Caring for someone with dementia? What you need to know: advice from a caregiver

Dementia symptoms and care

The cause of the pathological process is the death of nerve cells, which begins due to a number of negative factors. The disease develops in stages: memory deteriorates, thinking becomes disordered, speech changes, coordination of movements is impaired, hallucinations occur, and reflex abilities are lost.

Caring for a patient with dementia has its own characteristics and depends on the stage of the disease.

More often, the disease develops in old age; in young people, the causes of the disease can be vascular disorders, drug addiction and alcoholism.
Dementia in the elderly: symptoms, care

In the final stages of the disease, a person is completely dependent on outside help. A functional disorder of the brain can cause the development of various diseases, and then nursing care for dementia is needed.

Features of behavior of a person with dementia

With early manifestations of dementia, the person fully retains communication abilities. Unfortunately, the diagnosis of this disease usually occurs in the later stages of personality degradation, and it is important that the care of relatives is not too harsh. Caring for paralyzed patients with vascular dementia is complex and will require a lot of attention. In such cases, only a doctor can give recommendations, and these recommendations must be followed.

The weakening of mental activity critically affects memory, which leads to concern and causes an anxious state. Such patients become prone to loss of self-control, which can lead to sudden changes in behavior. Worry, anxiety, aggression or apathy only contribute to the deterioration of the condition and it is necessary to avoid stressful situations. A patient suffering from dementia is often sincerely convinced that he was deliberately not invited to dinner or that personal belongings were hidden.

Psychological contact

A person with dementia needs to be in a familiar environment; the person is not able to get acquainted with new things and absorb information. At an early stage of the disease, communication on topics of interest helps to slow down the progression of the disease. Treatment and care for dementia depend on the individual's independence. It is necessary to unobtrusively push the patient to action. This will allow him to concentrate longer and maintain his mental abilities at a certain level.

What to do:

• Let's solve crossword puzzles;
• Allow food to be cooked under control;
• Allow communication with children;
• Encourage dressing well and encourage choice by adjusting clothing for the season.

Try to prevent the person from losing interest in life; passivity and isolation lead to rapid progression of the disease.

Dementia - what is this disease?

Dementia is a severe disorder of higher nervous activity. The cause of dementia lies in organic damage to the brain. The first signs of dementia: decreased mental abilities, loss of existing knowledge and inability to perceive new information.

Dementia can occur suddenly, either as a result of a psychological illness or as a result of other diseases (for example, some infectious diseases). An acute mental disorder is manifested by agitation and confusion, accompanied by motor restlessness. Motor excitation usually includes speech excitation: speech is accelerated and incoherent. The patient may repeat the same words and phrases, non-stop conversations with himself (monologue) and shouting are possible. Movements become abrupt, impetuous, erratic and unmotivated.

Other manifestations of dementia are also possible: anxiety, aggressiveness, fun, etc. Symptoms of dementia depend on the underlying cause of the brain damage.

Organization of space

Caring for a senior with dementia requires a safe space. It is necessary to remove dangerous and complex mechanisms from view and keep simple and harmless objects within reach. Household appliances should perform only one function. Buy an electric kettle with automatic shut-off, this will prevent the room from catching fire.

If dementia manifests itself in an active form and a person strives for unconscious actions, it is necessary to secure the premises as much as possible:

• Buy locks for the windows;
• Insert plugs into the sockets;
• Change the door lock;
• In your absence, turn off the gas and turn off the water, leaving the required amount of food and liquid on the table;
• Hide toxic substances, piercing and cutting objects.

If you are agitated, you should consult a doctor. The doctor will prescribe medications that reduce the patient's activity.

Eating

Caring for people with dementia at home is complicated by mealtimes. In the advanced stage, patients cannot use cutlery on their own, and they often refuse to eat.

The most common feeding problems are:

• The patient does not recognize the food;
• Spit out contents from mouth;
• Forgets to chew;
• Asks to combine incompatible products;
• Completely refuses food.

People with dementia often forget how to use cutlery. Before eating, show how to use a spoon, finely chop food or grind it with a blender. Provide finger foods and constantly remind them to eat slowly and chew food.

Boarding houses for the care of the elderly and those in need of care “Longevity”

Boarding houses for the care of elderly people of the Longevity network are always ready to offer people with senile dementia the most comfortable living and care conditions. Sensitive and experienced staff helps guests who have difficulty in self-care. Complete hygienic care, feeding and walking, correct communication will help your loved one always feel worthy.

Our boarding houses are located in Moscow and the Moscow region: in Vidnoye, Ramenskoye, Zelenograd, Dolgoprudny, Solnechnogorsk, Mytishchi and Belozerki.

Incontinence and personal hygiene

Vascular dementia progresses rapidly. Lack of oxygen and nutrients causes the death of brain cells, because of this, nerve impulses about filling the bladder do not reach the central nervous system. The patient may forget what a toilet is and how to use it. Sometimes he does not control bowel movements.

Rules for caring for vascular dementia with incontinence:

• Encourage the patient to go to the toilet if he or she has gone there;
• Leave the door to the hygiene room open;
• Dress the patient in simple clothes so that they are easy to remove;
• Limit fluid intake in the evening;
• Place the chamber pot next to the bed;
• In severe cases, use diapers or disposable absorbent panties.

Progressive dementia requires care in personal hygiene, so you need to keep your hands, genitals, teeth and body clean. When washing and bathing, it is necessary to maintain special delicacy; some patients have a negative attitude towards outside help.

How to behave:

• Analyze at what time of day a person is most calm;
• Voice the offer to wash several times, making eye-to-eye contact;
• When approaching the patient, talk about what you will do now;
• You can wash your body in parts (head today, legs tomorrow, torso every other day);
• In case of refusal, replace bathing with sponge wiping.

Note. Treatment and care for dementia are carried out in parallel; unwillingness and aggression are suppressed with antipsychotics, which allow the necessary control over the patient. Vasodilators and medications that improve communication between neurons can slow down irreversible processes.

Causes of dementia

Various diseases can contribute to brain damage and disruption of nervous activity: Alzheimer's, Parkinson's, vascular and some infectious diseases (meningitis, encephalitis), head injuries, tumors, etc. Drugs and alcohol also have a destructive effect on the higher nervous system with the development of dementia.

The nature of this disease is not fully understood, but the main causes of its occurrence are considered to be:

1. Disruption of metabolic processes in the body with a lack of oxygen and atrophy of brain tissue (atrophic dementia).
2. Death of brain neurons as a consequence of diseases of the cardiovascular system (vascular dementia).
3. Infections and oncologies leading to dementia.

Features of caring for patients with severe dementia

Caring for people with severe dementia has its own challenges. At this stage, the patient loses speech and perception of the surrounding world. The person cannot move and is forced to remain in a wheelchair or bed.

Dementia – features of caring for a patient with dementia:

1. Communication. When courting, you need to talk to the person, talk about the weather, greet him by calling him by name. They recognize the familiar voice and respond positively to it.
2. Movement. Constantly give your body a new position, this helps prevent pneumonia and constipation.
3. Bedsores. A common problem is bedsores, which arise due to lack of blood circulation in the “pressed” area of ​​the body. It is necessary to change the position every 2 hours, turn the patient over, give him a massage to improve blood supply.
4. Body care. Hygienic procedures, washing, wiping with a sponge must be carried out several times a week. It is important to change diapers and underwear regularly. Control irritation and diaper rash in the genital areas, keep the skin clean.
5. Food. In the severe stage of dementia, patient care involves complete control over food intake. A person’s senses of taste die out, he does not experience joy from eating. When feeding, swallowing must be controlled. If the patient begins to choke, it means that swallowing reflexes have been lost. Enteral feeding through a tube is necessary here.

Caring for senile dementia in a severe stage requires relatives to provide round-the-clock care and constant monitoring; this causes a lot of trouble and exhausts people both physically and mentally. Nursing care for a patient with dementia will make life easier for relatives and teach them how to properly care for a frail person.

Products for people with dementia

The World Health Organization has recognized that dementia care has a significant physical, social, psychological and economic impact on people caring for a loved one. Particularly large financial costs have to be borne at the terminal stage of the disease. To slow down the atrophic processes in the central nervous system and maintain cognitive functions, the patient needs medications and the services of medical workers, caregivers, and psychologists.

You can simplify care and at the same time provide comfort to a frail person by using special products designed for people with disabilities. Caring for people with dementia without sacrificing your own health is also important for continuing care at a decent level.

List of medical products for the care of persons with senile dementia

Overalls for dementia patients solve the problem of access to the body and hygiene products. The design of the product, reminiscent of rompers for infants, prevents the ability to remove the diaper, which many patients suffering from severe pathology of the nervous system do unknowingly.

The diagnosis of “senile dementia” is the basis for assigning disability group 1. The status of a disabled person guarantees receipt of social assistance from the state, which extends to preferential purchase of technical rehabilitation equipment and medical products.

Caring for a person with dementia is hard work, which, moreover, due to the specifics of the disease, will not be appreciated or accepted with gratitude. The disease mercilessly erases a familiar and beloved personality, endowing it with hostility, anger, willfulness, and ill will. Instead of words of gratitude, curses, insults and reproaches are often heard from the lips of a parent who has lost his mind. However, the understanding that the cause of the patient’s inappropriate behavior is an incurable disease gives strength and the desire to alleviate his difficult fate.

Inpatient care for patients with dementia

If it is not possible to provide care for dementia on a permanent basis, you can place the person in a public or private hospital. In case of dementia, diagnosis, treatment, patient care, and prevention will be carried out in accordance with the requirements of the Ministry of Health.

Daily procedures include:

• Skin hygiene, every 2 hours;
• Change of underwear;
• Prevention of bedsores, every 2 hours;
• Help with bowel movements;
• Changing diapers and genital hygiene every 4-5 hours;
• General massage, three times a day;
• Feeding 4-5 times a day.

In addition, medical workers will monitor the patient’s well-being, body temperature and blood pressure.

If vascular dementia is diagnosed, care should include daily prevention. It is necessary to monitor the level of cholesterol and homocysteine ​​in the blood and prevent the development of hypertension. An important factor is an active social life and constant intellectual activity. It is necessary to move more and be in the fresh air. This will ensure the delivery of oxygen and nutrients to the brain. It is important to give up bad habits and follow a proper diet.

Dementia: how to be there without going crazy

Emotional burnout, depression, even suicidal thoughts - all this is familiar to those people who are forced to care for their loved ones for many days, months and even years, suffering from dementia - senile dementia. Psychologist and priest Pyotr Kolomeytsev, in an open lecture given at the Russian Christian Humanitarian Academy, talks about how to help loved ones with dementia and how to help people caring for them.

Priest Peter Kolomeytsev is the dean of the Faculty of Psychology of the Russian Orthodox University, a clergyman of the Church of Cosmas and Damian in Shubin (Moscow), the author of books and articles on Christian psychology.

Priest Peter Kolomeytsev

From cynicism to hysteria

Today we will talk about the topic of helping and caring for people who bear the heavy burden of caring for people with dementia. Because, as a rule, the people who take care of their 80-90 year old parents are, in general, not very young people anymore - they are 55-60 years old. Strength is limited, health problems. In addition, you need to constantly sit with your grandchildren, since children value their work, and getting them sick leave to care for their children is not always easy. And to all this are added problems with one’s own mother or father, which cannot be solved so easily. Who is the father or mother? This is a man who has always commanded and taught, but here we need to teach him, we need to educate him, but he doesn’t listen. It seems so funny, a man comes to me with a complaint: my mother doesn’t listen to me. And then it’s no longer funny: not only does the mother not listen, but you just want to kill this mother, “I scolded her, I spanked her,” and so on. But there is a commandment: honor your father and mother, and a person feels like the last sinner.

I say: “You still come to church more often!” They answer: “Well, how can I come to church when I’m such a sinner.” It turns out that this resource is also blocked, I can’t turn to God, I’m the last creature, I’m yelling at my sick, unhappy mother and I understand with my mind, but I can’t do anything, I’m just pissed off, driven to white heat.

But this mother usually turns out to be physically stronger. She always tries to do something: rearrange things, move furniture, turn on the gas, start the laundry, turn on the water. I turned on the gas in the oven, got ready to cook, but didn’t turn it off. I ran a bath and didn’t turn off the water either. In general, life is like on a volcano. And in the end, we see the absolutely desperate situation of those people who must care for people with dementia. There are two states in such a situation: either stupor, which in our Church we usually call “petrified insensibility”: when a person simply switches off and does not react to the person he is caring for, or to his children or grandchildren. Falls into a state of complete indifference bordering on cynicism. Or he breaks down, yells at everyone for any reason and is on the verge of hysterics. All of these are common signs of what is called emotional burnout.

Let go of the situation

This problem is very multifaceted, multifactorial, and cannot be solved in one fell swoop. The problem is psychological, but often its solution is associated with a spiritual understanding of oneself, one’s place and one’s capabilities. I can say that there were cases when it was the priest who managed to say the right word that the psychologist was not always able to say.

At every liturgy we hear the following phrase: “we will give ourselves and each other, and our whole life to Christ our God.” There are situations that need to be let go. Letting go of a situation does not mean giving up on it; letting go means bravely entrusting it to God. It’s like receiving an urgent telegram from the Lord: “Dear servant of God so-and-so, today I can do without you, because you are not God, it is I who am God, so feel free to give me the situation, I can handle it.” Indeed, we are not gods, we cannot take responsibility for everything.

In addition, we, especially people of my generation and older, are accustomed to not asking, “not to humiliate ourselves.” As my grandmother said: we are poor people, but proud. Therefore, I will not ask anyone for any help, especially children, they have enough worries of their own, this is my cross, I alone or alone will carry this cross on my shoulders, and let others rest. To this the priests answer: you cannot close salvation to other people; fulfilling the commandments to honor your elders is a spiritual responsibility not only for you, but also for your children and grandchildren. If they now begin to help you fulfill this commandment, then nothing bad will happen to them. They will see an example of reverence and righteous attitude towards the elderly. In the end, when our elderly parents die, suddenly other feelings come: we begin to understand that we did not give attention and warmth. Only then do we realize what we could really give to this person and what we didn’t.

I want, I can and I need

What does any of our work consist of, what are the main feelings? “I can” and “I want.” The work goes perfectly when it is possible and desired. It’s bad when you want to, but you can’t. If a person does everything through force, physical fatigue appears. It’s also bad if a person can, but doesn’t want to. When he does everything through “I don’t want”, there is severe emotional fatigue, he has to overcome his negative emotions about this. Therefore, it is ideal when there is a balance. When our efforts coincide with both what we can and what we want.

But there are also the words “should” and “must”, which cannot be avoided. There are situations in life that you cannot transfer to tomorrow or the day after tomorrow, from which you cannot escape. These situations are usually called force majeure and, unfortunately, a lot of effort has to be spent on them. Moreover, you borrow these forces from what you have put aside for tomorrow, which means that you need to return them somehow, you definitely need to recover. We'll talk about this below.

How to deal with an “adult child”

We also need to understand that our view of a loved one is changing. And it's difficult. How can you respect a person who has become completely different? We must remember and remember how much he did when he was able. How, for example, she alone, having lost her husband at the front, raised two children, how she solved complex problems, how much she carried on her shoulders. This gives rise to a feeling of gratitude for everything she has done and given, an understanding that her health did not deteriorate in one day and hour, that it was not her character that deteriorated, that it was the illness that took away her strength.

It is necessary to show an abyss of tact, I would even say cunning, so that the desire to command quietly is translated into consent to obey, because it is difficult for a person who is used to taking everything upon himself to suddenly feel weak and obliged to obey a person younger than him, especially one who himself when - was entirely under his control.

I remember the wise words from the Gospel: “When you were young, you girded yourself and went where you wanted; But when you are old, you will stretch out your hands, and another will gird you and lead you where you do not want to go” (John 21:18). Why, in fact, does the saying “old people are twice children” exist? Because they become children for the second time, only to an even worse degree. The child grows, but here it’s as if on the contrary, development goes in the opposite direction.

There is no need to try to immediately change this habitual state of a person and say: now you must do this and that. Try offering it as some choice all the time. You can do this, you can do that, you can rest, you don’t have to worry about it anymore, you can let it go, you deserve your rest, you deserve that someone else is now taking care of you and solving your problems.

It is important to understand what happens to a person when he begins to lose memory, begins to lose control over himself, events, things - in order to understand where this anxiety and irritability comes from.

And of course, the most important thing, which is very difficult to cope with: the fact that character deteriorates. Why do they become so obnoxious, why do they start speaking in such a manipulative tone? “You forgot that you have a mother, and that you are also a Christian and go to church. I know you all want me to die as soon as possible.” In fact, a person is simply very uncomfortable talking about his needs and very uncomfortable asking. It’s easy for a child to say: “Mommy, sit with me, I’m scared.” And it’s difficult to say to mom: “Daughter, sit with me, I’m scared.” You need to understand that especially memory loss causes great anxiety and great irritation, forcing you to constantly check your loved ones to see that they are really there, really ready to help, really enduring, since the sick people have the most terrible suspicions.

The apartment is like a prison

Constantly being with a sick person leads to the fact that all our perception is focused, like a zoom in a camera: we zoom in on the frame, and there is nothing in it except this problem.

Let me give you an example. The son says to his mother: “I will come to visit.” “What kind of guests, I have neither the strength nor the food to receive anyone, don’t come.” She sits with her own mother 24 hours a day, she only has a short hour of rest: when her grandmother falls asleep at 10 am after breakfast, she can rush to the store, quickly buy something from groceries and come back. Or once every two weeks the niece comes to give her grandmother a bath and also lets her go for an hour. This situation contributes to the fact that a person is completely devastated both physically and emotionally. And then the son is with his guests, and she immediately begins to think that she needs to prepare something, she needs to receive her grandchildren, and so on. No, not this! I am busy!

Or he puts such a son in constant waiting mode: okay, of course, visit your grandmother, but only when she is feeling better. But in fact, the condition is only getting worse every day, she stops recognizing her loved ones, stops recognizing her daughter. And he says to his grandson: “Who is this? A strange woman is in charge of the house, she wants to kill me.” This causes a feeling of shame, one becomes ashamed of her. When a respectable, independent person - and suddenly such helplessness. I don’t want her to be seen in this state, I want our old people to be “presentable.” But they are not presentable, and their presentability is fading more and more every day. This creates a very oppressive atmosphere.

But when, in the end, the son arrives, it turns out that there is no need to prepare anything - they brought everything with them; and talked to my grandmother, and she even came to her senses for a moment. I recognized my grandson, recognized my great-granddaughter, met her, held her little hand.

Even the photographs of this moment show that it was important. Soon my grandmother, at the age of 92, left this world. And the photo shows that she had a joyful moment in the last year of her life. Here is this picture where she holds the small hand of her great-granddaughter with two fingers, and her grandson is standing next to her. Then, many years later, having come to her senses and rested, her daughter will say: “My God! I locked myself up, like in a monastery, I didn’t let anyone in, I protected us from everyone. And suddenly it turned out very well, it’s good that you came then,” she tells her son and grandson.

Where to find strength?

There are a number of very simple tips, and they are, in general, all quite well known.

We must try to encourage our caregivers who live next to their departing parents. We need to remind them of what flight attendants remind them every time on an airplane: in the event of depressurization of the cabin, you must first put the oxygen mask on yourself, and then on the child. This is a strict safety rule. Take care of yourself and you can take care of your sick person.

We always need to remember that we rehabilitate our relatives with ourselves, which means we must keep ourselves in good condition. What help can we give if we come irritable, angry, and despairing? We are only making an already difficult situation worse. When our elderly relative hears a calm voice, in which there is no irritation, he himself calms down. In this way we convey to him a piece of our peace.

I repeat once again: you always need to think about yourself, you need to attract your relatives, humble your pride, ask your relatives to help, in order to free yourself for rest. Such a conscious approach, planned recovery time - when you can just go for a walk in the park, talk with other people - is a very important thing. One woman said that she went out to the park and talked with children and their parents. Just to feel like there is another world other than the nightmare she lives in every day, every hour, every minute.

Also, undoubtedly, the strongest resource is prayer. We thank God for what we have, for simple things: for the fact that today seems to be better than yesterday; because we took the pills and ate without whims. We have so much good news. God bless! We ask the Lord for strength, at least to stand for one more day, to hold out.

We ask for others and immediately understand that besides us and our ward, there are other people for whom we also pray, that there is a world around us and others also have problems. Our zoom expands and enters more into the frame of our perception. When this happens, the problem even decreases in scale a little; we no longer perceive it so acutely. Purely physically, next to other problems, it has already begun to take up a little less space; we see that this is a private problem. We prayed, thanked the Lord, asked for others, asked for strength at least to accept what we cannot change.

This time of our communication with God turns out to be a very powerful resource. Although experience shows that this is precisely what the helping person sacrifices in the first place: he sacrifices prayer, he sacrifices his rest, he sacrifices his sleep and physical strength. And the result is burnout, emotional suicide, masochism.

A feat is just being there

Therefore, we must try to support the person. We shouldn’t think that we came here to do good to this person here and now. We came to be with him, we came to share his last years, months, days, hours with this man. And this is already a lot, we have not begun to love our loved one less, our love simply began to be expressed in something else. The fact that we are just nearby.

It is a feat to go and share your fate with a person who will never get better, who will never get better, who will not be able to fully appreciate and thank you for spending time with him, who will die sooner or later. This is a feat, because we understand the complexity of the situation and do not regret this time...

Questions from listeners

It happens that the old man can be placed in a boarding house. The family's feelings about this are, of course, indescribable, but maybe you have an understanding on the part of this person: does he realize that he was taken to a boarding house?

I can say that for such a person everything that happens is perceived as a change for the worse. A familiar, familiar evil is better than an unfamiliar good. We are faced with very serious inertia; people don’t want to change anything. Even if he feels bad, he is used to this bad thing, and this habit turns out to be very dear to him. Therefore, it happens that a person, being placed in some even very good hospital, begins to complain. And when they return him, he suddenly begins to compare and understand that it was better there.

I know the story of how an elderly woman was placed several times in institutions with very good care, but she escaped from everywhere using some unimaginable tricks. Gradually it became clear that she had organized this on purpose. The doctors were perplexed: “How, excuse me, it was you who took her!” “Nobody took her...” In the end, we came to the option of hiring a nurse with room and board. There are such nurses, they usually come from the countries of the former CIS and live here. They do not pay for accommodation, they are fed, and they send the received salary to their relatives. And it turned out that with such a nurse, but within her own walls, she was better off than in the hospital.

I think that this is not an isolated case, but reflects some general trend. They say that houses and walls help, this is apparently very important. When a person simply does not have his own corner, his favorite chair, his own bed; strangers, a strange room - it can be very difficult. And so the memory disappears, and everything around is unfamiliar. That's terrible. And at home, at least something familiar is nearby, helping to maintain some kind of connection between you and yourself.

What is the hardest thing for such old people?

This turns out to be superfluous, unnecessary. You know, my friends’ father lived with them. He behaved unimaginably, to the point that he began smearing feces on the walls. Let's think about what this demonstration might be for? I understand that this cannot be explained rationally, but based on some very childish logic? What exactly did the person want to achieve with this? I think that there is some kind of super task here to attract attention. Maybe he just needs to say every hour: let’s go to the toilet with you. It’s just that if you don’t pay attention to a person, showing that he is an empty place, it has a very strong effect, and therefore, according to some strange non-adult logic, a desire appears to attract attention to oneself. And then you have to say: “So, Michelangelo is ours, let’s go to the toilet.” Half an hour has passed: “Let’s go to the toilet again. Exactly? Sit and think. Okay, we'll go again in half an hour. Let's think about it, what else do you want? Or maybe you can do something useful? By the way, you are great at packing. Give me some unnecessary books and tie the newspapers up with a string. And we’ll take them to the dacha as waste paper.” And you look, the person has some kind of meaningful work. He suddenly found himself needed, in the center of attention.

You know, there was one absolutely amazing doctor. One patient of his walked around and said to everyone: “I am Christ.” They had already told him: “Enough, I’m pestering everyone: Christ, Christ. Here people are believers, they can clean your face for such words, for blasphemy. And there are people who are non-believers, they will generally laugh.” And the doctor says: “Christ? Jesus?" He: “Well, yes.” Doctor: "From Nazareth?" Patient: "Yes." “Son of Joseph the Carpenter?” "Yes". “It’s you that I need, I’m missing a carpenter. Listen, I need to saw it off here, nail it here. A couple of trifles!” And a man with a hammer and a saw is already repairing everything there. “Well done, this one here, from Nazareth. Look, I fixed the fence and something else.” This is an important point on how to respond.

There is one patient who is 90 years old, we are taking care of her. We dress her, fasten her tightly, and within 5-10 minutes she manages to take it all off. You literally don’t have time to leave, she’s undressed again. She is not deprived of attention; when she is not sleeping, we communicate with her. She, however, remembers little and doesn’t recognize anyone. What it is? What to do?

Unfortunately, this is not a problem of one person, but of many. Old people also undress; many simply refuse to put on clothes. There is, apparently, some kind of latent fear of something constraining. The fact that a person is somehow embarrassed, that they seem to be trying to present a person as someone else, to change his clothes. It's difficult to understand the logic here. Maybe we can ask: “Who are you now? And what do you want? Bathe? We went to the shower, but there was no hot water. Well, maybe you like to swim in the cold.” We just need to find out something about this. If nothing helps, a person doesn’t hear, then somehow you have to come to terms with it. Or gently try to somehow resolve this issue: “Let you be dressed, and we’ll give you something else.” This is the kind of bribery, like with a child. This is a really common phenomenon, a lot of old people behave this way. Sometimes we can find out the reason, sometimes we have to demand it. “Lie as you wish in the room, but you have to go out into the corridor dressed.”

My mother has been living with us for two years now; she cannot be left at home. But she gets ready to go home every day, tying up bales of things, pulling things out of closets, calling me on my mobile. We're all going crazy already. But at home I forgot to eat, it was impossible, and we simply couldn’t afford a 24-hour nurse. But even so, we can no longer go home with these fees every day. What to do?

Get used to. To the fact that she gets ready every day. So today they gather, and tomorrow they will gather, and the day after tomorrow they will gather. Get used to. But when he leaves this life, there will be no one to go home. And so he does something - he’s getting ready to go home.

There are some things you can’t change, you just have to be very humble about them. If you have a definite goal to change a person, but this doesn’t work out, then, of course, everyone gets upset, but this is a common thing for her, she’s busy with something. Well, yes, I pulled out my things again. Okay, let's put everything back. “Tomorrow you’ll pack up again, but today all the trains have already left, put everything back, tomorrow you’ll pack up again.” Of course, you have to limit it when it threatens some kind of danger: flooding, arson, harm to yourself and your neighbors. And when it’s a harmless activity like getting ready to go home, then let, let the person do it.

Prepared by Pavel Ershov