Ruminating

SarahChe1

Hi there, I am new here.
I am the caregiver to my father-in-law, who was fairly recently diagnosed with Alzheimers. We will know more about the exact stage he is in once he has an upcoming test on 10/19. Until then, my father-in-law is also on the spectrum and has a tendency to fixate on certain things, particularly (retired engineer) numbers & baseball stats! As of late, he spends most weeks ruminating over his bowel movements. He got out of the hospital in July for some bladder issues, which may have been triggered by mild constipation. Since then, a discussion about his bowel movements is a daily topic. Since he is prone to tracking statistics, he has created a tracking system in a notebook, but even though her is regular, he is full of anxiety about not going. If he misses one day, it is all he thinks about, and because he cannot remember conversations, we just keep repeating the same series of words to try to keep him calm. It is a vicious cycle, because the more that he stresses over missing an AM or PM bowel movement the more he is prone to missing a BM.
I am wondering if ruminating over bowel movements is a common symptom of alzheimers? Has anyone else dealt with a similar situation?
Thank you so much in advance for any feedback or advice you may offer to help get him off of this hamster wheel. It is greatly appreciated!

Quilting brings calm

Fixation on any topic is common in dementia. Their brain gets stuck. Repeating the same question-answer cycle is too. Your goal is to redirect him to another topic. Favorite TV show. A favorite treat, a ride in the car. Etc.

An antianxiety medication might help.

SusanB-dil

Hi SarahChe - welcome -

Yes, we went through that stage. MIL was fixated on feeding the cat, and then herself, and then the cat, and then herself, and then…. yes, it was on a loop. After that fixation, she got fixated on another subject. As QBC mentioned, all you can do is try to re-direct. He likes statistics, so maybe he could get fixated on baseball?

As far as the stage, a lot of docs go by a 3-stage model. Most of us on 'here' find the DBAT 7-stage a lot more helpful. https://us.v-cdn.net/6037576/uploads/B0XGDF5TALMA/dbat-287-29-281-29.pdf

And do check out the book 'The 36-hour Day'. (and also make sure paperwork is in order, DPOA and HIPAA)

harshedbuzz

@SarahChe1

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

Both dementia and ASD are conditions that typically cause individuals to become "stuck". As the parent of an adult son on spectrum (high functioning like your FIL), I was struck by how dementia seemed to bring out autistic behaviors in my father who was the polar opposite. Things like lack of empathy, a tendency towards inertia, apathy, loss of social filter (in your case scintillating conversations about BMs), sensory issues, etc.

Like DS, dad responded somewhat to medication (an SSRI initially, later we added an atypical antipsychotic). This might be an option for your FIL. As his disease progressed, we were able to redirect him more easily with a change of subject to another preferred topic or a snack. Early in the disease progression, dad had enough cognitive reserve to resist redirection— that became easier later on. I mention this because given your description of FIL, you may also be dealing with the "gift" of cognitive reserve. This is when a particularly intelligent person brings a considerably high baseline of knowledge and reasoning to the disease which can allow them to pass as less impacted than they are.

TBH, assuming FIL lives with you, you would likely have a better sense of his stage than a professional will. That cognitive reserve can cloud things and make FIL appear to be less impacted by the disease than he is so the type of testing matters. A 5-hour neuropsych can reveal subtleties and stages quite well but the quick screenings like MMSE, SLUMS and MoCA might not. I was with my dad when he took a MoCA with his geripsych about 6 months before he died. I'd have put dad in stage 6 using DBAT, but the doc thought dad was earlier in the disease because of his cognitive reserve (dad, a lapsed altar boy) was joking in Yiddish and could do serial subtraction as fast as I could. His score slotted him as "mild cognitive impairment". Dad bragged all the way down to the lobby about being off the charts and then got into some random little old lady's car when I turned my back to turn in my valet ticket. TL;DR— you probably know best.

DBAT (1).pdf

Good luck.
HB