Dearest: Jacqueline Marcell, is a former college professor and television executive who, after the experience of caring for her elderly parents, became an author, publisher, radio host, national speaker, and advocate for eldercare awareness and reform. She is the devoted daughter in her bestselling book, "Elder Rage, or Take My Father... Please! How to Survive Caring For Aging Parents." Elder Rage is a Book-of-the-Month Club selection, is being considered for a feature film and has received 45+ prestigious endorsements. The National Adult Day Services Association honored Jacqueline with their Media Award for her tireless efforts to bring attention to the value of Adult Day Care. Numerous publications have featured Jacqueline, including Prevention, Woman's Day and AARP's Bulletin. The National Association of Women Business Owners will present Jacqueline with their "Advocate of the Year" award at their Remarkable Women Awards in October. Jacqueline also hosts the radio program "Coping with Caregiving," Welcome to Power Surge, Jacqueline. Jacqueline Marcell: THANKS! Dearest: I'm fascinated by the title of your book, "Elder Rage, or Take My Father... Please!" Does the "rage" come from the 'rage' your father experienced and spewed forth, the rage you felt as the caregiver, or both? Jacqueline Marcell: BOTH! Dearest: You want to elaborate? Jacqueline Marcell: He always had a bad temper, got worse as he aged, and he was furious with me for trying to help and then he got dementia on top of it. Dearest: It's ironic, the way you describe your father's rage and your mother being kind and quiet, I have the same situation. Jacqueline Marcell: I thought I was the only one who could have such a situation, but I have received thousands of emails from people saying we must be related because the had the exact same thing. Dearest: Do you think ill-tempered, self-centered people often get worse when they get old? Jacqueline Marcell: It is called the "More-so" theory of aging. Whoever you were as a young person, you are going to be MORE SO that way when you get older! Dearest: In the past 1 1/2 years, my once opinionated, outspoken, interior designer, 91 year old mother has developed difficulty forming sentences - communicating. She understands everything she hears, keeps herself busy reading and designing beaded jewelry. My brother and I won't consider putting her on medication for what we see as "the way she's aging." Under what circumstances would one give a 91 year old person medication for what is obviously dementia? Jacqueline Marcell: You must learn the 10 warning signs of dementia available on my website www.ElderRage.com and see if she fits any of them. People assume these odd behaviors are a normal part of aging, and they are not. That is what I thought, just how it goes when they get old. 50% of people by the age of 85 will have some form of dementia and Alzheimer's is just one type. What you want is to get a GERIATRIC dementia specialist to evaluate her because there are some medications that can slow the dementia down and help them for an extra 2-4 years. Aricept, Exelon, Reminyl, Memantine and if you ignore the warning signs, they progress to STAGE TWO, which is much much worse to manage. Early diagnosis is the key. Dearest: These are used for both dementia and Alzheimer's? Jacqueline Marcell: Dementia is an umbrella term. Alzheimer's is just one of many types of dementia. Dearest: As was the case with your father, when you find yourself in a caregiving situation for someone who's difficult, how do you know when you're in trouble? In other words, what is the fine line between kindness, understanding and utter frustration and anger? Jacqueline Marcell: I say that when they do something that seems illogical or irrational... IT IS! Don't second guess yourself because they are back to acting normal. Dementia comes and goes in the beginning, and it is so subtle, everyone ignores it until it has progressed to where the person needs full time care. My mission is to wake everyone up the first time their eyebrows go up and they say "What the heck was THAT?" that just happened and to get to the right doctor. Most GP's are not trained in dementia. I was sent home, being told it was a normal part of aging. Now I lecture to DOCTORS and teach them what they should know about dementia. Dearest: That's what my mother's internist said. It's hardening of the arteries. Is there a resource we can use to find a dementia specialist? Jacqueline Marcell: The first stage lasts 2-4 years, the second stage lasts 2-10 years and needs full time care. The third stage is 1-3 years, the end, nursing home time. If you get the medications into them at the first signs of it, you can delay it but you can't go backward. The professionals don't get the calls until there is a crisis and then the families are so upset to find out they should have acted sooner. The first time your mom asks you the same question OVER AND OVER, and you say, "MOM, you just asked me that!!" Don't get mad, call the Alzheimer's Association 800-272-3900 and get a referral to a dementia specialist, so she can be evaluated ASAP. It is a complex diagnosis: memory test, blood test, neurological test, and there are some REVERSIBLE dementias like a B-12 deficiency!! People have been diagnosed with dementia and all they needed was a daily B-12 shot!! There are many things that can cause dementia-like symptoms: a folate or thyroid deficiency even depression can mimic it. So again, the right doctor is the key. Peggy3: What are other examples of dementia besides Alzheimer's? Jacqueline Marcell: Lewy Body, Frontal Lobe, Vascular, lots and lots of them. One out of every 10 persons by the age of 65 will get some form of dementia. Elder abuse is reaching epidemic proportions because people are so frustrated with how to manage elderly loved ones. I am on a mission to educate people because with understanding the disease process AND the use of ADULT DAY CARE elder abuse can be reduced. I LOVED my father and I swear, I could have killed him. He attacked me 4 times and I had him taken to the psychiatric hospital for violence yet they released him every time because they couldn't find ANYTHING wrong with him!! I had the head of a psychiatric hospital tell me he was "normal for a man his age" 83. Demented does not mean Stupid! And he was socially adjusted not to show his "Hyde" side outside the family. So it wasn't ALL dementia, he was furious, but the dementia made his ability to use logic and reason distorted INTERMITTENTLY. Not all the time. So he'd be normal one day and then really nutty the next. I cried everyday for a year, begging for help in San Francisco and NO ONE had the answers of how to manage such a challenging elder. Once I solved it, medically, behaviorally, socially, I said, "I HAVE to write a book!" I had lived an incredible story and needed to purge it. It is now being looked at for a feature film. Dearest: Agree. I think the enormous baby boomer generation is having a major rude awakening! Our parents are living much longer than generations before them. Abusive isn't "normal" under any circumstances! My father is the same - street angel, house devil! You still sound angry with your father. I can relate. Jacqueline Marcell: What I would do now is to realize that we trained my father with his bad behaviors. We were responsible for letting him get away with screaming and yelling his whole life, though never at me before and I would know how to let his nastiness roll off of me. I would know the RIGHT doctors, the right combination of medications, the right behavioral techniques and Adult Day Care. I learned after a year how to do it. With the knowledge I have now, it wouldn't even take me a month to get it all moving in the right direction. The technique of distraction works when they are in the "broken record" mode and also validation of their frustrated feelings. Beth: Your situation sounds incredibly difficult. What approach would you take with an elderly parent who denies a problem and who seems to have memory and logic problems plus effects from dealing with a controlling schizophrenic relative in the home? The phrase "normal for a person my age" is used too. Jacqueline Marcell: Memory and logic problems are dementia. They don't think they have anything wrong with them. Have their trusted doctor give you a referral to the dementia specialist. Tell your parent there is a 6 month waiting list. Take them to lunch, casually drive by the doctor's (have the appointment already set up. Say, "Oh Let's go put your name on the waiting list--while we are right here." Then... "OH MY GOSH... the doctor has a cancellation and can see you right now! what luck! Don't tell them they have a problem, know what has to be done and do it. Short term memory cannot be ignored-that is it! Dearest: It's terribly draining on the caregiver. What are your thoughts on respite care? Jacqueline Marcell: The biggest thing I would do if I had to do it again would be to schedule a different friend to call me everyday. They don't get it. They have no idea what you are going through. You have to ask them to help you. RESPITE is a must and it is common to think you can do it alone. Hardest thing I ever did and I had NO help. There are online support groups now, physical support groups, so much help is out there. Dearest: I'm going to say something I wouldn't ordinarily in a chat of this nature. Dearest: Jacqueline, thank you for an informative and stimulating discussion about how to best handle caregiving for the elderly and dementia. I recommend Jacqueline Marcelle's book, "Elder Rage, or Take My Father, Please!" You can visit Jacqueline's Web site at www.ElderRage.com and hear excerpts from her radio show, "Coping With Caregiving" at www.wsradio.com/copingwithcaregiving. Disclaimer: Every guest in Power Surge is a highly respected professional whose opinions are his/her own. An appearance in Power Surge does not constitute an endorsement of a guest's views. None of these transcripts may be reprinted or reproduced without the express permission of Power Surge™ and the respective guest. Read other transcripts by returning to the Library. Dearest aka Alice Stamm Power Surge Founder, Facilitator, Host Copyright©1994- by Power Surge. All Rights Reserved.