The disease or manipulation?

AmeliaMH

My mother has vascular dementia and Alzheimer’s, as well as heart failure. Her PCP has told me she has between 6-9 months to live because of her heart. I understand that the heart failure will only make the VD worse over time and it does seem to have accelerated her memory issues. She lives in a MIL apartment added onto our home.

This weekend she was suppose to have gone to her brother and sister-in-law’s over the long holiday weekend to give my husband and I some respite. However, yesterday morning she got up, showered, dressed and was worn out. She fell asleep with a cup of cold coffee in her hand and spilled it on herself. After getting her changed and cleaned up, she said she didn’t feel like going; she wanted to stay home in her chair and surroundings. We cancelled the trip. I helped her back into bed to sleep and told her Jim and I were going to go run errands and have lunch. We’d be gone several hours. 

Around 1:30 pm, she calls me and wants to know where we are. I told her we were in Nashville and headed to Sam’s Club to get some things. She was agitated. After we hung up, I called her back and asked her not to walk to the mailbox until we got home. She said okay and again wanted to know when we would be home. I told her around 3:30 or 4. She told me she wanted to go to her brother’s. I told her to call her SIL and tell her. My husband generously offered for us to come straight home and take her.

We stop and fill up with gas and get home, unload the groceries from Trader Joe’s and go to her apartment. She was on the phone with her SIL and comments, “Well, here comes my daughter. She looks like she’s been busy.” I realize that she didn’t say anything to her about coming and that she forgot where we had been. After a 15 minute discussion, she decides she doesn’t want to go but wants to go to Sam’s with us. Now, Sam’s is 30 miles away and was on our way home. We’re now back tracking. We take her and go get our items.

My aunt, her SIL, says Mother was being manipulative and just wanted me home. I say it’s the disease. Any thoughts? Thanks.

M1

I think it's the disease Amelia.  Probably not enough cognitive reserve to be manipulative.  Have you thought about a Hospice evaluation?  Also occurs to me to wonder whether she's safe to be alone like that.  Glad she can still use the phone, that's one good thing.

AmeliaMH

I’m looking into getting someone to stay with her 4 hours a day Tuesday-Friday. We’re home on the weekends and every other Monday, a dear, dear lady comes and cleans her house and then takes her out to the grocery store, bank, store, and gets ice cream. We pay her for her time to do this. Mother loves her company but the last two times, she’s forgotten that she’s been cleaning her house for a year now and wants to know where I found her because “she’s delightful.” Maria is very good with Mom as her grandfather had Alzheimer’s and her grandmother had dementia. I wish I could hire her but she has other cleaning jobs and watches her grandchildren one day a week.

She’s still ambulatory and can shower, dress herself, make coffee, use the microwave and toaster oven. She even washes her own clothes, dries them and puts them away although it takes all day because she has little stamina.

I’m not sure what stage she’s in regarding dementia/Alzheimer’s. I have had to take over her finances because that requires too much mental exertion and concentration. She requested it. She knows something is wrong but doesn’t understand what it is or why.

MN Chickadee

Your mother's brain is affected by her diseases. I would chalk it up to the disease, because what alternative is there? It doesn't sound like she has the short term memory or cognitive function to be manipulative.

Often it is difficult to take a PWD out of their normal surroundings for overnights. You might try having the relatives come to her and you go away for the weekend for respite. 

Stuck in the middle

AmeliaMH wrote:

Mother loves her company but the last two times, she’s forgotten that she’s been cleaning her house for a year now and wants to know where I found her because “she’s delightful.” 

She knows something is wrong but doesn’t understand what it is or why.

It's dementia, not manipulation.  Your aunt doesn't know her as well as you do.

I leave written notes for my wife when I'm not home, with my phone number, where I'm going, and estimated time of return.  Works for now, so long as I'm home before dark.

Sjodry

AmeliaMH,

I remember when my mom was at the stage you are describing and I also remember thinking the same thing! There are some behaviors that can seem purposeful, planned and deliberate (and almost passive-aggressive), but they are likely not. My mother’s were not. Admittedly, I was the adult in the situation who had to make any (and all) adjustments. It will be a challenging journey with various stages for each of you.

One of the things that helped me not chew the enamel off of my teeth during those moments was to silently remind myself..that she is like a child and respond to her with the same understanding and patience I would treat my own children with.

Good luck!

Sandy

harshedbuzz

Amelia-

It depends. If your mom was all sweetness and light prior to her VD, than this change is likely a manifestation of disease progression.

IME, personality (or in dad's case mental health issues) persist well into the disease process. For my father, the lack of filter allowed some aspects of his behavior that were already challenging to become amplified by his lack of social filter and disorientation. My dad had always been self-focused, with dementia he became unable to put on the show that convinced others he wasn't.

HB