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Dear Helpline,
My grandmother has had dementia for about three years. Until recently,
she seemed okay living by herself, but now I’m 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 she’s 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?
— 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 grandmother’s local case management agency
accepts referrals for home-delivered meals, as does God’s
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 grandmother’s
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
Alzheimer’s Store offers a number of useful products and
www.thiscaringhome.org 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.
Please e-mail your Dear Helpline questions to
helpline@alznyc.org.
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