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She's in an Assisted Living Facility, and when I go visit one day she seems very alert. Although she still is hard to talk to because she has trouble finding the right words to describe situations, etc. The next day she'll sleep the day away, then the next she is agitated and abusive to everyone. Is this normal. I never know what to expect.

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KJ - first, I'd rule out having a UTI.They can make a dementia patient strange,
Then I'd suggest that you schedule a CARE PLAN MEETING. I'd ask the social worker at the AL how is the way to do this best.

For residents of NH, a care plan meeting is something that is required every 90 days and the family member that is DPOA/MPOA gets a letter with the date and time. But for AL, well they don't have to do this per se but you as your mom's DPOA/MPOA can request one. I'd start a log of your overall concerns and specifically the day to day changes that you are noticing or concerned about. At my mom's old IL that was part of a tiered facility (IL, AL, NH and hospice), we would have a resident renewal meeting every 6 months just so we all were on the same page as to what they expected the residents to be able to do and whether my mom was doing that and to what degree.

At my mom's NH care plan meeting, her doc is not there, but the RN for her floor is, along with someone from dietary, the activities director and the daytime LVN and a social worker. Sometimes there will be a gerontology resident (MD) as her NH is affiliated with a medical school. You get the latest on her weight, eating and activity patterns, her meds and changes with them and an overall evaluation of where is is on doing her ADL's. There should be no reason why the AL can't do something like this for you. Good luck.
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Yes, get a second opinion. We we referred to a new neurologist and he is finally doing some tests, etc, to determine what is really wrong...is it Alzheimer's, Dementia with Lewy Bodies or what....
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My mom's moods and behaviors can change throughout the day and day to day as well. My mom does better when she is busy and laughing. If my mom does not sleep well or the nap isn't restful well then it can be a battle on my hands or she can be in a real childlike state.

My mom has Alzheimer's and had I known more plus not listened to my siblings, my mom would have been on meds far sooner than was. I was told my mom struggling to get my name right for the past 2 years was old age when in fact it was Alzheimer's. She is now doing better with my name, but the childlike behavior now occurs.

I would recommend doing research on dementia and speak with the doctor about the behavior. The reason is there could be more going on or the dementia has changed. A friend of mine her mother had a brain tumor but behaved like Alzheimer's and she had what was called sundowners. Her mom was far more alert and with it in the morning versus in the evening. So best to check with the doctor and if you are not comfortable with the one you have check with another doctor.
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Sometimes my husband's behavior changes from morning to afternoon. The evenings are always the worst. Getting him to take his evening meds is a battle because he insists he just took his meds 20 minutes ago! He has NO concept of time so when he takes his morning pills at 9 am +/- , at 8pm he thinks that was just a few minutes ago. He can watch an hour TV program but thinks it was over in 15 minutes or less. If I had recognized all these symptoms a year or so ago, I might have been able to save myself some heartache and worry. Hindsight is always 20/20, though, and nothing can be done to change what has happened to him or me. What you are describing is not unusual so there is no need to worry unless you know that her meds have been changed or that she might have an infection (UTI is the first one I'm also asked about with my husband). Don't know how an infection can cause these strange/different behaviors, but apparently they can. Worth checking into.
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One of my roommates who had Alzheimer's would be alert and present one day and the next day be repetitive in her conversations, forgetful and disoriented. There would be no change in the med. I later learned it was put of the disease. There physical changes going on in her brain. Hang in there and God bless.
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If your mother is in charge of her medical decisions, the doctor has no reason to consult you, but you should pin him/her down to answer your questions regardless.
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I'm finding that my mother's moods and demeanor are different from day to day as well. She's in a memory-care residence and doing very well, but some days she's engaged and happy and other days she's disengaged and sad. Some days I can detect some agitation and paranoia and other days she's chatty and laughing. I think like any of us we have our moods, but with the dementia everything becomes more intense and distilled to an essence. Their personality quirks and flaws become much more evident and often much more annoying -- at least that's what I've found!
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Don't EVER assume that doctors will speak to you before changing meds, or doing anything else. From their point of view, why would they? They have been charged with responsibility for her condition and they are doing their job. They don't need your permission to make decisions and they can't wait around for it, unless something like surgery is involved that they want a signature for.
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It could be a matter of the meds that they have her on. My aunt spent one month in a nursing home, following being displaced by Hurricane Sandy, and when she was discharged I was shocked at the meds that they had her on! Her behavior was quite erratic during that time but I chalked it up to the trauma of the hurricane, being evacuated, etc. I'm POA and thought that someone would at least speak to me before changing her meds, but that didn't happen. I'd look at that first.
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