David Coleman advises a woman on how to help her childen deal with husband's early Alzeihmers.
ALMOST six months ago my husband was diagnosed with Alzheimer's disease, aged 58.
We have three children aged 21, 18 and 13. I am worried that the 13-year-old is not being open about it with me.
We did sit down with the three of them to explain as much as we can but their worries are still there. Is there anything more we can do?
IT MAKES sense for your three children to be worried. I am sure that you are also very worried and upset at the prospect of your husband's cognitive deterioration over the next number of years.
As you have probably discovered, if you weren't already aware, Alzheimer's disease can lead to confusion, irritability, aggression, mood swings and long-term memory loss. As your husband declines, he will probably withdraw further and further from you and the children.
From what I know about Alzheimer's, the main burden of care will probably fall on your shoulders, possibly shared by your children somewhat. This is likely to put a great deal of pressure on you.
From the outset, you may want to look for some support for yourself and your family. The Alzheimer Society of Ireland has support groups and www.alzheimer.ie has all the information.
Even though you received confirmation of the diagnosis six months ago, I can imagine that each of you is still trying to get your heads around what it will actually be like to live with your husband as the disease progresses.
Your husband may be terrified about the further degeneration of his brain and the losses it will bring. He may also be very afraid of his impending death.
From your point of view, you may be anticipating the distress of watching him get less and less able cognitively and, in due course, physically too. As he gets worse it will probably have impacts on your social life, maybe your own mental health and probably your family's finances.
Your 13-year-old is probably in exactly the same position of thinking about how this will affect his or her dad, you and him or herself. They just may not really feel able to talk about it with anyone.
Maybe they just feel overwhelmed and can't speak about it at all, trying to block it all away. Maybe they fear they will distress you further if they bring up their fears or negative feelings about what this diagnosis means for them and the family.
You may decide to respect your child's silence and their possible internal struggle to cope with the news of the diagnosis. You may also, however, decide to continue to give them permission to talk about their feelings by raising the topic with them.
Many children and teenagers find it stressful to be asked about their feelings. They often don't know how to answer (because they aren't sure of their feelings), or they don't want to answer (because they are trying to keep the feelings hidden), or they are reluctant to answer (because they are afraid of what you might think about their feelings).
Yet when we can create a space, without asking lots of questions, they can often find it easier to open up. So talking is not just about asking your son or daughter about their feelings.
Creating that space with your 13-year-old is about finding a time that may suit, when neither you nor he or she are under pressure or are rushing anywhere. It may also help to start a conversation in a place where he or she feels secure or comfortable, like their bedroom, or a family den, or the kitchen table.
Then if the place and time feel right, you might choose to start sharing your own feelings about what the diagnosis means for you.
You can also make empathetic statements about the feelings you can guess he or she might have.
This will help your youngest to know that you do understand that she or he is probably feeling distressed and that you are welcoming of any opportunity to listen to that distress if they choose to share it.
The more you offer this kind of emotional support and understanding, the more your son or daughter is likely to take it on board and perhaps share back with you about how they really do feel.
It may just take some time for your son or daughter to make sense of their own feelings before they feel ready to let you in on them.
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