How do we validate concerns and keep our sanity?
I have been reading a bit about the importance of validating concerns. I know I am terribly guilty of ignoring and minimizing my mother's concerns. I know I'm not really to blame, because I've been hearing the same type things every day for many years now. I've gotten immune. But I started to wonder if all the complaints may be a search for validation and knowing that somebody cares. And I wondered if ignoring and minimizing may be shortchanging her and keeping her reaching for validation. Maybe she needs to know that someone cares.
But then I wonder if she needs so much validation that it would drive me crazy, since there is no one else to help. She has two friends, but she avoids them for some reason. Strange, because when she is with them she really enjoys herself. It picks her up for a short while.
I thought that I really do need to be more validating to her concerns. She is old and facing death within the next few years. But then I also know that she is a deep well of need and is a bit of a drama queen. I might get totally engulfed if I become too validating.
How do we keep a balance when someone is such a deep well of need and there's no one else around?
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I'd suggest a physical and if she will do it, a psychological workup, but I'd also suggest that you try validation. See where it gets you. It shouldn't hurt and it may help at least a little.
By the way, I'd suggest the physical first as just something we all need to do and I'd write the doctor a note ahead of time saying that you'd like him/her to watch for a reason to refer her to a neurologist or psychologist. In your letter, list specific reasons for your thinking. Often people will follow up with these issues when a doctor refers them when they wouldn't listen to family.
Good luck and take care of yourself!
Carol
You are a caring, compassionate, sensible, no-nonsense person (at least by what you present here.) You can do a lot to help mom deal with her cognitive losses, but you cannot cure her dementia. You cannot restore her to reasonableness. This is (repeat with me) Not Your Fault.
So, do what you can. Kudos to you for looking up other approaches. Don't give up on validation but don't expect it to work miracles, and do know you'll have to adapt it to your situation. You are a good person and a good caregiver. The situation is Not Your Fault.
I like vstefans idea of pre-scheduled clinic visits. Coy's geriatrician wanted to see him every three months. (He had a number of health issues in addition to dementia.) Between visits I could call with concerns and she would generally prescribe or give advice without my bringing him in. This was really a useful arrangement. I could validate Coy's concern without taking him to a doctor. "Yes, dear, I understand that ankle hurts and I'm very sorry it does. The last time Dr. April looked at it she said it was arthritis and the best thing you could do for it was pain meds when it flared up. I'll start you back on the pills today. Then we see Dr. April in 2 weeks and she can look at it again. Would a root beer float help take your mind off your pain?" (Acknowledge the complaint. Sympathize. Suggest a solution and sympathize that there isn't a better one. Distract.)
While you are in a mood to look into different approaches, I'm going to suggest a book you've probably seen me recommend often. "Loving Someone Who Has Dementia" by Pauline Boss, PhD. I heard her speak and immediately bought this book. One of her chapters is devoted to "Good-Enough." We strive for perfection, and in its absence at least a continual improvement. But with dementia it is unrealistic to expect improvement. The disease itself is getting worse, so if we can just hold our own or not slip back too far that is a huge accomplishment in itself. You will never achieve a perfect relationship with your mother, even a "very good" relationship may be unrealistic. So go for "good enough." If you read the book, I'd like to hear your thoughts on it.
(And this whole mess is Not Your Fault.)
"Oh Mom, it certainly must be very annoying to you to repeatedly find problems with the floor. I certainly wish we could fix it once an for all so you could relax a little. You deserve some peace in your retirement."
"I can understand why you'd like to be waited on more. You worked hard all your life, you have health issues, and you deserve some pampering. I want you to be able to continue walking on your own, and the doctor says getting up to get your own drinks and magazines and such will help you do that."
Good luck!
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.
horselady and babalou, I've been on the group so long I have a bad habit of assuming that everyone knows my mother by now. I forget that I am just one of many. My mother is sick with something abstract almost every day. She wants to go to the doctor a lot. For two years I was going crazy, taking her to doctors 2 or 3 times a week sometimes. I stopped doing that, but at the same time I started ignoring and minimizing her concerns about her maladies. I know that neither extreme is good.
Then there is the house on stilts/floor issue that Jeanne talked about. And there is the moss growing in the yard problem in her mind. She's called our yardman to destroy it again this week. She zeros in on something, obsesses on it, and can't let it go. I've not been very effective in handling her concerns, since she doesn't pay any attention to things I say.
But maybe if I could find a way to validate her concerns in a way that doesn't drive me crazy. I could validate by taking her to the doctor every couple of days and getting out and chopping that poor moss to pieces. That sounds like I would just end up in an early grave. We've tried a couple of antidepressants because of some other issues. The one that had an effect put her into hypomania and extreme obsessive behavior. That scared me away from further testing of antidepressants. It was like it uncovered a hidden bipolar side of her.
I was interested in learning how other people validated their parents' concerns without running themselves ragged. I think Jeanne had some very good words if I rearrange them and make them sound more like me. My mother would faint if I ever sounded as nice as Jeanne. :)
It's my sig other who constantly wants validation and he doesn't need caring, he's a grown adult who works full time and can do things for himself. In the past I was interested in his health until I saw how he related to my major health issues... he wasn't caring, he was angry... so now I tune him out whenever he says his back hurts, etc. He had a doctor's appointment today and heaven forbid if I don't ask him how it went... he will whine and get in a snit.
I would not be able to do day to day care for someone like your mom. I think the distractions that are provided in an AL would be at least as therapeutic as meds.
The first geripsych my mom saw (while she was in the hospital having a 3 day eeg, and started having paranoid delusions), she truly disliked. He came to her room and talked to her, in our presence for maybe 10 minutes.
At that point, my mom had been in the hospital for nearly a week, and he was the first doctor who actually "saw" the whole person, her frailties, her fears and her poor reasoning. We met with him and he told us EXACTLY what she needed (better antianxiety meds, a more supportive environment and a geriatrics doctor).
When we returned to her room after we'd talked to him, she "well, I REALLY disliked HIM. I'm not seeing HIM again! I smiled to myself and thought fine, mom, he's already given you the best advice you'll ever get.
So, I guess my point is that your mom may only need to see this person, briefly, a time or two and then meds can be managed by her regular pcp or a NP who is nearby.
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