My brother and I are the legal next of kin for my paternal grandfather who is going through a rough time. I’m trying to convince my grandfather that he and his wife should sell the house and land to me or to both my brother and I because neither of them can manage all the work that goes with it, and things are really beginning to fall apart. If they sell the house and land to one or both of us, we will make sure that they continue to have the right to live in the house for as long as they want.
Grandpa is in his late 70’s and was told that he was in the early stage of Alzheimer’s disease. His wife is an LPN and she insists that she will be able to take care of him and the land, no matter what happens with the Alzheimer’s disease. We don’t think so! Both of my parents are deceased so it is up to my younger brother and I to look after him. He and our grandmother were always there for us when we were growing up. My wife and his roommate have already expressed their willingness to help.
Grandpa is a 275 lb. former marine who has been in outstanding health throughout his life. In addition to the training he got in the marines, he grew up on this land and has raised cattle on it throughout his lifetime. He can wrestle and tie down a bull, and no one is ever going to be able to manage him if his Alzheimer’s gets any worse. Right now, he only has some occasional episodes of it and then it clears and he is his normal self, but if it gets worse…. His wife is in her fifties and she is a very small, petite woman.
Grandpa is a hunter as well as a farmer/rancher. Two days ago, his wife called and asked if my brother and I would go looking for him. She was worried because he had one of his Alzheimer’s episodes last week and wasn’t completely back to normal yet. She noticed that his hunting rifle and some ammo were also missing so she figured that he must have taken it with him. He hadn’t said anything about going hunting that day, but he wasn’t in the house when she woke up and she couldn’t find him anywhere on the land. He must have left during the night because none of the morning farm work was done. That’s when she went looking for his rifle and the ammo. He had been said that it was time to go hunting again about a week before this happened, even though it’s not really legal right now. He would never break the law if he was in his right mind.
My brother and I searched the parts of the woods he normally hunts in and couldn’t find any sign of him. When it got dark, we thought about calling the police but decided to just wait until morning to see if he showed up during the night. This would not be unusual for him. He loves being outdoors and knows every inch of the woods by heart. Sure enough, at about six a.m., he came home hungry and thirsty, saying he had been out hunting, but he didn’t have his gun with him. He couldn’t remember where he left it, but assured us that it was “in a safe place” and that he would go out to get it later. (There is no such thing as a safe place for a hunting rifle in a wooded area where kids might be playing or exploring.) He does things like this on impulse without thinking about the consequences a lot now. This is so different from how he used to be when my grandmother was alive. She died three years ago and he never really went through any grieving even though they had been together since high school.
The woman he married right after she died was one of the people who came into the house to help take care of her when she was sick. She’s a nice lady, but doesn’t know anything about farming or raising cattle. There is no way that she will be able to care for him if he gets any worse with the Alzheimer’s, and there is no way that she will ever be able to manage the farm chores or even the complexity of selling it all. Grandpa always said that he wanted one or both of us to take over the farm someday, but we both went to college and ended up with jobs that paid better. Still, we don’t want to see the farm deteriorate. We could hire someone to manage it and we both know enough about farming to help with the work, but ever since Grandpa remarried, he seems more and more distant from us and less communicative about what he is planning to do with the farm as he ages.
Hello,
ReplyDeleteI am glad you reached out for assistance with this situation. I would also be very worried about the safety of my grandfather in this situation. It sounds as though your grandfather and his wife may not be ready to face the reality of their situation; being diagnosed with Alzheimer’s disease can be a difficult thing to hear. For your grandfather, it can mean the loss of his memories and his independence. This disease takes away a person’s sense of independence. They can begin to have unexplained behaviors and mood disorders that affect their ability to interact with others appropriately. Diwan, Balaswamy, and Lee explain that, “As the dementia progresses, profound changes occur in memory, language, object recognition, and executive functioning” (as cited in Gehlert & Browne, 2012, p. 399).
For his new wife, it will mean a new role as caretaker for her husband; while also trying to define her role within the family home. Elise Eifert and James Eddy state that, “for many family caregivers, seeking assistance is deemed as unnecessary and inappropriate because caring falls within normative expectations and an extension of regular duties” (Eifert & Eddy, 2012, p. 228). Oftentimes, families do not want to accept that their family member has this disease. They will avoid asking for assistance in providing care for their loved one out of a sense of duty or belief that families should take care of their own.
There are some wonderful resources that can be available to your family during this time and the level of involvement would be based on the current need of your grandfather. These services can be adjusted as his condition changes. I would suggest that you look into services with your local Area Agency on Aging. The Area Agencies on Aging have a wide range of community-based long-term care programs that can possibly assist with services for you and your husband. The program will complete an in-depth assessment to see what services your family may be eligible for and then assist you with obtaining the suggested services. For more information about the services available in your community, the Pennsylvania Department of Aging has a wonderful website that explains the services available in detail. The website is www.aging.pa.gov.
Another option would be to seek assistance from your grandfather’s primary care physician or the doctor that diagnosed him with Alzheimer’s disease. The doctor’s office may have a social worker on staff that could complete an assessment to determine the level of need and then that person could assist in locating needed services. According to Sadhna Diwan, Shantha Balaswamy, and Sang Lee in a primary care setting, “The social worker completes a psychosocial assessment to determine the strengths and service needs of the patient, develops a care plan in partnership with the patient and family, and seeks input from all of the health-care professionals involved in the delivery of care” (as cited in Gehlert & Browne, 2012, p. 409). Ultimately, any decisions regarding services will be made by your grandfather or the person he designates to make decisions on his behalf.
I would further suggest that you, your wife, and your brother sit down and talk with your grandfather and his new wife. Explain your concerns for his safety and her ability to provide all the necessary care once his condition begin to deteriorate. As a family, you could develop a plan for your grandfather’s long-term care. This would provide your grandfather with the ability to state his wishes clearly in front of all the family members. I hope you have found this information to be helpful.
Sincerely,
Anna
Hello,
ReplyDeleteIt seems as though you and your brother are facing some difficult challenges at this time. Alzheimer’s disease is life-changing (ALZ, 2014). You are worried about your grandfather so reaching out to the online community is one way of seeking support and assistance. First things first, there are a wide range of resources available to help support him. When your grandfather first got sick, his Alzheimer’s progressed slowly and from my understanding, you and your brother are the legal next of kin. You both are worried that he should sell his house and land. It was so sad to see him not be able to complete simple tasks such as hunting and managing his property. One time, he could not remember where he placed his hunting rifle when he came home hungry and thirsty, saying he had been out hunting. It is important to note that Alzheimer’s disease is a progressive illness that is affecting your grandfather’s ability to carry out the simplest of everyday tasks (ALZ, 2014).
Even though his wife insists that she will be able to take care of him and the land, your willingness to help is vital. Maintaining a relationship with your grandfather who suffers from Alzheimer’s disease is a challenging task, but know that you are not alone. There are resources available to help during this difficult time. One such resource is the Alzheimer’s Association (ALZ, 2014). The Alzheimer’s Association (ALZ) is a free online website providing no cost resources to individuals and families living with loved ones diagnosed with Alzheimer’s disease in the realms of care, support, research, and education for many years. ALZ also provides support services for individuals caring for individuals diagnosed with Alzheimer’s via their online blog. This may be a great resource for you and your brother; the website link is www.alz.org.
This resource also provides treatment options; one of which would be for your grandfather to visit his primary care doctor. This will help rule out any medical conditions that may be impacting his well-being in addition to the Alzheimer’s. Mental status examinations and imaging tests are great ways to help determine the severity of the disease. Your grandfather has always said that he wanted one or both of you to take over the farm someday, but he seems more and more distant from the both of you. Your grandfather is also less communicative about what he is planning to do with the farm as he ages. These are signs of cognitive loss (Lim et al., 2014). Your grandfather’s cognitive loss is more likely caused by Alzheimer’s disease and this appears to be extremely difficult for you both to witness.
Thank you for having the courage to write this blog. I hope this information is helpful and supportive and that you are taking steps to help your grandfather. Alzheimer’s disease gets worse over time (ALZ, 2014). ALZ (2014) has a resource called the Safe Return Program, which encourages individuals diagnosed with Alzheimer’s to obtain identification bracelets, wallet cards, and clothing labels. This may also be a wonderful resource for your grandfather as he is an avid hunter. I wish you and your family the best.
Sincerely, Louise
Hello
ReplyDeleteI am so glad you contacted us. Your grandfather is very fortunate to have such caring grandsons. I hope that what I have to share with you is helpful, because I may have more questions than answers.
You said that your grandfather was told that he is in the early stages of Alzheimer’s. Who told him this? How was he assessed? Early Alzheimer’s symptoms and normal age-related dementia symptoms can look remarkably alike, according to the Alzheimer’s Association. The website for this organization has a helpful chart of the symptoms of both Alzheimer’s and normal age related dementia at www.alz.org. This site also lists the top ten symptoms. The first symptom listed is “memory loss that disrupts daily life.” You did not mention this as one of your grandfather’s symptoms. In fact, you did not mention six of the top ten symptoms. Also based on the research, Alzheimer’s symptoms do not come and go; they are not episodic, as you described your grandfather’s. The Alzheimer’s Association recommends the following steps for a proper diagnosis. First, find the right doctor, preferably one who specializes in diagnosing and treating Alzheimer’s. A thorough assessment includes 1) a thorough medical history, 2) mental status testing, 3) a physical and neurological exam, and 4) tests to rule out other causes of dementia. An assessment that did not include all of these should leave you wondering about the accuracy of the diagnosis. This is important because appropriate treatment depends on an accurate diagnosis. NOTE: Another possibility that could be ruled out by a thorough physical exam, which includes careful blood screening, is dementia symptoms caused by medications. Does your grandfather take any medications? Just be sure the doctor orders blood-screens that would test for drugs that could produce dementia symptoms.
Because of my hesitancy about the diagnosis, I checked out another possibility, which generated the following questions: How long was your grandfather a marine? Did he see combat? Did he ever sustain a traumatic brain injury? Post-traumatic stress among older adults is a relatively new area of research. What your grandfather would call “shell shock” we now call Post-traumatic Stress Disorder (PTSD), which can sometimes go unnoticed until adults reach their later years. Stressors such as retirement, loss of loved ones (your grandmother), and simply age-related health issues can trigger PTSD-like symptoms in adults that have been healthy physically and psychologically throughout their adult lives. This older-adult form of PTSD is called Late-Onset Stress Symptomatology (LOSS). According to researchers on the VA website, www.ptsd.va.gov the above normal life stressors can trigger an increase in thoughts, memories, and emotional responses to combat experiences. It is possible that this is another valid explanation of your grandfather’s most recent “episode”. If you want to check into this further, I found this information at the above website under the title, “Posttraumatic stress symptoms among older adults: a review.” ....
Blog Post #7
ReplyDeleteHello Concerned Grandson,
It is clear that you care for your grandfather and are very concerned about his well-being. Does your grandfather’s wife, you, or your brother, have POA for your grandfather? You say he has times of lucidity, and times when he has Alzheimer’s episodes. It is common for people with Alzheimer’s to grant a trusted loved one with power of attorney when they receive their diagnosis. If your grandfather is not able to make that kind of decision, pursuing legal guardianship is an option that you could consider. There may be difficult decisions ahead for your family, such as what you will do with the farm/property. Once legal guardianship is established, you and your brother will not be in the position of feeling that you need to convince your grandfather to sell.
If your family decides to do all that you can to keep your grandfather at home, there are some pressing safety issues to consider. First, it would be important to remove the guns from the property, or keep them locked where your grandfather would no longer have access. Driving also becomes very dangerous for Alzheimer’s patients, so farm equipment (i.e.: tractors, combine machines) should be off-limits for your grandfather as well. This can be handled through keeping the keys locked and away from his access, or taking out the battery.
Although your grandfather’s wife may be well meaning and a nurse, she alone cannot provide your grandfather with all of the care he will need. Fortunately, there are programs that can help them during this difficult time. The Area Agency on Aging is well worth taking the time to check out. The Area Agency on Aging can assess your grandfather for services that he may need, such as the following: in-home health care, home delivered meals, medical equipment, and transportation. They specialize in assessing the needs of the aging population, and providing the resources needed (National Association of Area Agencies on Aging, 2015).
Another good resource is the Alzheimer’s Association website, which can be found at http://www.alz.org/ (Alzheimer's Association, 2015). This website contains a wealth of information for caregivers of people with Alzheimer’s. There are many tips for taking care of yourself when you are a caregiver, including a link to find local support groups. You can find the “find resources” link toward the bottom of the page, and enter your zip code to find support group meetings for caregivers in your area. These meetings typically take place at hospitals and nursing homes. This website can also give you information on what Alzheimer’s is, what current research tells us about Alzheimer’s, and access to message boards where caregivers share experiences, resources, and information (Alzheimer's Association, 2015).
It sounds as though you and your brother wish to honor your grandfather’s love of farming, ranching, hunting, and being outdoors. I hope these resources help you in your quest to honor him and provide him with safety and care.
M. L. Vernon
Hi there! Thank you for taking the time to write with your concerns. You are clearly very devoted to your grandpa. He sounds as though the last few years have been pretty difficult for him. I’m sure that losing your grandmother was terribly devastating for him. My condolences to you as well. It sounds as though the two of you were close also. Losing someone we love is never easy. Regardless of how old or sick someone gets, the pain of losing them never gets easier. You mentioned that he has not truly grieved. I cannot imagine how he must feel losing her after being with her since he was a teenager. It sounds as though he became involved with his new wife fairly soon after your grandmother’s passing. It is not uncommon for a new relationship to occur after a loss such as what he experienced. Having someone else there may take the sting of the loneliness away a bit. I am happy to hear that his new wife is someone who you and your brother feel is a good support for him.
ReplyDeleteIt is difficult to watch those we love decline physically and mentally; especially when it is someone who was as active and vibrant as you have described your grandpa was while you were growing up. As difficult as it is for you to witness, keep in mind it is even more difficult for him to experience. A strong man like himself would likely find it frustrating and even scary to be losing the ability to do things that once came so easily to him. I don’t doubt the new diagnosis of Alzheimer’s disease as I’m sure his physician did a thorough exam and testing; I would not be surprised if his grief was also playing a part in his forgetfulness. A psychiatric evaluation could be of benefit to him. They may recommend that he participate in individual therapy or perhaps a grief support group.
In terms of his farm, I would encourage you to have him meet with an attorney. I understand and appreciate your concern in wanting to protect his assets. It would likely be in his best interest to transfer the property into the name of you or your brother. Looking ahead, he may very well end up requiring long term care either in a facility or at home with continual support. These services can be quite costly. In order to receive these services without losing everything he has worked for all of his life, he would need to transfer his assets to someone he trusts in order to avoid estate recovery. This would have to be done at least five years prior to applying for assistance from the state. An attorney can explain this in greater detail to him as well as to you and your brother. I would caution you to tread lightly in regards to this issue with him. He has experienced so much loss already between losing your grandmother and receiving the Alzheimer’s diagnosis. He may be resistant to this as he may see it as one more loss in his life.
I encourage you to enlist the assistance of not only an attorney but your grandpa’s physician as well. Allow him to intervene in being the one to recommend a psychiatric evaluation, explain to him the need to remove the weapons from the house and perhaps even to stop driving. Information that may be unpleasant or difficult to accept is sometimes best delivered by those who are removed from the situation. In my work with older adults, I have found that often people respond better to the suggestions of those who do not have a direct involvement in their life. While I’m sure your grandpa knows that you love him and have his best interest at heart, you are still his grandson. A part of him still sees you as the little boy he bounced on his knee. He may have been the one to help you learn to tie your shoes or throw a ball. Tell him your concerns. Continue to show him the respect he deserves as the man who helped you become the man you are today. Too often people begin to talk to and treat the elderly in the same way that we do a child. Allow him his dignity. And above all, love and cherish him for every day you have him. Best wishes to all of you.
-A social work friend