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Chandrakanta Das, 87, of Mississauga, has been diagnosed with early-stage Alzheimer disease. (Peter Power/Peter Power/The Globe and Mail)
Chandrakanta Das, 87, of Mississauga, has been diagnosed with early-stage Alzheimer disease. (Peter Power/Peter Power/The Globe and Mail)

Q&A

Your dementia questions answered Add to ...

CAREGIVING AND FAMILY ISSUES

Q: My father insists on driving although I don't believe he is safe behind the wheel. He gets angry when I bring it up. How do I get him to give up driving without hurting our relationship?

A: Caregivers admit to some creative tactics in this area - from hiding the keys, to removing the battery so dad's car won't work, even sending the vehicle "to the shop" for a while. The problem is that this makes the caregiver responsible for what is often a very painful loss of independence. Judy McCann-Beranger, an elder mediator in St. John's, suggests booking an appointment to alert the doctor about your concerns - putting the decision in his or her hands. In most provinces, physicians are required to inform the motor vehicle department if someone should no longer be driving for health reasons. The real advantage: This way the doctor is to blame, not you. "Whenever dad gets frustrated, he can be angry at the doctor or motor registration, and not at the family member," says Ms. McCann-Beranger. She also suggests using some less-devastating language - saying the decision is "for a while," instead of "for the rest of your life."

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Q: I am the caregiver for my mom who was diagnosed about two years ago with dementia. Although she has a partner, I do all the cleaning, cooking, finances, etc. The one thing I need help with is trying to get her to take a shower and let me assist her. I also want them to move into my house into a basement apartment I have but I don't want to force her. One day she agrees, and the next day she changes her mind. Help!

A: Caregivers need to educate themselves about the symptoms and progression of dementia so that they know what to expect. Having open conversations about the disease is vital, experts say, as is enlisting the help of other family members and friends in the discussion. But don't wait, says elder mediator Judy McCann-Beranger. "It is important to address this early on while your mom can become more comfortable and accepting of assistance." That means talking to her partner, about how to get the help she needs and make a plan, perhaps by slowly moving her into the new apartment.  If a move is in the future, it is better to do it sooner rather than later, so that she can adjust to the new environment while her memory is still relatively strong. "It may not be realistic to expect your mom to be comfortable immediately," says Ms. McCann-Beranger. "Routine that is gently and supportive will eventually become familiar and safe."

 Q: I just turned 60 and my memory is not what it used to be, especially the short-term memory. When or how do you know what is normal for my age and what needs to be examined more closely?

A: Who hasn't misplaced a wallet or keys, or blanked on the name of someone they've met several times before? It is completely normal to forget things on occasion - but one of the signs that it might be time to see the doctor is if memory lapses are beginning to interfere with your daily living. If you're worried, book an appointment, and have your doctor assess your memory loss. Click here for information and warning signs.

Q: My husband refuses to let me tell anyone about his Alzheimer's diagnosis. How can I convince him not to keep it a secret so that his children can spend time with their father before he is too ill, and they can help his wife with his care?

A: Everyone copes with an Alzheimer's diagnosis differently, and it can be complicated to balancing their right to privacy with a caregiver's need for support. It's not uncommon for patients to want to shield family members from their symptoms or pretend that their problems will just go away, points out Mary Schulz, the national director of support services and education for the Alzheimer's Society. But it is important to talk about it: Making changes and investigating treatment may help your husband maintain his abilities longer - and help plan for the future so his wishes may be respected. Enlist the help of a support worker at the Alzheimer's Society, an elder mediator, or a pastor - often, says Judy McCann-Beranger, "people don't know where or how to start this extremely difficult conversation," and need a plan on how to do it, such as telling each child individually, or giving the news as a group with a support person present who can answer questions.

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