Dear Mary,   

My mother, younger (baby) sister and I live within 10 miles of each other.  I have noticed some troubling behaviors in my mother (leaving a pot on the stove and but not smelling smoke, not managing her medications) and have scheduled an appointment with her physician. Since any changes in my mother’s living arrangements and care will affect all of us, I have asked my sister to be a part of the meeting with the doctor. However, she responded by saying that I am making a mountain out of a molehill.

We have always had a good relationship, but I need her to understand that we must start planning now to make sure mom stays safe.

Dear Reader,

It is not uncommon for sibling tensions to mount when a parent shows signs of decline and caregiver plans must be put in place. Even as adults, many of us continue to play out the old roles we held in our families (such as big sister-little sister) and early parental expectations can come into play.

Continue to encourage your sister to attend medical appointments. To save your mother embarrassment and to discourage arguments from your sister during a visit, prepare a list of your concerns in writing and give them to the physician prior to the appointment.  If your sister refuses to attend, make sure you keep her posted as to what tests the doctor orders, what his diagnosis is, and what medications the doctor recommends.

If your mother is diagnosed with a chronic or progressive condition (such as dementia), try to give your sister time to come to terms with the diagnosis. Don’t oversimplify the situation; determine what it is that you expect from her and think about whether she will be able to meet your expectations. Make a list of what your mother is going to need, both short- and long-term and give it to your sister to review, allowing her to determine how she can be involved.

You may try to ease your sister into acceptance of your mother’s decline by watching a movie together. Yes, I did say watch a movie together! There are some very good videos dealing with Alzheimer’s disease and other dementias that can be watched and discussed (“Mom does that.”  “That reminds me of a time when Mom got left the stove on.” Or even, “I feel sad like that sometimes, too.”) Here’s a few you can check out: Away from Her (2007); The Savages (2007); Aurora Borealis (2006); The Notebook (2004); Noel (2004); A Time to Remember (2003); Iris: A Memoir of Iris Murdoch (2001); One Special Night (1999).

Dear Mary,

All my life I have worked in the communications field and now I find I can’t communicate with my husband who has early-onset Alzheimer’s disease. He is angry and depressed and I don’t know what to do to help. Nothing I say seems to help even when I tell him I love him.

Dear Reader,

Your husband’s depression is a relatively normal reaction to what has already been lost and to his awareness of future limitations and perceived burdens. In addition to the psychological reasons for his depression, Alzheimer’s disease affects the chemical balance in the brain, particularly reducing the serotonin level. Depressive behaviors include apathy, loss of interest in activities, social withdrawal and feelings of worthlessness, agitation or irritability.  Advise his doctor of the changes you see; there are antidepressant medications available for persons living with dementia that can significantly improve their quality of life.

His anger, when out of character, can be baffling. Even in this early stage, your husband realizes that he cannot control what is happening now or what is to come. This may cause him to lash out, say outrageous things, be fearful or distrustful, or even lie. No matter how much you try to reason, logic won’t work.

You may need to use some old and some new communication skills. First, listen empathetically and attentively, without agreeing or disagreeing. Keep your message simple, maintain eye contact and do not show anger, frustration or fear through your facial expressions or body language.  Most important – never argue!

Dear Readers, During March and April, the Department of Aging & Disabilities will host Behaviors as Communication? A Dementia Patient’s Attempts to Connect and Communicating with Health Care Providers. For information and registration, go on-line to or call (410) 222-4464 ext. 3043.

In partnership with the Alzheimer’s Association, the department will also host a monthly Memory Café, a relaxed setting for those with early-stage dementia and their care partners. For information and registration, contact Yolanda Wright at 410.561.9099.


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