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I have not been able to find an answer to this question. Can someone with dementia who is angry and delusion at the beginning of the disease become gentle and compliant later as the disease progresses? I hear stories about how a gentle person can become angry and violent but I haven't heard of any longitudinal study of the opposite.

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I have heard of and seen many cases where patients mellow out as the disease progresses. Especially when someone has an easygoing personality as their baseline they may go through phases of agitation or aggression in the moderate stages (often triggered by frustration or the environment) and then go back to being calm and content.
People who "always had to be the one in-charge" tend to get more angry and frustrated in the mild stages as they feel they are loosing control. This can continue through the moderate stage but eventually tends to burn out as they understand less of what is going on.

What the caregivers do with the patient makes a big difference as well. If the caregiver uses good communication techniques and adapts the environment in a way to help the person have a sense of control they often calm down. Delusions are often a passing phase that may stick around for 3-6 months but are rarely static. They change with the disease and situation.

Sometimes you get a person who has always been a difficult person but as the disease progresses they get nicer. A good example of this is the mom in the movie "Confessions of a Dutiful Daughter". The mom had never accepted that the daughter was gay. As her disease progressed she became more accepting and came to adore her daughter's partner.

In the advanced stages of the disease most patients tend to withdrawal and become more quiet. It may be harder for them to follow instructions as they have more difficulty with comprehension. In general they are less likely to act out. Because of this you tend to see a peak of caregiver stress from difficult behaviors in the moderate stage.
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YES. Mine did. Mother is 96. I dealt with the angry unappreciative side for several years (as I worked full time) but helped her daily through 3 decades of delusions et al. She was very high strung her whole life. She is very disabled now...severe dementia..blind..wheelchair..in memorycare now. ..but for the past year she has changed to sweet and appreciative. But I hung in there patiently through the bad years and am happy that the final years have become kind.
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Yes. I have two family members who had alzheimers and were difficult, angry and unpredictable at the beginning and during the progression of the disease off and on. As their speech faltered and they did not want to eat (or forgot how) and became more confused, it seemed they began to just "relax" if you will... because they could not process thoughts or even feelings and became more gentle and accepting... That was later when they could not get around or even "want" to go or do things... Kind of a "twilight" state which I have also seen in many seniors I helped care for, closer toward the end.. Everyone is different of course but with my family members, the most difficult and sad times were the earlier stages of the disease when they fought against most everything and were scared or so confused about their changing self and had such paranoia. That was the hardest. Good luck and May God bless all of you.
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Wow, it is encouraging to read the responses. I am hopeful that my husband will be less angry at me as his disease progresses. Oh, the irony of that statement...
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Yes, they can go either way. You usually only hear the horror stories of dementia. I was a caregiver to a lady who had been very difficult and demanding in her younger years ( as described by her children), but with Alzheimer's she was quite sweet and easy-going.
The book, "The 36 Hour Day", is a wonderful resource for caregivers of patients with dementia. In my own experience keeping days on a routine....predictable, being in their surroundings, and not changing routines....all of these things will go a long way. Frustration occurs more frequently when they feel stressed, or forget how to do everyday activities. Reminding them that it is no big deal and telling them how you forget things too also helps.
If you are the primary caregiver, have a backup person and take breaks...you will need it! Prayers for you.
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My Mothers spirit seemed to fade and she got quiet. The voices in her head stopped and she seemed to give up. The meds made her not care and she slept a lot. I was happy she wasn't tormented anymore, but sad that I had lost my Mother. I also think the brain quiets down when the disease progresses.
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So glad to read these comments, and yet so sad too.
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I hope your situation will become one where the dementia patient becomes more gentle. My experience has been the opposite. My mother, who was a tiny, gentle, caring person, became combative toward my father, who was her caregiver. She pulled a knife on him. My husband threatened me that if I didn't take him home from the nursing home, he would die. I couldn't take him home, and he died peacefully in his sleep. He won.
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My mom has her moments of both, but she always has. She is toward the end, but is physically healthy so will be with us for quite a while ;-)
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My mom has her moments of both, but she always has. She is toward the end, but is physically healthy so will be with us for quite a while ;-) hopefully.
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