Q:  Were there services available to the sisters regarding the care of their mother, and if so, did they take advantage of them?

A: One of the greatest challenges facing family caregivers everywhere, except those with extraordinary financial resources, is to find home and community-based services to help them care for cognitively impaired relatives at home. This is especially the case when cognitively impaired individuals have significant behavioral and psychological problems, as was the case with Mrs. Dooley. 

Cindy Countess was the primary caregiver for her mother Edna Dooley, but she had the support of her sisters, Norma and Linda, who were devoted to her and their mother. They did as much as they could, but Norma?s involvement was limited by her physical disabilities, and Linda lived out of state and had her own family responsibilities. Cindy and her sisters recognized that outside help was needed to care for Mrs. Dooley, but they were unable to locate available, accessible, and affordable home services. Their lack of success was not because they didn?t try every avenue they could. 

Sadly, Cindy had finally arranged for home-based care a day or two before Cindy killed her mother.

Q:  When children are dealing with a parent with dementia, what resources/groups are out there?

A:  There are many resources/groups in the community that can help, but three factors are critical?availability, accessibility, and affordability of resources. Another important issue relates to the caregiver having the time to look for resources, especially when they are overwhelmed by the stress of dealing with the care recipient.

The types of resources to contact to find out about resources and help in your community include, but are not limited to the following:

?         The local area agency on aging

?         Local Alzheimer?s and dementia support groups

?         Social work departments of hospitals

?         Elder law attorneys and community legal services

?         Mental health and public health agencies

?         Adult day care centers

?         Home health care agencies

?         Priests, ministers, and rabbis

?         Nursing homes and assisted living residences

            Internet resources for caregivers include but are not limited to the following:

?         Alzheimer Foundation of America (www.alzfdn.org)

?         Alzheimer?s Association (www.alz.org)

?         Alzheimer?s Disease Education and Referral Center (www.alzheimers.org)

?         Caregiver Information (www.caregiving.com; www.caregiverguide.com)

?         Family Caregiver Alliance (www.caregiver.org)

?         Violence (www.fmhi.usf.edu/amh/homicide-suicide/)

?         Administration on Aging (www.aoa.gov) 

            Recommended Books by Dr. Cohen:

            Donna Cohen & Carl Eisdorfer, The Loss of Self, New

            York: WW Norton, 2001.

             Donna Cohen & Carl Eisdorfer, Caring for Your Aging Parents,

             New York: Tarcher/Putnam, 1993

Q:  Should the mother have been in a hospital?

A:  It is possible that Mrs. Dooley should have been hospitalized in a geriatric psychiatry unit to be treated, stabilized, and had appropriate discharge planning. This might have led to needed home-based services or a long term care placement. 

It is important to emphasize that family caregivers are usually committed to doing everything possible to keep a relative at home.

Q:  What about Cindy? Given her history of mental problems, should she be in a

 hospital rather than jail?  Is Cindy receiving treatment now?

A: Cindy spent many long years doing an extraordinary job caring for her father, her father and mother, and finally her mother. She was overwhelmed by the tremendous burden of caring for her mother, especially given her long term history of physical and psychiatric problems.

Unfortunately, Cindy killed her mother, and she deserved some level of punishment. She probably is not receiving the behavioral health care she needs in prison, but there do not appear to be any other options.

Q:  Is it common for adult children to become primary caregivers for parents with dementia?

A: Yes, caring for aging parents with dementia and other chronic illnesses is a normative experience in today?s society. Indeed, family members provide more than 80% of the care needs.