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BlueHeron Asked March 20, 2024

Why is she cussing me out but not losing intelligence?

We're 6 years into this saga (at least, maybe 7 or 8). I guess whenever I heard that dementia patients raged at their caregivers, I assumed they were sort of unintelligible or partly babbling. Boy was I uneducated.


I wish my mother fit clearly into any of the dementias so I could have some idea of what comes next and how much I should be sweating about the money.


I know - everyone does dementia different and that's aggravating. She has a little bit of the classic symptoms of Alzheimers, a bit Lewy, kinda-sorta vascular. We've had so many doctors appointments and referrals. Two and a half years ago, cognitive testers said "congratulations- no alzheimers!" I could NOT believe it.


Yesterday was only the 1st part of a new round of cognitive testing and now we have to wait 2 weeks for 2nd part, then a week or two after that for the sit-down talk with the psychologist. We have waited so long to find out what in the world is going on! I threw my hands up yesterday and said I am moving her to an assisted living facility with the option to move into the memory care section if they see a need for it, NO ARGUMENTS. I put the deposit down and started the paperwork. She moves in by April 21.


She can't take care of herself and that's that!


Well, she has been cussing me out ever since, telling me I have a lot of nerve deciding her future without trying to help her get well first. Vulgar, nasty stuff too. I can't sit here in her independent-living apartment and babysit her when I've got a job and a husband to get back to. She is too terrified to be alone, delusions 24hrs a day, hallucinations in the evening, and wanders the halls looking for help. I left to go for a walk for 45 minutes one day and when I got back she was throwing the contents of her purse and wallet all over the place, all upset. Quetiapine helps with hallucinations somewhat just by knocking her out, but only half the time. It does nothing for delusions.


I've been here since early January when her delusions and hallucinations went into overdrive, and now it's March 20. Yes, my sister does 2 days a week, and yes I am paying someone $200 tomorrow to sit on her couch for 6 hours while I go to an appointment.


How can she be demented enough to be delusional and say she hopes my private parts fall off when I run around with all the men, BUT she can talk intelligently to a stranger about the education system, understand the newspaper, run the washer and dryer, feed herself, and go to the bathroom on her own?


AT LEAST SIX YEARS of family and friends saying "mom ain't right". Started with personality change, anger, inability to plan, hallucinations and delusions all in the first year. Now she's 79. No tremor. No shuffle. No incontinence.


Excuse me being blunt, but why isn't she dumber? Or not recognizing people?

lealonnie1 Mar 20, 2024
Whatever type of dementia this is or isn't, just get mother into AL next month and let her become someone else's problem. So you can get back to your life and she can move on with hers. Oftentimes you can't get a definitive answer about what type of dementia mother has, and certainly there is no cure for ANY of them, just meds to control the symptoms. Fwiw, my mother had advanced dementia thought to be vascular, and still knew who I was. Mean as a snake to me, and sweet as pie to "her girls" in Memory Care Assisted Living. It was best for both of us for me to stay out of her hair so she'd be able to be in a better mood.

Just get her settled and leave asap. Love ya ma, but I've gotta go now. Try not to get SO caught up in this situation that you'll ruin your own life in the process. Dementia is a no win situation for ALL concerned. Remember you didn't cause this, you can't cure it, nor can you control it.

Best of luck to you.
BlueHeron Mar 20, 2024
Oh my goodness, Lealonnie that's been my mother too! She even went so far as to tell a staff member in her community, "I wish you were my daughter", all sweet and light, while I'm standing there filling out all her paperwork and toting all her bags like a pack mule!
The people at the AL I'm moving her to have promised they will give her lots of attention and love her like family. It's in a rural area so there's not so much employee turnover.
I will drop in once or twice a week so she can have her target practice, and then I'll go dancing back out.
AlvaDeer Mar 21, 2024
You tell us this:

"Yesterday was only the 1st part of a new round of cognitive testing and now we have to wait 2 weeks for 2nd part, then a week or two after that for the sit-down talk with the psychologist. We have waited so long to find out what in the world is going on! I threw my hands up yesterday and said I am moving her to an assisted living facility with the option to move into the memory care section if they see a need for it, NO ARGUMENTS. I put the deposit down and started the paperwork. She moves in by April 21.

She can't take care of herself and that's that!"

Your approach was one of anger, and you acted before the completion of testing.

A much better approach would have been to complete the testing, then sit with MD and Social worker to explain that she needs 24/7 care now, and that you cannot take this on.
GENTLY.
WITH LOVE AND SYMPATHY. With mutual tears, I would think. With mutual grief.

I am surprised that her response to what you did is a surprise to you.
Did you think that she would take this loss happily? Something like "Oh, I understand dear. Go ahead and do what you think best for me. And go ahead in the middle of all this testing. Because I trust you to have my best interests at heart. You are in charge of everything now."
Is that the sort of gentle reply and response you expected?
If so, I guess the answer in all of this is not to expect "happy-and-grateful-all-the-time when someone has dementia. Instead, expect the unexpected.

BlueHeron, you were pretty blunt with your Mom. I can appreciate blunt when the other person is capable of fighting back. But in this instance, with your Mom about to lose EVERYTHING including her own power of decision for her own life? Might I suggest gentleness. I know you are both overwhelmed. But you aren't demented. I know you are burnt out. But you aren't demented and losing EVERYTHING that makes you who you are, including control over your own life.
ElizabethAR37 Mar 21, 2024
So agree. I hope that I will "go gently" into a LTC facility if/when I'm no longer able to care for myself. However, if I'm demented, I may not, as much as I don't want to be a burden to my family. I've always valued independence, and it would be VERY hard to lose what control I still have over my own life/living conditions. As I've stated many times, I hope to make my Final Exit before I lose all/most of my marbles. At 87 I think that's a reasonable hope. (I'm still compos mentis at this point.) I never intended or wanted to be old-old.

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Anabanana Mar 21, 2024
I, too, am puzzled by the progression of my mother’s dementia. Rarely recognizes me, bedridden, incontinent, delusional, zero concept of time, often thinks she’s under 30, living with her parents... but is still fully articulate, speaking in great descriptive detail. Now she appears to be relearning skills she lost (or gave up) 2+ years ago. Like feeding herself.

Her venom is reserved for me. Sweet as candy to others who visit.

I’ve long suspected that her dementia doesn’t just diminish some skills/tasks but also the motivation or comprehension of the reason to perform them. Was she unable to recall how to use the washing machine or was it feigned helplessness to get me to take on yet another chore? Had she lost her ability to work the stove or was she tired of cooking? Why walk when there’s a perfectly good wheelchair? (she decided when she’d never walk again) Why feed herself when someone else can feed her? She used to rage that I didn’t do enough for her and this is kind of a continuation. As if the mental capacity for “Why?” declined as much or more than the “How?” It’s so baffling and so frustrating.
BlueHeron Mar 21, 2024
It is truly baffling! My mom is definitely not on a slow continuous downward progression like Alz. She even got a little better for a couple years, when her delusions went back to sort of just being paranoia. But that could have been due to a medication adjustment plus quitting drinking. I think alcohol use disorder can "unmask" or magnify dementia symptoms.
Like your mother, I think my mom was done with serving herself meals and loading the dishwasher. She has me and my sister to do the waitressing. She sure doesn't mind nagging me to clean up the kitchen!
It's the fluent, clear speech with advanced vocabulary that surprises me the most. My great-aunt Annie babbled when she had dementia, nearly the whole time.
Beatty Mar 20, 2024
Wow. Yes I would expect after 6 years someone with Alzheimer's would lose cognitive skills, short term memory, recognise people less or have more word finding problems..

Hallucinatuons may be more in line with Lewy Body Dementia... personality changes & lack of filter with FTL. People can have mixed dementia symptioms & have other health conditions going on too.

I hope the 2nd part of the medical testing gives you some better answers.

As to a dx or not, your Mother cannot manage in independant living, she needs a higher level of supervision & care. She may be angry about this change. But as you say, there is no other choice. She lacks insight to this.
This is what it is.

Keep us updated if it helps you.
Take breaks & know that this too will end.

Scampie1 Mar 20, 2024
I have been told off, but thank goodness my dementia clients were good old church going ladies and socialites. LOL Now, my alcoholic mom was another case. It is weird, but some of the behaviors in dementia folks can mimic the behaviors of alcoholics. I have over forty plus years in Al-Anon, so I use the principles of the program when dealing with a recalcitrant and stubborn individual dementia or not. In Al-Anon, we learn it's the disease talking. In Dementia, it is the disease talking. The brain is broken.

Dementia folks do say some vulgar stuff. I remember my father in-law accused my ex husband of having an affair with this mother. We knew something was off even though he had not been tested. 👺

I've watched them showtime. They can act really good for awhile especially in front of company or physicians. However, when it is just the carer and the person, it's a different scenario. The stubborness, meaness, yelling and screaming comes into play. It seems like another switch goes off and you are dealing with another person. Dementia is a strange illness. You can try redirecting and maybe toileting if needed. Sometimes offering a snack or a drink of some kind can help. If this doesn't calm the person down, make sure they are safe, and leave the room to get a breather. This is the time I would do laundry or take out the trash.

Try to remain calm keeping your voice low. Nice music helps too. Try switching on to a nice radio station. I remember reading about music helping. When I did my clinicals at a nursing home over thirty something years ago, a nurse was passing out medication to an older man. She told him, you always have nice music. The music was nice, and he loved it.

Heck, if the music doesn't help the loved one, it would definitely put us in a good mood. I listen to rock when I want to get out of a depressive funk.

A good support group helps. Altzheimer's Association has a hotline you can call when we get overwhelmed. We do get overwhelmed.

Hopefully, your mom is in memory care, so they can work with her there. Go back to your life as soon as possible.
BlueHeron Mar 20, 2024
My dad and mom were alcoholics too. He died young. I wonder if it contributed to her dementia. It certainly didn't help! She's also got some small vessel disease and unruptured aneurysms that continue to grow. I'm curious to know if that has caused vascular dementia, but she refused to do an MRI ordered by a hospital doctor so we could compare to an old MRI.
She's always been a pill.
NeedHelpWithMom Mar 20, 2024
Blue,

No one has the answers to your questions. It’s impossible for us to know what is going on with your mom.

I stopped by to say that I am thrilled that you have decided to place your mom.

I am sorry that she has mistreated you so badly.

Honestly, I feel like it’s par for the course for them to treat people who offer the most help the worst. Maybe, it’s because they feel closest and safest with them. Who knows?

Anyway, good for you for getting this process started! Wishing you all the best.

Midkid58 Mar 21, 2024
You're doing the right thing.

AS far as WHY our elders get mean and even obscene with US, the family, when they play coy and cute with others will forever be a bafflement to me.

My late MIL had a mouth like a sailor the few months before she died. She'd always had that 'side' to her, but showed it to very few. Once her dementia got the better of her, she'd let it rip with anybody/everybody.

Honestly, if she hadn't been so foul at the end she could have died in her home, which was what she wanted. My poor SIL--the things my MIL could and would say were over the top.

There's nothing new that the ALF hasn't seen. Don't take it personally when she rages at someone (esp if that's you). It's the disease.
BlueHeron Mar 21, 2024
Thank you Midkid! The ALF has been very reassuring about managing her unfiltered language. Speaking of letting it rip, my mom belches all the time now. Just- BRRAAAAP!
She's a bird.
waytomisery Mar 21, 2024
When I worked in an SNF many years ago, we had a resident who had had a stroke but was totally with it . She was a really nice lady . One day a switch flipped and she went off the wall . Cussing etc . Hallucinations , delusions , you name it . It came on all of a sudden . It was not a UTI , another stroke , or delerium or electrolyte problem . The doctor didn’t think it was dementia , came on too suddenly . Everything they tested for was negative . Finally the doctor decided to test for one more thing and that test finally revealed the problem . It was syphilis to her brain . She must have contracted the disease at some point much earlier in her life and it was untreated . . It can take decades to cause symptoms in the brain .

Blue , I’m not saying your mother has this . It’s just another example of many reasons that can cause strange behavior . It can take time to sort and figure it out , by ruling out other things first .
NeedHelpWithMom Mar 21, 2024
How sad. Were they able to treat it at that point or is the damage irreversible?

What a wonderful doctor to continue running tests in order to determine what the issue was.
MiaMoor Apr 7, 2024
People with dementia behave differently, depending on what parts of the brain are most affected.
My mum has vascular dementia, from having had a severe stroke (it was a bleed at the back of the brain) 13 years ago. She was diagnosed about 2 years ago. However, it was difficult to tell because the stroke had already caused difficulties with memory and damaged the part of the brain that governs appetite and eating.
Mum's illness is completely up and down. On her down days, Mum is barely aware: on her good days, you wouldn't be aware that she has dementia.
Looking into it, the brain's neurological pathways can sometimes change, so that there are times when something that has been forgotten can suddenly come back for a while. At least, that's my understanding of what I read. And that's what I've seen in my mum.
Despite having significant brain damage, my mum can have times of surprising lucidity. She often beats me and her husband when we watch a quiz show on TV (a daily activity) and can sometimes explain the meaning of words that I don't know - I'm an English teacher! However, when she wants to express her needs or wants, or explain something, she cannot find the words. Mum can't make decisions and she no longer has any will power to force herself to eat.
Recently, she accused her step-daughter of trying to poison her. She will tell me to "piss off" if she doesn't want to do what I'm helping her to do, and my step-sister told me that Mum has also started to swear at her husband for the same reason.
They can't take it with a pinch of salt like I can. My mum worked with the elderly while I was growing up, and I have seen her calmly deal with those suffering from dementia so many times.

It's the illness, not the person. We have to be strong and make the tough decisions because they can't. We have to remember the person they once were. Because they can't.
KNance72 Apr 7, 2024
Wonderful explanation Mia .
KNance72 Apr 7, 2024
Blue heron try and read this article it may help you understand : Broad Institute ( MIT , Harvard medical School and Mclean Hospital ) written By Allessandra DiCorato - March 6 , 2024 - Schizophrenia and aging may share a common biological basis . I think it will be helpful for you - There is not a big difference between the 2 - schizophrenia and dementia - the brain is broken and the synapses are not working properly . I have been saying this all along . By watching the behaviors of 2 brothers with schizophrenia who have since passed at 42 and 55 and 2 parents with Dementia and Alzheimers - The Mother Passed in 2017 . I Did Not Know one brother was diagnosed with schizophrenia and was also Bi- Polar but he too took on a alternate personality I had never seen before at Dana Faber - nasty screaming at the Doctor and making up false stories ..... Eventually I had to Let Go and had a great social worker helping me at his new facility before he died . I dont think the Doctors and Nuerologists Know quite frankly what exactly is going On except we have a broken brain . Sometimes this nasty personalty comes out that we have never seen before and we are shocked especially if the anger is directed at us because they feel helpless . Usually the primary caregiver is the target of this anger . My Dad did some really mean stuff - Peeled all the Paint off My Car with a butter knife then spray painted My car , did the same thing with my new bicycle , Lost another new bike I had , temper tantrums , chased me around One time . I dont Know how I even survived some of the crazy behavior . I would tell His primary care Doctor and he would say " Let him Fold Laundry " or I would say " I am Exhausted " and be ignored . They really dont Know whats going On - You can explain it In medical terms but In reality it is an Enigma . I could write a book on My Father and write another Book on My brothers . My best advice is take care of yourself and let the assisted Living / memory care people take over . A great burden will be Lifted off your shoulders and you can breath again .

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