Do dementia patients have a negative disposition?

For the last ten years, I've been visiting a lady at the nearby state-run facility for people who had mental illness and are now diagnosed as having dementia. They are wards of the state. I would say that I have seen quite a variation of personalities when I was there.

Happy: Hope, the longest and oldest resident there, was always a joy to see. The staff said she was a favorite patient, always upbeat and never complaining. She sat all day in her wheelchair with her head bent to her chest but as soon as she heard a voice, her head popped to the side and she had a big smile and a friendly greeting. She died last year.

Content: Noah always greeted me enthusiastically and wanted me to come into his room to see his Bible collection. When I found out his last name was the same as a cousin of someone at church, I asked if they were related. She was shocked to find out that her Uncle Noah was there, twenty minutes from her house. She said he'd been "put away" as a young adult and no one ever talked about him. I told her how sweet he was and hoped she would visit. She didn't. He died last year.

Discontent, but happy in his delusions: James always told me that he was getting out of "this place" because he didn't belong there, he wasn't like "them." And then he would tell fantastic fabrications of being an ER doc, a mountain climber, the captain on a cruise ship, etc. He actually did "get out" -- his family was still involved in his life and he was moved to another facility closer to them.

Aggressive: A lady from Puerto Rico, who only spoke Spanish, was loud and intimidating. Those who could understand her (I couldn't) said she was mad about things that were not what she culturally grew up knowing, the food especially. She was always looking for a fight, I steered clear of her. Her family turned her over to the state because they were afraid of her and needed her to be somewhere safe. She also died last year.

Dull: The lady I visit, Ruth, has moments of brightness and then just disappears so to speak, no emotion. But she'll say things like, "They say I have dementia. I don't have dementia. I would know if I had dementia." Her first words to me this week were, "Jesus loves you." (I started crying right away, I needed to hear those words after just being through another hyper-spiritual tirade from my husband about how disgusting I am to God. It never ceases to amaze me how God can speak to us, even through the a lady with dementia.) The rest of the visit she talked repeatedly about falling and how she hurts all over and her food needs to be pureed. I tried to redirect her with some of the things I know about her past (she has told some wild stories but many of them checked out true -- her parents made horror and XXX movies back in the 60s and 70s -- I actually found their IMDB pages; they had three homes, one was on Long Island and I thought I could get her to chat a bit about growing up on Long Island) but she was fixated this visit on falling and pureed food and pretty much devoid of emotion.

So, not all dementia patients have a negative disposition. I really think much of it goes back to their disposition as a child. Hope and Noah both had Mennonite upbringing. James was highly intelligent, very academic and well-read (hence the detailed stories). The Puerto Rican lady I never learned enough about to picture her childhood. Ruth had a lot of unsavory people in her life as a child, I suspect she may have been abused by some of them (even filmed), and perhaps that is why she becomes dull, maybe she had a habit of shutting down emotions as a child.

Everybody including doctors seem to think a magic pill will fix everything. Well, they don't. Sometimes they seems to help...but they can also do harm and is especially risky for the elderly. SSRIs and SNRIs can have side effects and can cause constipation, diarrhea, nausea, vomiting, anorexia, headaches, excessive sleepiness or insomnia...and worse yet increase confusion, agitation, anxiety, and increase risk of falls leading to fractures and brain bleeds.

I walked my mom every single day for 5 years in the park and it did wonders for her. When it was rainy I took her to an enclosed parking lot and we walked there.

Of her 15 years of Alzheimer's she never was on any kind of psychotropic or narcotic, and the complications of her long-term insulin dependent diabetes killed her (chronic kidney and liver diseases). Still she managed to live to be 90 years, 3 months. She also had high cholesterol due to her diabetes despite the sugars being well managed--I could not treat it because of chronic liver disease. Cholesterol medications would have tore up her liver, and she could not communicate if she were having side effects from statins. So despite doctors trying to push statins on her I refused them for her because of her liver problems.

I think exercise made a big difference and she was bedridden for the last 2-1/2 months of her life, because she literally forgot how to walk and could no longer focus on that task of standing.

I sacrificed my life for her. But she was my mom and I love her dearly...not even death can take my love for her away but I grieve her loss everyday and it's been nearly 2 years without her. I ADAPTED...because we ALL die. So I came to terms with it...but I still miss her very very badly. Still if she were alive her brain would have been 100% gone from Alzheimer's. The last months of her life I had to use a feeding tube to keep her from dehydrating to death which can take weeks. Still, she died very comfortably and hospice came over daily to make sure she was comfortable and she was -- and we never did have to use that "comfort pack". She had the most peaceful death you can ever imagine and her family surrounded her in the end. She was surrounded with love to the end.

Everybody commented how great her skin looked. Not one mark.

Try taking her for walks everyday in the park. Do it daily. If she needs a walker, then use a walker. I always told my mom "this is the most important medication you will ever have--daily walks". I treated walking like a medication. Keep up a daily routine. I also took her out to the stores as long as I could (that was before COVID). If you need a wheelchair, use a wheelchair. Keep her going as long as you can.

I worked with Dementia patients for years. While some of them tend to focus on the negative, antidepressants, structured routine and enriching activities can help tremendously. Alot of people correct their loved ones in moments of confusion, which can often be very unsettling (and unneccessary). Everyday tasks or chores can help them feel needed and allow them to practice things like hand-eye-coordination, spacial recognition, etc. (I really need to get these coupons clipped and just don't have the time. Can you help me?) Music is a time machine. Everyday I would put on Shirley Temple or records of their eras of song and watch the years melt away. During sundowning, entering their world was key to keeping them settled, confident and content (Don't worry, I called your mom and she wants you to stay and have dinner with the girls ). All of this is extremely hard to manage for families as ot truly is a full time job. I always suggest for families to look into programs that have day care situations or, if it becomes too difficult to provide quality of life, a good NH with quality enrichment.

Unfortunately I have the same exact problem with my mom. She doesn't want to watch TV, read, do puzzles, crafts..nothing but sit there. I've tried everything to involve her in and now the answer is NO to everything. She sits and stares also, but is quick to tell you what to do. The wash won't even stop spinning yet when she tells me that I have to put the laundry in the dryer.
I feel for you so much because I know you want her to be happy. I think that depending on the dementia, it changes a part of the brain that can deal with happiness. I try to get a good belly laugh out of her each time I'm there. Mostly over sayings that they used when they were younger. Once I had my shoes off and she said " put your shoes on Lucy, don't you know your in the big city"! It cracks me up and then cracks her up. I think laughter is the best medicine! Try and ask her about her younger self and the things she did and the sayings they used. Try once because I know it could backfire and make her more unhappy that she can't do those things anymore. I wish you all the best and know that you are not alone!!

Everyone is different.
My Husband was easy going prior to dementia diagnosis and after as well. He was non verbal but every time I talked to him he would smile. When I told him I was leaving to go to the store, he would turn his head and give me a kiss, when I got back he would give me a kiss. (He would kiss me if I leaned in to kiss him, he never initiated a kiss or a hug) He would hold my hand as much and as often as he could.

Dementia is brain damage. She cannot control her thoughts or feelings. It is not her fault. It is hard on family members, please keep reminding yourself it is not her fault.

My grandmother didn’t have dementia, but was miserable most of the time. When she wasn’t miserable she was worrying about… oh, pretty much everything. The weather, her family, falling, death, bills, food possibly going bad in the fridge, that story on the news about a crime that took place on the other side of town. All day.

We took her out for her birthday once. Middle of dinner my mom asked her how she liked everything. She frowned and said, “I don’t care for it.” Okay then, sorry we tried to give you a good birthday.

We tried for years to get her to take a mild antidepressant or calming meds. She would never hear of it, yelling how they would make her addicted, doped up, or ‘crazy’. She was afraid of any medication and would take half the dose of anything prescribed to her (even antibiotics) because she was afraid she would overdose and die from the prescribed amount. A relative who is a nurse practitioner explained how meds work and they were safe to take. Nope, grandmother wanted to tough everything out.

It’s sad that she spent her whole life angry, afraid, and depressed, when it never had to be that way. She suffered so much, needlessly. Meds can work wonders when taken properly.

I would say they have all the stops out, in that they are not socially inhibited as most of us are. They are not able to "put a good face on it". They react as they feel. For the elderly there is little to be thrilled about it. Whereas for you there is everything ahead of you, a world of possibilities, for us it is behind us, and ahead is loss after loss after loss. We lose our loved ones, our careers, our importance to family, our mobility, the ability to have a well body rather than one that aches in every part, and finally we lose our minds, and the ability to retain the memories that make us who we are. It can be a depressing world. For more of us than you can imagine, we will not be sad to make our exit; we have "been there and done that" if you will.
Why don't you ask gran about happy memories. Ask her what is difficult for her now. It might not be happy talk,but you might learn a lot about what she feels.

My 94 y/o mother with dementia has a nasty disposition with me; with others, she's as nice as can be. All she does is complain and bemoan her lot in life, and how her life has been miserable, and how her husband didn't give her what she deserved, and blah blah BLAH. Meanwhile, she's never had cancer, a serious surgery, nothing. She's led an easy peasy life with no hardships of any kind, no poverty, nothing to really complain about, so she invents it. She's never been grateful for a single thing in her life, ever, and that's a disgusting way to live life. For ALL us who have to listen to her, frankly.

Your gran should thank God for all she DOES have and the family who bends over backwards to make her happy and give her company & help. Or one day, she may find herself alone b/c the family got sick and tired of putting up with her crap and quit coming around. Then she'll REALLY have something to be upset about huh?

People living with dementia are certainly at increased risk of clinical depression. On top of that, living as they do in a world that is no longer making sense, where weird stuff keeps happening that they cannot understand, is it any wonder that they can be fearful, anxious, paranoid?

Your grandmother's focus on the negative, though, does suggest that she is feeling the sadness and despair associated with depression; and there may be ways to correct the chemical imbalance that could be causing it. Ask her doctor to consider and investigate the possibility.

Try to set aside your natural feelings of rejection so that you don't resent her seeming ingratitude. Just at this phase of her cruel disease, she can no more appreciate the warmth and love that the family surrounds her with than a blind person can see the beautiful flowers.