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I am a caregiver once a week for an 80-year-old woman. She's pretty self-sufficient, and needs help with projects around her apartment, shopping, and housekeeping.


I say "it may be the beginnings of dementia" because she keeps her world so tiny. She talks incessantly and in excruciating detail about herself (I just nod and say nothing), and really has no interest in anything other than herself. She has children and grandchildren living nearby, but she never hears from them, probably because they can't get a word in edgewise.


She has no interest whatsoever in anything other than herself. She rarely watches TV and only re-re-re-reads books she's already read (very lightweight ones). She describes herself as "living in my bubble."


I know it's none of my business, but I'd like to help her expand her world a little by getting interested in things other than herself. She's not stupid, and I don't like seeing her making her mind into a bonsai tree: stunted and tortured into an unnatural shape.


Should I just let it be, or does anyone have any suggestions? She doesn't like to leave her apartment, and has problems walking, so I can't ask her to go for a walk.


Thanks for your help.

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If it is dementia, it means she is on a cognitive decline. She won't be learning anything new, taking up hobbies, or suddenly become interested in other people or activities -- she can't, her brain is broken. I would contact her family (preferable the one who is her medical PoA, if there is one) to let them know your concerns. To continue to be a valuable caregiver you need to educate yourself on what dementia is, how it changes people and how to engage with people who have it. As they slowly lose their reason and logic you will need to employ other methods to work with her.
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Other possibilities may be:

Hearing loss - sometimes this provents a proper two-way conversation. A monologue is left.

Anxiety - kind of overexcited, sped up, talking over you style.

Either of these fit at all?

Certainly a shrinking social world does increase dementia risk - but is just one factor.

I suppose tactfully asking if she is lonely..? Does she *want* to be living in her 'bubble'? Or would prefer to see more people?
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If you only see her once a week, realistically you aren't going to be able to make much of a difference. Since her children and grandchildren are uninvolved, there is really not much anyone will be able to do.

And you are right in that perhaps there if no involvement of the family because of her self-absorption.

I will share that my mother was like that when she lived "independently" in her condo. I was the only local sibling -- my 3 brothers lived out of state. I saw what was happening, but she could showtime enough on phone calls that it took a long time for them to see what was really happening, since they came only infrequently.

I tried to widen her bubble for a while, but she adamantly refused any suggestions. So I just gave up. There is only so much one person can do.
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Since you only go once a week, I would let it go. It really isn't your job to get overly involved. Remember "no good deed goes unpunished". You really don't want to become the person she relies on. If you see other changes, short term memory loss, she says you are stealing from her. She places things in weird places and tgen can't find them. She gets paranoid, then time to call a family member. Its admirable that you want to help but as you continue in this field of work, trying to help people will end up stressing you out. There's just those people who don't want help.
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I don't think your idea of living happily at 80 matches hers, but that doesn't mean what you'd want is the better way.

Lots of older people like what's familiar because it's safe and easy. Re-reading books takes less brain power than following a new plot, and the same goes for watching TV shows in reruns. (My folks could have recited entire episodes of The Big Bang Theory verbatim, I'm sure.)

For some, like my mom, a small, self-contained existence is exactly what they want. My dad was the opposite and always wanted to try new things. As my mother's health declined, he once said to me, "My world has become so small." It was heartbreaking, because my mom's abilities were what defined the size of my dad's world.

I think you should confined your expansion of your charge's world to bringing a coffee table book with you that she might look through, or some music she might like. You won't make huge inroads, but a little variety might brighten her day and get the subject off herself. Better yet, ask her to tell you about her early years and write down her memoirs for her.
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Unfortunately, I’ve had to learn a lot about narcissism in the past few years. There are many different flavors and varieties. She is likely what you might call a conversational narcissist. I have two of those in my life… All you can do is what you are doing—nod and acknowledge politely. Accepting that it is what it is is the path to your sanity.
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Not every old person develops dementia. As people age, there will be changes in habits and activities. Because, the brain also ages there is a normal decline in cognitive functions. Old people lose interest in some previous activities and there is a constriction of interests. The only thing that will benefit her is to make her more active physically. Being sedentary will kill her fast. Try to get her involved in anything that will require moving and some walking, even if she has difficulty. Just make sure she doesn't fall and break her hip. Sitting hour after hour on the same chair shouldn't be allowed. Make her have a short break and give a few steps from time to time. If she will get some physical exercise only once a week is better than nothing.
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She describes herself appropriately. That means I am giving my no vote to dementia. She says she is living in a bubble.
I myself am somewhat a hermit. I have children who don't live in my area. I am very much a home body who is most content reading and gardening. I require the input of very few people and am in fact most comfortable with my "social outreach" being online social media. Here and Facebook gives me the only dose of "humanity" I really require during my day.
I do travel to see my daughter, enjoy getting out and walking, going to the library. But otherwise my life is quite quiet, and that's exactly how I like it.
So I think the question really is her safety. Sounds to me like she may be perfectly content. I don't hear complaints. Are there any?
What may seem a bonsai to you, to another may seem just lovely.
Why would you want to expand the world of someone who is content?
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