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Mom has moderate dementia and has raging fits and other times seems lucid, the next minute she may be screaming for me to move out. This seems to be typical dementia but there are times that I really think she has had a mini stroke. The other morning she walked into my bedroom wearing her housecoat and 10 minutes later is standing in front of me holding it saying, "Can someone please tell me who the h_ll this belongs to and what it is?" We have a dog and a niece is here with her dog and Mom was feeding her dog its food, then turned right around to give it to our dog who cannot eat it and when we stop her she is screaming at us that she was feeding the same dog and we tell her no it was the other dog and she calls us a liar and every name under the sun. I spent two years going back and forth to Las Vegas with her caring for her sister until she died. Now Mom will on occasion bring up the fact that her and I went to Arizona to care for her mother living in a small house there (where I have never been) or she confuses me with her sister (who is dead).

I know it all sounds like it could be the dementia but it is just different than what we normally put up with and it seems like "something has happened" during the night or moments earlier and I can't figure out if it could be a TIA mini stroke. She is on Coumadin to thin her blood and takes meds for Atrial Fib.

Does anyone know how you can tell the difference?

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Wyndie - This is good...the fact that u posted pops up in my email! I'm not sure whether you were answering Persie, me or both if us. You seem very clear on what you say and yet l'm confused. It looks like ur saying ur mom has an HMO and she has Medicare and a secondary? Here in Calif, those are mutually exclusive and make all the difference of the doctoring you can have. As l reread your note, it looks like maybe ur saying that "she, the new doctor" is affiliated with an HMO, whereas the retired doc wasnt AND that ur mom is medicare + supplemental (so, like a PPO she can self refer and go to the doctor(s) of her choice. If l'm on the right track with this (?), l believe you'd want both a cardiologist and a neuroligist. Some folks like the idea if a gerontoligist but in my experience they arent worth the powder to blow them up wi, so to speak. You might find a cardio who does "primary care". When u ask about a GP, l think that you actually mean primary care. This would be the doc that would oversee her care should she need to be hospitalized. Neuros rarely do PC, but u should call & check. If you could find one who does, that would be the BEST as long as mom's problem are primarily brain. If u think it's more important to monitor her heart (or if she continues to object to neurology) a cardio who does PC would be gr8. If neither in ur area, u could go w/ an internest w/gerontological experience. The most important thing is a caring doc with whom YOU can communicate!
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My father first noticed that Mom was losing her memory before any of us realized what was happening. He passed away in late 2006 and Mom basically locked herself away. The Neurologist said her brain was shrinking but he thought she had done this to herself by refusing to take part in life outside the house. She would promise to go to dinner with us or on an outing while in his office and by the time we hit the car, she was telling us he was full of crap and she wasn't going to do it!

She doesn't show the typical signs of stroke as you have listed it is that break or strangeness of things being all the sudden different than what she was just acting that made me this it could be TIA. So all of this is strictly the dementia.

Her primary care doctor has just retired leaving us with a Brand new doctor who has never practiced before and she belongs to an HMO that we do not belong to. Mom is Medicare and Private Ins., I just don't know what type of doctor to look for another GP or a Gerontologist. I don't even know what a Gerontologist covers, or if they would take the place of a GP. Mom doesn't have a Neurologist as she fought us to stop going, she did not want to go through the cognitive testing. We gave in to her and now I wish we hadn't. It has gotten to the point that we need all hands on deck so to speak.

Thank you for your input I really appreciate it!
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I apologize 4 all the typos. The little screen on my Android didn't allow me to navigate with any ease to edit. Arrrrgh. I forgot 2 say that l lived w/ my mom full time from 2003 thru her passing. I see it allowed publication of my email addr...please feel free to write anytime.
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Dear Wyndie - Persie's info abt strokes is very good. Unfortunately strokes are a possible side effect of A-fib and atrial flutter. The blood gets sludgy in the atria due to sluggish pumping. Thats why they give the warfarin. They often also give a beta blocker if it better controls the heartbeat. The only way to be sure of stroke or TIA is CT scan or MRI. A neuroligist told me they can only diagnose a new incident within 72 hours, after that, it's "old" & they can't tell "how" old.

You haven't stated here how long your mom has had AD but it sounds to me like she has started progressing more rapidly of late. If it is mini strokes or TIAs, if u r her conservator or health POA, u will have to decide how far u will go with treatment, keeping in mind that prior to treatment, she will have 2 b put thru more rigors of testing, almost all away from home where she will b out of her comfort zone and take u with her (out of YOUR comfort zone) and u may both b miserable for no appreciable advantage. To b sure, u or whoever is "in charge" must make the medical, caretaking and living decisions for ur mom, but ethically in my opinion, that means making the same type of decisions u b'lev she would have made when she was competent. It's a bit of the responsibility of the caregiver to move one's own ego out of the way. Again, just my opinion, but also my sincere wish that u really know & understand your mom's perspective on her end of days -- and this includes everything from invasive heroics to doing nothing but comfort care and letting nature take its natural course.

Be sure you keep the doctors up to date on her progressing condition, even more regularly than her appointments such as by fax &/or email, and discuss care options w/ the doctors, documenting the discussion in future faxes/emails. This way, whether u decide 2 treat aggressively or not to treat, the doctor has been made an aware party to your investigation and intelligent decisions. If her doctor disagrees with your decisions, get a second opinion. If u believe you're right & can't feel doctor cooperation, shop to find a different doctor.

Your mom's behavior sounds like normal progression to me. In the 60s when l was in my 20s, l helped one great aunt take care her sister, my other great aunt, as she was passing from cancer which had spread to her brain causing dementia. They didn't call it that then, but it WAS that. In the 80s, the 1st great aunt had a classic stroke, half body paralyzed, fortunately no dementia but unable to ambulate or speak which frustrated her greatly until she passed 8 mos later. In the mid 80s, l helped a friend take care of her husband with ALS (Lou Gerig's Disease) - literally the opposite of dementia: body doesn't work but mind does. In the 90s, l helped my mom take care of my dad who died from AD in 1995 and concurrently was the POA for my aunt (mom's sister) who had alcohol dementia. Itook care of her for 6-1/2 yrs until her death near the end of '99. My mom had substantial physical problems, orthopedically and chronic hepatitis B. The medications she was on had a predominately anti-cholinergic action and the combination caused her to develop drug-induced dementia, signs showing in 2005 but not diagnosed until 2010. Just after her 94th birthday in 2012, she began to have funny feelings in her chest & was diag w/ A-fib. Right after New Years this year, she fell very early a.m. & the doc said her heart enzymes indicated a heart attack & she was hospitalized. We brought her home but the combo of her not feeling good and a throat ulcer made it hard to get her uo and about. This led to rehospitalization for pneumonia from which she did not recover, passing Jan 29th.

You might say l've had some small experience with what you're going thru. One ofmy best friends was a PhD in Psychology and she gave me the BEST advice about interaction w/ a dementia patient: YOU have to observe what makes THEM tick, each person is different, don't do what sets them off, do what you can to keep tgem calm, happy, laughing if possible. With my mom, while very ego-centric (typical of dementia), she was sensitive to my needs if called 2 her attention. When she would do what l call "flip", go from fine to raging in the blink if an eye, l found if l ignored her ir walked away or, worse (horrors!), corrected, it inflammed her. What turned out better for us is that l pretended apologetically that l urgently needed to go to the bathriom. Til the end, in her case, she could still appreciate bodily functions. By paying attention to when l thought she might explode, or catching the explosion right at the crest, then begging her permission 2 b excused (just like a polite little girl), she usually decompressed in short order and l waited out if sight long enough that she forgot that she had been mad. That's just an example of what worked in our case. You must find your own path but l'll tell u this: anything you'l b ok when she's happy but anything, ANYTHING, that upsets her is goung to end up upsetting YOY and that is 2 b avoided AT ALL COSTS if u r goung 2 b able 2 continue caretakung her.

This is my 1st time on thus forum. I am typing from my Android phone and it us no substitution for a computer. I doubt l'd be checking this site for response or questions.
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Oh, honey. It sounds like a roller coaster. Her dementia has really kicked in. I would not even engage with her. Just don't take what she says seriously. When she has her outbursts, walk away. You can also tell her why you walk away - "Mom, I don't like the way you are speaking to me - it is disrespectful. Until you can be more civil and calm down, I won't listen to you."

A mini stroke would show in her face and body. What changes do you see?

They may include:

Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
Sudden vision changes.
Sudden trouble speaking.
Sudden confusion or trouble understanding simple statements.
Sudden problems with walking or balance.
A sudden, severe headache that is different from past headaches.
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