Dear Mary,

I have been my mother's primary caregiver for the last five years and before that for my father. In May I placed her in a small nursing home because she has Alzheimer's disease.

My mother is an animal lover and has two dogs that still live with me. I take them to visit her but she wants to come home to see them. I do not think it is a good idea for her to come home because she may not want to go back to the nursing home. She likes where she is but thinks it is a hospital. I feel badly because she does not understand and keeps asking to come home to her animals. What can I do to ease her anxiety?

Dear Reader,

Since your mother thinks she is in a hospital, play along. Tell her you know how much she misses her pets but she has to get better before she can come home. She will surely forget your answer and ask again the next time you visit or call - it is OK to repeat the same answer. 'Loving lies' are compassionate responses to difficult questions when truthful answers cause unnecessary pain. Continue to bring her dogs to visit as often as possible. Pet therapy is commonly used to boost spirits and get dementia folks reconnected to the environment.

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Dear Mary,

My father has some degree of dementia as well as diabetes and a neighbor comes in twice a day to give him his insulin injections. My mother has disabling effects from two strokes and dementia, too. They both are noncompliant with their diets and medicines and Mother does not believe she needs to wear incontinence pads. Dad, too, is incontinent and refuses to bathe. But Mother is the biggest problem because she resents the attention my father is getting and even resents me.

Although they have other children the majority of responsibilities fall on me and I have relocated to be closer. They have life insurance policies that cover burial and their only income is Social Security so there is no extra money to hire help. I have sought assistance from different resources for the elderly but no one wants to help. I am very tired and all this is taking a toll on my health. How do I handle my mother's resentment towards me and get some help for them?

Dear Reader,

It is hard not to take things personally, but you must accept that it is her illness that is causing her behavior. Talking with others is therapeutic so joining a support group will help. If you feel hopeless, I urge you to seek professional counseling. It is also time to get your siblings to step up to the plate to help either physically or financially.

I do not know what community resources you contacted, but there are services out there. For example, the Alzheimer's Association has funds available on a sliding scale fee to reimburse for respite care. I hate to sound like a broken record but the first call you need to make is to your local Area Agency on Aging and speak to an Information and Assistance Specialist. He or she will be able to guide you to the appropriate resources. Call the Eldercare Locator at 800-677-1116 to find the agency nearest you.

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Dear Mary,

My aunt is quite elderly and recently was sent to the hospital with a urinary tract infection. Now she has something called sepsis and is not expected to survive. My question is how can anyone have a urinary tract infection and not know it? You would think someone would have recognized it before it got so out of hand.

Some normal changes with aging occur that put older adults at risk for severe consequences of simple urinary tract infections. As we age, pain sensitivity diminishes limiting our ability to feel uncomfortable sensations that would alert us to infection. We also do not respond as readily by running a fever and our immune system is less effective in fighting it off. So sepsis, a system wide inflammatory response to infection, can occur.

Signs and symptoms of urinary tract infection to watch for in older adults include change in behavior, confusion, lethargy, strong odor and/or cloudy urine, more frequent urination, or incontinence.

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