Elder Rage
Jacqueline Marcell
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Get *Elder Rage* delivered to your door! Elder Rage
or, Take My Father... Please!

Jacqueline Marcell
addendum by Rodman Shankle, MS, MD
Impressive Press
April 2001
368 pages
rated 3 of 5 possible stars

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Elder Rage or, Take My Father... Please! is a narrative autobiographical account of author Jacqueline Marcell's life and family relationships. Subtitled How to Survive Caring for Aging Parents, the work, apparently based on detailed journal notes, describes chronologically Marcell's efforts to cope with spinal surgery, job loss in the entertainment industry and a broken relationship while trying to live with and care for aging, co-dependent parents with different live-in caregivers over three years.

Curled Up With a Good BookMother, age 82, is recovering from a heart attack, and Jake, the father, age 83, has been recovering from heart and coronary artery disease and displaying progressively more confused, paranoid, irrational thinking; domineering and controlling behavior; and threatening, sometimes dangerous, rages. At the beginning of the story Jake has managed to confine his rages to private moments at home with wife, daughter and caregiver without revealing publicly the scope, severity and disturbing aspects of the behavior. He has been able to snow others and maintain a facade of politeness and sociability with physicians (including psychiatrists), police officers, social workers, the wife's occupational therapist, neighbors, family and friends, but the pattern changes dramatically during the book's time frame.

As the story unfolds chapter-by-chapter, more physical, social, psychological and medical crises, questions and treatment/behavioral management problems for the parents, author and live-in caregivers surface. Has Jake's personality changed permanently? Is his behavior obsessive, manipulative, controlling and deceptive on purpose, or is it a natural consequence of some psychological disturbance and/or undiagnosed dementia of the brain? Is he psychotic? Will the household residents be harmed or experience fatal "accidents?" Throughout the book, Marcell describes and documents many glitches in the delivery, responsibility, coordination and jurisdiction of managed healthcare services. She details some worthwhile household products and helpful procedures for the reader to consider. She shows, for instance, how Velcro can be used to stabilize vision and improve coordination to support aging parents use of phones, clocks, microwaves and refrigerators. She decries the lack of caring resources and specific services for adult chronically-ill combative patients and heavily burdened caretakers in managed care.

The reader follows the author's painstaking search for parental care, understanding, support, accurate diagnoses and specifically focused treatments, health, hygiene, behavioral modification, protective services and socialization activities. Later, the author acknowledges she had more time and resources available to her than many family caregivers will have in coping with aged, ill and dependent parents, but many of the experiential examples are informative and applicable to similar family settings and social-psychological dynamics. At times humorous, but occasionally disconcerting, are Marcell's hip, somewhat breezy style and use of a wide variety of movie and TV soap characters, actors and scenes, as well as song titles and quotes, to describe intimate feelings, stressful dialogue, relationships, crises and, at times, heart-warming interactions. A number of such references may be unknown, unclear or their meaning obscured to the reader (e.g., Mary Richards, David and Maddie, Hillsborough, etc.).

Marcell concludes with a number of practical suggestions for caregivers in similar or future situations, including the need for long-term care insurance, durable power-of-attorney, adult protective services and adult day-care programs. She provides, courtesy of the Alzheimer's Association, ten warning signs of Alzheimer's; three stages of Alzheimer's disease; guidelines for behavioral modification with specific examples of how to use them; and the addendum, "A Physician's Guide to Treating Aggression in Dementia," by Dr. Rodman Shanklin, with a meaningful listing of valuable resources (e.g., web sites and phone numbers) and recommended reading. This book is highly recommended for anyone struggling to plan for, protect and care for elderly parents or otherwise aggressive family members burdened with some form of dementia.

© 2001 by David L. Johnson, Ph.D., for Curled Up With a Good Book

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