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aries1 Asked January 2015

Mom has fits of crying, "tantrums" and paranoia. Normal?

My Mom had a small stroke in Nov.causing short term memory loss. She is also blind and unable to perform everyday tasks. I have been her primary caregiver, living with her, for the past 7 years. I have PO A and have handled her medical and financial things during this time. She resents being told what to do, even when it is for her own good. She then accuses me of yelling at her all the time. Tonight she insisted on walking on her foot that has had a very bad infection and is just getting better...she got so mad at me that, when I was trying to calm her down,she was telling me to leave her alone and then literally let out a loud scream. She then said she will find someone else to take care of her. She was so upset I thought she may have another stroke. I understand that she is having a hard time losing control of her life, but this type of thing is happening more often and I am not sure how to handle it without yelling back. We do have a caregiver coming in 4 days a week, which does help, but the regular caregiver (who she really likes) has been on vacation over the holidays and there has been a substitute. We will be going back to the dr. in about 2 wks, what questions should I be asking him? And, in the meantime, how best do I best handle this and maintain my own frustration levels?

IloveMom Jan 2015
Can you asks for another substitue? Walk her. Ask why she is upset. etc. As aboutthe s mood swinging drug Prozac?

IloveMom Jan 2015
Try putting on some good ole music, movies, radio statons. Sundowners it quite the show time Walk her if you can a bit.. If it gets too much, tell her you need to use restroom... step away for a few minuites.. get on line at chat with us,,It s a good way to vent. OH BOY My Ambien is finally kiciing in....... Need to shut the thing down. Sorry.

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jeannegibbs Jan 2015
Thank you for that update! I hope the new medication is helpful.

aries1 Jan 2015
After visiting with her G.P. he has prescribed an anti-anxiety drug for the times her frustration level is too high. I asked if she should be seeing a neurologist (she needs a referral) and he felt it was not necessary. The ct scan did not show anything, he did say an mri might show something, but even if it did, nothing could be done now. Things seem to have eased up some, so we will see how things go. I thank all of you for your replies and insight.

blannie Jan 2015
You've gotten lots of good advice, I just want to give you a virtual hug. This has to be so difficult for both you and your mom to go through. Hugs to you both...

BarbBrooklyn Jan 2015
It's called Sundowning and is one of the hallmarks of dementis. Click the Eldercare tab at the top of the page and read about dementia and Alzheimers. She needs meds.

aries1 Jan 2015
Thank all of you for your informative answers. I now have a basis for inter-acting with her GP. I do note that her depression and confusion escalate in the evening and since her frustration is enhanced by her inability to be in control of things, by the end of the day she just "explodes".

pamstegma Jan 2015
Oh gosh, I know your frustration level is high, but her anxiety level is even higher. I would call the MD TODAY and ask for anxiety meds.. Then when you see him in two weeks, he can determine if that works for her, or he needs to add in an antidepressant. Who was the attending Neuro doctor when she was in the hospital? Can you follow up with him/her?

Sunnygirl1 Jan 2015
Yes, there is good advice above. I would have her see a neurologist. Write down all the things you have encountered, so you can inform the neurologist. That will help him in his evaluation.

The resentment, yelling, etc. sounds familiar. My cousin started out that way in her dementia. It took years before we knew the cause. But, it could be something else. If that is it, you just have to develop a tough skin and go about doing what you know you need to do. If it is dementia, you'll have to study what to expect and then make your long range plans. Rarely, will the care not increase dramatically.

In the meantime, I might try to provide your mom with as much input as possible. I do that with my cousin, since they have little say about things. I ask things like do you want tea or water, ketchup or not, do you feel like a nap right now, would like a new hair style? I try to allow her input on as many things as possible. It may or may not help, but it's a good thing to try.

lindaz Jan 2015
I;m not sure if this caused by the stroke. Does she just break out in tears out of the blue? Or is it after what she perceives is a confrontation. The reason I ask is that there is something called (not sure of the spelling) Pseudo Bulbar Affect. I think this comes after a trauma like a stroke. But she really needs to be seen by a good neurologist. As written earlier it could also be the beginning of dementia and that is a roller-coaster ride of emotions - for everyone. I think the first step to the neurologist and I think you will get more answers from there. Blessings, Linda

BarbBrooklyn Jan 2015
You need to be aware that the standard "who's the president, what day is it) isn't going to get at the reasoning deficits that are often present in dementia. GPs are often happy to say everything is fine when in fact the caregiver knows it is not.

Changes in mental status can be scary and can be indications of utis or other infections.

notrydoyoda Jan 2015
I would think this problem would be out of her general practitioner's field. What does your insurance policy say about specialists Do you have to get a referral from your primary care doctor? I bet the doctor does send her to a neurologist who is going to want to see the ct scan results. I would definitely write down your observations of her behavior and probably give that to the doctor before you visit or ask to see him briefly the day of the appointment before he sees her and share your observations.

aries1 Jan 2015
Thank you for your answer. Since the stroke she has not had any follow-up except with her general practitioner. A ct scan has been taken, but we have not gotten the results, we are scheduled to see him 01/13. I will see what his prognosis is and see if he will refer her to a neurologist, if not, I will suggest it to him. I know it is her frustration contributing to this and am hoping that things will not escalate before we get to the dr. (I called for an earlier appointment and nothing was open).

BarbBrooklyn Jan 2015
Sounds like she might be developing vascular dementia. Has she been seen by a neurologist or neuropsych for testing? Geriatric psychiatrist might be able to recommend some meds to make this easier. Sounds like she's very frustrated and scared.

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