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LivingSouth Asked July 2020

Dementia or delayed grief?

My dad was basically calm about my mother's death several months ago. He did cry a bit at the time, but then seemed to accept it and didn't get very emotional, so we decided to tell him the truth when he asked about her. Now he has suddenly started looking for her and when I tell him about her, he starts crying a bit and goes to his room. Would this be a dementia thing or delayed grief? Before the pandemic he did see the hospice grief counselor but he never got him to open up much about my mom. He did tell him about their first date, but never showed any emotion, so his grief now is kind of a shock to us. If we try to hedge an answer about her to cover up the death - he can sense it and tells us that something is not right and he wants the truth. He does not have a short term memory basically.

disgustedtoo Aug 2020
"...sometimes gets up from table to go to bathroom and then forgets to finish his meal." Was this going on before or just after losing your mother? Does he live with you? Hopefully you can gently guide him back to his meal. Good nutrition and hydration can make some difference.

All too often the early stages of dementia can be missed. People are often good at "covering up" for short periods of time, say a visit, dinner, doctor visit, etc. Our mother seemed fine, but between errors in managing her finances and repetition during phone calls, I was suspicious. Once we took the car away (she was already just over 90 and unexplained mostly minor damage to the car said it was time, before she killed someone or herself!), I had to take her shopping or bring supplies. Buying stuff and/or asking for items she already had plenty of were also indicators. There were other instances preceding this that could have been little warning signs, but I only made the connection later after learning about dementia (accusing others of taking items for instance.) Finding things in the freezer unused and shriveled up veggies in the fridge that she bought the last time helped me realize she was no longer cooking - just eating frozen meals and boxed stuff.

Ruling out UTI is good (hopefully that can be rechecked at some point, or they did a culture, not just the dipstick test.) UTIs do really odd things! Mom's first after moving to MC resulted in sun-downing to the max! The last 2 resulted in night time bed wetting.

Depression - although some people might recognize this in themselves and admit it, I think the majority of people really don't think they are depressed or need help. Asking him and/or having someone try to get him to talk about it likely isn't going to be very productive.

I'm not a doc, only have experience with my mother and what I have learned here and online, but it does sound like your father might be in the early stages of some form of dementia (or possibly a stroke?) The short-term memory loss, easy to cry when frustrated or told about his wife's passing could be how it manifests in him. Although there are common symptoms for the various stages of dementia, not everyone experiences them and they don't always follow a pattern. Each person has their own journey.

Rather than subject him to intensive testing, there are simple tests his regular doctor can do (and you can access some of these online and try them too) which can identify cognitive issues. If desired you could pursue this further, as sometimes the cause behind the memory issues is treatable. IF it is dementia/AD, there is no cure. Learn all you can about it so you know what to expect and how to deal with it when it happens.

When we were hiring aides to try to keep mom in her condo, they sent a nurse who did the testing with us there in her condo (Medicare did cover this.) She confirmed what I suspected and made some suggestions, like a timed/locked med dispenser. At that time, the signs/symptoms were minimal, but definitely a flag to what was coming! The aides didn't last 2 months, when she refused to let them in. In her mind, she was fine. She's now just over 4.5 years in MC, doing well enough, but clearly living in the past (at least 40 years ago!)

Hopefully he lives with you for now, so you can monitor him better. When he asks about his wife, it would be best to try to deflect and/or fib about it. From what you have written, he sometimes seems to see through this. Although some insist we tell the "truth", personally when it comes to dementia I think it is best to avoid it, IF you can fib your way around it. Because they don't remember, it is painful for them every time they are told again. When my mother asks about those long gone, I use some excuse or brush off to get past it and try to change the subject. Her mother has been gone over 40 years, so that's a tough one. She's also the only one left of that gen on both sides!

Marie Aug 2020
You have so many good responses already.
From my experiences-
my father in law took care of my mother in law who was confined to a wheelchair at the end of her life. He was in great physical shape.
We always thought she was being very bossy telling him what to do.
We began to realize after he was gone, she was being bossy was because he had early stage Alzheimer’s.
MargaretMcKen Aug 2020
Exactly the same in my daughter's inlaws, except that MIL died suddenly, and then they realised how her being bossy had covered up FIL's dementia.

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CANDYCANE124 Aug 2020
This isn’t an answer I just wanted to say I lost my mom in hospice on Wednesday, July 29th She was 84 it was very hard, but the hospice nurses were Angels from God I’m so glad that she was peaceful and that received the care that she deserved. I took care of her for almost a year and it was my greatest honor to do so!
Isthisrealyreal Aug 2020
Candycane, I am so sorry for your loss.

May God grant you grieving mercies and strength during this difficult time.

I am happy to hear that hospice care was a blessing for you and your family.
Llamalover47 Aug 2020
Imho, I do not profess to be a medical professional, BUT some elders' mindsets are that their short term memory is not there, but long term memory is typically good. Perhaps he could be seen by a neurologist. The fact that is looking for his deceased spouse may be indicative of some dementia.

Idontremember Aug 2020
Most likely yes, take him to a neurologist to confirm. You will probably need to contact his doctor and have them make the referral first.
Ricky6 Aug 2020
Why would anyone subject their LO to a physician and/or neurologist examination for this situation. Not only is it going to cost money or an insurance claim, and perhaps make the patient uncomfortable, but the answer will be the same. It’s Alzheimer’s Disease with dementia.
Ricky6 Aug 2020
Dementia memory comes and goes, one day the patient may be quite lucid and other days oblivious to all that maters. You have to play it by ear. Some days you may need to deflect other days you could be straight truthful, but I would be careful how much and what you say. Franklin’s response (below) is right on.

Franklin2011 Aug 2020
When my husband would ask about a family member who passed, I would try to have a very upbeat voice and tell him they were in heaven and they were very happy. He might sadly reply,” they’re in heaven“ and I would say yes and acknowledge his feelings and then tell him who else they were with (their mom, dad, etc.) and how happy they were now. AfterThat, I’d try to redirect? That usually helped

AlvaDeer Aug 2020
This sounds like dementia with the short term memory and the knowing,and the searching. It may be coming on quickly due to the grief.

Jannner Aug 2020
My mother cared for my stepfather thru his Alzheimer’s. She seemed confused after his death and exceedingly hostile. She had a difficult personality so assumed it was her way of reacting to his death but I wondered if it was the start of dementia. Roughly a year later she began having delusions , they did a CT scan and found she had had a few strokes during my stepfather’s illness. Diagnosis:vascular dementia. Please take him to a neurologist .

RedVanAnnie Aug 2020
It does not sound like you.r father has really ever allowed himself to grieve. If he never does fully experience grief, episodes of depression and confusion will continue.. Dors he really not understand that his wife has died, or is he just refusing to accept it?

Dvinsant123 Aug 2020
Has he been checked for Parkinson’s disease? This can cause not only dementia but also the delay in response to things such as this. Just something to consider having him checked for. Also he may just not want to believe it so he don’t that can be a coping mechanism. Prayers to your family it’s very hard to have a parent gone and one also having problems. Sending you lots of love this can be very hard.

LivingSouth Jul 2020
Yes he definitely has memory loss - sometimes gets up from table to go to bathroom and then forgets to finish his meal. My mom was taken by ambulance to hospice and he went one time to see her - she was asleep from the morphine - but was not there when she passed away. We have talked to another family whose dad has dementia and they said they even took their dad to see the gravestone - but next day he had forgotten all about it. I have been telling him that she passed from the very beginning. If he had gotten upset, I wouldn't have told him. Some other family members have told him she is 'away' and he seems to know that's not the true story. Guess his generation doesn't believe in showing emotions to strangers because the grief counselor gets nowhere with him. Also tells them he is not depressed. Counselor kept trying to prompt him about how he felt, to no avail. He was checked the other day for UTI and it was ok, so guess it is not Alzheimer's but some other dementia. He seems to have a type that affects emotions - he will sometimes cry when he gets frustrated at buttoning his shirt. This is a guy who would make fun of his children when they cried about anything!

sjplegacy Jul 2020
Does he not know what she died from? You say you "decided to tell him the truth", and "to cover up the death", and "he wants the truth". Has he been misled about her death? Experiencing grief after only several months of her passing is not unusual. I lost my wife of 52 yrs in Jan of 2018 and still have moments of sadness. There is no "normal" grieving period. Overcoming grief is not a linear experience. Some days are better than others. I can understand his lack of emotion, and later his crying.

I was depressed after my wife's death from AD. Could that be your dad's issue also? Depression can cause cognitive problems like short term memory loss. At this time, I wouldn't consider dementia until he was evaluated for depression by a psychologist. I would maybe call the hospice counselor back also to see if she/he could help with his grief. After the death of a spouse, lonliness is the biggest obstacle for the survivor. Often times, reminiscing helps, like when he talked about their first date.

Don't jump on the dementia bandwagon yet until his grief is better addressed and depression is ruled out (although I don't know how it could be).

Isthisrealyreal Jul 2020
No short term memory is an indicator of dementia.

However, it could also be a urinary tract infection, so rule out any medical conditions 1st. UTI looks a lot like dementia. My mom ended up in the hospital with UTI, dehydration and kidneys shutting down after her husband died. They just don't take the same care because they are grieving.

I hope it is a simple UTI and not the journey of dementia. Best of luck!

Grandma1954 Jul 2020
Where was he when she died? Has he been her caregiver?
How long had she been ill?
Often caring for someone they are more able to "hide" signs of dementia since they are on a routine that rarely changes they can handle the tasks.
There is also evidence that the caregiver of a person with dementia often develops dementia as well. (I'm not sure if this is age related or the deprivation of activity and conversation I have not read more detail about it)
If he has not seen his doctor in a while I would schedule that.
If the Hospice is doing a Bereavement Support Group get him involved with that.
But also keep in mind there is no "schedule" for grief. But the fact that he continues to look for her leads me to believe that there may be some dementia involved.
Condolences on the loss of your mom.

Geaton777 Jul 2020
If he keeps asking it is most likely short-term memory loss and cognitive decline. That's how it's been with my MIL...she occasionally asks about her deceased husband so my husband gently reminds her. But others will have better suggestions on how to handle it.

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