How do I know if it's depression or worsening dementia?

Jocelyne, thank you for your kind words but I did not feel guilty because of your first message. I am very suspicious of medications in general and I am really glad to know that there may be a way without them. In any case Mom seems to be doing much better with the new treatment. She is still able to throw tantrums (which will hopefully be more manageable), but she is much more composed and now expresses herself clearly. She is fully aware that she is losing her memory - she told me yesterday that she wished that she could save it all somewhere. I do believe that it would not work out if she were home with me, but it never hurts to be reminded of it...

Dear Sendme2help,

It turned out not to be an infection...just runny bowels....he is fine now...(other than the Alzheimer, which is enough to handle)....Thanks, marymember

I wondered if my reply wouldn't cause a tad of guilt... I am sorry for that. My main point was that taking her off the meds made all the difference in the world. I would never suggest anyone who has a destructive relationship with their parent, to take care of them and allow their souls to be chipped away day after day. No, you are no doubt doing what is best for you both. If she were to chip away at you day by day, there would be nothing left to give her. You are no doubt being responsible for yourself and I applaud you. If she chooses to remain combative, you have to draw the line. No one would be a nice daughter who would be getting afflicted everyday all for the sake of caregiving. A caregiver must take care of themselves equally as they take care of their charge. God bless you...

Thanks for all the replies - I now have a better understanding of what is going on. They are trying to find a comprehensive treatment for her that would take care of several symptoms, while to me some of these symptoms (such as anxiety) are traits of her personality which have been there all her life.
Jocelyne it is great that you are taking such good care of your mother - I often think that my mother's life would be very different if I took her with me, and I feel guilty about not doing so. However every time I spent a few days with her we would always end up bickering savagely - I felt constantly taunted and hurt. I am not a nice daughter.

All I can say is when I took my mom off of dementia AND anti-depression medicine, her life came back - spunk and all. But, I do have her at home, and that may be another reason she recovered so well.

Start a log/journal, simply put of her symptoms, behaviors, time of day when you see her. What you describe may come and go, improve or decline over time. It is not always a steady decline; or a drastic decline, depending on the diagnosis. Keep asking the doctor, sometimes a second opinion can help.

Geriatric psychiatrists?

Why is it that Alzheimer people get so many urinary tract infections? My husband drinks lots of water, eats well, but I can tell he has an infection due to blood stains on underwear. He takes an antibiotic and alternates it with sulfa. But it seems the infection is back. marymember

My mom was given risperdal and ended up acting out on her aggressive paranoid behaviors which got her in big trouble. She's never been in trouble before! Come to find out risperdal has a black box warning in patients with dementia! It's the biggest FDA warning that should be on the damn label! I got her a new doctor a geriatric psyc who was able to test her and told me there is no doubt the riperdak gave my mouth a breakdown and she has now been diagnosed with early onset dementia. My mother refused a new medication but I got a health care proxy and I give her the medication in her pill box. My father states she is taking her medication. It's all been frustrating and very saddening for me when I go to their home and check in. She has VNA once per week. Medicare wont pay for medication administration! The namenda xr has recently been started but she is already more redurectable

IT Is can be dangerous especially in men. Its hard to diagnosis in the elderly since symptoms are different than in younger people. Throw in Dementia and ALZ it's really hard. A urine test has to be done. My Mom has a history.

I'm probably going to be the curmudgeon here as I have very strong opinions about the use of medicine, especially psychotropics, for behavior control of elders. My father and aunt both had strong reactions to it. Yet I know that nursing homes use these meds in part to control patients' behavior, for good as well as not so good purposes.

What I do now to avoid the sometimes routine practice of medical personnel prescribing them is to list psychotropics as drugs to which my father had reactions and side effects. That's stopped the use completely.

He is a strong person, though and doesn't even take pain meds unless it's after surgery.

I'm also wondering if your mother has had UTIs - they can cause a temporary change in behavior.

You have gotten good advice though on seeing a neurologist to find out what, if anything, is going on.

It may be that there's just been too much change and disruption to her everyday routine and she's not able to get back to her baseline; new and changing meds don't help the situation. While that may seem simple, for older folks it can really upset their equilibrium.

This isn't a solution, but I always try to integrate natural methods of calming someone (including myself!) - music and pet therapy, relaxation and just talking - sometimes things like this can help return someone to a baseline more effectively, unless there are significant mental or health issues that are well beyond that.

At one nursing home in which my mother recovered, the staff had instituted gardening therapy. There was an assistive gardening bed outside on a small patio. Patients could weed sitting down. I don't recall what plants were there, but if I ever were in a position to create one I would have a lot of fragrant and butterfly loving flowers. Sometimes just having a beautiful little butterfly flitting around can create a sense of momentary calm.

But at least try the natural therapies; if the facility has pet therapy, make sure your mother has a change to participate. Same with music. Then watch to see if her behavior seems to return to more or less normal after these nonmedical interventions.

Good luck; I hope you can find some safe solutions, quickly.

I wonder if there is a nutritional issue involved in this? I know I have my mom on several supplements, and she seems to be doing better than some. Since I don't know if this AgingCare will allow links to other sites, I would recommend doing a Google search on Ethelle Lord. From there, make contact and ask about "the four horsemen" of vitamins. I wish you all the luck in the world. I know this cannot be easy for you.

Yes, my mother was also on Risperdal for aggressive behavior associated with her mid-stage Alzheimer's. While on the drug she definitely calmed down and lost the urge for aggression (she had never ever been aggressive before). But after a couple of months, she was removed as it wasn't intended for any relief from Alzheimer's (nothing is). Risperdal is a black box drug, so I'd be very careful. A neurologist specializing in geriatrics is your best bet. Finally towards the end of stages of Alzheimer's, she was on the lowest dose of an anti-depressant and that was all the drugs she took. Much better !

Please, get her to a neurologist immediately. Risperdal can be a good drug, I suppose, if necessary, but it comes with a number of trouble some side effects along the lines of the ones that you're mentioning. My father, who does have Alzheimer's, was put on Haldol and then Risperdal when I raised concerns about his behavior. Both drugs are antipsychotics, both have black box mornings for dementia patients, and both are used more commonly, according to what I read, than necessary. After I did my research, I had him removed from both drugs, and he has regained some functioning rather than being The stereotypical zoned out, drooling dementia patient. He has not regained all function, however, and I deeply regret his having been on these drugs even though it may have been necessary initially because he was showing some aggression. Please, visit a neurologist, and even more importantly do your own research. In my admittedly un-medically degreed opinion, the speed and type of changes you're describing sound like they may be significantly drug-driven.

By the way, getting her to a good neurologist is excellent advice.

Whoops! Meant to post a neurologist who specializes in memory disorders not behavioral!! Sorry about that! I need coffee I think!

Van is exactly right about getting her to a neurologist. Find one who specializes in geriatrics and behavioral disorders. They are thorough in their assessment and good ones only try to alter/ add meds one at a time and will offer great advice for a treatment plan.

Is your mother still on Risperdal? I don't have any experience with this but reading on the internet it seems like a very heavy duty anti-psychotic for a dementia patient! I found with my mother that the slightest, most insignificant seeming medication, i.e. blood pressure meds, could send her into a tailspin of the crazies. Urinary tract infections really threw her for a loop also. Any medication can either be a miracle or make a bad situation worse with a Dementia patient. Anti-depressants helped my mother enormously. However, that said, I would think your mothers' doctors would start eliminating some medications and evaluating the effect of the elimination before they start piling on more. My experience with my Mother taught me that just about any change would have dramatic results, good or bad, with Dementia and an elderly metabolism. I think you are preparing well just by starting to ask questions.

My mom had a similar decline (increased paranoia and delusions) when put on meds typically used for psychotic episodes. Prior to these meds she had a sudden "break from reality" with confusing dreams . with real life. She was admitted to a behavioral unit at the hospital via the ER for a 10 day stay coming out much worse unfortunately. This happened October 2013. She could not dress herself, shower without direct help with step by step directions and assistance with water temperature, took off her Depends most nights and wet the bed, and sat in a chair without the ability to communicate clearly and had delusions. Fast forward to one year later- around October 2014- she could follow a list of instructions for getting dressed and taking a shower and knew how to adjust the water temperature to appropriate level, she stopped having delusions ( but continues to be confused throughout the day and needs help- won't eat without someone making it but can make a sandwich when prompted) watches movies, can play an easy game of cards( she formerly played bridge but can't now) and can communicate with clarity while showing an interest on life and other people. She has been on an anti-depressant combo of Venlafaxine in the morning and Mirtazapine (referred to as California turbo or something like that). She is more cheerful, has more energy, and is more cooperative in doing things like sitting outside to get sunlight- for about five minutes is all she'll do) using light hand weights while sitting in a chair and eating more. Treatment for depression has helped her tremendously and I would follow the doctor's recommendation to try it to see if her symptoms improve. I really hope it helps as much as it has for my mom. BTW- if sensitive to meds- what is typically prescribed for some can be of course reduced- as the initial recommended dosage for Venlafaxine e was double what works best for my mom. The best of luck.

I have read that depression is very common with early dementia. I can imagine why! If you can, get her to a non staff doctor, preferably a neurologist for a proper evaluation. She may need an antidepressant, more visits, music, a nursing home with more activities. Pay attention to her stories and check her for bruising, elder abuse is not always a delusion unfortunately. Be well and take care.