Ask Miriam – July 2024
Dear Miriam,
My dearest friend was recently diagnosed with Alzheimer’s disease. Both of us are in our 70s now, and when we were both widowed within a few years of each other, she moved into my home so we could save on finances. Her doctor told her a year ago that she had Alzheimer’s, but at that time, it wasn’t too bad. However, she has recently been looking pretty disheveled (her clothes, her hair, etc.) and I don’t think she showers regularly. This is getting to be too much for me. I haven’t minded paying the bills, cooking, and managing our household, but I know I can’t do hands-on care. It’s just not me. She does have children, but they live far away, and their relationship is not close. She only has a small pension and social security. I don’t want to abandon her, but what do I do?
—Overwhelmed Friend
Dear Overwhelmed,
It sounds like the two of you have an amazing friendship, and that you have already taken on quite a bit in terms of managing the activities of daily living for both of you to help your friend to function as well as possible. I realize this is a challenging situation, but there may be some avenues that you can explore to ensure that both of your needs are met.
First, I am wondering if you have had a conversation with your friend about your concerns, and whether she realizes that she is having more trouble. From your description of her symptoms, it is possible that she no longer has good insight, and that therefore someone will need to step in and make some decisions regarding her care, since she is losing that ability.
While it is not necessary to convince her that it is important to contact her children, you may want to let her know that this is a step that you feel you need to take. I understand that your friend is not close to them, but if her children haven’t seen her for quite a while, they may not realize that her situation has changed and that her dementia is progressing.
If your friend does not have a Power-of-Attorney document where someone is designated to make decisions on her behalf, when you speak to her children, be honest about her condition and ask whether they are able to take on more responsibility. If one of them is named as her Power-of-Attorney, you will want to let that person know that you are unable to provide care as she declines. If it turns out that you are the best person to make decisions, you will want to consult with experts in the field, including her physician, an elder law attorney, and those knowledgeable about dementia.
Other options that would help your friend, as well as take some of the burden off you for the time being, include enrolling her in an adult day program and/or bringing care into the home. Both of these do cost money, so you will need to assess whether your friend can pay for assistance. Once you have assessed her finances (and know whether her children will contribute), you can decide on the balance of care needed. Ultimately, she may need to live in a memory care or nursing facility.
You, as her friend, can continue to find ways to have a relationship. You can reminisce about the past together, listen to music you both enjoy, or play simple card games (and, of course, it doesn’t matter if they are played “correctly”). It’s also important for you to get support as you cope with the loss of what the relationship used to be. Support groups or individual counseling can help, as well as simply sharing your feelings with someone else you trust. You do not have to be a caregiver to be a good friend. And your love and friendship are still meaningful even as the disease progresses.
For more information on friendship and coping with Alzheimer’s disease, call the Alzheimer’s Los Angeles Helpline at 844-435-7259.
Best,
Miriam
Questions for Miriam can be sent to askmiriam@alzla.org.