When a long-term friendship is impacted

djae

I’m concerned that a dear friend of mine may be experiencing early cognitive decline. They are in their mid-60s and recently lost a spouse. For the past two years, I’ve attributed their behavioral changes—especially increased frustration and verbal outbursts—to grief and the challenge of navigating life alone.

However, their mother had Alzheimer’s, which adds to my concern.

Over the last two years, my friend has verbally attacked me in public settings (a hotel, a restaurant) and accused me of saying or doing things that never happened. What once occurred about once a year now happens every 3–4 months. When I try to discuss these incidents calmly, the response is either further hostility or a refusal to engage.

I understand that friends can disagree, but the intensity of these episodes is jarring and increasingly hurtful. My friend has also accused others of stealing, abruptly ended lifelong friendships without explanation, lost their sense of smell, and fallen victim to phone scams involving sensitive financial information. I know any of these issues can occur for many reasons, but the pattern, the timing, and the family history make me wonder about possible cognitive decline.

After enduring another two-hour verbal attack, I told my friend I cannot continue tolerating this behavior. They dismissed it as “just a fight.” I don’t believe it is.

I don’t want to walk away from a 20-year friendship that once meant so much, but I also can’t continue experiencing this. I’m heartbroken, hurt, and unsure what to do next.

If anyone has seen similar behavioral changes in a loved one with Alzheimer’s—particularly when much of life still appears “normal”—I would appreciate your perspective.

jgreen

Dear @djae

Welcome! So sorry to read about your friend.

I can only speak for myself. I witnessed many of the same behaviors in my husband who is diagnosed with Alzheimer’s Disease (AD). You are quite observant.

As a good and longtime friend, I think the best you can do is to speak with their family member (hopefully they have family) about your observations and concerns. And let them know you are worried about your friend’s safety. I hope family have power of attorney and can step in on their behalf. If your friend hasn’t had dementia diagnosed, a good place to start is with their primary physician (and better yet - have the primary referral them to a geriatric neurologist) for a thorough work up to rule out medical problems that could be causing these behaviors.

IF your friend does indeed have a dementia type, arguing or trying to rationalize with them will not work. Dementia carries a condition called anosognosia - the inability to recognize impaired function in memory and general thinking - their ‘reasoner’ is broken. Your friend is not in denial if they have a form of dementia.

Without having any type of legal paperwork for yourself to act on their behalf, that is about all you can do. I hope things work out for both of you.

trottingalong

If she has family, I would approach them about your concerns. Your friend most likely does not recognize their own shortcomings which is common. Discussing it with them is an exercise in futility. I have a friend exhibiting behaviors very similar to my husbands. I casually asked her husband about it and he became very defensive, so I immediately dropped it.

SDianeL

Sorry you are going through this with your friend. Ditto on speaking privately with the family. If they are open to listening I would tell them about this online community. Someone in the family needs to see an attorney right away and get a DPOA so they can help your friend. We will help them. Also tell them about the book “The 36 Hour Day” which explains the disease and gives tips on communicating with a OWD. If the family is in denial maybe you can record one of your friend’s outbursts and give them specific examples of his behaviors. There is a tool called the DBAT that shows behaviors in each stage of dementia. You could also show them that tool.

H1235

I agree with the others. Tell family what you are seeing. I would be cautious. Sometimes families just refuse to open their eyes. If there is no family or they refuse to even consider the problem, you might consider adult protective services. If you choose to continue a relationship with her I would avoid any talk of her symptoms or limitations. Pointing these out will only make her mad. You may even find the need to apologize and take blame for things you didn’t do in an effort to avoid conflict. The idea is to live in her reality where nothing is wrong with her. Of course this is going to get tricky if she tries to do something that is not safe. If there is ever any kind of incident that involves her going to the hospital, I would stress to staff that she is a harm to herself (if you feel it’s to that point) and ask for a psychiatric evaluation. Im not sure how much they might do with you not being family. But diagnoses is is a really tough first step and making doctors aware might help. I will attach the DBAT tool and some information on anosognosia that might be helpful.

Anosognosia and Dementia - AgingCare.com.pdf