SORRY AUNTY CHOW WE CAN'T HANDLE YOU

I rejected  Mrs Chew's mom,  Aunty Chow who has dementia and recommended her to take homecare for her mom instead of daycare at our centres. I hate to do this but it was necessary. Generally many dementia cases can be managed and from my personally count about 75% are manageable. But not this Aunty Chow

The main reason in most cases that I reject was because the family members were not truthful, they  were either lying or hiding critical facts or omitting it totally.

How do we know that the potential resident has problem or the family members will be lying? Easy, it always begin with this statement, "Oh there is nothing much wrong with my, she can walk and eat herself, I just want her to have activities and company." 

Let's be honest, how many Malaysians you know are willing to pay us a few thousand ringgit if their mother or father can do things on her own? 

I am not saying that Mrs Chew is a bad person, but rather a desperate person. This article is to share the trials and tribulations of people with parents suffering from dementia. Mrs Chew knew how hard it was to care for her mother and she knew she can no longer do it herself.

Mrs Chew the daughter of Aunty Chow did not disclosed honestly her mom's conditions. And her mom's conditions were so serious that our centre is not equipped to care for such conditions without medical help. Let me take you through this.

The daughter did not disclosed her mom's medication truthfully to us and that she has quite a serious dementia condition, okay all dementia conditions are serious need care but some elderly react differently. For most cases the residents with dementia just wanted to go home. Aunty Chow will break our door if she cannot go home and she will pull the shirt of other residents and staff and go down on her knees to beg people to take her home all the time crying and shouting like a Hong Kong TVB drama series

Aunty Chow gets restless, agitated and aggressive and even verbally abusive. It took more than 2 caregivers to take care of her. Aunty Chow would walk in and out the entire centre, trying to open every door, beg anyone and intermittently cry. The caregivers lost a few kilograms following her.

Besides dementia, my experience and observation tells me that she is not just having dementia alone. I suspected that she could be suffering from bipolar. I checked her medication list given in our assessment form. Only  two types of mild sedatives to manage her dementia but certainly it does not feel enough.

I called Mrs Chew the same day  to bring all her mom's medical report and all her medications.

True enough, the daughter wilfully did not disclose a drug for a serious mental disorder giving the excuse that the Dr gave her for 'firefighting'. From my previous encounters I knew that drug will never be given for firefighting, it was meant for managing her mom's mental conditions on a regular basis.

When the daughter gave us all the drugs, and my and nurse and I were shocked to discover there were a lot of drugs in terms of quantity. on further probing the daughter admitted that she had not given her mom most of the medications for her mental health.

This explained her mom's behavior.

You see managing an elderly with dementia is a partnership between us and the family members, we cannot do it alone. Everyday is new with elderly suffering from dementia, what works one day may not work the next.

With dementia,  family's ability to pay does not equals the centres ability to manage. Money is not everything and it does not compel us to accept them. 

When it comes to care, dementia and all her related disorder are the most difficult to manage and there are not many places who can take them in. I can count with one hand once I exclude the government facilities

But why do many family members lie or withhold truth and facts from us?

Embarrassed is one of them, many family members felt embarrassed that their parents had this disease. It is also a reflection of their own fear that the condition may be genetically passed on to them.

But the most common reason for not giving medication is "afraid of side effects." Which, is true all medications that can manage mental related disease will have side effects, some more than others. I fondly remembered my Professor and mentor on mental health, Professor Maniam of UKM told me this, "Any medications without side effects has no effect."

The family members fears are real and I understand. But we also need help to manage serious mental disorder and dementia. This is a conundrum that is waiting wantingly for help but not forthcoming.

The fear of side effects caused another side effect, the mom became unmanageable.Resulting in them having to manage their mom themselves. 

If this article inspired you to explore dementia care, do go ahead and find out more. It is such an important segment of aged care that so few indulged in that many family members are left without hope.