My Grandma S. had a stroke, which forced her to move from New York City to my family’s house, in Hawaii. She was diagnosed with Alzheimer’s disease, a neurodegenerative disorder where brain function decreases until autonomic functions (such as breathing, heart rate, digestion, etc.) no longer operate. Over seven years, my family and I stood witness to the decline of my grandmother’s capabilities and personality.

Grandma S. was confrontational, loud, and stubborn. As the disease progressed, she became very quiet and spoke softly. Other symptoms of Alzheimer's started to appear. She would shoplift, steal, and wander. If you’re struggling with these issues, child safety gates and doorknob covers can prevent wandering. To prevent shoplifting, you keep them from bring bringing bags into the store or have someone stay with them. Also, large stores like Costco can be a great place for them to exercise while you’re doing your shopping. Caregiving is embarrassing, frustrating, and occasionally hilarious.

During this time, my Grandma J. was diagnosed with Alzheimer’s disease and vascular dementia. She did not live with us but my mother and I assumed a lot of the caretaking responsibilities. My mom created a binder that listed her medications and appointments. In the binder, her daily medications were wedged in baseball card protection sheets. This is a handy tool to stay organized and doctors love it. Grandma J. was a fall risk, which pushed us to search for elderly daycare facilities for both grandmothers. To look for daycares, a simple Google search will give you a list of local facilities. You can schedule an appointment ahead of time to meet with the managers.

Cost, care, and activities were concerns for us. If your loved one is fall-risk, I recommend looking for a facility that has a lot of staffing and assisted walking. Different daycares have different dynamics. Some daycares we visited sat in a circle and others had activities scattered. If you want to encourage friendships, I propose a daycare that sits in small groups but does group activities. Art and exercise are positive outlets and encourage range of motion. I also advise you look into activities your family member enjoys, which is why Bingo was a huge selling point for us.

My grandmothers did not respond well during the daycare interviews, and perhaps it was a mistake to take them. Outbursts included whacking us with a cane and yelling about how we were abandoning them. We knew a daycare would provide them with the care they needed and we understood they could not fully comprehend their own needs. Hard love was necessary for their health.

The first weeks were hard and my grandmothers made sure we were aware of their hatred for the facility and their abandonment feelings. However, their passionate disdain transformed into a secretive fondness; then they asked us if they could go on the weekends.

Hostility grew within the home as Grandma S.’s abilities decreased. My mother made the decision to look for a nursing/care home for her. If you’re taking that step, ask a geriatric psychiatrist for a list of nursing/care homes. Ask physicians for advice and utilize them as a resource.

We interviewed facilities and looked into price ranges. My mom decided on a care home that was affordable and offered a single room and bathroom. The owner had decades of experience and provided diverse activities. She showed an authentic kindness and compassion I wish I could emulate. Grandma S. adjusted well to the environment; we never told her it was permanent.

Grandma S. recently passed from lymphoma cancer. The care home owner slept beside her during the final days so she wouldn’t be alone at night. After a fall, Grandma J. was admitted to the same care home. If you have trouble convincing your loved one to enter a care home, you can have the doctor help tell them. When they forget, remind them that the doctor mandated they move to a home. Both my grandmothers listened better to a doctor’s authority. To say Grandma J. is reluctant is an understatement. Guilt will readily haunt us, if allowed. However, her quality of life and health must always take priority.

Finances were a bigger problem for Grandma J. She didn’t have a pension or large social security income. Consult a financial adviser if you struggle with this. My parents decided to move into her house and rent their house to pay for her care.

I learned the importance of giving my grandmothers the best quality of life. This is a lesson I wish I had learned sooner because I regret being angry and resentful. A few times, my mom took the brave step to take my grandmothers to Vegas. I was confused why she would give them an experience they would never remember. My mom would respond, “Because they will enjoy it”. Although they would never remember it, they still deserved the joys and smiles life had to offer. I realized the anger was my own problem and I had to stop projecting it on them; I learned to blame the disease, not my grandmothers.

My advice to anyone undergoing similar circumstances is to prioritize quality of life for a loved one and themselves. The symptoms of dementia will test patience and emotions. However, keeping a clear perspective is healthy for the entire family dynamic.