“I need to get a dog so it can mother me,” says Sara, smiling through her tears.

Sara is a 51 year old single woman who has been losing her mother to Alzheimer’s for seven years. In this past year, though, there has been a serious decline. Mrs. Jacobson still recognizes her family but her memory is severely impaired; her ability to take care of herself and her home has significantly deteriorated, and she is becoming paranoid.

Sara’s father, a retired teacher, was the primary caretaker until his sudden death six months ago. Sara and her two brothers immediately hired three round-the-clock aides, so their mother could remain in her home.

Mrs. Jacobson’s moods have become more pronounced; she goes from being depressed and unwilling to get out of bed to being nasty and regularly firing her aides. Fortunately, Sara’s four daily phone calls have helped soothe the aides enough for them to continue working with her mother.

While she is fed, bathed, and kept safe, her aides are not trained to work specifically with Alzheimer’s patients. Sara has come to realize her mother needs more stimulation; and she would like her brothers to consider a nursing home that specializes in Alzheimer’s. Mother would have more activity and socialization. But her brothers won’t discuss even looking into such places. They both say Sara is overreacting; their mother isn’t that bad. The older brother says, “Mother is safe and well cared for; she is just going through a difficult period since Dad died.” The younger brother says, “After all, Mother hasn’t lived without Dad for almost 55 years. She hasn’t adjusted to this yet.”

All of that is true, says Sara, but she believes it is her brothers who haven’t adjusted yet to the fact that their mother is losing not jut her memory, but her competence and her personality. She believes it is her brothers who haven’t adjusted to the fact that mother has Alzheimer’s and is in a decline. “We can’t talk about it,” moans Sara. “I’m so alone; I miss my father terribly; I miss my mother as she used to be. I’m alone – even though I have two brothers.” 

Contrast Sara’s situation with Maddie’s and Catherine’s. These sisters live in the same town as their widowed father who has had Alzheimer’s for over a decade. These sisters are not as alone as Sara, even though they too are sad watching their father fade away. They work well as a team in taking care of him and spelling each other when one is overwhelmed with other life issues. Unlike Sara, they have a sibling’s support. They cry a lot, but they cry together. Sara’s sadness is compounded by all the fighting with her brothers.

The quality of the adult children’s relationship before their parents’ crisis usually, but not always, shapes the way they deal with their ill parents. If siblings were cooperative before, they probably will continue to work cooperatively in handling the details of taking care of their parents. If they were distant or hostile, or if there are unresolved issues from childhood, the stress around caring for the parents inflames those old feelings, so that working together becomes more difficult.

Sara says Stuart, her older brother, has been critical of her and either ignored her or was hostile towards her ever since she was little. So, she is not surprised he won’t even consider her suggestions for helping their mother. “He was always the bossy big brother, and what he says goes.”

While she and Carl, a year younger than she, haven’t been particularly close since college, before then, they had been. She had counted on him to at least listen to her thought that their mother might get more stimulation in a nursing home — more stimulation meaning less rapid decline. What she hadn’t counted on was that Carl, as a child and even now, idealized Stuart. This clearly outweighs his old affection for Sara. He goes along with whatever Stuart thinks is best for mother.

Sara believes that if mother doesn’t have more activity and socialization, she will slip away even faster. She is trying to hold onto what is left of her mother. From everything she has read, a specialized nursing home may offer the best chance for their mother to maintain some skills.

“I would like Mom to be able to stay in her own – If that’s the best thing for her. I’m not asking my brothers to make any decisions, only to look into another option and to consider the advantages and drawbacks to her remaining at home.”

Sara has sent them information on Alzheimer’s and the importance of stimulation to prevent decline. She has gotten information about the best nursing homes and has offered to set up appointments – to fit within their schedule – to visit them. “There’s no commitment, but let’s just go see what they have to offer,” she has begged. “Maybe it won’t make sense, but let’s see what they are like.”

Her brothers have refused to read anything about Alzheimer’s, including the pros and cons of keeping someone at home vs. a nursing home. They have deflected each of her suggestions, saying she is making things worse by talking about changes.

When Mrs. Jacobson’s condition deteriorates and alternate decisions can no longer be avoided, Sara and her brothers, unlike Maddie and Catherine, won’t have a good basis for making them.
Now, though, Sara feels most vulnerable, having lost her father and now losing her mother. She carries her grief alone, since her brothers won’t talk about any of this with her.

“They are jerks,” she sighs. “They aren’t being realistic, but I don’t have any more energy to keep fighting. So, I’m letting go even though that means Mom will probably get worse faster. They wore me down; I feel so emotionally empty. That’s why I need a dog – so it can mother me.”