Behavior change after stroke. Any suggestions?

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99 yr. old had a stroke, prior to that she lived alone and was very independent. After her release she has become combative, does not want the caretaker in the house; refuses help with bathing, dressing and still tries to be independent. This presents a problem when you have timely appointments- she take hours to get ready. Her mood changes daily, from quiet to aggressive, when she is being aggressive she uses bad language and swears everyone is stealing. She is hoarding the mail and refuses to let the caregiver see if anything of importance is there. Her behavior has become 180 degrees since the stroke; her doctor has said that the stroke did not effect the portion of the brain that controls behavior, but that is what has changed. If this is dementia - is there medication that can be given? Thanks for any suggestions.

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GA,
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There's also the possibility that the stroke changed her perception of her health, her lifestyle, her possibility of leading a normal life....i.e., life changing events. And she's angry, not necessarily at anyone in general as a cause, but just because she's frustrated, perhaps frightened, and uncertain what kind of a life she'll lead.

I went through a period of that kind of uncertainty and anxiety after I had a stroke earlier this year. My first thoughts were not only of how my life would change, but how I would care for my father.

I took some time out, embarked on a relaxation program and tried to clear my head with solid plans going forward. It helped; finding a way to deal with all the uncertainties is a good plan, but it's hard to get past the fear after a stroke, at least it was for me.

I couldn't help wondering if that's an issue with your mother (?) as it seems the areas in which her behavior has changed are primarily control ones. If she's more sensitive to losing control, it makes sense that she'll fight anyone who she perceives as challenging control of her own life.

I'd back off for a while, give her a chance to get used to the "new norm", but let her know you and the caregiver are available for her needs. I'd brief the caregiver on this as well so you're both "on the same page."

Meanwhile, what things can she do? Can you ease those into her daily routine to help build up her self confidence and self esteem?
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I'd make sure the doctors were informed of her behavior. Any change in mental status should be reported to her doctor. I'd ask them to rule out other things like UTI, medication reaction, Vitamin deficiency, etc. Her symptoms do sound like dementia. You can inquire about medications that may address her anxiety. That was helpful for my cousin. She was very anxious, worried and agitated. Her daily med for anxiety and depression was quite effective in helping her.

Has she seen a neurologist lately? Had MRI lately? You can explore that, but, I'd try to consider if at age 99 she would want to go through that. Does she have an Advanced Medical Directive? If so, I'd try to honor it. I might consider how many appointments that she needs to attend. Can those be limited?

Resistance to care is not uncommon with dementia. I'd work on finding a bath attendant who is experienced in working with people who are resistant. If her needs can't be met in her home, I'd explore placement. Basically, if it is dementia, it's mainly, working with the person, hiring people who are trained to work with them, having patience and understanding.  Medication can help sometimes.  But, getting them do handle things differently, is not really possible due to changes in the brain.  I'd consult with a doctor who focuses on dementia as well.  It seems like her doctors don't know about her behavior changes yet. 
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