Dear Laird: I feel like I am on a 24/7 treadmill, and it keeps going faster and faster. My wife was diagnosed with dementia 12 years ago. She was stable for a long time, but not anymore. While she can still move around and eat by herself, she is declining. She is now incontinent and can’t take care of herself hygienically. She won’t even let me help her in the shower, and she won’t wear Depends. What do I do? Signed, Allan

Dear Allan: Incontinence is common in the late stage of dementia. It is a significant strain for family caregivers because it forces us to recognize the physical decline of our loved one. 

You and the rest of us men have scarce experience with toileting another person. It is natural for your wife to push away help from anyone; however, in late-stage dementia, she may have little awareness that there is a problem.

A daughter may be a better fit as a caregiver in this case than a husband. Service providers are another option. Home care companies are non-medical care providers that help with activities of daily living including toileting. Home health care companies are different. They provide medical care, not personal hygiene care. Home care costs about $30 per hour. Medicaid or Medicare might cover it. For seniors, the Area Agency on Aging may cover up to six hours a month of care.

It is common to resist a stranger’s help. However, most trained professionals can win your wife over. Then again, your wife may resist the stranger and decide to allow you to help.

Let’s step back and talk about your future. During late-stage dementia, patients require much more care. Eating, bathing, transferring and walking all require care. You will need more and more help as time passes. Understand that no one person can do it all. So don’t think badly of yourself if you can’t. 

It’s time to make a plan. You may be able to enlist help from either family members or  friends. It may also be time to consider placing her in a care facility. At the end, hospice will be a blessing for you both. If you qualify, Medicaid can help with the cost of placement. Medicare can cover the costs of hospice.

Please do not think you are failing if you ask for help. No matter how much we love, there are tasks we cannot do. Our job is to find a way not to be the only caregiver.

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