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So, Dad--91, Parkinson's, depression, dementia (not quite sure which one) has been in a geriatric psych ward undergoing evaluation. Symptoms include hostility, delusions, short term memory loss. I'm in Michigan, he's in Mass; a couple of weeks ago, I managed to get out to the East Coast on business and visit with him (along with stepmom). It was a very pleasant visit which, three hours later, he had forgotten (and our phone conversations went back to "I don't have a son any more"). Last week, stepmom (along with her sister and niece) also had a very pleasant visit--but, a couple of days later, it was back to the same old phone calls ("Who are you sleeping with?"--although quite a bit more vulgar). He's been on seroquel but they will be changing to zyprexa. Now, I'm not expert, but I'm wondering if the dementia is tied into these two very different personalities--in-person, polite Dad and on-the-phone, paranoid, angry Dad. Any insights?

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Oops -- I meant I mute the TV for her. Wouldn't help much to mute the phone. :)
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The phone is confusing to some elders. My mother struggles to hear well on it, even though it is amplified. She has forgotten that she needs to mute the TV after she answers the phone, making it doubly confusing, since the TV is blaring. When I'm around, I mute the phone for her. She has dementia, so has to put her powers of comprehension into rapid use. She is not able to do this anymore. She gets agitated and confused sometimes. Generally when it is family, she calms fairly quickly. It could be that this type phone agitation makes your father lose the train of thinking that he has in person.

Some people with dementia can't talk on the phone anymore. Hearing and comprehending and knowing who they're talking to becomes too difficult. It may be the same personality, but with a touch of phone-stress added.
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Probably no more to it than - it's a lot easier to become hostile and say nasty, insulting things over the phone, than it is in person.
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Adam, I understand what you mean by feeling there are two different people. It is so tough seeing a person who was always so full of life and bright reduce themselves down to someone who is becoming more and more confused. I just can't wrap my brain about this, it really can rattle me.

My Dad has basic memory loss, I haven't seen an upset stage as of yet, hopefully not. But I have noticed that my Dad is much more alert on the phone when I call him, then he is when I am visiting with him.

It is so strange how some of the simplistic things can get my Dad confused. Yet when I was going over the Contract that he got on his house, which is For Sale, he understood everything I was saying... remembered all the places he needed to initial and sign. Go figure.
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Adam, I'm not sure what you mean when you ask about the dementia being "tied into " these two perdonalities. But i can tell you that early in my mom's vascular dementia, she would often accuse me of not being who i said I was when we spoke on the phone; we was hostile and paranoid about many things. That phase passed, thankfully. She's on two antidepressant meds and one for anxiety.
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