My mom began stuttering and became increasingly forgetful, so we took her to see her family doctor, who ran many tests. At first, we were told that she had "small blood vessel disease," but as she rapidly became worse, the doctor changed the diagnosis to Alzheimer’s disease (AD). From what I'm reading, her case doesn’t fit the norm. She is angry most of the time, flies into fits of rage, lies, throws things, and insults people in public places. She has trouble remembering things, but appears to have no memory of her past at all. I have known other people with this disease who frequently talk about the past, but my mom is unable to do this. It’s been hard on my dad, who is her caregiver. She knows him, but often says she only pretended to marry him. She hardly sleeps and refuses to go to the doctor. Are these symptoms related to AD or are there other factors that could cause these cognitive and behavioral changes? [ 04/26/11 ]
Most of the symptoms you mention do occur in Alzheimer's disease (AD). However, it is certainly possible that there could be another disease or condition, in addition to AD, causing your mother's behaviors. It is not uncommon, for example, for patients to have overlapping symptoms resulting from one or more different neurodegenerative conditions, often blurring the lines of diagnosis. You mentioned that you suspected that your mother's behaviors go back a long time, since you were a child even. It is therefore possible that your mother could, in addition to AD, have another pre-existing condition that continues to influence her behavior. Chronic severe depression or manic-depression (also called bipolar disorder) can each cause paranoia, irritability and mood swings, insomnia, and even memory lapses among other things. Your mother may have knowingly or unknowingly had one of these conditions before developing dementia.
Unfortunately, because the common repertoire of symptoms that accompany a diagnosis of AD include many of the behaviors you list (tantrums, aggression, memory impairments, speech impairments, mood swings, etc.), without a thorough examination by a doctor who specializes in dementia, it is difficult to say if another related condition or disease is causing these symptoms. Your mother's doctor should be able provide you with more information about the different aspects of AD. Out of concern, you may also consider discussing your mother's behaviors with her doctor—perhaps some of these are symptoms which the doctor is unaware of and should be informed of.
My husband has been incontinent for a couple years, and wears a pull up diaper. Hygiene is a huge problem because he forgets to change his diaper and take a shower. When I remind him about this he gets angry no matter what my tone of voice. I’m concerned about infection. He is also under treatment for bladder cancer and has to have a cystoscopy every 3 months. He does get bladder infections occasionally and I believe it is from not keeping himself clean. I’m willing to help him without making it a big deal, but he won't let me. Do you have any creative suggestions on how I can approach this issue to bring peace to us both? His short term memory is all but gone, but he responds to conversation, sings in church (still beautifully), and recognizes all of our children and grandchildren. I'm not ready for him to leave our house where everything is familiar to him. [ 04/05/11 ]
Bathing and personal hygiene are always difficult issues to deal with. It sounds as though you are really understanding and patient, which is commendable considering how frustrated I'm sure you must feel sometimes!
In general, motivating a patient with Alzheimer's disease to do something is more about gaining his cooperation rather than forcing him to do a task. Some techniques you may find helpful (if you haven't already tried them) include:
- Ask him to try to do something rather than tell him to do it.
- You can also make him feel like he has some control of the bathing situation by saying “The bath is ready for you whenever you are.”
- Keep instructions simple and clear. Avoid lengthy explanations.
- Bribe him with a favorite food or drink as a reward for changing his undergarment.
- Call the diaper an undergarment or underwear instead—he might be embarrassed by the word “diaper.”
- Offer simple choices. For example, ask him “Do you want to get changed by yourself or do you want me to help you?”
- You can also ask him to help you with the task. Everyone likes to feel needed, so if he thinks that he can be of assistance to you, you may find he is more willing to cooperate. Don't forget to praise him for his efforts.
- Maintain a pleasant and calm tone of voice. Sometimes how you say things is just as important as what you say. And don't forget to try to smile.
- Stick to a routine. For example, always try to get him to change his undergarment at least in the morning before he gets dressed.
- If all else fails, leave him alone and try again later using a different approach. It will give you an opportunity to calm down and reassess the situation if you are feeling frustrated. Also, his mood may change in the meantime, and he may be more amenable later. Don't continue to push him if the technique you are using is not working.
My mom is 86 years old and is considered to be ready for hospice. I have two questions. First of all, she can still read out loud, but can’t carry on a conversation, and only speaks in short sentences occasionally. Can she read aloud because that part of her brain is not affected by the disease yet? Secondly, she has been averaging one transient ischemic attack per week lately. Is this a sign that she may be headed for a major stroke? [ 04/04/11 ]
In response to your first question, your hunch is correct. The area that is responsible for being able to read is distinct from the areas required for carrying out a conversation and formulating questions and answers. A conversation requires much more complex thought than simply reading out loud. For example, just because your mother reads out loud does not necessarily mean that she actually comprehends the text. In this sense, reading out loud is like being on “auto-pilot”—the recognition of words and how they are pronounced may still be intact, but their individual meaning, as well as the meaning of the text as a whole, may be lost.
Transient ischemic attacks, or TIAs, are an important risk factor in predicting if a stroke will occur. Most studies indicate that in a third to a half of all stroke cases, the stroke was preceded by a TIA. Because your mother has had a number of recent TIAs, there is high probability that she will suffer a stroke, most likely within the next year, if not sooner. Please talk to your mother's doctor, who will be able to provide you with more information that is specific to your mother's condition and answer any additional questions you may have.
I’m a family friend to someone with Alzheimer’s disease. For the last 3 years, I have helped to care for this woman. She lived in the same home for 50+ years. But, she had to move after the death of a family member. This has been a very upsetting change in her life! After an adjustment period, she has been comfortable living locally for the last 3 years with one of her daughters. Another daughter, who was out of the picture for many years, now wants custody of her mom for 6 months out of the year and to move her to yet another state. The mom does not want to go, and just wants to stay where she is living now. Unfortunately, the courts want to grant joint 6 month custody, even though the mom told the judge publicly in court that she does not want to go! Is there any way that I can prove that such a move would cause a detrimental effect on an elderly Alzheimer’s patient? [ 04/04/11 ]
The laws pertaining to adult guardianship vary from state to state, and when the battle over the custody of an elderly parent crosses state boundaries, the case can become quite complicated. If the daughter in your state has not already done so, it would be best that she contacts an attorney who specializes in elder issues. Such attorneys can be found, for example, through the ElderLawAnswers organization and the Administration on Aging.
In my professional opinion, a living arrangement in which the residence of an Alzheimer's patient is changed every 6 months seems unnecessarily disruptive and could potentially increase the occurrence of anxiety, agitation, or other negative behavioral issues. If it is possible for your friend to present any evidence to the judge, then a signed statement by her mother's doctor indicating that such a living arrangement would not be in the mother's best medical interest could be influential in court.
I care for my mom at home, who is 83 years old and has dementia. Are Alzheimer’s disease and dementia the same thing? She says many very mean things about my family. I know we aren't supposed to argue with her, but she is unrelenting. If we react even a little bit, she gets even meaner. How do I respond to her verbal attacks? Can I ask her to please stop? Is it better to completely ignore her unless she says something nice? I just can't take her to the store or church anymore. I used to do this for years, but I am now worn out. She says that I keep her in “prison.” [ 03/16/11 ]
Dementia is a term that describes a condition of decline from previous cognitive functioning, not explainable by adverse medication effects or other simple reversible medical causes. In addition, it is characterized by memory problems and problems in one or more other areas such as recognition, ability to do learned tasks, use language, or to problem-solve. Alzheimer's disease is the most common dementia, and accounts for two thirds of the dementia cases among older adults in the United States.
The best approach to dealing with an argumentative or physically aggressive Alzheimer's disease patient (AD) is to try to change the subject or get the patient engaged in a new activity. You are doing the right thing by remaining calm and generally ignoring her comments. Arguing with an AD patient never accomplishes anything, and usually just serves to further agitate the patient.
Determine what your mother's favorite topics are and try to engage her in conversations concerning these subjects. It doesn't matter if she gets names, places or dates wrong—don't bother correcting her unless she asks—just let her talk. Or get her hands engaged in something that will take her mind off of her agitation, such as folding laundry, kneading dough, arranging flowers in a vase, drawing a picture, etc. These activities also can potentially serve to give her a sense of accomplishment and usefulness. Just remember to keep the tasks simple and clearly explain and/or demonstrate the steps involved.
Additionally, if you have not done so already, you may want to try keeping your mother on a fairly regular schedule each day. You can also try posting a large calendar or agenda on the wall that clearly lists the day's and week's activities. Post a schedule next to the clock with the times for each activity (e.g., listing mealtimes, different activities, bathroom breaks, bedtime, etc.) This can help to lessen anxiety about what's coming up next, which may aid in reducing aggressive outbursts.
Your mother may have moments of clarity in which she realizes that her cognition is deteriorating. She may not be able to remember a word or a face and this can be scary. It is also possible that she may be ashamed that she cannot remember the family member who just visited, and therefore becomes defensive when you insist otherwise. Even though this behavior is frustrating (to both you and her), it is all perfectly "normal" for Alzheimer's disease.
Most caregivers say that taking care of a loved one is one of the most difficult jobs they have ever done, and also one of the most rewarding. Every day can present new challenges, but you have to remember your mother's actions are no longer her own, as they are influenced – and sometimes completely governed—by the disease.
My mother, who lives in a care facility, is 95 years old and needs a wheelchair. She has, until recently, had full control of her faculties and a sharp mind. Now, I wonder if she has Alzheimer’s disease. Her memory is good, she is surprisingly alert to her surroundings and seems to understand the world news. However, she seems to be going through some form of mental torture and believes that she cannot trust anyone. She is very depressed, sleeps poorly, believes there are bugs in the bed, and believes that her family is “stabbing her in the back.” How can we help her? It is so distressing for us to see this progressing. [ 03/15/11 ]
Hallucinations, paranoia and depression seem to be your mother's chief symptoms, and can be caused by a number of different illnesses in the elderly, not just by Alzheimer's disease. In some instances these types of symptoms can be treated quite effectively. For example, sometimes certain vitamin deficiencies, drug interactions, or thyroid hormone imbalances can cause dementia-like symptoms in older patients, and are largely correctable. Therefore, it is important that your mother get evaluated by her physician to determine the cause of these symptoms so that any necessary treatment appropriate for her condition can be started. Alzheimer's disease is typically associated with memory impairments and cognitive problems, and because your mother's memory and cognition seem fairly intact, if your mother is indeed determined to have dementia, it is unlikely that it would be of the Alzheimer's type.
My mom was diagnosed with Alzheimer's disease. Her speech sometimes is not understandable and she cannot walk on her own because she loses her balance and falls. She also does not want to eat much and prefers only certain foods. Also, she leans sideways when she sits in a car or on the couch. Recently, it has become difficult to give her medicine. She sucks on it like candy. It's also hard to check her mouth to see if she has swallowed the pill because she does like us to do that. We were crushing the medicine up and putting it in certain foods like peanut butter or mashed potatoes, but that isn't working well now because she is not eating very much. Are these symptoms are normal. Is there anything that can help her to eat more? Does the winter season make her symptoms worse? [ 02/25/11 ]
Of course it is terribly difficult to witness a loved one succumb to this disease, but you can take some comfort in knowing that you are providing her with very good care. Regarding your mother's loss of balance and sideways leaning, it is possible that she is suffering from vertigo, which can affect elderly individuals regardless of whether or not they have Alzheimer's disease. Your mother's physician can test for vertigo and possibly even correct it depending on its cause.
It is fairly common for AD patients to have decreased appetites and lose weight as a result. A decreased appetite may be due to a loss of interest in food, decreased or altered sense of taste, decreased energy expenditure (therefore requiring a lower caloric intake), or a loss of the feeling of pleasure or satisfaction normally derived from eating (referred to as anhedonia). Because she is eating less, what she does eat therefore matters more. Your job is thus to make sure her food is nutrient rich so that every bite counts. If nothing else, you can try using liquid meal supplements to provide her with additional calories and essential nutrients. Some additional caregiver tips for encouraging AD patients to eat are provided by the Alzheimer's Disease Education and Referral Center (ADEAR) through the National Institute on Aging (NIA).
Finally, the long and often sunless winter months experienced in more northerly climates can sometimes lead to a condition called Seasonal Affective Disorder (SAD). Although no study has formally tested this, since Alzheimer's patients are more prone to develop apathy or depression than non-AD persons, dreary winters might affect the mood of these patients and increase the risk for depression. Regular exposure to sunlight can help to improve an Alzheimer's patient's overall mood and—when combined with calming, dim lighting in the evening—can help to keep a patient's circadian clock on track. This internal clock frequently becomes disrupted in Alzheimer's patients, such that they end up being awake at night and sleeping during the day.
My mother is in an EMI Residential Unit and has been suffering with Alzheimer's disease for 2 years. She is unable to walk anymore and is fully incontinent. Up until recently she has been eating well and has always had a cheery disposition. All of a sudden, however, she has become very tearful and doesn't know why. We don't know if she is in pain; we get contradictory answers. Is it possible that these behaviors are symptoms of Alzheimer's disease and we just have to muddle through as best we can? There seems no where to turn to ask questions. Thank you in advance for any advice you have to offer. [ 02/23/11 ]
Alzheimer's disease affects a person's mood as much as it affects his or her memory. Blunted and/or exaggerated emotional responses are characteristic of the disease, and emotional changes can occur suddenly and without warning. Excessive tearfulness, sadness, anger, fear, or anxiety can all rear their horrible heads at times, and families of AD patients are often just as surprised and confused about these unexpected emotions as are the patients. The important thing to keep in mind is that these negative emotions and behaviors are symptoms of the disease and are not conscious decisions on the part of your mother.
And as for finding answers to any questions you may have, the EMI unit should have staff trained in dementia care who can provide you with answers to your questions, or at the very least direct you to suitable resources in your area. If you haven't already considered it, it may also be helpful for you to join an Alzheimer's disease support group. The people in these support groups often are a wealth of knowledge and, more importantly, have experienced much of the same emotional roller coaster as you have undoubtedly experienced yourself.
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Last Review: 04/29/13