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Does Dad Suffer from Dementia?

15 December, 2016
Q For the past 6 years my father has been suffering from some kind of mental illness. He is now 80 years old and physically reasonably healthy for his age. His problem is that he seems to completely believe that he can’t do anything and that he is on the way out. He will do nothing for himself and needs to be strongly encouraged to the point of pushing to do anything. By anything I mean eating, drinking, getting up, washing, going to the toilet, standing-up Etc. He will physically try to resist, shouts at the top of his voice “I can’t, I can’t”, makes all sort of totally illogical excuses etc. He won’t feed himself but although he shouts and says it’s killing him, he will open his mouth and take the food. He cannot make any decisions, doesn’t want to engage in conversation or talk to people. However with patience and when he is not being pushed to do anything he will answer questions, he will get involved in doing the crossword and will show some interest in the newspaper and TV. At these times it is clear that he has no loss of memory (over any time period) and is fully aware of what is going on. He is as good as anyone at the crossword and will make sensible comments about sport, current affairs etc. Even though he won’t get up himself to go to the toilet, occasionally during the night he will. Any explanation, suggestions would be most welcome. What shall we do with him?

Answer

Answer:

As-Salamu ‘Alaikum,

It can, indeed, be very distressing when a family member reaches this stage, when it seems like the person is being defiant, as your father is being now, especially given that he is able to do these tasks but just refuses to do so in the belief that he can’t. If his memory is still intact, as you suggest, and he is actually able to complete these tasks, it is highly unlikely that he is suffering from dementia although it is certainly something to keep an eye out for as he is in a higher risk category now at his age.

As his child with the most frequent contact with him, you will be the best source of information for the doctors should this genuinely turn out to be dementia. If you are concerned that this might be the case, do not hesitate to take him to the doctor and get him professionally checked out. The doctors will rely on your firsthand account to progress with seeking any kind of diagnosis of dementia. It might be worthwhile beginning with seeking medical advice on this to rule this out as a diagnosis before seeking other methods of dealing with his behavior. If it is dementia that he is suffering from, then he will need your support in ensuring that his needs are taken care of such as washing, dressing and eating, etc.

The symptoms that you speak of may simply be due to the psychological impact of accepting old age and almost giving into the fact that certain aspects of functioning do unfortunately deteriorate as we are told in the Qur’an,

“If We grant long life to any, We cause him to be reversed in nature: will they not then understand?” (36: 68)

He may, therefore, just be resigning to this acceptance that he has reached old age and succumbing to it ahead of time even though he is still capable and has become lazy in taking care of himself. This is something that commonly occurs in the elderly and is why the Prophet Muhammad (saw) used to recommend the following du’aa’:

“0 Allah! I seek refuge with You from cowardice, and seek refuge with You from miserliness, and seek refuge with You from reaching a degraded geriatric old age, and seek refuge with You from the afflictions of the world and from the punishment in the grave.” (Al-Bukhari)

A sense of depression and is very common in older age. Depression in old age can be due to a number of things such as fearing that death will soon come, fearing losing your capacity to do the things you once could, sadness from losing others around them. Symptoms of which include the lack of motivation to engage in self-care and certainly with the mindset that he “can’t” do these things, he will begin to believe such thoughts and will behave accordingly to support these beliefs in the belief that he really can’t do them.

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Certainly, he will require support of some sort, whether it be physical, emotional, or both, as he passes through his old age. As his child, you are obliged to do so as he once did for you. Ma sha’ Allah, the very fact that you are reaching out for assistance with managing his behavior is a good sign that you care for him and, as much as it is difficult to live with, are looking out for his best interests.

“And your Lord has decreed that you not worship except Him, and to parents, good treatment. Whether one or both of them reach old age [while] with you, say not to them [so much as], “uff,” and do not repel them but speak to them a noble word. And lower to them the wing of humility out of mercy and say, “My Lord, have mercy upon them as they brought me up [when I was] small.” (Quran, 17:23-24)

With the kind of resistant behavior he has been exhibiting, you might find this very difficult, but it’s important that the kind of support you provide him is most conducive to his well-being. It might be that due to his “can’t do it” attitude, every time you do a task for him, you only reinforce his belief that he can’t. If you are to encourage his independence in these self-care tasks, then, at times, you will need to just leave him to do them himself even if he resists and says he can’t. Eventually, he will get hungry or will have to go to the toilet and will do so himself without your assistance. Except if it begins to get to a stage of concern that he just does not eat or soils himself. Then there is a bigger problem at play. However, be aware that if he genuinely cannot do these tasks, then you will need to assist him with them.

It may be that he is doing it to get your attention, in which case try giving him the attention he desires, but in a different way. Give him attention for the good things he does and praise him when he does these things for himself so that he may feel more inclined to behave in this more independent way again. Give him positive attention for other things that are not related to the tasks that he refuses to do. Let him feel generally good about himself that he doesn’t feel the need to seek your attention in the way he is right now. You might join him in starting a new hobby such as gardening, or growing vegetables, for example. Anything he enjoys and is not too hard on him. This way, he is getting one-to-one care from you as well as a sense of accomplishment that reinforces the belief that he is actually able to do something useful with himself – something that can contribute to well-being in older people. This will serve to challenge this belief he has that he can’t do the things he says he can’t as he comes to realize that actually he can.

May Allah (swt) reward your concern for your father and make it easy for you to support him through this difficult time.

Salam,

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About Hannah Morris
Hannah Morris is a mum of 4 and she currently works as Counsellor and Instructor of BSc. Psychology at the Islamic Online University (IOU). She obtained her MA degree in Psychology and has over 10 years of experience working in health and social care settings in the UK, USA, and Ireland. Check out her personal Facebook page, ActiveMindCare, that promotes psychological well-being in the Ummah. (www.facebook.com/activemindcare)