I’m concerned about my loved one

Concerned Loved One

I have a loved one who I am very concerned about. A few of my family members seem to think he may have Alzheimer’s but this has not been diagnosed by a specialist yet. His doctor has referred him to see someone in the next few weeks for his memory issues. He has gotten lost while driving by himself on several occasions. He refuses the help when it is offered to him.

Lately he’s been very agitated and argumentative which has caused his wife and other family members to get upset with him when this happens. It seems like his condition is getting worse each day which I am very concerned about this. Don’t know what to do at this point. Just wanted to see if anyone else has dealt with this. Any suggestions would be greatly appreciated.

harshedbuzz

@Concerned Loved One

Hi and welcome. I am sorry for your reason to be here but pleased you found this place.

This is a difficult situation. I had something similar drag on for almost a decade because mom was in denial. When the feces hit the fan, he ended up getting a tentative Alzheimer's diagnosis during an inpatient stay for altered mental status.

On one hand it's great that the PCP referred him to start the diagnostic process and that is only a few weeks away. On the other, the first appointment will likely be a detailed history, current concerns and symptoms, some quick cognitive screenings like MMSE and MoCA. The will likely be blood tests and imaging ordered to rule out conditions like vitamin or hormone deficiencies and lesions which can mimic dementia unless these were done recently. If LO had a CT scan, and MRI or PET scan might be ordered. The doctor may refer LO to a neuropsychologist for more in-depth cognitive testing. This is to say, you probably won't get much information or assistance at the first appointment and the follow-up could be 1-2 months after that.

Does LO have his legal paperwork like POAs and such done?

I would urge the DW in this situation to create a bulleted list of symptoms and behaviors ahead of time. It would be useful to know how that first appointment will be structured. Dad was seen at a university memory center; we met the doctor, they took dad off to do his cognitive tests while we shared our concerns with the doctor which allowed us to be frank. In smaller practices, you might not get a chance to talk privately, so it's important to be able discretely report with upsetting or agitating the PWD. If there's a patient portal, sign up because this can be used to discretely report behaviors.

The driving is difficult. We were fortunate that 1) dad didn't kill anyone during that time he shouldn't have driven and 2) the neurologist banned him from driving so we didn't have to be the bad guys. This is something to ask about at the appointment. Many docs will say this is a family decision which is unfortunate. You could initiate an anonymous report to the state DMV if that is a possibility in your state.

There are meds and care strategies that can tamp down aggression and agitation. These are best prescribed by a geriatric psychiatrist, but that can take time. Has the DW asked the PCP for something to take the edge off the LO's behavior? When dad was at his worst, I discretely made a video on my phone which I sent to his doctor to help him understand the degree of agitation dad had at home. He tended to showtime (when a PWD can get it together and seem perfectly calm and OK) at the doctor's office so telling the geripsych he needed a higher dose of his antipsychotic looked like I wanted to sedate the man.

It's possible the LO has a condition called anosognosia where he is unable to recognize the changes in his cognition and skills— in his mind he is the same as always— trying to convince him otherwise will just lead to agitation. Look into Teepa Snow videos on YouTube for behavior management.

These two links are useful for people new to Dementia Fight Club.

https://tala.org/wp-content/uploads/2019/04/Tam-Cummings-LLC-Handouts.pdf

https://www.smashwords.com/books/view/210580

mommyandme (m&m)

welcome to the forum! Many of us here have dealt with the same issues in the beginning and beyond, many still are. I’m so sorry you and yours are on this relentless and heartbreaking journey. It’s a steep learning curve to start and is often difficult to differentiate which behaviors are a LOs personality and which are the disease. A dementia patient sometimes presents with anger and paranoia etc… as their worry, fear and confusion overwhelms them. The people our LO are closest to, their safe place, often get the brunt of the outbursts. It’s surprising and for me it was a difficult task not to take things personally and/or blame my mom for her behavior. It benefits us, as caregivers, to put the grief, disappointment and frustration on the disease and not our LO. IMO, most PWD wouldn’t wish this on you and would never treat their caregivers poorly if they had a choice. As we move forward, we must accept the new realities and make necessary adjustments and adaptations because our LOs cannot.

Please keep coming back here to share, vent, question, support etc… There are many wise and compassionate folks here and can be a lifeline.

H1235

I have found this helpful. Your not alone.

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