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I was told by a family friend that there is no behavioral test for Dementia. Oh they have the memory and math tests; the classic “clock” test; the brain scans; but there is no official troubleshoot for Dementia based on behavior.


My question is – is there a test in the US?


Bearing in mind – she is also Schizophrenic and pre-diabetic, these are the following behavioral “anomalies”


1) She is constantly wanting to go somewhere; to where – she does not know. I caught her pacing back and forth to a bus-stand outside our house on Sat 27th of April at around 5 pm. She then got a taxi, but 15 mins later – was back home. She’s restless and can’t seem to realize her behavior is strange. The police know her now and her escapades have been logged. This morning, she was dressed to go out, but said she decided not to.


2) She’s been constantly queering her bank for its working out of her interest figures. She’s been in touch with the banking ombudsman and has quizzed the local Lloyds bank manager on how the interest figures are worked out. She also accuses me of trying to manipulate her money. She keeps taking out money, £100 cash, from the cash machines; she says it’s for her taxi fares. On the 10th of May – she withdrew some amount – only to re-deposit it back in. This was noticed by one of the bank staff who is a friend of the family.


3) She’ impulsive. She can get an idea and expects it can be carried out immediately. This affects her preaching as a Jehovah’s Witness – since she’s expecting her calls to apply for baptism on spec. The local elders forbade her now, since she is not carrying out the preaching work correctly because of her inability to judge disinterest.


4) She’s spending time in her room with the door shut. I was able to peep in on what she does in there. It seems she’s just standing on one spot with eyes closed and embracing herself. She has a poor sense of time and this can go on for hours. She even bars her door. The Police had come out once – when I was concerned that she had barred herself in and was not responding to my calls.


5) She has to be reminded to eat; unless I prompt her to eat breakfast or lunch – she will not eat. Then at night when she’s really hungry – she’ll get up and eat cake or biscuits.


6) She keeps complaining of losing her wallet, mobile phone, house keys, phone/iPad charger and little bits and pieces. She then finds them again – as she had stashed the item in a bag in her room. We all do similar forgetful things – but I know now to ignore her when she says she’s lost her keys or wallet – because it will turn up eventually.


7) Hoards fruit, cakes and sweets in her bag. Perhaps it’s in anticipation of her sugar levels, but it seems too much to keep such things in suitcases.


8) She insists on selling her stamp/coin collection; she thinks she can make money out of it. The stamp/coin collection expert at Corbitts – Mosley St.; Newcastle upon Tyne – says they are mostly standard coins and the stamps she has are nice, but they are not of great value. Her collection is good – but not worth much. Still – she wants another firm to price the stamps.


9) She is using the F-word now. She never use to. She telling her voices to F-off!


10) Has developed a habit of listening to JW audio and video material – in various languages – that she does not even understand. She says she’s learning the language. She thinks she can process the language despite the language barrier.


Can these be simply attributed to Schizophrenia? She’s been schizophrenic since I’ve known her; she’s not done these “crazies” to be noticeable to me before 2018. Is this simply old age?

I don't know the answer to your question, but.....

Dementia is a specific disease process that affects the brain's ability to reason, to sequence, to judge, to remember and to apply facts to situations.

The best "test" for dementia is a full neurocognitive workup that looks at memory, reasoning skills, insight and judgement.

Behavior can be disordered for many reasons. A schizophrenic may be doing something because her/his voices are telling her to. A demented person may be doing the same action because they are no longer reasoning from facts. A more generically mentally ill person may be doing the same action because they are stuck in a depressive rut and can't manage to do anything else. A person with autism may be doing a behavior due to perseveration.

All behavior is communication. But what the person is communicating varies based on what is going on in their brain.

It is incredibly hard to tease out what is dementia and what is pre-existing mental illness of any kind.
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VAuser1 May 20, 2019
I appreciate the difficulty. But what's really stressing me - is that the system only swings into action when things are "on fire." There is absolutely no pro-active mechanism; just wait for the worse - and then jump in to fix it when it's fully broken.

I'm now in the mind-set to allow my mam to do whatever she pleases. She use to walk out at 3 am in the morning wanting to travel abroad. I use to get so stressed - cus it's so freaky-crazy dangerous. But now - I just leave it all to slow-mo into coming about, because I can then use the Police presence as evidence that she did a crazy.
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I have a relative with Sz. While I'm sure it affects everybody differently, if my relative was acting out of character I would;

#1 query if meds were not being taken correctly & try to find out if this was the case.
#2 Could be start of a manic episode - even if meds are being taken correctly
#3 ? UTI - often goes with increased confusion. Any 'off' smell after using the toilet, frequency etc?

The agitation but especially your point 9) telling the voices to F-off - that to me rings alarms of increase of positive Sz symptoms (auditory hallucinations).

Is there are way to convince her to have a check in with the Doctor? Does your Doctor do house calls?
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VAuser1 May 20, 2019
I spoke to an Admiral Nurse - on the Dementia Help line UK. She suggested the Schizophrenia med needs to be either changed or seriously overhauled in dose.

She admitted - there is no "behavioral" test for Dementia - as in a test that would probe emotions. A friend of ours said - it's not her memory that's failing - it's her emotional/impulse control that's broken. Dementia is not just about forgetting.
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Did you post a while back about having to settle your mother in with a new consultant, or am I muddling you up with another family? How are things going in general with your mother's care and mental health management?

I'm not quite sure what you envisage as a "behavioural test for dementia." Like?
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VAuser1 May 20, 2019
Probably; the new consultant - still works under the original. We only have one fully qualified "Psychiatrist" in the team - and any other are subordinates.

Nothing as changed apart from they are more aware that I'm making a lot of noise. The dosage for her Clopixol has gone from high to now - just above previous last years. We had to insist on that. I think she's better under the new dosage. The team is planing changes in care, but they are in the pipe line.
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Countrymouse May 20, 2019
Thank you :)
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Only conclusive diagnosis is an autopsy upon death. Docs can make well educated guesses, though not certainty.

Has she been checked for a UTI?
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VAuser1 May 20, 2019
First thing the GP tested for. All fine. Even blood work for high level of Prolactin; all came negative. She's physically in good shape; apart from Gout and Diabetes.
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Most medical and behavioral testing is globalised. Publications come from all over the world. When a paper describes a certain medication usage, it does not make sense to use a different mode of testing. This is called "best practices". As for individual physician practitioners, they do get to choose which standardized test to perform. Some may taylor to shorter or longer forms of testing in their practice. Imagine if the person being tested has advanced dementia. The practitioner may choose a shorter form if the patient loses interest or is known to get angry. I hope my answer helps
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Your Mom seems very agitated. It could be the Sz but with any problem with the brain, I think Dementia is a given. Behavior, thats part of the Dementia not sure if there is a test. I know ur healthcare is different in the UK, but I think Mom needs a Psychic eval. Maybe a few days in a facility where her behavior can be watched. She may need a med adjustment. It should be supervised until they get the right mix since she suffers from a mental illness too. Poor lady.
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VAuser1, I can't see any way round this - back to square one with her GP and seek an urgent referral. Tell the GP what you've told us. Email is often a good way, but start with a phone call.
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VAuser1 May 20, 2019
This is the advice I'm getting from nearly everyone; close friends and help-lines. The GP is the most powerful piece on the chess board. Yes; I'm heading that route.
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