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Dementia

(69 Posts)
Cherrytree59 Fri 14-Aug-15 09:50:21

MiL (90+) has the yearly dementia test this afternoon, but over the last 2 weeks her dementia has got much worse. Very aggressive esp towards her only son, my DH she has meals on wheels on wheels. Last week the very kind friend who went in every morning to remind her to take meds has stopped going in because of this aggression. So now she is worse as one tablet is for depression. Can any of you kind folk advise on any particular things I should saying or asking of dementia lady. I will of coarse explain her behaviour.

Liz46 Fri 14-Aug-15 09:55:31

I think one of the things that I learned whilst looking after my mother was never to argue with someone with dementia. Just smile and agree with everything she says even if it is nonsense. White lies were told to keep my mother happy.

kittylester Fri 14-Aug-15 10:00:51

When my mum became aggressive she agreed to go into a dementia unit for assessment (we were prepared to have her sectioned if necessary!). There they looked at, and changed some of her medication. She was prescribed memantine (??) which is prescribed in increasing doses over a four week period. It certainly helped in mum's case.

I do know of someone on gn whose relative has just started on this drug - she might be along in a while to share her experience. Your Mil has done well ( presumably with lots of help) to stay in her own home - my mum has been in a home for about five years now!

Good luck!

Luckygirl Fri 14-Aug-15 10:06:12

Maybe you ned to discuss hr medication at this visit. It is well known that very elderly people react in a somewhat idiosyncratic way to drugs, so maybe the anti-depressant is causing problems. A medication review might not come amiss.

posie Fri 14-Aug-15 11:06:41

I agree with Liz46, never argue or try to try to get them to see the logic in something because it's just impossible for them.

I would ask if it's possible for them to send someone in to make sure she takes her meds in the morning. This is sometimes possible depending where you live.

annsixty Fri 14-Aug-15 11:15:42

Cherry my DH has Alzheimer's and I am intrigued by the yearly dementia test she has. We do have visits from a CPN and any medication and behavioural changes are discussed but it is very informal and no testing has ever been done since the original consultation with a Psychiatrist. You do need to tell her all the changes that have taken place.My DH is not aggressive but he is moody and cantankerous at times and the drug kitty mentioned-memantine- is prescribed for aggression and similar. DH has been on it now for about 6 weeks and we have a review in September. If we are all happy that he is ok on the meds and can continue then the CPN will hand us over to the care of our GP and Heaven help us then!! It is nearly 2 years since diagnosis and we have had not one bit of interest from them in that time.
DH certainly could not be on his own for even a day so it may be time you,as a family were looking at alternatives for her.
Good luck and keep us informed.

Cherrytree59 Fri 14-Aug-15 11:15:56

Thanks all of you will get meds reviewed. Just the prob now of getting help with finding someone to prompt her to take them. We live 20 miles away. Tried calling her but she either says she's taken them even if she hasn't. Done so or doesn't answer phone which means quick dash over to check on her.

annsixty Fri 14-Aug-15 11:20:27

It is nice to hear from you posie as I remember you posting when you were having lots of problems.I think your H went into care,if he didn't I apologise but if I am right has he settled ok and happy?. It is what we all don't want to think too much about at the stage I am at.

Cherrytree59 Fri 14-Aug-15 11:30:21

The dementia test is just the quiz where they ask their name age etc. Then they give them a score out of 20 I think. I also Impliment the agreeing with her tactic. But unfortunatly the last out burst was with the friend I mentioed accusing her of having affair with her DS My DH ! Hard one to agree with sad

kittylester Fri 14-Aug-15 11:49:15

Mum had lots of those tests but hasn't for a while. The never argue but never lie advice doesn't work for very long as, in our experience, one just gets tied up in knots. sad

kittylester Fri 14-Aug-15 12:16:20

Another thought Cherry tree, it might be worth getting a uti test done. Mum's confusion is much worse when she had a uti.

harrigran Fri 14-Aug-15 12:24:11

My aunt asks after my parents, deceased for 30 and 28 years, " oh just the same " is the reply. It is not a lie as such and she seems happy with that.

MiniMouse Fri 14-Aug-15 13:07:58

kittyl That's a really good suggestion about a uti test. My DF changed drastically because of a uti and also when I noticed that he had a sore throat.

Bellanonna Fri 14-Aug-15 13:14:27

My husband, who does not have dementia, gets frequent Utis because of his physical situation. I always know when one is starting because he gets confused and very tetchy.

hildajenniJ Fri 14-Aug-15 14:18:47

Good tip about possible UTI. Does your MiL take any cognitive enhancers eg. donepezil? It might be worth asking to have them discontinued, as they give the demented just that little bit of insight that, as the disease progresses, they can do without. Doing this helped a lot in my Dad's case.

annsixty Fri 14-Aug-15 15:43:51

Without knowing your Dad's situation hilda it would seem from what I am told Donepezil is supposed to keep the dementia at bay for a bit longer. My DH had to come of it because of side effects. I can only think maybe your Dad was distressed by his failing memory and it was felt he would be happier not knowing. It is a balancing act.My DH knows what he has and while he gets very frustrated we can cope although I now have to do everything, in the home,finance,"admin" and look after us both.We have been to the INR clinic today as we have 4 times in the last few weeks,and every few weeks for the past 2 years, he doesn't know where we go,what happens when we get there and actually why he goes. It is a terrible illness.

hildajenniJ Fri 14-Aug-15 17:05:08

I think that Dad had been on it for a couple of years, and as he was becoming increasingly unsteady his GP decided that the time had come to discontinue it. The effects of donepezil and other cognitive enhancers only lasts for about two years any way. Falls were a problem. It was not long after this that we decided that residential care was required. He is now well settled in a lovely care home. He came off warfarin also, due to the falls.

Cherrytree59 Fri 14-Aug-15 17:17:12

Just back from MiL. Have arranged urine sample as was suggested. Dementia lady(not sure of her proper title) is looking in arranging social worker to get in touch with me to discuss some care in mornings MiL states she doesn't want anybody! but will cross that bridge later. Her mood was complete opposite to what its been ( all very friendly even to her DS). I was able to explain how she had been over last 2 weeks before she went to speak to MiL which was helpful. Hopeful might setttle down with medication being prompted. Not sure how soon this can be put into place. if this doesn't help then will ask for medication review. Time for a cuppa brew

Cherrytree59 Fri 14-Aug-15 17:42:04

Just back from MiL. Have arranged urine sample as was suggested. Dementia lady(not sure of her proper title) is looking in arranging social worker to get in touch with me to discuss some care in mornings MiL states she doesn't want anybody! but will cross that bridge later. Her mood was complete opposite to what its been ( all very friendly even to her DS). I was able to explain how she had been over last 2 weeks before she went to speak to MiL which was helpful. Hopeful might setttle down with medication being prompted. Not sure how soon this can be put into place. if this doesn't help then will ask for medication review. Time for a cuppa brew

Gracesgran Fri 14-Aug-15 17:57:37

My mother has been on it for 3 years although I had read it looses its effect after about 18 months. If you have been told two years hildajenniJ then there is a good chance no one actually knows. She could only go on the lower dose - we had the most awful (aggressive) week when they tried the higher level. The nurse said "oh yes, it can over stimulate the brain" ... she got that right.

UTI's are a definite problem and they seem to increase with older ladies. They certainly cause confusion.

I used to telephone mum morning and evening Cherrytree and it was a little hit and miss but then she had a TIA and I knew we could not rely on the phone calls. When I asked about carers to give the meds I was told we could not get them through the local authority. As I understand it, if she had a medical condition that stopped her taking them she would get the help but not for a mental condition [growl emoticon]

Because of this we pay for carers (mum does but I have POA) for 15 minutes. Originally, on leaving hospital after the TIA we had them morning and evening but I realised the hospital had altered her meds - adding one - moving when she took them so she was only taking one in the evening. I rang her doctor who is also her practice care coordinator and asked it was possible for that to be taken in the morning. It was so we only have carers in the morning plus a longer one once a week when mum has a shower. The carer gets other jobs done for her while she is there as mum has a wet room and can manage - although it's extremely exhausting for her but she likes to do it herself, understandably.

One thing I keep telling people as I didn't know I didn't know until recently - three years after mum's diagnosis - is that most people with it are exempt from Council Tax under the Severely Mentally Impaired Person's Discount. The council will contact your doctor to check there has been a diagnosis and the person needs to be receiving one of a list of benefits - Mum was on AA. We did get a refund and not paying this helps to pay for the carers.

I hope this helps Cherrytree. It is such a minefield and by swapping information on here we should make it a little easier for one another. Mum will be 95 in a couple of months by the way and is generally happy - as long as we don't disagree.grin Not always possible if you are to care for her real needs but it is amazing what you can say that means one thing to you and another to her and I love your "oh just the same" harrigran

durhamjen Thu 20-Aug-15 11:28:45

Just read this.

theconversation.com/we-all-know-about-dementia-but-the-lives-of-the-most-vulnerable-make-for-sobering-reading-44605

Apparently 25% of people with dementia live on their own. I fond that thought quite frightening.

I went to visit my mother-in-law on Monday, and she was asleep most of the time. They lifted her out of her chair and put her in a wheelchair to take her through to the dining room. She never opened her eyes, never ate or drank anything for the time I was there in the dining room.

I've sent a message to my brother-in-law to find out what her wishes are as far as being fed in this state but have not had a reply about it.

janerowena Thu 20-Aug-15 19:00:05

It depends on the stage they are at usually, though. Those with times of lucidity can be very good at seeming totally capable when being assessed, much to the horror of their frightened DCs.

Grannyknot Fri 21-Aug-15 08:50:33

cherrytree flowers

My MIL was diagnosed with Alzheimer's 20 years ago. In terms of the progression of her care, it went like this: her husband looked after her at home till he could no more. When he died, she was more or less at the stage you describe and had a carer come in in the morning. It took a while for the penny to drop (with us, her family) that she could no longer live alone. She then moved in with one of her daughters and has been there ever since (about 12 years). Although in an advanced stage (in a wheelchair with eyes closed and no speech), she is physically strong because she loves her food. She will open her mouth to be fed.

're the white lies, it makes it easier if you play along, or "become the person" she thinks you are. We used to like play acting with my mother-in-law. My husband (her son) was at various times her brother, her father and "the doctor". The most difficult but was when she would embarrassingly and openly flirt with any (non-family) male that came into the house! You need to keep a sense of humour.

It can be a long haul. Good luck.

whitewave Fri 21-Aug-15 09:45:26

Some good news folks - apparently the report that suggested that level of peop!e suffering from alzhiemers will get worse was probably incorrect, by at least 22%! So we can rest easy!!

Gracesgran Fri 21-Aug-15 09:54:43

I do blame the press for winding these things up. They have, as you say, discovered that the huge jump will not continue but the a smaller rise will.

I imagine the "huge" jump was because of the under diagnosis previously and the continuing smaller rise is because of the larger cohort living longer. Simples - but not for the "how can we frighten you today" press.

What should we make of this. If you were going to get dementia if you lived long enough in the past, you still will. If you were not, you will not.