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As an example, I frantically moved heaven and earth to get a new nebulizer for my 82 yr old mother, racing between calls to her Dr, nurse, a supplier, a delivered (I don't drive, ms) and got it there in six hours. After all that she said, "I don't know what the big deal was." She would have ended up in the ER. Just a little gratitude?

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I feel so bad for the many caregivers in your situation. Was your mother more thoughtful before the dementia? Maybe then it would help to remind yourself that she is no longer in her mind.

Do you think it might be partly denial of her failing strength and abilities?
"Thank you so much, dear, you did a good job."
"Huh , that wasn't any big deal"
In her mind, which of those sentences preserves her illusions that she is still independent and runs the show?

I know a couple of elders who don't have the explanation of dementia who say things like, "Well I could have done that myself, you know. Stop interfering." Of course they couldn't have done it themselves, but that is a very, very hard thing to do.

Is she generally congenial except in the gratitude department?
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So true. You are not alone. (((Hugs)))
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Gratitude? S’matter’chu? Some parents/people just don’t have it in them.

My parents simply expected me to drop everything to serve them (way before they were old and needed help.) Have you heard the saying, “if wishes and buts were candy and nuts, we’d all have a merrier christmas?” It was near the holidays when I decided to thank myself. Everytime my father would fail to thank me, I would drop a bite-sized candy into a bowl. On days I was particularly distressed, I would have a candy. Ok, this was almost everyday, and my endophins thanked me (and I pretended my waistline did, too.) 

Probably not the best substitution, but now that I am no longer caregiving, it makes me more cognizant of gratitude (giving and receiving) and I eat less chocolate.
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Thank you for your insights. Gratitude was never her strong suit, perhaps it is just exhaustion talking. Thank god for me fellow caregivers. Self pity is compartmentalized for responsibility
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My husband is going thru hell with his dad. He is 93 and so rude to the people at the rehabilitation center. He thinks the minute he wants something everyone has to drop everything. If it is not instantaneous, he gets very nasty with them. It is harsh and embarrassing. My husband tried to be the full time care giver, but that was hell on earth. Now rehab is ending and we need to find a semi-permanent solution. He was accepted to Veterans home, but has approx. 3 month wait list. Looking for temp solutions that are affordable. At wits end!!
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I know it must be frustrating. What was odd with my LO, is that before dementia, I did a lot for her and her mother (now deceased) and she never seemed grateful at all. But, once she got dementia, she thanked me all the time. I guess she forgot that she had thanked me, so she kept doing it. Still, it was appreciated, because she didn't used to do it much. Over time, she has lost that ability and I don't expect more. She's progressed and her speech and orientation is very limited. I know she feels it though.
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As my dad said "I never say thank you"...... and he was right! I make dinner every night and maybe once in a great moon he will say "it was OK. Every other night, nothing. If my daughter makes something he says "that was great" but never thank you. My mother raised us to say thank you all the time. If my wife or daughter does something I say thank you. Our daughter living with us until she gets her house. She empty's the dishwasher and makes coffee every morning. The first thing I say is "thank you". This is the reason she does it because we appreciate it. I and my wife do everything around here. Once in a while she will explode and he will help a little. He now (after 4 years) will sweep the kitchen but waits until my wife is pulling in the garage so he can get his gold star. "I swept today" he says now. My wife says "OK". She wont say thank you becasue he wont. It is like living with a child. Now tonight he is making dinner. First time this year. He will expect accolades for doing what I do every night.
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I care give for a 97 y/o. Her son recently gave her the “Rolls Royce” of rollaters for Valentine’s Day. Cherry red. She was so mad and told me she was going to give him hell.

Most of us do things for some kind of appreciation and a show of simple gratitude. I told her my daughter had given me something once and I got mad about it and the hurt look on her face was devastating. I told her I never did that again. She listened intently and then gracefully thanked him that night.

I believe when I personalized it she paid attention. I didn’t give her a hard time about her behavior. I just reflected my experience and it worked.

And now she brags about the rollater and there’s serious status envy where she lives! Only one other person has one at the facility and the sidelooks crack me up!
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My mother does say thank you to me sometimes, but it's pretty meaningless because I am expected to do things for her and she has yelled at me that I don't do much at all for her.
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It could be the truth as far as they know. They just do not comprehend the enormity and ramifications of things. Their world is so small they just do not
know.
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I was in those shoes just last week! I went to see my dad on Valentine’s Day and took him a box of chocolate turtles...he proceeded to say they weren’t that good and that Russell Stover had gone downhill. I took the box back and told him my husband will love them! I took his hearing aids then to go get them cleaned and checked brought them back and again no thank you. Then he proceeded to complain ad nauseum about every little thing wrong and I finally said, "Dad, I need to go. See you later." That was over a week ago and I haven’t been back. I know he is depressed and in a negative spin. I know he has dementia but it doesn’t mend hurt feelings. Realistically he wasn’t in a place where he felt grateful...he feels like his life sucks. I don’t expect miracles from him but sometimes we need to distance ourself from the situation and that’s what I did. I’m going to see him today, but if he begins the negative talk again...I’m going to say if you want me to visit, then we need to visit. I can’t listen to complaints every time I come.
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BMF your FIL sounds like my dad! You might look into a senior group home. Those are less expensive than LTC facilities. They look like regular homes and take only a small number of people. I’m glad your hubby isn’t doing FT caregiving now.
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Maybe a hug from a fellow caregiver would help? ((()))
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To all on this site. You deserve gold Metal ‘s . Your are Warriors for the elderly . It’s hard taking care of someone Who doesn’t recognize it and lives in their own world . I salute all of you . This forum is awesome, remember they can’t tell you they love you, or even sometimes remember you. But don’t forget to take time for you,  a friend, or group and vent. Get some wine, or a bubble bath, and take some me time. When you had it, refresh go back do it again. Find the me time, it’s so worth it.
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I would have loved a Thank You from my husband. But for the most part he was non verbal. I was shocked once we were at Costco and as we walked around he took samples they were giving. (His favorite thing to do on an outing) and much to my surprise he said Thank You!. But never again and never to me at home. But..he would always stop his little noises and chewing on a blanket to give me a kiss good bye and when I returned a welcoming kiss.
That said ...
I bet there were times your Mom moved Heaven and Earth to get you something you wanted or get you someplace you wanted to go and I bet there were times you did not thank her.
This happens a lot when we are comfortable with the person that is "doing" and we forget the little niceties that go along with being on the receiving end of things.
In my Husbands case..I took every smile he gave me, every time he held my hand or brought my hand to his lips to kiss it as a Thank You, I love you. Would I have loved to hear the words...maybe but I think the gestures meant more. Anyone can say words not everyone means them.
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I think It´s better not to expect any "thank you". We caregivers should feel proud and self recognized, we are doing the correct things for our loved one, and that´s more tan enough.
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I am so sorry.

I am fortunate. My dad always thanked me for everything. And my husband thanks me daily.
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Paula, you are correct, it is or should be more then enough and none of us do it for gratitude, however, a simple thank you when we have been run ragged again would go a long way in helping some of us keep up the good fight, especially those of us that deal with a self centered, manipulating narsisist.

Keepinup, I know it is not the same but, I thank you for all you do for your mom, you are a loving caring daughter and what you do is appreciated. Hugs and love to you for who you are and all you do😘
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Even though we do it because we are caring or dutiful or loving...and know we don’t NEED to be thanked, I think we can get to a point of overwhelm where it would be nice to feel some appreciation. My dad will never know or understand what I do and have done for him. It’s a lot and he never did anything like that for his parents. Yes he was my parent and young and raising a child was part and parcel when you decide to make babies. I do my part and am responsible but at a price to my emotional and physical health as a senior myself. For me that is why this support group is vital. You all "get it" like no one else. Thank yous and hugs to all!
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You may be doing so much behind the scene without telling her - how much of what
you did would she have realized? - we all do this to reduce the stress to our loved ones

Now shut you eyes & relive how much your mom would have seen or noticed & I'll bet you did such a good smooth job that her reaction can be understood - you know how much work it was but she didn't - also she probably thinks of you as a spry 25 year old with no health issues of your own -

So lets make lemonade with the lemons - you most likely are doing such a good job with her care & keep the problems away from her notice [we all do it too] that her remark should be seen as a compliment that you are doing it smoothly at least as far as she can see - so I say good on you & I say "THANK YOU" on her behalf

Also I want to tell you a story - when a grandmother complained to a friend that she sent some small item to her grandchild & didn't get a thank you note about it ... the friend said 'when did you last send a thank you note for the painting or card the grandchild gave you?' - all in perspective - not that you don't thank you mom at times but how many times did she drive you when you were a teen somewhere/made a favourite meal /etc & you didn't thank her when she might have deserved it?
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Today, an apology is in order after he was late, me having to rush, then rush him, turning me into the bad person! I drove home with skipping heartbeats, causing me to cough with each skipped beat.
A thank you for the ride even would not have been enough. I need an apology, and for him to get with the program.

Oh, I forgot.  He has a disability and cannot sustain getting with the program.
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Mom has Alzheimer's and vascular dementia, mid-stage. Even in the early stage, she didn't express gratitude for anything I did for her, just guilt that she had to rely on me or anyone else to get her needs met. I always reassured her that she's my mom and I want to help. Now in mid-stage she makes a point of rejecting my hugs by "freezing" or pushing me away, so I quit displays of affection. Gifts are left unused, put away, or returned to me with tart remarks like "I don't need this" or "Someone left this here," etc. I think she does this to take back some of the control she thinks I (and not the disease) stole from her. It used to bother me but it doesn't any more. Her brain is broken beyond repair. The only gifts Mom gets from me now are anonymous, sent in the mail or left in her room when she isn't watching. This way I can do something nice and spare myself the rejection. As far as errands like taking her to the doctor or picking up something she needs? I just do it with no expectation of gratitude. A 5-year-old shows more gratitude than mom does.
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many times I wished just once it would be nice that mom thanked me for whatever. my dad said thank you all of the time to me. he was so loving right up to the end. mom was a tough cookie, but at the end before she died she said" I want to thank you so much for everything you did for daddy and me. I love you so much please don't forget that." mom and dad both passed away recently a couple of weeks apart. when mom said that to me the night she died I realized she know every thing I was doing for them and was very thankful for it all. it made every thing I did for them for years of taking care of them so worth it all. it also brought closure to any questions I had of them. I realized that they trusted me so much to make any and all decisions with out
any doubt what so ever. I miss them both so much....
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When my mother-in-law and we moved in together, she had advanced dementia. She had no idea what state, city, or room of the house she was in. She could no longer clean, bathe or dress, cook, or find anything to eat or drink. Thank God she could still feed herself!
As a younger women, she was egocentric and eccentric, but the years had softened her. Now she'd become mostly pleasant - but vulnerable. She still could make wisecracks, and 'understood' humor; or maybe just the smile and chuckle with it caused her to laugh.
When living together, whether it was a plate of food, a drink, or a muffin we offered, she always said thank you. I loved that she said thank you (her mother taught her well).
Now she is more lost than ever, and rarely acknowledges anything given to her, probably because she just doesn't understand. But I still hear 'thank you' in my mind's ear because it was her natural response for so many years.
And truth be told, how many of life's gifts do I take for granted? These past couple years I've seen more of my own flaws mirrored than I knew existed!
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I never cared. My mom was cold and unloving all my life, though polite enough. I didn't care what she said or thought, and much less as time went on. I was running myself into the ground taking care of her, and a bright smile and heartfelt thank you from her wasn't going to help a bit. As long as she was agreeable and not nasty and stubborn as her brain died off, that was good enough!
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keepingup: Oftentimes the elder will not thank you. I don't know why. However, I thank you! Sometimes the elder's mind is so broken that their brains are thinking of the  next best thing that they will verbalize. 
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Next time if nebulizer breaks let her go without it & see how she likes that better.
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Based on my experience with my mom some people are like that and always will be and I have slowly had to learn that I have to keep doing things for my mom and not expect appreciation. The odd thing is my dad is the primary issue, with Alzheimers, and he seems to be very appreciative, but my for my mom whatever I do for her in helping her with my dad is not enough. She always demands more. I have to draw boundaries but still feel bad for lack of appreciation. But just accept that's the way it is.
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p.s. - expecting thanks and smiles, gratitude and loving embraces all 'round with these people, with damaged brains? Don't. It's not going to happen any more than that they will one day wake up all happy and jolly, start walking, talking, driving, or going to sit on the toilet by themselves multiple times a day. Downhill. All the way.
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With dementia-
It takes a rational mind to see the action then realize that it was difficult to do, done for them, requiring effort and energy on your part. There isn't a rational mind with dementia, so we just have to "thank" ourselves and believe they would too, if they could.

Without dementia-
I believe that the longer you live, the more your world narrows and your scope of seeing and understanding things is limited. I think their world is so self absorbed that they don't realize that anything exists outside of themselves and their needs. Thus, they know they need something, are unable to get it but want it right now. As in an emergency, we would expect someone near us to help us right away, they perceive what they want to be an emergency and want it right now.

My dad thanked me for everything I did for him. Mom wasn't much with thanks. Lately, she's been thanking me for our visits and telling me how nice I look. Neither would have ever been said in the 60 years of my life prior to her getting dementia. Better late than never, I guess.
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