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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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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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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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I know exactly what you are going through. My mother has what looks like dementia, but she refused to see a neurologist. She has been taking some form of benzodiazepine -- Valium, Xanax, Ativan -- for 50 years now for generalized anxiety disorder. She is almost 86. She also has what acts like depression, particularly since her husband of 64 years died. She has a dependent, avoidant, narcissistic personality -- a whole mix that can make her act borderline crazy at times. She also has diabetes II, high blood pressure, and spinal stenosis that she takes medicine for.

So, I often ask myself which of the three D's I'm looking at -- dementia, drugs, or depression. She has let me take charge of her diabetes and bp medicines, but don't touch her Ativan! When I took semi-charge of Ativan by putting it where I could see it, her dementia improved substantially. I am of the mind now that at least half of her Alzheimer's-like dementia was caused by taking too much Ativan.

At her age and with her history, there is no reason to address my mother's dependence on Ativan. But I do want to keep her use of it down as low as possible. Since I have been talking to her about it, the use has gone down to "normal" and she is acting almost normal (for her).

But she still refuses to see a neurologist. Maybe she doesn't need to if it was simply the drug causing the "dementia."
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I have to add on the my mother's dementia was "acting up" yesterday and I asked her if she had been taking the Ativan. Her memory was terrible. She couldn't even think of the year. She was confused. She told me that she had not taken any of the Ativan that morning, but when I counted her pills, it told me the truth.
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My mother refuses to believe she is suffering with Alzheimer's/dementia and is still driving. But her area of familiarity is very, very small. Her hearing is nearly gone, too. However, my sister is allowing her to drive and hoping all goes well. I feel that it is time to admit some aging deficiencies before anyone is hurt or killed. How to work with a sibling who just wants to please Mom?
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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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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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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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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 mother is pretty much is the same boat, except for the diabetes. I took her to a pscychologist in June per Dr. orders to get some kind of idea what we are dealing with. Unfortunately my mother was leaving not soon afterwards for a two month visit with my sister in New York so we had to put any recommendations on hold. While in NY however, my mother has had some hallucinations and outbursts for which we had to contact the psychologist again. She conferred with a pscychiatrist in her group (who can write presciptions) about the case. He stated that no one should be on ativan long term and we are now weaning her off of it, which is a slow process. She was taking 3 pills a day, one right after dinner and two before bedtime and the doctor couldn't believe any MD prescibed it to be taken like that. So he changed it immediately to 1 in early am, 1 at noon and 1 at dinner, then started weaning her off them 1/2 tab at a time so by early in September she will be off them totally. He also put her on zyprexa (5mg.) for the confusion and hallucinations. It helped somewhat but since then it has been bumped up to 10 mg. this week. Anyways, I would seriously look at getting rid of the ativan, with a physicians help of course.
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