Dear Helpline  

Dear Helpline,
My grandmother has had dementia for about three years. Until recently, she seemed okay living by herself, but now Iím not so sure. She says she is fine, but I am worried about things like making sure she is eating enough, maintaining her house, and things like leaving the stove on or water running. How do I know when sheís no longer making decisions in her own best interest and could use some additional help? And how can I introduce the idea to her without threatening her independence?
ó Concerned Grandaughter

Dear Concerned Granddaughter,

It is often difficult to know when a person is transitioning from being fairly independent to requiring assistance with daily activities. Some questions to keep in mind while deciding if your grandmother needs additional help are:
  • How is she spending her time? What are her days like?
  • Is she shopping and cooking for herself?
  • How has she been eating?
  • Is she managing her finances? Paying her bills on time?
  • Is she paying attention to personal hygiene?
  • Is the house clean?
If you are unsure if your grandmother is eating well or are concerned about her ability to cook for herself, she may benefit from a home-delivered meal program. Prepared meals may be delivered to your grandmother up to 7 days a week. Your grandmotherís local case management agency accepts referrals for home-delivered meals, as does Godís Love We Deliver. If your grandmother is on a special diet that is not accommodated by the meal program, home care may be the option for her.

Home care workers can cook for your grandmother and perform other household duties such as laundry and cleaning. You can start with 1 or 2 days of service each week and gradually increase the amount of service as necessary. Introducing a home care worker to your grandmother may take some time, as she may still consider herself to be quite independent. In cases like this it may be appropriate to tell a small un-truth such as introducing the home care worker as a family friend. It is also a good idea to have the worker give your grandmother a gift (which you provide) as a way of ingratiating herself. For example, if your grandmother enjoys gardening, having the worker give her a book about flowers may help ease the transition. Having a good relationship with the home care worker is one key to ensuring your grandmother remains safe in the community. The worker should be able to evaluate your grandmotherís situation on a day to day basis and keep you informed accordingly.

If the worker tells you your grandmother has been doing dangerous things such as leaving the stove on or water running, you may want to consider removing the knobs from the stove and looking into safety products such as anti-scalding devices and wandering indicators. The Alzheimerís Store offers a number of useful products and contains vital information for ensuring safety in the home.

Communicate with your grandmother as best you can about the changes you are noticing. Take your lead from her, remembering not to engage in an argument should the conversation escalate. Include her in as much of the decision-making as possible, remembering that she may be unable to make the best decisions for herself. Honor her wishes as best you can while always respecting her and ensuring her safety and dignity.

Our 24-Hour Helpline can provide you with information about these and other resources, as well as with emotional support and assistance with care planning. We are available around the clock, 365 days a year and can be reached at 800-272-3900.

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