Are dementia patients capable of being lucid and completely capable around most and some not?

Dementia patients will attempt to hide deficits around people they don't see often, including family and MD's. Now on the other hand they can't hide their mistakes from primary caregiver, nor do they try, but they will spew anger at the very people who are doing the most to help them. At this point medications for anxiety or depression are very helpful. Don't assume the aggression indicates abuse, quite the contrary, the most anger is directed at the person they know will take it without lashing back. So strange, a real roller coaster.

My husband has vascular dementia, they can hide their shortcomings from people for a bit, enough so that they can fool people that do t see them often to thinking there is no problem. My husbands psychiatrist told me that Dave can fool people for a while....interesting the psych saw through him...lol. And yes, he can be very angry, aggressive with me at home when no one is around....also he can be so sweet and loving, I live for those moments and file them in my memory bank....

I strongly agree about patients who try to hide the fact that they have dementia. I've seen this happen, And one of the most recent situations that I saw was when an elderly friend of mine was trying to hide an injury from a fall from his bed the night before. Any time any of his caregivers come around, he always tries to hide other things as well, I've also seen that happen. I also strongly agree that yes, they really do express the most anger toward people who are helping them the most because this is something that I also faced before I finally had to step away and watch this person fail. You can only do so much before you must let go and wash your hands of the situation. I had to do this because I learned that you just can't help someone who just doesn't want help. I know how it feels to have the best intentions possible only to face failure because you have to step away knowing that you could not make a difference in the life of another person. This can be especially hard when people are really set in their ways and you just can't change them from what I discovered. When someone is set in their ways, you just can't change that especially if they're used to doing things for themselves in an independent lifestyle. This is especially true if you lived alone for most of your adult life and never had a family. The longer you're alone, the more set in your ways you become to the point it's near impossible to change that as you get older. This is why older people are notorious for becoming cranky, and as another friend of mine once said, "cranks make the world go 'round" were his exact words. I'm sure he was joking when he said yes because you have to find a sense of humor sometime or life would just be downright miserable. When you're used to doing things for yourself, you tend to become very angry that anyone noticed your inability to do things for yourself.
I'm glad that not everyone loses their independence with age, I know someone who actually ran a farm well into his old age. He doing everything around the farm and he was still driving at that age. However, at some point his kids took the keys and will no longer let him drive just because of his age. This was for his safety despite the fact he had a clean driving record and was no threat on the road. It seems like at some point other people started taking over farm duties sometime around the time that he got a hospital bed. I'm not sure how long he lived after that, but he was mentally sharp just because he kept busy

It was so frustratng when my husband appeared okay when his children visited and for a while when we went out to dinner with friends. But soon the friends noticed that the stories were oft-repeated old ones. His children only thought I was nuts! Each of these stages last for indeterminite amounts of time--and the next one is usually worse! Sorry. It is good to save the good memories and to let go of the bad behavior--as loong as you are safe from harm and so is he.

Tran07. Absolutely. It is called 'cognitive masking' or 'social masking'. You can Google 'Alzheimer's cognitive or social masking' and gets lots of info on it. March 2015: When my father was being interviewed by the Hospice Nurse (he was 89) for possible Hospice care, she spent a full HOUR with him; she then came back into the interview room with me (his daughter) and the Hospice Social Director. Nurse said "I just spent an hour talking to Mr XXX in his room and I do NOT see any signs of late stage Alzheimer's or any evidence of poor physical health, I do not believe that he would require Hospice at this time.".
At age 88 my family doctor diagnosed my father with ALZ and multiple medical issues from labs, x-rays, testing. He had already fallen and broken a hip. he was in a wheelchair, but very mobile in it.
I had been taking care of my father for about 19 years at that time so I knew he had ALZ and had multiple health issues.
My father's regular doctor had been seeing my father every 3 months for about 20 years. He NEVER diagnosed ALZ or any medical problems.
He had been in another nursing home for 11 months, I had him moved to this new facility and a new doctor suggested my father would soon be needing Hospice Care. So this was not a new thing.
I then asked her what did they talk about, did he lead the conversation, was it general conversation, did he state zero pain or medical problems, etc.
She said 'yes, that is how the conversation went'.
I then said "how many 89 yr old men who were coal miners, hunted, fished, were very active their entire lives, broken hip less than a year ago, wheelchair bound, history of bed sores, etc., have zero medical problems or aches or pains?"
Pause to think about that one.
She recapped the conversation as him taking lead, asking HER questions.
This is an evasive mannerism of an ALZ patient. Keep the attention away from themselves, they want to lead the conversations and chats.
the primary care-given (family member for example) is the one who recognizes all behavior changes. Family and friends who rare visit see the 'normal side' of this patient. They think YOU are the crazy one since the patient has normal conversations, acts just fine around them. It is a defensive mannerism.
Most aggression will be directed toward the primary care-taker. Everyone else gets the pleasant person. However, once the ALZ gets to very late stages of this disease, the patient will most likely display their ALZ to everyone and can no longer mask it because they no longer have the abstract abilities (due to brain deterioration) to do so. Good luck with all of this.

Look up "show timing" as it relates to dementia. What an education. And no, we can take comfort in knowing that we are not all crazy.

While my mom doesn't have dementia, she does a good job of hiding how sick she is. When the hospice team came to evaluate her this week ( to switch her from palliative care to hospice), she put on such a good show. I told the nurse and social worker "you're seeing her at her absolute best"- they smiled knowingly and said that is always the case.

Most responses have talked about "showtiming" -- the deliberate effort to appear at their best for a short time. This absolutely does happen, and it can be frustrating for caregivers, to say the least.

But there is also true fluctuation in cognitive abilities. In Lewy Body Dementia that is one of the identifying features, and I believe it happens to a lesser extent in other kinds of dementia. My husband had good days and bad days, good hours and bad hours. He wasn't faking the bad times to get attention, and he wasn't show-timing the good times. There were actually fluctuations in how his brain was working.

My MIL has Alzheimer's and recently broke her ankle. She had surgery and is in rehab right now. She'd probably get up and dance right now if they'd send her home today. Puts on a good show for the neurologist too, when I take her to see him. I have to remind myself that he's been in this business for years and can see through her. She tells him her memory is good and she's just doing great, etc.

The challenges I had was that the staff in ER's and other facilities aren't trained in dementia or neurology and would often not recognize the symptoms. They would just ask a couple of questions and then post "alert, aware of surroundings, etc." Then when I wasn't there - they would ask her things and accept her answers.