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I can't tell if she is in the early stages of dementia or if there is some medical problem. I feel guilty when I leave her. I need my own life. Help!

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Is she on new medications since operation? Look into side effects. Has she been checked for depression. Medical problems can bring depression on.
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She could possibly have a urinary tract infection. That is very common in the elderly, and that can cause someone to be a "different person". Or, there could be a problem with the Pacemaker, or she could be in pain and not be able to tell you???
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I've also heard that it's quite common for people that have had heart surgery to go through a depression of sorts. Talk to her doctor.
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