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Im sorry that this sounds like a rant. Perhaps I just need to vent. So this weekend Mom s back to "you're no daughter". She doesn't need my help. Four sibs take turns staying with her around the clock. She claims there's never anyone here and she's tired of not knowing who is sleeping on the air bed in the living room every night. No party for us, either Mom. She's not grateful for anything when she's like this. Not sure sure what puts her in these funks but they are worse every time. I probably take it the hardest being the eldest daughter. Today she wants a shower. That's a weeks worth of work for her even with my help. But today she intends to do it herself. Claims I'm selfish and can't spare 15 minutes for her. IM HERE 4 DAYS A WEEK!!! I know many say to to redirect her. My mother does not redirect. She's angry at the world , but mostly, me claiming I've done this to her. On some level I know it not my Mother speaking, but on another level I'm certain it is because for so many years she's been like this, but was able to be independent because she was stronger, but we never knew why. Now that this vascular dementia has come up so suddenly, I wonder if In fact it's been going on for many more years that we realize. Oh, and she's the quintessential showtime - for the docs, the nurse practitioner, the out of town sibs. I just wonder from those with vascular dementia experience, is this the norm? What can I expect next, any advice on coping? As always, I appreciate this forum, the outlet it provides and the advice it offers. I'm hoping that tomorrow my Mom shows up for a bit.

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I have no idea what kind of dementia my mom has - neurologist said she was too old to bother testing but that she was atypical in her math skills etc - she does not act like the Alz residents in her memory care facility whom she thinks are crazy or drunk

I think she's lost her memory from falling so many times and hitting her head but her mood can turn in a nanosecond from saying thank you you're so nice to get the bleep away from me. I feel extremely sorry for her and she has been lonely for years as the youngest of an immigrant family all gone - I know she's afraid at the memory care facility and tells me she doesn't know anyone I.e., trust anyone and I can't say I blame her - I have private caregivers for her and she says but they don't know me - she thinks only relatives should be helping her but they're aren't any - i long ago gave up expecting any appreciation for all I do for her but I know that is the dementia.
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WearyInPit, my mothers emotions are all over the place. A typical day will have her asking me to do something that I know doesn't need to be done. I try to ignore her, hoping she'll forget. Soon it comes up again and again and I'll say maybe we'll do it next week, hoping it will pacify. That stirs up the Incredible Hulk and she wants it done RIGHT NOW. She really pushes the anger until I'm about ready to leave for good. Then she'll get sweet as sugar and very child-like. That drives me even crazier than the anger... and almost as crazy as the obsessions.

I think VaD is a disease that can be diagnosed by how crazy the caregiver is. Half of the time I feel like a cat with my claw in an electric socket. I know that not all people with VaD have the personality quirks, but many do. My mother was difficult even at an earlier age. The VaD just put the mood swings and need to control into overdrive. Fortunately, she is okay most of the time. My best defense is not spending too much time with her. Spending too much time in one sitting seems to increase the problem. I am also learning to not mention things that need to be done around the house, because it gives her things to worry about and fixate on. What she does is come up with a "JessieBelle do list" that she wants done NOW. (Sigh)
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Notwithstanding what CM said ( I'm pretty terrible at sustaining tbe "this is the fisease thing") you need to take care of yourself. You will be of no use to your mom if you are ill, dead or insane.

Truth be told, it is SO much easier for professional caregivers to do this work, because there is no emotional valence. When my mom is weeping because she thinks she's in someone else's wheelchair, i can only think of the many times in my childhood when i could have been helped by a little understanding and was met with " make the best of it". I'm not saying i had an abusive childhood by any measure, but i notice that my sisters in law are both better at dealing with mom's complaints than i am.

No, you can't force her into care. But you can step away and say, this situation is not good for your care or my mental health. Something has to change.
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I take my hat off to all four of you for figuring out this rota arrangement and making it work. Even so. If one or more of you gets to the end of your rope, what are the next options?

Your poor mum, you know. I know you do know, and I know how it feels to think "poor mother, you are DRIVING ME ROUND THE TWIST" and I also know the 'don't mind me I'm just the help' feeling when she gets all smiley and excited picking up a phone call. But, all the same again, from her point of view, your children and your grandchildren are lovely but your friends and your peers are still all dead. Plus you physically feel like cr*p. There's less and less of a bright side for her to look on, really.

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I suppose it depends on just how self destructive she becomes. Eventually, people who are not mentally sound don't get to call the shots, regardless of how nasty and resistant they may be. If her symptoms warrant it, she may need to be hospitalized to get her properly diagnosed and treated. I hope it doesn't have to go that route, but I'd stay in touch with her doctor.
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Weary, not being in your situation, I don't know why you all are trying to care for her at home. Once our mother became fraught with anxiety and every day brought on a new emergency, I simply (really not so simply) said "I can't do this anymore". She argued; I told her that brother (golden child) would die of a heart attack racing to her emergencies.

I guess you could say that I refused to participate in the circus. The obvious answer to the fact that she needed a more stable, predictable environment was for her to move somewhere that would provide that. If she wasn't going to do that, it was simply NOT my job to enable her delusions.

I know. I sound cold and hard hearted. I learned it from her. She taught me to protect myself at all costs from this kind of insanity.
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From her doc for what I estimate to be years. Not a fan of autocorrect. Lol
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Babalou- she has not. Refuses to see anyone but her pcp ( a geriatric specialist) and the home care folks. It is only VERY recently I'm even allowed to be in the office during her visits. She usually tells me to keep my mouth shut. Fortunately, her doc is great and has called to speak to me about what's going on. She's been hiding symptoms Dom her doc for what I eating ate to be years.

When the hallucinations and delusions first started, she mentioned that maybe a psychiatrist would be a good idea. I tried to encourage that but it was short lived. She k owns care decisions need to be made when she is lucid, but then just thinks she'll die and that will solve everything.

Her pcp tried to treat the depression about 2 years ago, I forget what medication it was but Mom hated it and stopped taking it. It did appear to make her anxiety even worse. NP suggested that the Ativan may be contributing to her hallucinations so now she won't take that either.
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Weary, has she been seen by a geriatric psychiatrist, with YOU there to describe or show her videotaped behavior?
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Church mouse - oh I get the martyrdom. Often wonder why her Mother didn't name her Martha.

I'm sure depression comes into play here. She's wanted to go to sleep and not wake up "just like my Mom" for the last 10 years. Mom was the youngest of eight children and she has surpassed all of their ages. All of her siblings are gone, all her friends are gone. She has " no one". I guess her 7 children and the 4 who care for her around the clock are "no one". I know many, many people who would be eternally grateful for someone to come visit them once a week. Not my Mom. Nothing is EVER enough.

I vacillate between feeling sorry for her and being so angry that I have to walk away. And walking away is pretty hard in a 1 bedroom apartment.

Right now she's on the phone with her baby son - all is right with the world until she hangs up the phone and realizing she's here with me.

Once again, sorry for venting but thank you!
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Is it the norm with vascular dementia I'm not sure about; but in my sample size of one (my mother) it was. Usually expressed through the smell of burning martyr rather than seething rages, e.g. the time I thought "hmm, she's quiet..." and popped my head round the door only to find she'd been sitting alone in a steadily darkening room and believed we'd all gone out and left her there indefinitely. She did have a call button by then, by the way. Just 'didn't want to bother' me.

Caveat: it could be depression. Depression is extremely common after stroke; and vascular dementia, when all's said and done, is basically an ongoing series of microscopic strokes. Worth investigating because if that's the case then she's not only angry, she's miserably unhappy. Citalopram helped us but it takes a while and it's not a miracle cure.
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The sudden rage and anger instances with Vascular Dementia can be alarming, confusing and frustrating. I've seen it with my cousin. She would go ballistic if she saw a commercial on tv that didn't make sense to her. She'd yell about it and get very upset. She's get angry about imagined things too. I didn't realize at the time that convincing her of anything was not possible. I would usually just leave the room, come back later and change the subject. I was fortunate that through it all, she always told me that she knew I loved her and that she trusted me. It was still so challenging though. I know it's difficult to tune out the negativity.

If I had known then, what I know now, I would have tried to get her on medication earlier for her mood. When she went on Cymbalta, it was like night and day. She was so much more content and I didn't see any of that distress. I would discuss that with her doctor. If she is already taking something, I'd discuss modification.

If it helps, please keep in mind that sometimes this type of behavior may change as their level of progression changes. My cousin stopped the repeating and other temper driven behavior. I'm not sure what to attribute it to.
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