OCD-like behavior common?

rzrbaxfan

Mom is 83, stage 6 (I like to say 6.5, because she's getting worse without going into the next stage), and I am her FT caregiver.  I've noticed that she has some very repetitive behavior lately, and some of it needs redirection.  For example, after meals, she likes to wash her face and rinse her mouth out in the kitchen sink.  We've tried the "you should do that in your bathroom" vibe, and last night, I "did the dishes" camped out in front of the sink for 45 minutes...and that lead to a stand off.  She pouted until I cleared out, literally staying up past dark waiting for me to clear out so she could do what she should be doing in the bathroom (by the way, she has her own bathroom!!).

There are other, more disgusting, things that she is starting to do that I have to get a handle on.  I've always been able to steer things a little here and there, but this is requiring constant attention and getting resistance.

Thoughts?  Is this disease progression? I can't give up, as some of these things are incredibly unsanitary...so, do I change my approach to steering?

DrinaJGB

We got into this from a different route---brain injury from a viral infection dementia/mixed etiology. My DH has displayed OCD behaviors since. It typically is due to damage to the prefrontal cortex. OCD is an anxiety disorder and the behaviors (compulsions) are done in an attempt to reduce anxiety brought on by the obsessive thoughts.

 There's not a lot that can be done about it except perhaps some anxiety medications (Buspar; benzodiazepines ) out there--my DH could not take; made him mean as a snake. His are tolerable, so I really don;t sweat it much any longer.

 You might want to contact her doctor with this and see what he suggests. Good luck.This stuff can really drive you nuts; along with a dozen other things.

mommyandme (m&m)

In my experience or I could say inexperience, OCD is a definite part of this disease. For us it was very evident when she turned the mild/moderate corner.  Also, it’s not gotten worse since then, the same things she was OCD with then she’s still obsessed with today.

I’ve definitely changed my approach to her strange focus of attentions.  Picking battles that are unnecessary is frustrating for both of us, especially me. Steering my mother basically makes her put on the brakes. We go slow enough as it is! 

Although, the toileting issues we were having were completely unsanitary, unsafe, unsavory, unpleasant, UNACCEPTABLE! I quit steering and basically shoved her to the passenger seat and  took over the disgusting vehicle.  No more bathroom time alone, that avenue is closed. 

It’s very hard for me to constantly be up in my own head. Thinking, thinking, thinking, where, when, what, why, how…is she.  The physical stuff I can work through, but these mind games I play amongst myself and the second guessing… wondering, criticizing, worrying about my caregiving. I find it hard to find a real smile and I’m so tired of the plastered cheesy one I project to my mother.  My poor family, ugh, after pretending to be patient and kind all day, my smiles and laughter are few and far between.  oops venting tangent… sorry

So, I guess the battles you choose are your own. Make them really count and be important for safety.  Maybe, just maybe, it’s not so important where she washes her face. Will the tidying up after her cleansing session take less time and energy than the stand off.  Only you know that. 

My hope is for some quiet head space for all of us today.

towhee

Yes, it is a progression of dementia, but probably not all behaviors are for the same reasons. For example, I will lay odds she grew up for a while in a house with only one bathroom. When a whole family shares a bathroom sink more things get done in the kitchen. As dementia progresses older memories and old patterns of behavior can come to the forefront.

Also, is her bathroom sink low? She might feel off balance trying to use it.

Think about what you can tolerate and what you can't. You could spend 30 seconds wiping down the sink with a Lysol wipe, no problem, or waste a lot of energy trying to get her to change her behavior. Save your energy for what is really important or your stress level will constantly stay too high and impact your health. Also, if you are constantly trying to get her to change her behavior, she will get frustrated and angry and your caregiving relationship will deteriorate. If you do not have someone to give you some respite time, you might want to find someone. 

Best Wishes

DrinaJGB

Think of it like dealing with a terrible 2 toddler or a defiant and oppositional adolescent---pick your battles. Otherwise, you will find yourself in a constant state of being war torn and battle weary.

Rescue mom

My DH also engaged in behavior I would have sworn was major OCD, if I did not know he has Alzheimer’s. Much of it was repetitive, and much involved moving things around and “sorting” in ways nobody understood. He also picked at, “sorted” and you might say played with, food on his plate. A serving of English peas would keep him busy for an hour. So would the contents of the trash cans, if I didn’t watch, or the refrigerator. Etc.

I learned to overlook it or just pick up quick, later. There was no changing the behavior, and it really did not hurt anything except make a mess or maybe be disgusting to visitors. Anyway, it usually wasn’t unsanitary enough to cause health concerns. Short of that, I just had to (mostly) let it go. There was too much else that could be truly harmful to worry about, and I only have so much energy. As said, I had to pick my battles.

Lindsay22

For sure this is a thing with my mom.  Everything has a place and you cannot move it.  We had a fight about a towel she kept shoving under the door I would say "don't do that, it blocks the door, it doesn't need to be there" and she would say "I need it there, just leave it" and if I took it away it would be back before I knew it.  I'm no AD expert but I saw it as part of what I call her "scripts" if she doesn't stay on script she gets lost and doesn't know what to do.  If anything different happens it throws her off.  This also became a thing with eating and dumping her food in the toilet.  I have no idea why but she would get about halfway through a meal and then go scrape her food into the toilet.  No matter how many times I told her not to or to use the kitchen instead it was to no avail.  Again, not a doctor, but my interpretation is that when you are experiencing a major cognitive decline certain things become part of a routine and then you feel compelled to do them to create some sense of order.

kmasen_act2

Yes, this is very common with ALZ patients. I'm a CDP and I go over this in my training. There's a few reasons why they display repetitive behaviors. 

One is that they really do forget that they already did something. That's also true for when they keep asking the same questions: they literally forget they just asked you the same thing 5,000 times 5 min. before. 

Another is because they need reassurance. It's more of a comfort and piece of mind issue for them than anything else. Sometimes you'll see this with hoarding too. Remember, they grew up in a different time than what we're living in.

The best thing to do is NOT judge or be condescending, as hard as that may be. They truly don't know any better. Redirection sometimes works, if not, just roll with it. We can't force them to come into our reality, we have to adapt and go into theirs.

rzrbaxfan

Update:  We were able to redirect her behavior to her bathroom.  Only a slight modification in her eating routine and gentle guidance after meals, and she's good.  In retrospect, she was into routines long before dementia, but I guess I'm sensitive to disease progression, and was curious if any of you noticed more OCD like stuff as things moved on.  Thanks to all that shared insights.

Wilted Daughter

I don't know if it's "common" but OCD behaviors are not unheard of (e.g. hoarding). Glad to hear you found a resolution of sorts to address the issue of using the kitchen sink as if it were the bathroom sink. All I can say is it could be worst. Someone shared with me that their mom starting going potty on the kitchen floor...I don't even want to imagine that. 

Take care

rzrbaxfan

We've had it on the floor as well.  What is crazy is that we had it in Stage 5, but it went away as she progressed.  I think Donepezil helped us there.