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My father-in-law can't remember how to go to the bathroom. He doesn't know what to do when he gets in to the bathroom. The same is true for the shower and other tasks. Someone has to tell him each step and he will ask multiple questionis and clarifications for each step.

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I also noticed that my mother does not start any conversations. She will talk when when talked to directly but the only time she speaks out loud is usually when she is stuck in a "loop". We can stop the repetitive questions or comments that she makes sometimes but not usually. Answering the same question again and again does little to stop her from asking, redirecting her attention or thought process can sometimes get her out of the loop. We always try to remain very calm when she is stuck in a "loop", but it sure breaks my heart when she looks at me and I see the same sparkle in her eyes but I also see bewilderment too..........
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bls0901, that's an extreme example of a fairly common dementia phenomenon. Just because they can do something five times in a row doesn't mean they can do it the sixth time, especially if there is some distraction, like listening to conversations.

Sadly, some people assume the person with dementia is faking the sudden impairment to get attention or to be manipulative. No. Dementia really and truly can vary that much that quickly. Thank you for this clear example.

(This kind of variation is "typical" of Lewy Body Dementia, but it is not unheard of in other kinds of dementia as well.)
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In the middle of a crab feast my mother had already opened and eaten about 5 crabs. As the conversation around the table picked up and she stopped to listen I handed her another crab to eat. She looked at, turned it over, then smashed it with the crab mallet. I asked her why did she do that? She replied "I don't know how to eat this thing!"...........I reached over and opened it for her and showed her what/ how to get the meat out. .........
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Just roll with it make the time count, treats, happy, sunshine. they need sunshine.
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Ambien kicking in: Ill make it quick. No straight answer to this. Signs: talks about the same things or questions within 5 minuites. Forgets what they are doing. Forget everyday things, shoes, clothes, etc. My friend went from pro master diver, and motor cyclist. She was in late 50's, for got how to turn on motorcylce, forgothow to talk, feed herself, and downhill within 2 years. Artist too. She loved to ride fast. 130 miles on freeway, the cop pulled her over to realize she was the masterdiver of the dive trip he just took. She lived life to its fullest. Miss her. She would call me up, and say we were have a BBQ at my house this weekend. Now that's a friend. We will always miss you Marilyn. Her birthday is coming up. She passed 2 years ago. .... Enjoy the time with your loved one, You don't know when it will change......
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Unfortunately you dont know. My mother has had it with Parkinsons and she has her good days and her bad. She will cry and tell me shes stuck in herself which is horrible to hear. I'm not sure what is easier! I do know that you do not acknowledge any mistakes just agree, If she makes a mistake or can't remember I always tell her that the same thing happens to me. I know what makes her happy so I change the subject and distract her. When my mother is made aware of her mistakes, she feels horrible and has a terrible day. Good Luck!
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I would like to say to everyone in our position of making decisions for our parent consider the private ALF homes in your area. In my area there are numerous private homes that are set up for "age in place" care for the elderly. Most that I looked into had between 4 and 8 residents. One care giver for every 4 people. The same care giver stays Monday through Friday then a weekend person comes in. The care giver has her own bedroom and the motion detector alarm for night time is in her room. A hairdresser comes in as needed, Pets on Wheels comes to visit, the public library brings books, and a activity person comes in 2x a week. The day time caregiver paints my mom's nails does crafts with her, and plays cards or dominoes with her. They have a shaded patio out back and they have dinner on the patio. My mom gets the care and attention she needs at a fraction of the cost of a nursing home. As my mother grows older and if the level of care changes they are willing to keep her there, the price will rise but living in a home setting is so much nicer that a nursing home. I hope never to have to move her into a nursing home.
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That brought a tear to my eye. I remember how I needed that objective eval too. You can't believe, don't want to believe it of your own parent/loved one. Glad you found out and got her into a good care situation. Bless you!
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After Drs. said they would not release my mother from the hospital due to extremely high blood sugars, low kidney function and her memory problem to go home to live alone we had her sent to re-hab to give us time to find an ALF home. I already had 2 letters from 2 different Drs. I had already started looking into finding one a few months earlier so I knew what I was looking for. It wasn't until the caregiver had me sign off on the 2 week assessment that they did on my mother that I realized just how bad off my mother was. I never took the time to compare notes with my sister who interacted with my mother more than me on what she had seen over the last year. It was staring me right in the face! My mother didn't know the day of the week nor what year it was, she could not figure how old she was, she knows her birthday, needed help bathing, dressing, could not cook, use a telephone other than to talk into it, read a book, magazine, or follow a movie, write checks or pay bills. We just moved her to a different place in March and there is a man who sits a reads the newspaper and my mom thinks that is my dad behind the paper, but that is ok it makes her feel secure and she no longer complains that she want to go home. She still does ask the same question over and over as if she is stuck in a loop but I just answer again, and again. I take her out to eat and she has a grand time, we always finish off with a small ice cream from somewhere. She is nearly 85 years young!
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Sure is different levels here.My Mom shuffled about 4 years ago and stopped walking, talking, and started choking. With good home care, she can go on many years like this her Doctor said. She is smily and laughs a lot, at nothing mostly, and during the night, in her own little world. I would say you are in the beginning stages with your Dad. Patience, thats all you need and you'll have lots more questions as the stages pass. I too wonder how many years my Mom will go, sometimes I think she will outlive me, lol. Good luck.
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Everyone is different especially when it comes to mental illness. I feel it's best to take it one step at a time. One thing I've heard about to help people with dementia is to write notes for the person. For example, putting a note in the bathroom that says something to the effect that you first pull your pants down, then step 2 be over the whole toilet,. step 3 go. Just an example. It may help them and it will be less stress on explaining everything over and over again. I've heard this works for some people. It's always best for the caregiver to always keep their patient.
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Lois, glad to hear you are not pushing the mower yourself! My grandmother was using a push mower in culverts at the age of 83 and had a hernia. She was taking care of my grandfather at the same time and he had dementia. Scary. Now she has the dementia we take care of her. Good luck!
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I found this link that is very good.
"Stages of Alzheimer's/Dementia":
http://www.alzinfo.org/clinical-stages-of-alzheimers?mtc=google&kwd=alzheimers_stages&gclid=CjkKEQjw5-OdBRDW3ceD9fL0r4QBEiQAW7htXa0EpMujW-lTWPAFvOs5r8hvFDXZpzyk223ltMEGho7w_wcB
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I am the wife, the one with Alzheimer's, What is the difference? I haven't been tested except a head scan that said that I had brain atrophy normal for my age.
That was a few years ago, and a different doctor who was probably too kind to tell me I had a problem. He just said normal.
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Two pups, I hear you.. I am thankful that he can remember the way past, but cannot remember where the bathroom is. The phrase he uses most is "I'm lost. What am I supposed to be doing now?" He is beginning to spill his food on the way to his mouth and just cannot manage buttoning his shirts, asking for help getting his t-shirts off, etc. Two weeks ago he managed most of this stuff.

His balance has gotten so much worse. We have been to the balance clinic three times and were hoping to go again, but I do not think he can manage understanding what they will expect him to do. Perhaps I am just being reluctant to find out.

Thanks for the reply..
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Dryad, I understand your concern about mowing the lawn! Many have warned me. We have a 48 inch John Deere that is a pleasure to run - Makes me feel real macho, don't you know.. So much power, etc. It's fine when it runs OK, etc. Then I call my son. I usually remember to take along the Cell phone, especially in the winter when I run the snowblower.. Believe it or not, I really enjoy doing these chores. It gets me out in the fresh air.and away from cleaning and dusting. If I paid for help it would most likely be for a house cleaner. LOL

One of our neighbors thought she was commiserating with me years ago when she said, "You know, Lois, if you did not learn how to do this stuff, you wouldn't have to do it..." She doesn't know what she is missing. If it's a challenge, I go for it.

It takes all kinds, I guess.. and I'm usually the odd kind...

Talk about good judgement and VD, he showed me a photo of a bush hog today and thinks I should order one to use on the paths we have through the 200 some trees we planted around the property 24 years ago.. It can all be mowed if I can find the time to remove all the dead branches downed due to storms, etc. The grandkids usually get together and pick them up for me, but it has been a very busy summer for them this year.. A Bush Hog at age 90 - I think not!

But, I will think about your answer and talk it all over with the kids. And I shall ask the Dr. at our next visit what he thinks will be the next phase to expect...Thanks.
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One thing you will notice with dementia, is that your sewer runs slowly, stops and backs up. The roto rooter man will be summoned and he will find all kinds of paper products in the line. Chux pads cut up to line underwear fall in the toilet bowl and mom flushed them thinking they will break down. They don't break down, they stack up. The blue plastic is non - degradable. FYI
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You need to know answers to these questions but more than that you need to keep yourself healthy too. Doing assessments and sitting and talking with someone who is knowledgeable about your abilities/ limitations and health will give you peace of mind. The last thing you want as the primary caregiver is to find yourself hurt too. That would restrict you far more than anything anyone has to say about your situation. I would argue that someone else should be mowing the lawn. If you got heat stroke pushing the lawn mower, who would save you? Remember too that part of VD is loss of good judgement. Involve your children in these discussions to get more points of view and the kids might have more questions for you to ask. Hope this helps!
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We had a Dr appointment July 3rd ( Pshyc doctor) he is amazed how well my husband is doing, but I asked where he thought we were in this journey he said, late six moving into final, that's scary, I just pray every night if I can just keep him the way he now ( oh we've been through some horrific times over the past years) he's gentle, congenial, helpful, loves to help out, everything is by instruction via me, every step, he's about forgotten the names of everything, the refrigerator is now Number 4, does no good for me to try & give things new names, it has to be from him, no name for tissues, though he goes through boxes & boxes. He is still ok in the bath rooming department, showering ( as long as I'm close enough to give start instructions like yes the glass box is the shower. But I smiled at the references here of using something other than shaving cream, I went in one morning & his face was totally lime green, he had put old spice deodorant all over his face ready to shave. Its not perfect, but it's not going to get any better, I read that stage seven, final stage can be from three months to a year and a half, so I also just keep reinforcing what he knows. I'm not going to get all bent out of shape over a time now being placed on his life and I know it could be shorter or longer, one day at a time, that's all I can do. I also have the same issues with deceased mom & dad ( he's 83) cars, keys, getting back to work before they throw him in the brig! This is some trip. When I read on this forum that someone has lost their spouse, I am sad, but also thank God for helping to get my " Sister" stuck in the maze of Alzheimers out of it.
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My hubby and I are both 90 and he was diagnosed with Vascular Dementia about three years ago, but our son had noticed the decline before that while they were working on a project in the garage.. Having pneumonia and a blood infection along with CHF and being intubated and on a breathing machine for 5 days did not help.

He has had hallucinations and very often asks me how he can get hold of his wife. I do explain that I am indeed his wife, but he only answers, "If you say so", very politely. For a while he thought that the Army had sent me to cook for him. I do all the outdoor work - 4 acres of lawn - and do not have any regular help. Our son is nearby and comes to my rescue when things break down, or I need a day off, etc.

The last several days he is having much trouble buttoning his pants/shirts, fumbling and becoming frustrated. His balance is poor - peripheral neuropathy - as well as his eyesight. This evening he fell reaching for his walker and will probably be hurting in the morning - nothing broken..

There is no real conversation possible unless it is memories from long ago. We talked today about our realization 73 years ago today, the Fourth of July, that we were going to be a couple. And he went to war two years later, but we married first. He remembers all of this, but cannot remember what day it is or that the kids were here, visiting - grumbling that they 'never come over and don't care about him'. We have four - two close by and two 3 and 4 hours away. So, the short term memory is shot. He cannot understand why his wife allows me to do all the work around here.. And some days I swear he is back to normal. It is soo confusing.

I am lucky to be healthy and energetic enough to care for him and want to as long as I can. However, I am finding that it is harder to manage paper work and calling for driveway coating and house painting when needed and stuff like that. There is some depression which I assuage by reading, reading, reading... My computer is a godsend in keeping touch with friends and what's going on in the world..

So, my question also is just how long can I expect him to be manageable without seeking outside help? I fear having social workers come in and make assessments and rules that we might both resist, etc. But, is being independent and not asking for help detrimental? So many questions...
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Hello Caregiver99, I agree, that in some cases, with the more advance dementia patients, just going along with their delusions is the way to go, but unfortunately it's not all that simple for most. My mother's delusions insisted her father was still alive, and she demanded (actively, angrily, violently) that she be allowed to see him. She would try to leave the house (in the middle of the night, in her nightgown, in the winter) to go see him. No, we could not go along with that. And no we could not distract nor redirect her. And no, sedatives did not sedate her either. Yes, telling her that her parents were long dead was painful for her, but once (and if) we managed to reorient her, she would at least stop trying to leave. Often safety trumps happiness.

And sometimes there's not only one person's feeling to consider. Mom also used to get confused about who other (living) people were. She would be demand to see my dad. (His name is Aldo) She would turn to me and demand "I want to see Aldo". In that moment she clearly didn't know me, (or she would have said "your father" instead of "Aldo." Now, I didn't care that she didn't recognize me, but my father was nearly in tears, standing directly next to me as she said it. I would say "Mom, Dad is right here. Aldo is right here." And she would say, "Not him ! I want my Aldo" and push him away from her. This was crushing to my elderly father. How do you tell and 88 year old man that he has to pretend that he doesn't exist.

All I'm saying is that, there is no one size fits all answer. And even in cases where the "going along" is eventually the right answer, how do you know just when you're supposed stop trying to keep then oriented and in reality, and switch to "lying to them to make them happy"? Because they don't just arrive at the moment out of the blue. It's a long terrible slide down that slippery slope, with the caregivers fighting the deterioration for years, maybe decades. And unfortunately a good number of dementia patients are never happy, and never calm, and never cooperative, no matter how much you lie to them. Because for folks like my Mom, the lies never worked.
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Although it may be hard, when a person believes his beloved to be alive, though she be dead, it is a thoughtless cruelty to make her dead a second time.

My sister and brother dealt thus with my mother in her 90+ years dotage.

I always went along with her delusions because they made her happy to think her husband, dead more than a decade, would soon be home. It didn't occure to her that he never did get home. But, who was hurt?

It gave her happy moments in an increasingly unhappy and lonely life. That cannot be too much to ask.

It is not about being right or accurate: it is about being kind.

My Ma also believed she had three cats, but only had one. My sibs used to argue her until she became frustrated and angry. Who was the winner there?

If Ma said she had three cats and pointed them out to me, though they were but shadows, I saw them too!

How hard is that if it keeps a darling happy? My mother's mother, my mother, my sister, and my brother are all argumentative and cannot slide into peaceful gear to save their lives. If you said the Pope was a Roman Catholic, they would argue that he was a Jew!

Why spoil a good and comforting thing?
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While no two cases will be absolutely alike, the general trend is for a decreasing loss of cognitive skills, memory, and ability to perform everyday tasks.

As Wordsworth wrote,

"

We talked with open heart, and tongue
Affectionate and true,
A pair of friends, though I was young,
And Matthew seventy-two.

We lay beneath a spreading oak,
Beside a mossy seat;
And from the turf a fountain broke,
And gurgled at our feet.

"Now, Matthew!" said I, "let us match
This water's pleasant tune
With some old border-song, or catch
That suits a summer's noon;

"Or of the church-clock and the chimes
Sing here beneath the shade,
That half-mad thing of witty rhymes
Which you last April made!"

In silence Matthew lay, and eyed
The spring beneath the tree;
And thus the dear old Man replied,
The grey-haired man of glee:

"No check, no stay, this Streamlet fears;
How merrily it goes!
'Twill murmur on a thousand years,
And flow as now it flows.

"And here, on this delightful day,
I cannot choose but think
How oft, a vigorous man, I lay
Beside this fountain's brink.

"My eyes are dim with childish tears,
My heart is idly stirred,
For the same sound is in my ears
Which in those days I heard.

"Thus fares it still in our decay:
And yet the wiser mind
Mourns less for what age takes away
Than what it leaves behind.

"The blackbird amid leafy trees,
The lark above the hill,
Let loose their carols when they please
Are quiet when they will.

"With Nature never do 'they' wage
A foolish strife; they see
A happy youth, and their old age
Is beautiful and free:

"But we are pressed by heavy laws;
And often, glad no more,
We wear a face of joy, because
We have been glad of yore.

"If there be one who need bemoan
His kindred laid in earth,
The household hearts that were his own;
It is the man of mirth.

"My days, my Friend, are almost gone,
My life has been approved,
And many love me; but by none
Am I enough beloved."

"Now both himself and me he wrongs,
The man who thus complains;
I live and sing my idle songs
Upon these happy plains;

"And, Matthew, for thy children dead
I'll be a son to thee!"
At this he grasped my hand, and said,
"Alas! that cannot be."

We rose up from the fountain-side;
And down the smooth descent
Of the green sheep-track did we glide;
And through the wood we went;

And, ere we came to Leonard's rock,
He sang those witty rhymes
About the crazy old church-clock,
And the bewildered chimes."

--- William Wordsworth
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Oh Sheilaallison - I have the toothpaste thing going on here too! It sounds as if my husband is at about the same stage as yours. My biggest issue right now is he is delusional especially in regard to loved ones who are deceased - got really annoyed with me when I tried to explain to him his Mother was deceased last night.
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Yes als seems to progress differently to Vascular dementia mum is ok so far with washing when she does wash??

Ive been told that VD only lose the short term memory but will not really lose long term?? i still dont know if this is true as ive had conflicting views about it?

as Cap says everyone is different AND i think personally it depends on the persons personality mum was always an angry bitter unhappy woman and so this has escalated with the illness whereas my neighbours dad was a lovely gentleman and although hes lost his memory completely hes still gentle? hes in great health and is 86yrs old.
I know mums diabetes complicates her dementia so added health issues can have a huge effect of the progression and shes progressing fast of course if she watched her bloods and her lifestyle she would progress slower.

Yes its so hard to know but i do think als is easier to predict than other dementias it seems to have more of a pattern?
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As other have said each person is different. My husband is in the middle stage of alzheimers. He can shave himself but will put toothpaste on his face instead of shaving cream. He can shower by himself but I have to watch and make sure he uses soap. As the other readers have said be thankful he cooperates with you that is a real blessing. My husband fights me with everything, especially wanting to drive. It's so hard especially when he yells constantly and asks the same questions every ten minutes. Thank god I work or I would be crazy by now. I have an aid but he fights with her. I have tried taking him to daycare but he refuses to go.

Hugs to everyone of us that has to deal with this terrible disease
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Mray- I am taking care of my 77 year old dad that has both dementia and Alzheimer's and he also has forgotten how to give himself showers and refused to have me help h so I had to get a bath aide to come in twice a week. He has messed himself many times as he can't hold his bowles and refuses to wear adult pull ups. He can't do anything for himself anymore even pour himself cereal. I believe with everything I have studied on this he is in the later stage of it.
You are very lucky that your FIL listens to you because my dad does not he argues with me and has almost hit me 4 times.
I have looked up Alzheimer's association and called them a few times and asked questions they are very knowledgeable.
Good luck and god bless
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There is no typical anything...kind of like define "Normal"-right???
Keep answering the questions & just focus on one thing at a time...ex: lets wash feet....lets pee....& on & on....
BLESSINGS....
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mray, I don't know if there is a typical progression. Alzheimers.org gives things to expect in the stages of Alzheimer's, but many people with dementia don't have Alzheimer's. They have another form. Symptoms and progression can also vary so much from person to person. It probably has to do with what areas of the brain are affected and if the brain is able to use alternate pathways to do a certain task.

I've read posts from the different people here who are caring for someone with dementia. One of the things that struck me is how different each person is. There are certain similarities, so we understand what each other is going through, but the abilities and personalities vary so much.

It sounds like your FIL is in a fairly late stage of dementia. This is very difficult for caregivers and I know it is even worse for the person with dementia. Something that I am glad to read is that he works with you, instead of against you, in caring for him. That is something to truly appreciate. He must be quite a gentleman. I am sorry that this disease did such damage. If you want some idea of what to expect in the future, check the later stages on www.alz.org. They won't be exactly like your FIL, since everyone is different, but it may help you to prepare. (((Hugs)))
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i s'pect everyone is different but in the case of my mother when she began walking with a shuffle and only one foot in front of the other she had only months to live . she never did lose control of things shed learned by repetition . ie eating / using toilet ..
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