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My mom is a very shrewd woman, in the early stages of Alzheimers...she is very manipulative & really must be watched almost constantly...she seems to pick & choose the things she remembers...how can I tell if it's the Alzheimer's or her being coniving?

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Assume it is the Alzheimer's Disease. Why would you impute some kind of nefarious motive to your mom when her world is collapsing around her? My guess is that your heart is broken about this and you're somewhat in denial. AD is HORRIBLE. I am so sorry.
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GramzieWytch13, it is my understanding from the articles that I have read here on Aging Care that it all depends on where the brain is where what I called looped at the time you are communicating with your Mom. You might catch her brain looped in a current today at the moment state, then the loop will start to slide back into a world that doesn't make sense. Your mother has no control over this.
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I understand your question. They can be coherent one minute and "out there" the next. We have to assume it is the disease but I believe there's a bit of manipulation also. So frustrating and hurtful for caretaker.
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I don't think it's possible to sort out that kind of behavior. Once they have AD, it's not really important. Just chalk it up to the AD.

I had the same concerns with my loved one. She was an only child and had always been rather spoiled and selfish. So, when the dementia first started, we mistook it for her being lazy and spoiled. But, we were wrong. It was the dementia. Eventually, you will see what I mean. Actually, after the dementia really progressed, my loved one became less self absorbed and not nearly as demanding. I guess it depends on the person.
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You have hit one of my hot buttons, so bear with me if I get overly excited, please.

Your mom's brain is damaged. If she has always been a shrewd, manipulative person, she probably still has those "skills" to communicate with. But HER BRAIN IS DAMAGED. Stop trying to figure out what part of her behavior is coming from the brain damage and which part might be her long-term personality. It doesn't matter.

She is now a vulnerable adult. She needs protection, love, acceptance, care.

I don't mean that you need to allow yourself to be manipulated. I hope resisting manipulation is a skill you've learned along the way. I just mean do your best to act in her best interests and don't worry about what motivates her behavior. Give up any notion that you can "teach" her not to try to manipulate you. She has a damaged brain, remember?
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Are there adult care services for Alzheimer's patients that drive them around show them a good time?
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