He speaks to the mirror

French

I know I' ve seen a post on this recently, but I can't find it. 

Today the caregiver sent me a video of my partner talking to the mirror and showing to his image the photo album I made for her, introducing family members.

Since a few days, he has a lot of changes in his behavior. He is very angry and has aggressive gestures, he urinated on the television...

I know that these are usual developments.

I can't help but think that going to this MC may have accelerated the disease. At the same time, if it had happened at home, I don't know how I would have managed to deal with all this on top of my work, the children...

I know that many of you do it, but I never felt able to.

M1

French don't second-guess yourself.  But this is when it must feel hard to be a plane ride away.  Hang in there.  Do they seem to be able to handle the aggressive behavior?

M1

By the way, I think it was Butterflywings whose husband also talks to the mirror a lot?

French

They already have been twice to the neuro with him.

 The fist time, she proposed quetiapine 25. It has been pushed to 50 one week later. It didn’t worked more than 2 days.

The second time, she proposed 50 quetiapine twice per day. Sertaline is replaced by deroxat (paroxetine) and she added amytril (Amitriptyline)

I think they manage best that I would have done. Here it is very long to have an appointment with the neurologist and our family doctor is not very used to all that.

 They just phone and have an appointment with the neurologist the next day ! I am quite confident.

abc123

French, please don't second guess yourself! This new behavior could very well be a natural advancement of his dementia. I'm thankful he is in a safe and well run facility. Take good care of yourself!

Jo C.

I am sorry to hear about the changes in your husband.   It has happened so quickly; all at once and in multiple ways.  When that happens, it is good to look for a "trigger" that may be causing such a change.  Always best to do that instead of instantly blaming the dementia. 

Because of the abruptness of the behavioral changes, a primary medical exam would be warranted with full labs done - first; a urinalysis to check for a "silent" urinary tract infection.  These are common and will have no overt symptoms of pain or burning, but there is often a significant negative change in behavior.  Also good to have an expansive list of blood labs done to check and see if there is something else wrong within the body. Sometimes, even dehydration can be a problem issue.

Has he had a change in his caregivers?  Changes in his routine?  Is there something that is deeply upsetting him, or caregiving that has become problematic?  Are they trying to keep him to a schedule that he refuses, or . . . so many other things.

I am sorry you cannot see what is happening, but if you continue to communicate, perhaps there will be a trigger that will become apparent that could be adjusted.

You must be worried on his behalf; let us know how it goes.

J.

Ed1937

French, I think you know you wouldn't be able to handle that at home. You are both better off having him where he is. Hopefully they will run tests to check for other possible causes. If there are none, maybe medication can help?

sandwichone123

French wrote: I can't help but think that going to this MC may have accelerated the disease.

 

I say: This may have accelerated the *symptoms* but the disease does what it does. Once the current symptoms are brought under control things will continue. I think we feel guilty about symptoms because we can see them but we can't see the underlying neurology.

Stuck in the middle

The artist Andrew Wyeth spent a lot of time at a farm near his home and did a portrait of the farmer as a gift.  One night, the farmer found his wife speaking to the portrait as if it was him and becoming angry that he did not respond.  He had to move the portrait to the barn to prevent damage.  This happened in the home the woman had shared with her husband for 50 years.

Memory care did not cause your partner's symptoms.  Memory care is part of the solution.

ButterflyWings

Hi French -

I also think maybe this is just his next phase, and they will be better equipped to handle it well than if you and your children had to try and manage the inevitable dementia progression at home. Especially urinating on things. He is in the right place to manage these behaviors and cleanup, etc. 

Hmm, M1 you may be recalling when my DH was talking to the furniture...during a UTI. I had forgotten about that. Actually couple of times recently he has started saying Hi and waving to a photo of himself or others, or speaking to a face on one of the few videos we may watch. Something is definitely changing there, in terms of his perception of the picture being a live person. And if it doesn't worry him, it doesn't worry me at all. Just another quirk and I can live with it until the next new thing starts. But no, he hasn't talked to the mirror. I do recall a few members had that experience though, and had to cover the mirror if it was upsetting to their LO. 

I hope it sorts itself out soon, French. Maybe he has a UTI given the random peeing on the TV? I don't know...I'm not really into the needles and blood samples so much anymore. More palliative care (comfort) and now in-home hospice now of course. 

JoseyWales

I'm so sorry it's progressing to this point. It's just so sad to see what this disease does. And it's just so interesting to see what behaviors each individual goes through. I often wonder if those suffering with EO have a more difficult time, behavior wise.

But here's the good news: He likes the photo album. There is staff to take him to the dr appointments, and you don't need to take off work to do that. You're not dealing with these behaviors at home with your children. 

I think of you often. 

Crushed

There is a well known psychosis DW had it

 Mirrored self misidentification

Mirrored-self misidentification is the delusional belief that one's reflection in the mirror is another person – typically a younger or second version of one's self, a stranger, or a relative.[1] This delusion occurs most frequently in patients with dementia[2] and an affected patient maintains the ability to recognize others' reflections in the mirror.[3] It is caused by right hemisphere cranial dysfunction that results from traumatic brain injury, stroke, or general neurological illness.[4] It is an example of a monothematic delusion, a condition in which all abnormal beliefs have one common theme, as opposed to a polythematic delusion, in which a variety of unrelated delusional beliefs exist.[1] This delusion is also classified as one of the delusional misidentification syndromes (DMS).[4] A patient with a DMS condition consistently misidentifies places, objects, persons, or events.[4] DMS patients are not aware of their psychological condition, are resistant to correction and their conditions are associated with brain disease – particularly right hemisphere brain damage and dysfunction.[5]

https://en.wikipedia.org/wiki/Mirrored-self_misidentification

Crushed

French wrote:

I can't help but think that going to this MC may have accelerated the disease.

Do not ever think this without medical support.  We hardly know what causes  Alzheimers much less what accelerates or delays it 

Post hoc non propter hoc

Remember there is an underlying disease and there are symptoms of the disease.  Symptoms change due to environment but no the underlying disease 

For millenia people have tried to connect unrelated events. EG masturbation does not cause insanity no matter what medical people said.

West J Med. 2001 Jul; 175(1): 66–68.

doi: 10.1136/ewjm.175.1.66

PMCID: PMC1071473

PMID: 11431412

 

 The solitary vice

The superstition that masturbation could cause mental illness

By the early 1800s, European and American physicians concurred that masturbation led to insanity.2
  

Beachfan

French, 

It’s good to hear an update from you, although I’m sorry you have serious concerns being so far away.  First of all, don’t doubt your decision.  DH is in trained hands; it will all work out.  

While he was still at home, and not long ago, my DH had animated conversations with the “guy” in the mirror.  Interestingly enough, these non reciprocal chats consisted of the most coherent phrases he could make at the time. “Hey, do you want to go? Okay, I’ll pick you up. We can go later.”  Then one day, he stopped with the mirror and soon began chatting with the plants, furniture, or just the air.  These inanimate object conversations sounded much like pep talks to his teams from past years of coaching high school baseball and basketball. (He continues his pep talks in his MCF; caregivers call him “ coach” and he responds immediately.)

I, too, was concerned at first that DH’s MC placement (3 months ago) accelerated his progression.  I was quickly assured by a sweet care giver that I wasn’t able “to see the forest for the trees”.  In actuality, DH is severely compromised, but since I cared for him exclusively and pre-empted any and all problems, I didn’t realize how dependent he is.  I have calmed down considerably and am happy to allow MC staff to manage his care.  I see now where I was running on empty here at home.  Stay calm, relax, think good thoughts- - you are both where you need to be.  It will get better.  

extex

My wife has been talking to the mirrors for years.  I’m thankful.  Sometimes it keeps her occupied and out of trouble for hours.

mrl

French,

My DH also talked to the mirror usually about me...it was heartbreaking, but harmless.

Sorry,

Michele

Jo C.

Talking to the person in the mirror is perfectly fine as long as it is a peaceful positive thing; if a person gets severely upset or angry, then of course that is not good.

My neighbor whose husband has dementia speaks to his "friend" in the mirror throughout the day and has really good conversations and he is happy.   No harm in that and it is a positive for him.

As said, there may be a trigger for what has happened to cause the abrupt changes in your husband or there may be an actual medical physical cause.

When a Loved One is near so one can make frequent visits, it is easy to keep up with things and detect changes which may be upsetting a LO or even that a certain care aide is not a good fit and also to detect anything else that has become inappropriate for our LO.   This is very diffcult when one is far away and cannot be present.

Do you know if there is are any support person in Tunisia that are like Social Workers but perhaps with a different name that will follow a Loved One for family and make visits and determine how things are going and inform family?   We have them here in this country and they are called, "Geriatric Care Managers."  They can be very helpful, but must be paid privately.

If there is no one like that available, is there any other way someone could make routine weekly visits for you that could let you honestly know the circumstances and how things are going?

Though dementia does indeed cause many changes in our LOs, this onset was very, very abrupt, severe, and more complex for it being so abrupt; when a LO has abrupt changes it is always best to look for medical reasons such as infection, or other condition, or other triggers that cause such changes.  It takes some time to work this out. If it is a medical condition or upsetting trigger, it can be addressed without adding significant drugs which can carry their own unhappy effects.

Please let us know how it is going, we will be thinking of you.

J.

 
 

French

Thank you for your kind thoughts. I know that I mustn’t feel guilty, but it is not easy.

I have a spy in the hotel. I am in contact with the husband of another resident. He is only 67 years old and their with his wife who has Alzheimer. He is going golfing every morning and every week proposes to my partner and his caregiver to come with him. He spends a lot of time with my partner, walking to the beach, the Medina ou the marina.

He call me as soon as he thinks I must be alerted about something. The caregiver like him a lot because he is very kind with the residents and all the young caregivers. They frankly speak to him. This evening when wants to discuss with me because my partner is very disturbed about a letter his mother (still and always she) sent. My partner has been very agitated after having the letter, the caregiver already told it but I can’t know exactly why. I hope he will know more.

Pam BH

French, please don't second guess yourself. I think you need a pat on the back because you are doing everything possible to ensure your husband is well taken care of and you've covered every base by having your "spy" to let you know how he's doing. Of course you're concerned because you're not there but that would be the case if the facility was 5 miles away also. You've done a wonderful job finding the perfect place.

Beachfan, I love the advice given to you about not being able to see the forest for the trees. That's so true. I'm sometimes so enmeshed in the details of what's going on and being in the fix-it mode that I lose sight of what's really going on. Thanks for sharing that.

French

Yes beachfan, you are true. Distance doesn’t change things. I was so surprised in September when he was unable to answer the dr simple question « how many children have you ». I hadn’t noticed he was now unable to remember how many children he has just because when he was hesitating, I answered before him to prevent him from stress. I would be in Tunisia that I certainly wouldn’t have the solution. 

Part of These New behaviors certainly appeared because I am not here. 

I am not here in the night to help him going to the toilets. He does as he can.

He was beginning to be very agitated here also. Not agressive but susceptible.

When I call him every other day, he always tell me he is fine and that what is important. The new medication has worked since Tuesday, this is a good news. If he sleeps again, I think he will be better tempered.

About the mirror, it would certainly have begin here too…

The only thing I am sure is that I would have find difficult to manage all this and I feel relieved to have act before. I was on the good timing for him as he is still able to enjoy the activities and for me.