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Published February 25, 2012, 11:30 PM

Bursack: Dad with Alzheimer’s obsessed with wallet and paying bills

Dear Carol: My dad has Alzheimer’s and lives in a very good nursing home. What I’m wondering about is his habit of repeatedly taking his wallet out of his pocket and emptying out the contents. He then carefully puts everything back. He also tries to pay the nursing home staff when they help him. Telling him everything is paid for simply doesn’t work. Any insight? – Julie

By: Carol Bradley Bursack, INFORUM

Dear Carol: My dad has Alzheimer’s and lives in a very good nursing home.

We visit often.

What I’m wondering about is his habit of repeatedly taking his wallet out of his pocket and emptying out the contents. He then carefully puts everything back. He also tries to pay the nursing home staff when they help him. Telling him everything is paid for simply doesn’t work. Any insight? – Julie

Dear Julie: I can say with confidence and sympathy that I know what you are going through, and so do many others. The situation isn’t uncommon, particularly with men.

After my dad’s brain surgery – meant to correct some effects from a WWII brain injury – left him with severe dementia, Dad became obsessed about his wallet and with paying for everything.

Like many men, Dad’s wallet seemed to signal to him that he was still a provider. The other issue associated with his wallet may have been that his proof of identity is carried there. His driver’s license (lapsed), his credit cards, clubs he belonged to – all of these cards would have his name on them. That could have been reassuring to him.

I believe that is what your dad is doing – looking to reassure his identity. Understanding what your dad’s billfold means to him can help you better understand his behavior.

Dad, too, couldn’t understand that he was already paying for everything at the nursing home. Generally, when a staff member helped him with something, he insisted on paying them on the spot. He did the same at meals. He’d get so upset when we’d tell him everything was paid for that I wondered, sometimes, if he felt that he was taking charity. Even telling him that they put everything on a “tab” to be paid at the end of the month didn’t alleviate his anxiety.

We tried leaving a few dollar bills in his wallet so he felt as if he had cash, but the low denomination of the bills made him feel “broke,” so that backfired. Next, I dug around until I found some expired credit cards with his name on them, and closed the accounts, but he didn’t use them.

My most successful solution was to make him “business cards.” When someone helped Dad, or he ate a meal, he offered his business card as payment. That way he felt responsible, and also had an ID, so I think it helped both wallet issues. The staff members were most gracious about accepting the cards. They even recycled them in an envelope hung in the kitchenette.

You’ll have to experiment and see if any of these suggestions work for your dad.

Try to remember that this too will pass.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.

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