Also, I find that faults AND virtues of temperament can become exaggerated. My
mom has always been very caring, especially toward children, vulnerable people
and animals.  With dementia, she is far too worried about other people's kids
in public, objecting loudly, and taking it on herself to keep watch, when
parents don't hold their young children's hands in parking lots.  

Before she got dementia she tended to take offense a little too easily, and now
that's worse... if someone in public or at a doctor's office is rude or
condescending to her she'll get right in their face, don't you dare talk like
that to me you so and so.  I'm always trying to diffuse these situations, and I
have to do so without embarrassing her or making her feel she is wrong.

I think the caregiver sometimes gets the brunt of hostility during the hostile
phase for the same reason we all tend to yell at our spouses, kids, and dog
while we smile and joke with the neighbors.  It's safe to be yourself and vent
your frustrations with the people you trust the most.  I personally think this
becomes exaggerated with a person with dementia.  Also, the person with
dementia is frightened.  They're losing their memories, judgment and power and
up to a certain point, they KNOW it. They're sometimes looking for someone or
something to blame, and the person right with them can sometimes seem like the
most likely cause.  "I live with you every day, I'm miserable every day,
therefore you are the one making me miserable."

I was told dementia lowers inhibitions (think of how many of us act when we're
drunk... either too happy and silly, or morose, or mean) and can cause people
to think too simplistically.  Either you are a saint from heaven or the devil's
child... there is little room for middle ground.

On the other hand, I think dementia sufferers often have SOME degree of control
and can put on a front so other people won't know they have a problem.  I think
dementia sufferers can be very smart.  They have to be, I believe.  As I read
in some literature about AD sufferers, "these people are impaired but they're
not stupid." Survival is harder for them and they need to find ways to take
care of themselves and get others to take care of them.

I think sometimes we can ask ourselves how we would feel if we sensed we were
losing our minds and knew deep inside it was going to keep getting worse and
one day we would lose our faculties completely.  How would I cope?  Would I
accept it gracefully and peacefully or would "rage against the dying of the
light"?  Would I tell myself "yup I have dementia all right" 24 hours a day or
would I seek refuge in denial much of the time in order to keep myself from
going stark raving mad from the horror of admitting what is happening to me?
Would I be happy and pleasant all the time or would I be filled with depression
and rage that my fine, quick mind, skills honed over a lifetime, and my prized
independence are abandoning me?

I admire my mom for having some awareness of what is happening to her and yet
continuing to get up every day and wanting to live some kind of life.  That
takes guts. She's difficult a lot of the time but hell so am I sometimes, and I
don't have dementia as an excuse. ;)

___
"Don't worry Alba. I'd never let anyone else kill you." -- Naked Tango