How do you deal with the mean, hurtful side of dementia?

Your mother-in-law has stage 4 brain cancer & stage 4 lung cancer. Based on those 2 diagnoses alone, I'd get hospice involved immediately and make sure she's on pain medication to keep her totally comfortable. Her mean words are likely caused by agitation resulting from the brain cancer & dementia. Hospice is the kindest thing you can do for her right now, and withdraw radiation and any other treatments the doctors are saying are required. At this stage of the game, nothing is going to save her life and extending it is just a cruel thing to do. Keeping her comfortable and not agitated also means you and your DH get to (probably) hear a lot less mean & hurtful words coming out of her mouth. She has no idea what she's doing or saying at this point, since you say she has always been such a sweet and kind person before now.

Wishing you the best of luck with a difficult situation.

Your husband needs to remind himself that her brain is broken from the dementia. It's the dementia saying those things. He knows full well his healthy mother would never say them. My 99-yr old aunt has mod/adv dementia and says all sorts of awful nonsense to me, and she helped raise me for 20 years. I just go back to my best memories of us together because that is the reality, not what dementia makes come out of her mouth now. It's hard. Maybe he can choose to walk out of the room or change the subject to the weather. Whatever it takes.

Has she been evaluated for hospice? She may not need it yet but it'll give you time to do a little research.

How old is your MIL? Poor lady. She has been thru the wringer. You have to know, besides the dementia killing her brain, now she has brain cancer that what she says is not really aimed at you. Whether its the Dementia or the cancer, her brain is dying. She has no control over what she says or thinks. She doesn't realize what she has said.

Find out what the Psychiatrist can do. If the testing for cancer shows its not curable, I would call in Hospice. Yes, family still does most of the work. But you get an aide to bath her. A Nurse will check in every few days. She will get morphine to help with any pain. You can get respite for a few days.

Mindgames, I wonder if a session (not a course) with a therapist could help your husband. Many people find it easier to accept advice from a ‘professional’ than from a family member. Your husband needs help to cope with his difficult mother, and it would help you if he was less upset.

That's a really really hard aspect of giving compassionate care to loved ones in the face of sweeping and shocking alterations of personality. Unfortunately, the only solace I see being granted here is her death, which appears like it is pretty imminent. Just know in your hearts that she is not herself and the sweet person you remember is still deep down inside of her. Choosing how you remember her is your gift now. I wish you strength and resilience.

Pray. Ignore. Forgive. It’s not her or the real her. It’s remnants of her sickness.

Remember the brain is a body part. It’s full of disease at this point. She has no idea what she’s doing and if she did she’d be the first one to be mortified by it. Try to remember her previous goodness as much as you can and remember her “computer has a virus”. After she passes try to remember all the good things she did in her life and let these sad memories fade.

My brother was like that when he was dying from renal cell carcinoma.
He was on a morphine pump so I knew logically, he didn’t mean it.
I would walk outside, sit down on the parking lot curb, and bawl.
Its not easy, it still hurts our hearts, but their “social filter,” is gone.
My father was twice as awful.
I hope I don’t leave my life, mean. 😇

Its a very difficult, heartbreaking situation.
Best to focus on COMPASSION and do this 'mind training' when not around MIL. To be ready to separate 'who she was and how her brain and body is now.
* Be ready to feel sadness, pain, hurt.
- Prepare ahead of time how to shift (compassion)
- Take a break - a walk for a couple of minutes - anything to interrupt the interactions if momentarily.
* Exercise - get the feelings out in healthy ways.
* Role play to deal with it before it is in real time.
* Agree with her - all the time. Do not set up ANY situation where there is arguing or correcting her. "I know how you feel" . . . "I wish I had a magic wand" . . . "I love you."
It hurts and moving through grief is the only way to move forward and not get stuck in the pain. It is not easy and my heart goes out to both of you.
NEVER FORGET. It is the changing brain 'talking' not the MIL you used to know.
Touch Matters / Gena

Mindgames: Imho, please know that your MIL cannot help what she verbalizes as she has a broken brain and cancer. Albeit difficult, do not take it to heart.