When I took her to a parade, she loved the little kids watching it, moving close to them, getting in their face, smiling and talking. That was OK with some toddlers, as long as she also talked to the mom, but some kids got a little scared, and are told not to talk to strangers. Today Mom got really mad at me for the first time, even hit me she was so angry (totally out of character). The issue? She rushed out with an open box of cookies coming up behind a man with a moving power weed-whacker, trying to give him one. I kept trying to call her back. Fortunately, he saw her and stopped & took what she offered. She came back in and two minutes later, out the door she went again, with the same cookies for the same man, ignoring my pleas to come back. He was gracious, and stopped & talked to me about the weather while he accepted them. This is a landscaping outfit that likes to get the whole job done in 15 minutes & move on, real fast. When she came back in she was furious, saying "what's wrong with that?" I told her that it's fine to offer cookies and be nice, but there's a limit, and she hadn't remembered that she'd just done it, and the guy had to get on with his job. That's over and beyond the safety issue with the power tool. She was furious: "That's ridiculous!" she yelled, and hit me on my shoulder--something she's never done in her life. So, it's OK to be nice to strangers but not to your daughter/caregiver? I know she's been calling me "Mom" lately, and won't eat my stew because she didn't like her mom's stew. Am I choosing the wrong battle? Or is there cause to worry? I'm afraid she's just so friendly that she's vulnerable to any stranger who comes to the door, and will frighten those elsewhere. How to handle it?

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Your advice is good, and your analysis pretty right on. It was like a toddler lashing out. She stayed kind of agitated all evening, and this is the first I've seen of this behavior, so I haven't discussed it with the doctor yet. She just stopped taking Ebixa a week or two ago and I wonder if that has any link to it. I've been trying to identify a caregiver's support group in the area, and will make a phone call tomorrow. I've been taking care of her for a month now, and for a week about a month before that, and have seen steady deterioration; she's 7 years out from her original diagnosis. The link between cause and effect is definitely missing for her now. The other day she picked up a wasp in her bare hand, saying "Look at this poor creature"; I saw it stretching its abdomen to sting her and swiped it away to her dismay and anger. "It was going to sting you" I told her, and she said that was OK, and wouldn't believe me that she wouldn't like it. As you say, it's a lot like a little kid, but without the ability to learn from experience or advice.
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When children are too young to understand risks to themselves and inappropriate interactions with strangers, we make sure they are never on their own, we phsyically retrain them by picking them up, we breifly apologize for them. We also train them regarding these matters as they get older and begin to venture out on their own.

I'm afraid that your mother is at a point like that stage where a child just cannot be allowed to encounter strangers alone. Unfortunately, you can't count on training her for more independence. She is only likely to get worse in this regard. She has no inhibitions and lacks a clear understanding of risks. You'll have to protect her as you would a child.

I would be concerned about her interupting someone using a power tool, but I wouldn't worry too much about wasting the worker's time or repeating her offer of a cookie. Most working adults can take care of themselves in this regard, will quickly catch on that friendly person with the cookies isn't "all there." You've got your hands full protecting your mother from her own impairments without trying to protect the general public as well!

You may have to resort to installing a lock that is difficult for her to open, so that she can't open the door to strangers on her own, and can't run out and offer her cookies without your supervision. I understand that sometimes putting a hook-and-eye lock above eye level may be enough for Alz patients.

The hitting sounds like a toddler lashing out during a temper tantrum. But an adult can be more powerful than she realizes and I'd be more inclined to worry about that behavior than about the urge to give cookies away.

Have you discussed these behaviors with her doctor? Do you belong to a caregiver's support group?
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