Mom has dementia with abrupt outbursts, is there something that happens in the brain for this sudden change to happen?

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Mom is currently in and out of dementia. She has outbursts that appear out of nowhere in the middle of a conversation. Though I don't live with Mom and I don't take care of her 24/7, I have been told by her CGivers of her horrible yelling and screaming for whatever it is she wants - usually ice cream and candy (she's diabetic and obsessed with sugar). I've also been told that if no one responds, she throws herself on the floor and yells, though I find this hard to believe since she's largely bed bound.

I was just with her Thanksgiving. The whole time my brother and I were there, there were no "tantrums", however the CGivers contributed her energy and new behavior to the chemo. She felt great, sounded great - completely diff than before. It was wonderful. However, my brother and I were with her while the visiting home healthcare nurse was there. The whole time, she engaged with the nurse. Out of the blue, after the nurse had just discussed reasons to eat this and that and reasons NOT to include this or that in the diet, before my eyes, Mom seemed to stare up the ceiling and YELLED - I WANT FRIED FISH FOR DINNER. The nurse just gently responded Oh My! and we continued gentle conversation. We left the room and Mom kept SCREAMING the same thing.

Q: is there something that happens in the brain for this sudden change to happen? Was it triggered by words or something?

What is suggested that the CGiver do if they SEE it occur?

What is suggested that the CGiver do if they walk in on whatever is being screamed?

Nine times out of ten, they don't give in, but occasionally they do, and this worries me. Especially at this early stage in the game. CGivers are mother and son who is helping his mother (see my profile).

Thank you.

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I'm sorry for the difficult situation you are in. It's hard to care for our elders, and then they do things that make it worse! God bless you.
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Yes, she has been diagnosed with dementia and has been on Namenda for several years. I'll let the CGivers know of your suggestions and see what they're response is. That's the best I can do. I would love a "play by play", but I don't see the point of it if no one is following the guidelines. Still, I agree with you all.

Thank you so much.
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You didn't answer jeannegibbs question as to whether your Mom has actually been diagnosed, by a doctor, as having dementia. As she said, a person does not go in and out of dementia. There may be good days and bad days, even good hours and bad hours, but the person still has dementia. Your Mom needs a proper diagnosis if she hasn't received one.

If she hasn't been diagnosed with dementia, it's possible that these outbursts are being caused by something else, possibly medications or other physical ailments. Has the doctor been apprised of what is happening with your Mom? If not, he/she needs to be informed.

Is this person taking care of your Mom a professional caregiver? If so, she should be documenting everything that goes on. Even if the person isn't a professional, she should still be documenting -- for both her safety and your Mom's safety. Everything out of the ordinary that happens should be written down, as well as what regular activities are carried out from day to day. Relying strictly on what someone SAYS might be a problem down the road. If your Mom is on a strict diet due to her lymphoma and chemotherapy, the caretaker needs to abide by the diet, no matter what! Issues could arise in the future due to her lack of taking care of this part of your Mom's care. She needs to be made aware of the seriousness of the situation!
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Thank you for your feedback.
Of most concern to me is that the CG is not well trained, or trained at all perhaps, in this area. There is no documenting of anything unless I ask or unless Mom winds up in the hospital and I ask what led up to it (other health issues).

Secondly, the tantrums are mostly and repeated about food (sugar &/or exactly what she shouldn't have). Since I posted this she "expressed" her desire for a hamburger and the CG got it for her. She is newly diagnosed with Stage 4 lymphoma, in week 2 of chemo and told to stay off RED MEAT and SUGAR during her treatments. She knows this, the CG knows this, but I don't know that the CG can "hold out".

CG is long time companion to Mom and will never be dismissed for ANY reason.

Anyway, I guess what I meant by in and out of dementia is that yes, she can have good moments and bad moments within the same day. And one never knows when it will happen. Since the CG has a 2 way baby monitor in her room, I have even suggested that when Mom starts screaming for ice cream or candy, that the CG not even go in to entertain the idea - rather respond on the radio with some excuse that she'll be in later, or whatever calm reason for not going in 'at that moment". She disagrees with me and won't consider it.

Anyway, I guess as long as Mom is safe, that's all that matters. I guess I'm just "wishing" things could be easier on everyone. Thank you again.
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Has your mother been diagnosed with dementia? If so, do you know what type? What are her other dementia symptoms? What is her memory like?

One does not go in and out of dementia. There is a physical problem in the brain, such as plaques, tangles, protein deposits, etc. and that problem only changes by getting worse. But many of the symptoms of dementia can fluctuate a lot. Dementia patients can have good days and bad days, even bad hours within a good day.

Have these tantrums been discussed with her doctor? That is where I would start.

Dementia, and to a certain extent just old age, reduces inhibitions. When I sit in the office of the certified diabetes educator and listen to what I should be eating and what I should limit or avoid, I may be thinking "I HATE having my free choice being curtailed. I HATE feeling less independent. I don't WANT to give those things up." But I am a polite, well-socialized adult and I don't throw a tantrum. I say, "I know you are right. But it is so hard!" If my inhibitions were to desert me, I'll bet I'd be throwing a tantrum, too!

It is hard to supervise via long distance, isn't it? If the CG would make notes each time this happens (so she isn't relying on memory when she talks to you) you may see a pattern. It may also help you understand what CG means by "throws herself on the floor." Then I would definitely discuss this with Mom's doctor.
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While I can't imagine why your mom would start to scream about wanting fried fish for dinner, was the nurse talking about anything pertaining to fried fish? Or did that just come out of the blue? If it just came out of the blue I'm not sure anyone can say why your mom would yell such a thing. People with dementia do the things they do, say the things they do, because of the dementia. It's nonsensical to us and very frustrating which is why we can't expect our elderly loved ones to be present with us. We have to crawl into their world because they don't exist in ours anymore. One of the cruelties of the disease.

When the caregivers see this kind of behavior occur they should document it. In fact, they should be documenting everything. When your mom gets her meds, when she has a shower, etc. But if your mom has an outburst it should be documented. What time did it occur? What precipitated it? What was the nature of the outburst? How long did it last?

As for what the caregivers should do while your mom is having an outburst, in order not to agitate your mom further the caregivers can try to redirect her. Try to interest her in a tv program or a conversation, a newspaper article or an activity your mom enjoys. But these things shouldn't be forced upon your mom if she's having a fit, it will only make things worse. Gentle redirection can be tried but if it's not successful it's best just to let your mom go on until she wears herself out. Depending upon the kind of outbursts she has she shouldn't be left alone if she can hurt herself. If she's just sitting in chair or laying in a bed screaming the caregivers can step out of the room for a bit and check on your mom in a few minutes.
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