About Me, and my LO

TiredAlready65

Hi everyone,

I am new here.  My name is Lynda and I'm 57, I care for my 92 year old mother.

Mom has diabetes, heart problems, angina, hearing issues and dry macular degeneration.  She takes a slew of medications such as Januvia, Plavix, etc. along with Iron pills and Vitamin D2.

My mom has always been a narcissist...growing up I endured a lot of emotional and verbal abuse from her, partly because I have ADHD (and possibly mild autism).  She often put me down, yelled at me, and resorted to mild forms of hitting like pulling my hair or smacking my arms.  She cursed me out, told me I'd never amount to anything, etc.  I had to get counseling.

I did manage to get a full time job, which I held for 34 years.  I retired last year to move in and care for her, because a) she needed someone to help her with getting places, getting groceries, etc. and b) she lives in the country where it's peaceful.  She SEEMED to mellow out as she got older, but in the past 2 or 3 years she has begun to go back to her old ways.  Over the past year I've noticed that just before or during exciting or stressful events like having company or going somewhere,  she's more prone to tantrums.  During these tantrums she says and does the most outlandish, cruel and almost sadistic things.  Today, just before we were to have company over, she got upset because I didn't reply to her in the tone she expected.  That was all it took to send her into a tantrum.  She proceeded to threaten me to move out, that I'm a b, I never loved her, haven't changed, etc.  When I tried to correct her (and I did raise my voice back at her as she was raising hers) she didn't hear me right and accused me of not wanting to care for her, which I NEVER said.  So I tried to make her understand.  When I told her I loved her, she laughed sadistically.  I told her that was rude and cruel.  More laughter.  Then she said she'd go to a nursing home, and when I told her she'd be mistreated and left to sit in her own bowel movements, she just mouthed off more.  THEN she proceeded to become hostile and when I tried to gently touch her and tell her I really loved her, she said Don't you hit me, I'll have you arrested!  I told her I'd never do that (and never have), She clenched her fists and accused me of doing the same.  I showed her my OPEN hands and told her I would never clench my fists to her.  I had to step out of the room when company arrived and Mom of course put on her happy face, acting like nothing was wrong. 

She's broken my heart and said the cruelest things without remorse.  She has done that to me many times before, even when she had her mind.  But now...I am wondering if she might have dementia, as the laughter and accusing me of attempting to hit her are somewhat new. 

She won't go to a NH or ALF.  Doesn't have the money anyway.  She thinks she's doing good and has her mind.  She attributes her confusion and other issues to old age.  She lives on her own property and her house is paid for.  she lives on a 100 acre piece of former farmland, where she was born.  My brother D. bought it 7 years ago and is making payments to her, so no chance they could take it if she DID go to a NH.  In reality, she KNOWS the NHs and ALFs are no good here, my dad was in one.  So truthfully, she'd rather die in her own home.  I am more than happy to care for her and I DO LOVE HER.  I tell her daily I love her.  I told her today If I didn't love you, I wouldntve sacrificed my job and life for you.  When she's having a fit, she won't believe me but the rest of the time she does. 

OK that's my explanation, sorry it's so long.  She has a doctor appointment Thursday.  I would like to have her tested for dementia WITHOUT HER CONSENT.  Naturally she thinks she's fine.  But I know better.   Is there ANY way to have them test her, without her figuring it out?  She's intelligent and often thinks ppl are out to get her.

Stuck in the middle

I would probably ask the doctor to present it to her as routine screening, required by Medicare as part of the routine for people over 90.  Talk to the doctor in advance, so they can give her a MMSE as part of the exam.  

Welcome to the board.  I'm sorry you have to be here.

harshedbuzz

Cobbling onto what SITM said, you'll want to report what you are seeing to her PCP ahead of time. A bulleted list format is quick and easy to read. It would also be useful to record one of her tantrums and send a clip ahead of the appointment. 

This might help you be more empathetic when she's at her worse.

Home | Thoughtful Dementia Care (understanding-dementia-experience.com)

Jo C.

Hello Lynda, and a very warm welcome to you.  I am sorry for what is happening and can well understand how you are feeling. There is a wonderful writing regarding dementia and why things happen as they do; it is: "Understanding the Dementia Experience," by Jennifer Ghent-Fuller.  You can find it in the pdf version at:

http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf

It is not at all unusual for a person with dementia, once they have reached a certain state of being, to lash out at the person doing the most for them and it can be pretty upsetting in its vitriol.  It comes from the "broken" brain.  Logic, thinking, reasoning and judgment are highly compromised and they will move in the moments feeling.  Often, high irritability and agitation are running the show along with false beliefs which are called, "delusions."

One cannot argue, or try to educate or change the person's mind.  Their delusions are as real to them as the chair you are sitting on.  One must simply try to change the topic by re-focusing or leaving the scene.   Sometime, one can address the feelings behind the words rather than the words themselves.  I had to do this when accused multiple times of stealing my mother's purse; "Mom, I am so sorry your purse is missing, I cleaned today and moved it, I am so very sorry; and can understand how angry you are; I would be angry too . . . " of course she misplaced her purse, but it was best to take the blame. Then I would find the item and immediately refocus the topic onto something or someone else or going to the kitchen to get coffee and a sweet.  Whatever works.

If our LO has a "silent" urinary tract infection, that too can cause dreadful changes in behaviors without any physical symptoms until the UTI is treated, so do have her checked for that.  If all is well, the doctor may want to refer her to a dementia specialist but the doctor will have to find a fib to get that done such as, the appt. with the other doctor is for blood pressure or arthritis, or something else.   There are medications that can be prescribed that can make all the difference in the world for behaviors.

It is good that she will be seeing the doctor.  One of the things I did was to write a detailed memo outlining all changes in cognition, function and behaviors and get the memo to the doctor several days before the appt.  I usually sent it in by fax and let the staff know it was coming and was time sensitive to the meeting and to please get it to the doctor asap.  Then I followed up to ensure it had been done. I also carried a copy in my handbag. I would excuse myself from my Loved One (LO) to "use the bathroom," and then went in the back to ask the staff if doctor had seen and read the memo, if not or any question about that, I gave them the copy to  give to the doctor asking it be read before the exam.  This usually got things done well.

It does not sound as though your mother is a candidate for Assisted Living, she is not able to care for herself and her behaviors would be an issue.  She would qualify for a Nursing Home with Medicaid helping, but the income from what her son pays her would more than likely be used as her "share of costs" along with her social security. 

There is another option; that is of having her admitted to a Geriatric Psych Unit (GeroPsych), for assessment and initiating meds that would help her behaviors.  Many of us have had to have that happen as outpatient treatment was not sufficient in that the LO was over the moon and would never consent to such an admission.  In such a case, the doctor would arrange it with GeroPsych and she would be a short term involuntary admission.  It is a benefit under Medicare.

The Alzheimer's Assn. has a 24 Hour Helpline that can be reached at, (800) 272-3900.  If you call, ask to speak to a Care Consultant.  There are no fees for this service. Consultants are highly educated Social Workers who specialize in dementia and family dynamics. They are very supportive, have much information and can often assist us with our problem solving.

Do let us know how things are going, we truly do care.  With warm thoughts being sent your way from one daughter to another,

J.
 

Cyndisaunt

Ugh, this is the most difficult part for me also. 

My LO went through several months of paranoia and lashing out with delusions, hallucinations, etc... then it seems like she moved into the next stage and is less paranoid and angry in general. She will still have a few days when she has had a lot of visitors or a doctor appointment, anything out of the routine, but then she is back to going along with the routine. 

I do find routine to be best and I rarely tell her until an hour before what is going to happen next because she is at a stage where she can only hold onto an idea or thought for about 20 minutes, so repeating for several hours prior only adds to her agitation and frustration with herself. 

Given the past traumatic relationship, please try to find someone to give you respite. 

I try to remind myself that her brain is "broken". This too will pass. This is not her fault nor my fault. I take intentional deep breaths and try to rephrase when something I say seems to agitate her. 

When friends come to visit, I will let them know I will be in another room folding laundry or some task just to have time alone. If the visitors are reliable, I will even ask how long they plan to stay and let them know I am going for a walk (you can do anything you want, but most people seem to allow for walking so that is what I tell them). 

Then I go... no stopping to fold or clean up just walk out the door and sit and take deep breaths. Call a supportive friend who knows to just listen and keep the conversation light and grounding. 

hope that helps... 

Cyndi