unusual.
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Yes, the behavior is normal. There is no rhyme or reason to ALZ. She probably has no idea why she doesn't eat his dinner. Does she even realize he is her husband? Maybe he is a stranger to her. The husband is expecting a logical answer and there isn't any. Everyones Dementia journey is different. My Mom was easy to care for, her aides loved her. Then you have people suffering from a Dementia and they are mean and nasty. They become like small children. She preferred a banana over a nice meal. As we say on the forum, the brain is broken. ALZ/dementia is very unpredictable. She may be mad at her husband for some unknown reason. They get something in their heads and won't let go. She has lost her ability to empathize. As said, the Caregiver usually gets the brunt of it all. You are there 4 hours so she is able to "showtime". He can't expect her to be who she was, she's not. Her brain is dying little by little.
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OP you asked us “Is she being rude to the husband by not taking his nicely prepared dinner?” Who knows? It depends on so many things. You say “He is trying his best and needs to know how to deal with all of this rejection”. Isn’t that why “he is already going to counseling”?
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Makeadifference Jan 2023
I give up, and wish that I could delete this post. I obviously did not ask the question the correct way. I don’t care what a person says counseling or no counseling, Alzheimer’s Disease is a Journey and sometimes people get stuck and do not quite know ho to take their loved on a behaviour. He asked me, because he knows I have 22 years of experience working with clients as well as witnessing my mother’s decline with Alzheimer’s and my fathers fall with Lewy Body Dementia/Parkinson’s and Aphasia. I was hired over a year ago because of my vast knowledge with Alzheimer’s Disease and every once in a while he will ask if this or that behavior is normal. Remember that going through it is a journey in itself. I have made myself available to the entire family, including 2 adult daughters because I think it is so important that if I am going to be an integral part of the wife’s life that I report each event we do on a daily basis and let them know if I feel there is any cognitive decline. (Chart notes). That is part of my job. Sometimes counseling doesn’t cover every aspect of Alzheimer’s. Thank you.
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Just read your profile. I’m very happy that you have found caregiving to be so meaningful to you.

Best wishes to you as you continue on in your caregiving career.

People often show different sides of themselves, even without dementia. Butter would melt in their mouth and they will be sweet as pie to others. Yet, with people that are closest to them, they act differently.
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Is this your question?
"is she being rude to the husband by not taking his nicely prepared dinner?"

You need help answering this for the husband of your client?
Is he confiding in you? Asking you?

My advice to you is to not interject yourself as a counselor between the wife and the husband.
Do not take sides in this difficult illness.

She is your client, she has alzheimer's.

Maybe suggest that he go for some counseling.
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Makeadifference Jan 2023
I am trying to help the family not be a counselor in any way. He is already going to counseling, all I did was ask a few questions, and did not expect to get people questioning my role. This is a lovely family, I have worked with them for a year. I care dearly for the wife. All of the time, 4 days a week, and she texts me all of the time. She is my focus. Please don’t be so judgmental about what I am doing. Is helping the whole family really that bad of a thing. I would move mountains for this family. I have been doing this for 22 years, I know what I am doing!
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The site was very slow, sorry!
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NeedHelpWithMom Jan 2023
It is extremely slow at times. Don’t worry about the posts becoming duplicates. It happens sometimes.
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If the family is very well educated about Alzheimer's then they should expect this behavior! Which tells me they're not very well educated about AD at all. The patient always treats the primary caregiver or loved one they live with the worst...its just the way it goes. They'll Showtime and schmooze it up with caregivers and friends, and save all their angst for the one closest to them. Is she being rude? Of course, but the filters are gone now so all bets are OFF so he can expect more horrid behavior as her disease progresses. I'd call off lovely dinners and serve easy, small meals 6x a day instead. Tastes change drastically with AD.

I suggest you and the husband read this 33 page booklet which has the best information ever about managing Alzheimer's and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2


Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Best of luck.
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Makeadifference Jan 2023
I have worked with Alzheimer’s Clients for 22 years. All I was doing was asking a simple question. I don’t need you to judge if they are educated. They like all families are learning as they go and I am gently guiding them through the stages.
I will look at that book, that was one positive thing you said. Of course the Do’s and Do nots but there is a tone and a way with grace that a person can gently tell the family what to expect. Sometimes even the most Educated people need reminding that compassion care and love and the tone in which you write night be the most effective.

I am not sure if you are a caregiver or like myself saw your mother and father go through this wicked disease to their death. It all requires softness, patience and understanding. That is far different than Counseling. The best of luck to you why ever you are with agingcare.COM.

”kindness and soft tones go a long way with Alzheimer’s.
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Now this is the same question asked 4x
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NeedHelpWithMom Jan 2023
I think they are pushing the button more than once because the site runs very slow at times.
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