How can you tell if a parent is getting Alzheimer's/dementia, or mental illness, or drug induced side effects or normal aging?

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My mother has always seemed to enjoy illness. Her pain or sickness is always worse than anyone else's. She has been on lots of pain meds (including a fentanyl patch) for almost a decade. She is 75 and seems to be losing it sometimes. She says something totally crazy followed by something totally lucid. She is hard to explain and hard to deal with.

What I really am curious from other's who have had a family member with Alzheimer's is how does it start developing in the person? Can they be confused for a short period of time and then seem to be mentally fine for most of the other time? Does it gradually begin to get worse?

I just don't have any first hand experience with any type of dementia so am just curious.

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My mother also has Alzheimer's/Dementia and is currently taking Aricept for this. She has good and bad days and she also has "Sundowners" so it gets worse at night and especially during a full moon, right before and after! She will get up at 2-3-or 4am to go rip someone's a** over something she just remembered. Just in the last year she has gotten significantly worse to where my brother had to install a security system on the door's so she cannot get up in the middle of the night and go outside. She get's lost very easy and forgets most everything. Believe it or not she still likes to quilt, she has not forgotten how to do that but her sewing is getting bad and she has to rip out seams and re-sew when her hand slips while sewing. We have learned to only talk about positive things and not to tell her anything negative because that is what she will remember about 3 am and wake up in a pissy mood and then wakes up the whole house over it. She is in a doctor's care and goes to all of her appointments and takes her meds that are prescribed. My Dad hands out the meds and she takes them, so we do not have a problem with that. It's just very frustrating over her moodiness! And she knows she cannot drive anymore so there has not been an issue with that.
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Every person is different. My Moms mind was fine until surgery for a broken hip. What ever they gave her started her on a slow downhill slide. She fell and had a second surgery on the other leg. She was given Darvaset which put her out of her head for 3 days. She is now 96 and takes no meds but she is gradually loosing it. She did give up driving 10 or 15 years ago---her choice.
Now Daddy was a different story. He refused to stop driving even tho he was seen running stop signs and pulling out in front of people. Mother took his car keys and sold his car. That won't work for everyone but how about watching for a chance to get the car keys and hide them. If your parent still lives on their own, be sure to take the keys with you so they won't be found. Also there are usually 2 sets. You can help hunt for the keys and offer to take them places in your car.
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Thank you, wuvsicecream. I have come to accept in the past couple of days that it isn't just drugs for my mother, but there is dementia. Her discontent has been increasing, as she lives in a state of confusion. She is struggling to "keep herself" by telling me that she does not need me to handle her meds, and that I can go on trips. Of course, I know better. She has also decided she wants to sell the house and move with me to Texas. I tell her that the house is the only asset that she has that is protected from spend-down if she has to go on Medicaid, so we have to stay in it to protect it. That satisfies her. The truth is that I know a move would totally destabilize her. I am trying to keep sameness around her to keep the confusion down.

It is hard to know what to do, so we have to go by our instincts. wuvicecream, I related to so much that you said. I feel the struggle our parents go through with this in trying to keep their "selves" inside of them with everything is going so wrong.
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I am going to give you a crash course on dementia... from what I lived and experienced. First of all there are many causes for symptoms of dementia. So with that... Behavioral Health is the issue!!! If someone is showing signs of DEMENTIA (not thinking in a way they normally would, personality changes, mood, behaviors, memory loss and confusion, daily functions out of wack etc.) I always say pshyc. meds are for stabilizing, not to make more personality disorders. If meds are not taken as prescribed this could make a person worse in many ways.
OK for example my Mom was in a behavioral health hospital totally stable, for one... she was diagnosed and medicated and treated properly,meds at same time daily, and routine stable environment, daily schedule was routine.....eating meals... dressing... activities... setting... so therefore stable daily routine in conjunction with proper diagnosis(brain scan or possible loss of oxygen from other reasons, circulation etc.), and nothing to trigger a switch in any behavior is all part of "stabilizing" (as normal as a person could be, given the fact of other health factor issues).
What this ALL means is there are many factors involved.
I realized that once my Mom was stable she still was confused, delusional, story telling, wandering but her personality was still Mom. I knew they key word
"ICE CREAM" She may not have known what time of year, what day, what she had for lunch, how old she is, who I was in relation to her, but her favorite thing in the entire world that made her smile since the day I can remember about her personality was/is "ice cream"!!!! If she has a negative response to "ice cream" I automatically know that's not my Mom or she's really not well... something is bothering her. Another thing that never changes is the thought of her Dad. She see's him everyday (fantasy) but she never thinks of him in a bad way, it makes her smile when she thinks of him. She also loves music, This is how I can tell if she's "MOM in there".
OK now The transfer from the Behavioral Health to the NH was not a problem.....
until they messed with her meds. I saw her personality change way before they did. They kept telling me it was just me she's fine with us.... I knew that was a temporary mood change in the slow eruption to the exploding volcano!!!! So after me telling them the last thing I wanted was for them to fill my Mom with harmful drugs so she would accept my presence, and I knew my Mom was not acting that way just because of the dementia it was withdrawa,l and the meds were working if they didn't change them!!! I thought to myself well they will see for themselves if they don't listen, her mood will surely reflect what I am trying to tell them. I witnessed the slow decline of her hygiene approval, her wanting to get out of there, her not wanting to participate in things she enjoyed when she was stable on the meds and prior to her condition...THEN the VOLCANO ERUPTED!!! She went from being the EASIEST resident to being the TROUBLED MOST DIFFICULT ONE!!! So they understood my persistence in her stability being due to the right meds. AFTER the fact they asked me how to deal with her.
My point is everyone has a personality we are all unique. This is distorted with dementia but can be possibly regain a balanced to a point with meds, and daily events at low change of routine day by day surroundings and activities (for some cases, if it's just due to a chemical or brain disease). Anyone who tries to make logic out of a mental unstable person, prior to knowing what the cause is, is fighting a losing battle. Understanding the cause and the personality is key. If it is a parent you are caring for you know what makes them happy you know what makes them upset you know what relaxes them you know how to push the buttons... you see just because they shout out I hate you or go away your bothering me doesn't really mean just that. I remember saying those same things to my Mom to get her to ive me what I was really wanting... to get my way....to do what I wanted... she was either trying to protect me or it just wasn't possible at that moment... I didn't get that so I said I hate you or said something mean out of anger !!! She didn't give in because she knew right from wrong!!!!
So now when Mom say's go away your bugging me, I know I am doing what's right for her and I say "Ok I'm going to get Ice Cream do you want some?" If that bribe dose not work, I know she is really saying help me somethings wrong.
She deep inside knows I care but is embarrassed when I am the one she needs because that is just not in her programming, she tells me "I am your Mother...you are not mine." BUT she calls the AID that dresses and baths her, "MOM" (in a joking way) and all is good. So if I act like she is my boss and NOT like she is unable to care for herself she can handle that. BUT that is my Mom!!! I hope this helps.
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My father passed a few years ago. He started to drive about 35mph in a 55 mph zone. When he started hearing voices and seeing people who were not there, I went to his doctor to try to get him to have dad stop driving. This was before he was deemed incompetent. His doctor admonished me that I was violating g my father's rights. I called the DMV and they said they could not get him to stop driving without a doctor deeming him incompetent. So my sister paid a guy to come over to pull some cables on the truck so it would not run. Then we told my dad the truck insurance had lapsed and he could, not drive it. It upset him greatly but we could not live with ourselves if he had caused an accident.
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It certainly seems like every case is different and every cause is different. It seems like some strange mental behavior soup caused by genetics, medications, environmental factors, etc. A lot of times the problems start way before you even notice them.
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And oh yeah, she thinks she is driving over. And that is NOT happening. Last time she drove me into the city, we ended up wrong direction, one way street.
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Wow, I feel like you all are my family here. My mother fits this profile you all speak of. The last time I intervened about illness, she signed an anti-hippa form so that I would not be allowed to view her medical records. Stubborn as they come. I am driving her for a surgery in a few days. an 8:30am appointment. Mind you that the surgery is 25 miles away, we have to leave 3 hours before that because of her anxiety about being on time. AND she lives right next to a medical park, which is the known as the epicenter of world class surgeons.
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My 97 yr old Aunt is experiencing almost 75% short term memory loss. She only takes 3 scripts, thryoid, lasix and Vitamin B12 so they are not the cause. She is obsessed with her stocks, Cd's and bank accounts. She has quite a few and needs to go over them frequently. The problem is, she can't find them if she puts them in her room. I make myself, and her, copies and have been keeping the Originals in the safe deposit box. I need to explain things to her over and over because she forgets from day to day. BUT she knows every Company she has stock with AND every Bank she has a CD in. (This is long term memory, so it is intact) Every time the bank statement comes, I have to explain again that she has two checking and two saving accounts and they haven't moved her money. She wanted it this way and to change it would create more problems.
She can add and subtract quite well and reads the business section and stocks every morning and remembers things from about 5 years ago with no problem.
This has me confused because her only problem seems to be this short term memory so I don't know if it's early dementia or something that was caused from the hyperthermia that resulted from her Fall in Jan and not being found till the next day. She broke both hips and had double hip repacement plus her femur was cracked during the hip surgery and she had surgery to fix it 3 weeks later.
She is recovered to the point of walking with a walker and being very independent with all her personal needs but I insist that she now live with us and she is happy about that.
I would like to have her checked for memory but she is sharp enough to know that is what is being done and refuses to return to her Dr. if it happens.
Needless to say, continually having to locate the 'papers' she wants and can't find, is becoming stressful.
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Alzheimer's patients can have days where they are very lucid. As it progresses, the confusion and memory loss increases. My mother also is in denial and refuses to stop driving. We reported our mother to DMV by sending in the form from the DMV website for unsafe drivers. It has been 3 weeks now so I know they will be contacting our mother in the next week or 2. It can be done confidentially. We couldn't get our mother's dr. to report her or to even tell her to stop driving. Unfortunately because of so many adult children having taken advantage of their elderly parents or abused them, the laws now protect the elderly so much that when you try to "honestly" help your elderly parent, and they refuse, you can't do much until they become incompetent which means they can cause harm to themselves or someone else in the meantime. My mothers short term memory started to decline first. She would have trouble finding the right words to use just simple things like that. Then she started having confusion and that was when I knew she had Alzheimer's/dementia. The confusion started in Nov. of 2010, she has now progressed to where she can't balance her checkbook, gets confused on appt. dates, and recently she closed out her checking account because she can't balance it, and opened a new account. She did this about 3 weeks ago. She received the new checks in the mail yesterday and was angry because she does not remember closing the account out and is blaming the bank. Yesterday was a very bad day for her with confusion and memory. Yes, Alzheimer's/dementia progresses gradually in most cases but can progress faster with some people. Anything that they experience as a very stressful or traumatizing event can throw them forward also. My mother's confusion started after an out patient surgery. I hope this helps you dwt, and I hope it helps the rest of you regarding the driving issue.
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