Dec 6, 2012

Dr Ruth Should I Talk to My Father About Dying

I still feel bad that I couldn't figure out how to talk to my father about dying.

Alzheimer's Reading Room

Dr. Ruth Answers: Not Divulging Information to Family and Friends
Dr Ruth Westheimer
Our reader Chipmunk asks Dr. Ruth.
Q. My father died at 93, he had dementia and terminal prostate cancer. We timidly tried to explain his condition once or twice but he would become extremely angry, paranoid and frustrated because he couldn't understand all the stuff we were saying. I didn't have the heart to bluntly say he was dying because I couldn't explain why.

When the doctor tried to explain the dementia part, my father became dangerously angry and offended because he thought the doctors were saying he was crazy.

I still feel bad that I couldn't figure out how to talk to him about dying. I always felt it was important for someone to know they were going to die and to be able to express their last wishes, but I fell short of the task. I was too overwhelmed myself and didn't know what to say to him.

Did we do him a disservice?

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A. Your father wasn't in his right mind. I don't know how much Alzheimer's had affected him at that point but I think it's safe to say that he just wasn't the man you knew over a lifetime as your father.

If you had told him, would he have understood or remembered? Probably not.

So all you would have accomplished was that for the period right after you told him he would have been very upset.

While each person with Alzheimer's is affected differently, one can make the broad point that when the disease is well advanced it's somewhat like dealing with an infant. If a three-year old asks you a question about something complicated you don't give him or her the full answer because it won't be understood. So you should look at your father as, because of Alzheimer's, having come full circle so that he was more like he was at 3 than at 93, and therefore you acted absolutely in an appropriate manner.

I understand that you would feel guilty about this because outwardly he was your father but you have to let that guilt go because you really did the right thing.

Now that is not to say that one should treat every senior citizen as an infant, which some people do. If an older person is of sound mind, you would owe him or her an explanation.

Or at least you could ask whether or not they wanted to know about their condition. But when you're dealing with a patient with Alzheimer's you just have to go with the flow and if telling this person that they are going to die is going to make matters worse, then better to leave well enough alone.

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In her book Dr Ruth presents coping strategies for both the practical problems and emotional stresses of Alzheimer's care.

Dr. Ruth shows you how to avoid caregiver burnout; get effective support from family and friends; resolve family disputes; maintain your relationship with a spouse or parent with Alzheimer's; manage behavior; make your home safe; and deal effectively with doctors, care providers and facilities.
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