Dearest:  Jacqueline Marcell, is a former college professor and television executive 
who, after the experience of caring for her elderly parents, became an author, 
publisher, radio host, national speaker, and advocate for eldercare awareness and 
reform. 

She is the devoted daughter in her bestselling book, "Elder Rage, or Take My Father... 
Please! How to Survive Caring For Aging Parents." Elder Rage is a Book-of-the-Month 
Club selection, is being considered for a feature film and has received 45+ 
prestigious endorsements. The National Adult Day Services Association honored 
Jacqueline with their Media Award for her tireless efforts to bring attention to
the value of Adult Day Care. 

Numerous publications have featured Jacqueline, including Prevention, Woman's Day and 
AARP's Bulletin. The National Association of Women Business Owners will present 
Jacqueline with their "Advocate of the Year" award at their Remarkable Women Awards 
in October. Jacqueline also hosts the radio program "Coping with Caregiving," 

Welcome to Power Surge, Jacqueline. 


Jacqueline Marcell:  THANKS! 


Dearest:  I'm fascinated by the title of your book, "Elder Rage, or Take My Father... 
Please!" Does the "rage" come from the 'rage' your father experienced and spewed 
forth, the rage you felt as the caregiver, or both?


Jacqueline Marcell:  BOTH! 


Dearest:  You want to elaborate? 


Jacqueline Marcell:  He always had a bad temper, got worse as he aged, and he was 
furious with me for trying to help and then he got dementia on top of it.


Dearest:  It's ironic, the way you describe your father's rage and your mother being 
kind and quiet, I have the same situation. 


Jacqueline Marcell:  I thought I was the only one who could have such a situation, 
but I have received thousands of emails from people saying we must be related
because the had the exact same thing.


Dearest:  Do you think ill-tempered, self-centered people often get worse when they 
get old? 


Jacqueline Marcell:  It is called the "More-so" theory of aging.  Whoever you were
as a young person, you are going to be MORE SO that way when you get older!


Dearest:  In the past 1 1/2 years, my once opinionated, outspoken, interior designer, 
91 year old mother has developed difficulty forming sentences - communicating. She 
understands everything she hears, keeps herself busy reading and designing beaded 
jewelry. My brother and I won't consider putting her on medication for what we see as 
"the way she's aging." Under what circumstances would one give a 91 year old person 
medication for what is obviously dementia? 


Jacqueline Marcell:  You must learn the 10 warning signs of dementia available on my 
website www.ElderRage.com and see if she fits any of them.  People assume these odd 
behaviors are a normal part of aging, and they are not. That is what I thought, just 
how it goes when they get old. 50% of people by the age of 85 will have some form of 
dementia and Alzheimer's is just one type.  What you want is to get a GERIATRIC 
dementia specialist to evaluate her because there are some medications that can slow 
the dementia down and help them for an extra 2-4 years. Aricept, Exelon, Reminyl, 
Memantine and if you ignore the warning signs, they progress to STAGE TWO, which is 
much much worse to manage.  Early diagnosis is the key. 


Dearest:  These are used for both dementia and Alzheimer's? 


Jacqueline Marcell:  Dementia is an umbrella term.  Alzheimer's is just one of many 
types of dementia.


Dearest:  As was the case with your father, when you find yourself in a caregiving 
situation for someone who's difficult, how do you know when you're in trouble? In 
other words, what is the fine line between kindness, understanding and utter 
frustration and anger?


Jacqueline Marcell:  I say that when they do something that seems illogical or 
irrational... IT IS!  Don't second guess yourself because they are back to acting 
normal. Dementia comes and goes in the beginning, and it is so subtle, everyone 
ignores it until it has progressed to where the person needs full time care.  My 
mission is to wake everyone up the first time their eyebrows go up and they say
"What the heck was THAT?" that just happened and to get to the right doctor.  
Most GP's are not trained in dementia. I was sent home, being told it was a normal
part of aging.  Now I lecture to DOCTORS and teach them what they should know
about dementia.


Dearest:  That's what my mother's internist said. It's hardening of the arteries.
Is there a resource we can use to find a dementia specialist? 


Jacqueline Marcell:  The first stage lasts 2-4 years, the second stage lasts 2-10 
years and needs full time care.  The third stage is 1-3 years, the end, nursing home 
time. If you get the medications into them at the first signs of it, you can delay it 
but you can't go backward. The professionals don't get the calls until there is a 
crisis and then the families are so upset to find out they should have acted sooner. 

The first time your mom asks you the same question OVER AND OVER, and you say, 
"MOM, you just asked me that!!"  Don't get mad, call the Alzheimer's Association 
800-272-3900 and get a referral to a dementia specialist, so she can be evaluated ASAP.  

It is a complex diagnosis: memory test, blood test, neurological test, and there are 
some REVERSIBLE dementias like a B-12 deficiency!!  People have been diagnosed with 
dementia and all they needed was a daily B-12 shot!!  There are many things that can 
cause dementia-like symptoms: a folate or thyroid deficiency even depression can 
mimic it.  So again, the right doctor is the key. 


Peggy3:  What are other examples of dementia besides Alzheimer's? 


Jacqueline Marcell:  Lewy Body, Frontal Lobe, Vascular, lots and lots of them.  One 
out of every 10 persons by the age of 65 will get some form of dementia.

Elder abuse is reaching epidemic proportions because people are so frustrated with 
how to manage elderly loved ones. I am on a mission to educate people because with 
understanding the disease process AND the use of ADULT DAY CARE elder abuse can be 
reduced. 

I LOVED my father and I swear, I could have killed him.  He attacked me 4 times and I 
had him taken to the psychiatric hospital for violence yet they released him every 
time because they couldn't find ANYTHING wrong with him!! I had the head of a 
psychiatric hospital tell me he was "normal for a man his age" 83.  Demented does not 
mean Stupid!  And he was socially adjusted not to show his "Hyde" side outside the 
family. So it wasn't ALL dementia, he was furious, but the dementia made his ability 
to use logic and reason distorted INTERMITTENTLY. Not all the time.  So he'd be 
normal one day and then really nutty the next. I cried everyday for a year, begging 
for help in San Francisco and NO ONE had the answers of how to manage such a 
challenging elder.  Once I solved it, medically, behaviorally, socially, I said, "I 
HAVE to write a book!"  I had lived an incredible story and needed to purge it.  It 
is now being looked at for a feature film.


Dearest:  Agree. I think the enormous baby boomer generation is having a major rude 
awakening! Our parents are living much longer than generations before them. Abusive 
isn't "normal" under any circumstances! My father is the same - street angel, house 
devil! You still sound angry with your father. I can relate. 


Jacqueline Marcell:  What I would do now is to realize that we trained my father with 
his bad behaviors.  We were responsible for letting him get away with screaming and 
yelling his whole life, though never at me before and I would know how to let his 
nastiness roll off of me.  I would know the RIGHT doctors,  the right combination of 
medications, the right behavioral techniques and Adult Day Care. I learned after a 
year how to do it.  With the knowledge I have now, it wouldn't even take me a month 
to get it all moving in the right direction.  The technique of distraction works when 
they are in the "broken record" mode and also validation of their frustrated 
feelings. 


Beth:  Your situation sounds incredibly difficult. What approach would you take
with an elderly parent who denies a problem and who seems to have memory and logic 
problems plus effects from dealing with a controlling schizophrenic relative in the 
home? The phrase "normal for a person my age" is used too.


Jacqueline Marcell:  Memory and logic problems are dementia.  They don't think they 
have anything wrong with them. Have their trusted doctor give you a referral to the 
dementia specialist. Tell your parent there is a 6 month waiting list.  Take them to 
lunch, casually drive by the doctor's (have the appointment already set up.  Say, "Oh 
Let's go put your name on the waiting list--while we are right here."  Then... "OH MY 
GOSH... the doctor has a cancellation and can see you right now! what luck!  Don't 
tell them they have a problem, know what has to be done and do it.  Short term memory 
cannot be ignored-that is it! 


Dearest:  It's terribly draining on the caregiver. What are your thoughts on respite 
care? 


Jacqueline Marcell:  The biggest thing I would do if I had to do it again would be to 
schedule a different friend to call me everyday.  They don't get it.  They have no 
idea what you are going through.  You have to ask them to help you.  RESPITE is a 
must and it is common to think you can do it alone. Hardest thing I ever did and I 
had NO help.  There are online support groups now, physical support groups, so much 
help is out there. 


Dearest:  I'm going to say something I wouldn't ordinarily in a chat of this nature. 
 But... My father is intolerable. He pushes everyone's buttons. Always wants to fuss 
and crab. My mother is as sweet as can be, keeps herself busy and is a pleasure to be 
with.  My brother has become the primary caregiver because, in all honesty, I simply 
could not do it. Is that selfish? I've been there for all these years for them.  My 
brother just came back from England and is living with them. I'd go starkraving mad 
if I had to be there 24 hours a day.


Jacqueline Marcell:  Ask your brother what you can do to help. Perhaps you can clean 
out the garage, pantry, closet, or take the car in for service, or do yardwork. 


Dearest:  Oh, I help all the time.


Jacqueline Marcell:  Just offer with the tasks that you can do without jumping off a 
bridge and give your brother a LOT of THANKS and money is always good too. Get
him a caregiver to care for them so he gets to go to a movie, and take HIM out
of there once in a while.  Just telling him you understand and how grateful you
are is big. 


Dearest:  I do, but if I had to live with my father, I'd have strangled him by now. 
He's simply impossible, always was and worse the older he gets (93 now). I want to 
bring someone else into the picture. I have someone ready, but my brother isn't happy 
with that idea.


Jacqueline Marcell:  It is a 63% higher death rate than people your own age when you 
are a primary caregiver. Be very aware of the stress he is under.


Dearest:  Oh, I'm very well aware. He thinks he has things under control, but I'm 
worried more about my brother than I am about my parents. 


Jacqueline Marcell:  Yes, I know. Common to think they can handle it. 


Dearest:  And, like you, I was always the devoted daughter with two brothers living 
away. Anyway, let's go on with the queue. Thanks so much for your input.  The day I 
realized I could drop dead from the stress my father gave me was the day I had to 
learn to become a little selfish. 


Jacqueline Marcell:  Good for you. Setting boundaries is so important.


SturdyWoman:  How will someone know if they need outside help? The parents' 
behavior or the caregivers frustration level?


Jacqueline Marcell:  Most people get so far into it before they reach out, thinking 
they should be able to do it and it is a family thing, and so hard to find 
caregivers.  I went through 40!!! caregivers.  My father would spit and spew and 
throw them out of the house!   No one would stay and put up with him.  But I TURNED 
IT ALL AROUND!  

My book is a success story and it was amazing that I got my 85 year old father to 
behave even with the onset of dementia.  Once I got the right diagnosis, medications, 
doctors, then I started behavior modification.  We rewarded his good behavior, just 
like a kid and we walked away when he was being deplorable. He eventually learned 
that screaming and yelling wouldn't work, not overnight, not 100%, but we came miles 
from where we were.  We should have walked away from him for 50 years, instead we 
trained him he could get away with being nasty and we walked on egg shells trying not 
to upset him.  Extra dessert worked great too to get him into the shower as he is 
yelling at us he just took one a WEEK AGO! 


Dearest:  Didn't you say both your parents were misdiagnosed with early stage 
Alzheimer's?


Jacqueline Marcell:  Yes, Mom was a cupcake, so easy, and had AD too.  I kept them 
together with 24 hour care in their home for 5 years and in Adult Day Care--which 
SAVED ALL OUR LIVES! Without the Day Care--I couldn't have survived.


Dearest:  Do you have any siblings? 


Jacqueline Marcell:  I have a 9 year older brother who lives a half hour away who 
wouldn't lift a finger. BUT I'm not BITTER ABOUT IT!! Actually, you have to let it 
go.  Can't make anyone care or do anything they don't want to do and my father was so 
horrible to him growing up, much different upbringing than I got, that he just wasn't 
going to help.  So, I have made peace, and we have a great relationship.


Dearest:  Amazing.  I know all about it. I also have an "oldest" brother who distanced 
himself conveniently. 


SturdyWoman:  How will you know when you need outside help for your parents? 


Jacqueline Marcell:  When you find yourself going batty, but hopefully you will act way 
before and start getting things in place.  If you have healthy loved ones, look into 
LONG TERM CARE insurance before the diagnosis of any dementia.  After that you can't
get it.  It would cover the cost of caregivers in the home. Everyone thinks their
health insurance will cover it. NOPE! 


Dearest:  What if no doctor has diagnosed dementia yet? 


Jacqueline Marcell:  Get estimates from John Hancock, GE Capital, MetLife.  It is maybe 
$2,000 a year but if you need full time caregivers in the home, you are looking at 
$3,000 a MONTH minimum usually. 


Athena:  What an awful experience you had. I work with elderly people, although not as a 
social worker. Sometimes their children call and tell me their parents have a "mild" 
form of Alzheimer's after several years. Is that possible? Isn't it always progressive? 
My father in law had Alzheimer's and was in a vegetative state towards the end. It's 
strange how he was never interested in who is who with family and friends, although not 
unsociable because he wasn't that interested, so everyone took his forgetfulness as 
normal. 


Jacqueline Marcell:  It is progressive and you must get them diagnosed and on medication 
to slow it down.  Loss of initiative is a warning sign. 


Dearest:  Should you decide to bring in an outsider to help, how do you choose good 
help? What questions do you ask and what credentials do you look for? 


Jacqueline Marcell:  Hire from an agency that is bonded.  Make sure they do background 
checks,  get that in writing as to what checks they are doing,  State and National, back 
10 years and for all types of crimes.  You want to talk to the last five families the 
caregiver has worked for--that's the best.  Then go see them in their own home and 
expect that level of cleanliness and organization in your parents' home.  I have an 
extensive list of questions in my book about how to hire a caregiver.  I did it all 
wrong, but I LEARNED the hard way! 


Marlo:  Hi! I lost my parents two years ago of natural causes and very old age.  I was 
very sick over it.  Now my mother-in-law is sick. She can't walk.  She eats and sleeps 
till one in the afternoon. We have two women that take care of her. She has dementia. 
She goes back in time. She always asks for her mother. My question to you is: When they 
say these things should you go along with them or change the subject, so they won't get 
confused? We always go along with her.


Jacqueline Marcell:  Validate the FEELINGS behind what they are saying.  Say, "Tell me 
about your mom."  Don't argue or thwart, just be there.  Give physical affection.  Long 
term memory is still in place.  Let her talk about the past.  Record these stories, 
because even though you have heard them a thousand times, when she is gone you will want 
to hear them again. 


Dearest:  I think the most important thing is not to pressure them to remember things, 
to understand everything you're talking about. Forcing things from someone with memory 
problems can be problematic and cause them great stress, yes? 



Jacqueline Marcell:  Talk slowly, simple directions are best.  Doesn't matter if the 
facts are wrong.  Many professionals believe that when people with dementia say things 
that are "off" their minds may be trying to work through unresolved issues of a 
lifetime. 


Marlo:  Thanks Jacqueline. That's what we do. We just go along with whatever she says.  
Sometimes she screams out loud.


Jacqueline Marcell:  Yes, the screaming can be helped with medication.  Ask the 
GERIATRIC DEMENTIA SPECIALIST to evaluate her meds.  MOST people who have AD,
are greatly helped with an anti-depressant, along with the AD meds. 


Dearest:  Jacqueline, I've always been very close to my mother. Since she can't 
communicate as well as she once did - I've learned to slow down. She understands 
everything I say, but is it strange if I say that in a sense I feel I've lost part
of my mother? 


Jacqueline Marcell:  SO NORMAL! HUG!! Focus on the life that is left. 


Dearest:  I sometimes think it's a preparation, of sorts, for the ultimate end. Does 
that sound crazy? 


Jacqueline Marcell:  You are required to make sure she is safe, but you are not required 
to let caregiving destroy your life, nor would she want that for you.  When you can get 
to a place of acceptance, and focusing on the life that is still there, not the decline 
you can enjoy her. Refuse to think about the decline. 

You know, my parents would drive from San Francisco to LA to see me and the whole time 
I'd be focusing on how much they had aged.  Do you know what I would give NOW for them 
to be able to DRIVE 400 miles to see me?  It is human nature to think of what has been 
lost.  But we all will pass, and it they are older than 74 for a man and 80 for a woman 
they have beaten the odds.  Make them safe and make sure they have the right doctors and 
meds and that they have something to do all day, not sitting in front of a TV and plan 
for good KARMA.  You'll be old someday too. 


Dearest:  I buy her beads and more beads. I found something that could keep her busy. 
She's always beading and I know how much it's helped. That's all I wanted to do was to 
find something so she could focus on something else - although she's not a self-absorbed 
woman. She's already filled 5 cookie tins with necklaces she's made... Just sometimes, I 
wish I had her back :( 


Jacqueline Marcell:  I know. SUPPORT GROUP would help you big time.  Also, please try 
Adult Day Care on her.  She'll hate it at first, will take a few weeks to make it her 
routine, but then she'll love all the varied activities and friends and the stress on 
you will be DRAMATICALLY reduced. 


Dearest:  Do you still have your parents? 


Jacqueline Marcell:  I lost both and I am so grateful they are out of the horrors of AD 
but I am so sad I didn't know then what I know now and that I could have helped them a 
year sooner.  Had just ONE professional I turned to begging for help simply shown me the 
Ten WARNING SIGNS OF AD, I would have understood what was happening.  Again, they are
on the front page of my website, www.ElderRage.com and you should spread them to 
everyone you know.


Dearest:  What is AD? Adult onset dementia? 


Jacqueline Marcell:  Alzheimer's Disease.


Dearest:  At 40, the busy woman is on top of the world. By 45, she's in the throes of 
premenopause. By 50, she's likely to be postmenopausal, and the feeling of freedom from 
suffering returns. But, by then, she's likely to find herself in the position of having 
to be a caregiver for elderly parents. It's a tremendous responsibility. Maybe the next 
book should be called, "Midlife Rage!" Your comments?


Jacqueline Marcell:  Yes, a whole series of Rage. My printer just went out of business 
so I'm thinking "Writer's Rage" may be next!   Actually, I don't think I will write more 
books.  I wrote Elder Rage to affect CHANGE to our eldercare system. It is a mess, and I 
have testified about the need for funding of Adult Day Cares but so much more has to be 
done. 


Dearest:  Thanks. What sort of nutritional recommendations do make to treat patients 
with dementia/Alzheimer's?


Jacqueline Marcell:  Vitamin E, 400 I.U. AM & PM, with 500 mg Vit C each time--but ASK 
YOUR DOCTOR, I AM NOT A DOCTOR.  I lecture around the country and ask every dementia 
specialist I meet and they all take it and use it on their patients for prevention and 
even after diagnosed.  BUT it can thin the blood so make sure you do not self medicate 
with Vit E.  The doctor has to know how much you are taking.


Dearest:  What about the fairly recent study that suggests that people who use statin 
medications, such as cholesterol-lowering drugs (Lipitor), widely used to prevent heart 
disease and stroke, may be 70% less likely to get Alzheimer's disease and other 
dementias. 


Jacqueline Marcell:  More studies are being done.  The problem is that all medications 
have side effects.  So again, the right doctor would have to make the determination with 
the other meds a person is taking.  The research is looking good but remember they told 
us HRT was good for us too!  Now we know it DOUBLES your chances of AD as well as heart 
disease and stroke! 


Dearest:  When one is at one's wits end not knowing where to turn for help in caring for 
someone with dementia or Alzheimer's, what do you recommend they do (besides reading 
your book)? 


Jacqueline Marcell:  Call the Alzheimer's Association for a support group.  Now I know 
what you are thinking: "I don't want to go listen to other peoples' problems!"  
Solutions will present themselves.  Don't reinvent the wheel.  There are almost 5 
million people with AD.  All that you are doing through has been gone through by others. 
Forget your friends who aren't there yet--they don't want to deal with it. Being around 
others who are--creative solutions will occur.



Dearest:  Jacqueline, thank you for an informative and stimulating discussion about how 
to best handle caregiving for the elderly and dementia. I recommend Jacqueline 
Marcelle's book, "Elder Rage, or Take My Father, Please!" You can visit Jacqueline's Web 
site at www.ElderRage.com and hear excerpts from her radio show, "Coping With 
Caregiving" at www.wsradio.com/copingwithcaregiving. 



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Dearest
aka Alice Stamm
Power Surge
Founder, Facilitator, Host


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