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Medical Forum / Diseases and Disorders / Alzheimer's / July 2007

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Good and bad days for Alzheimer's patients

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brianna_1938 - 05 Jul 2007 01:29 GMT
Why do Alzheimer's patients have good days and are so very nice, the next
minute they turn and curse God and everyone else around them.
Evelyn Ruut - 05 Jul 2007 02:48 GMT
> Why do Alzheimer's patients have good days and are so very nice, the next
> minute they turn and curse God and everyone else around them.

I think it is part of the nature of the illness, Brianna.   If you think
about what emotional implications are involved when someone is losing their
memory, and all the control of their own life, you may realize that it is a
tough thing in the few moments when they do remember.   If the mood changes
are very difficult the person may possibly be experiencing delusions, and
you might want to ask the doctor about that.  There are some medications
that can smooth the way a bit, like anti-depressants if it is mils, and
anti-psychotic medications in extreme cases.

Signature

Best Regards,

Evelyn

Mary_Gordon@tvo.org - 05 Jul 2007 05:01 GMT
Brianna, think about what life must be like for them. Not only is
their memory impaired, but so is their ability to do all kinds of
ordinary, every day things they used to be able to do, and their
emotional control is damaged. Their understanding of social niceties
is evaporating, and they make curse and swear in a way they never did
before. Brain damage can change their personality as well.

Imagine how upsetting things must be - just a jumble that makes no
sense. Its confusing, its frustrating, its infuriating. They are
trying so hard to hold things together, and they are failing. It has
to be just awful if they are at all aware of what is happening. I know
my mother in law had lucid moments when she was just horrified and
embarrassed about things she had done - or incredibly humiliated, such
as when she realized her 3 year old grandson could work the VCR she
could no longer use.

And think about how different days go. A day where not too many
demands are made on them, where they don't experience too many
failures or frustrations, they might be relatively calm and happy -
and then the next day, they might be entirely overwhelmed by what they
are trying to accomplish, or by having too much going on at once, and
just snap.

Sometimes, a person may not be able to realize there is something
wrong with them, or their pride won't let them consider it. They make
up explanations that make sense to them - like a loved one stealing
their money, or someone breaking into their home and hiding belongings
- and they can be really angry and bitter, calling someone they love
terrible names and making dreadful accusations - and then forget the
next day they've said something hurtful.

The most important thing is not to take the behaviour personally -
they really can't help it. And yes, its weird and unsettling when they
can do a task perfectly well one day and not at all the next, and then
again a week later they can do it again, or they are calm in the
morning and agitated in the evening.

Many caregivers get a good feel for how to manage behaviour - what
will set the person off, or how to time challenging activities so the
person tackles something difficult when they are at their best (well
rested, fed, calm).

My MIL only needed medications to settle her down a couple of times,
but she did have some episodes of agitation where she got very wound
up, and no one could figure out what had set her off.

M
brianna_1938 - 07 Jul 2007 21:19 GMT
>Brianna, think about what life must be like for them. Not only is
>their memory impaired, but so is their ability to do all kinds of
[quoted text clipped - 43 lines]
>
>M
Dear Mary,
Thank you for your letter. The person I refer to is my brother-in-law and my
sister takes good care of him.  I am trying to learn all I can about the
disease so I can in turn help her.  She goes through a lot with him and I
feel very sorry for both of them.  She has increased his medication according
to the doctor so he isn't as agitated as before.  He doesn't like to be left
alone and wants her to sit with him most of the time.  Is this another trait
of the disease?
brianna_1938 - 12 Jul 2007 05:30 GMT
Hello Mary,

I must tell you about an incident that happened yesterday.  It was my
sister's birthday.  He cursed her royally that day.  She asked him if he knew
what day it was, he said no.  She said it is "my birthday"  He said "Happy
Birthday, even if you don't deserve it!"

I ask myself why does this happen and why to her.  She is a kind and loving
person with so much compassion for him and everyone else!  I am always asking
for prayers for her from the rest of our family and I know that God will take
care of things in time. Please pray for us.
Thank you,
Bri

>>Brianna, think about what life must be like for them. Not only is
>>their memory impaired, but so is their ability to do all kinds of
[quoted text clipped - 9 lines]
>alone and wants her to sit with him most of the time.  Is this another trait
>of the disease?
Dennis P. Harris - 12 Jul 2007 10:36 GMT
> I ask myself why does this happen and why to her.

It's happening to *** him *** because he has a disease that is
slowly destroying his brain cells.  She's just having to deal
with the effects of the disease.

You have to remember that IT'S NOT ANYONE'S FAULT, it's just a
disease.
Tumbleweed - 13 Jul 2007 20:49 GMT
> I ask myself why does this happen and why to her.  She is a kind and
> loving
> person with so much compassion for him and everyone else!

Why do you ask this?  Have you ever seen any evidence that the world works
the way you would like it to?

Signature

Tumbleweed

email replies not necessary but to contact use;
tumbleweednews at hotmail dot com

brianna_1938 - 14 Jul 2007 03:02 GMT
Why do I ask this?  No evidence the world works way I would like it to be. I
am trying to understand the disease, not trying to be a smart aleck.  But
thank you for your response.  

>> I ask myself why does this happen and why to her.  She is a kind and
>> loving
>> person with so much compassion for him and everyone else!
>
>Why do you ask this?  Have you ever seen any evidence that the world works
>the way you would like it to?
Evelyn Ruut - 14 Jul 2007 03:26 GMT
Brianna, Tumbleweed isn't being sarcastic.   It is just that all of us have
been through this awful illness with some loved one or other, and NOBODY
deserves such a horrible illness.   Unfortunately there is little in this
world to show that the good get good things and the bad don't.   It is a
random universe to which we bring meaning, but that is my opinion only.

Signature

Best Regards,

Evelyn

> Why do I ask this?  No evidence the world works way I would like it to be.
> I
[quoted text clipped - 7 lines]
>>Why do you ask this?  Have you ever seen any evidence that the world works
>>the way you would like it to?
brianna_1938 - 14 Jul 2007 16:44 GMT
I realize that the good don't always get good things and the bad don't.  Just
a question that doesn't have an answer.  I shouldn't have asked but we are
new to this.  Thank you for your reply.
bri

>Brianna, Tumbleweed isn't being sarcastic.   It is just that all of us have
>been through this awful illness with some loved one or other, and NOBODY
[quoted text clipped - 7 lines]
>>>Why do you ask this?  Have you ever seen any evidence that the world works
>>>the way you would like it to?
Evelyn Ruut - 14 Jul 2007 18:24 GMT
Brianna,

That is perfectly OK.   These groups are for discussion, for venting, for
sharing, and for helping.   I received a lot of help here throughout the
course of my mother in laws illness, and I think others have too.   Feel
free to say whatever is on your mind, answerable or not.   That's what these
groups are for.

Signature

Best Regards,

Evelyn

>I realize that the good don't always get good things and the bad don't.
>Just
[quoted text clipped - 16 lines]
>>>>works
>>>>the way you would like it to?
Tumbleweed - 14 Jul 2007 10:06 GMT
> Why do I ask this?  No evidence the world works way I would like it to be.
> I
> am trying to understand the disease, not trying to be a smart aleck.  But
> thank you for your response.

Well the disease happens for various reasons practically none of which are
understood, but NONE of which, AFAIK, are to do with the goodness of the
person or their relatives. Asking 'why did this happen to me' implies there
is some all overseeing thunderbolt wielding god in the sky that apportions
people their just rewards via  various cruel diseases. I'm sure even the
most religious person doenst REALLY believe that.

Signature

Tumbleweed

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brianna_1938 - 14 Jul 2007 23:54 GMT
Only rhetorical.

Bri

>> I ask myself why does this happen and why to her.  She is a kind and
>> loving
>> person with so much compassion for him and everyone else!
>
>Why do you ask this?  Have you ever seen any evidence that the world works
>the way you would like it to?
brianna_1938 - 25 Jul 2007 19:32 GMT
Hello Mary,

I have a question, do Alzheimer patients tell stories or little white lies?
My brother-in-law was telling me he had been to a concert and they sat in the
front row of the place.  My sister told me later, they had never been to that
concert and she didn't know what he was talking about.

Bri

>Brianna, think about what life must be like for them. Not only is
>their memory impaired, but so is their ability to do all kinds of
[quoted text clipped - 43 lines]
>
>M
Baird Stafford - 05 Jul 2007 09:57 GMT
> Why do Alzheimer's patients have good days and are so very nice, the next
> minute they turn and curse God and everyone else around them.

Because that's the way the disease works.  Never make the mistake of
thinking that the *patient* has turned on you - he or she hasn't.  The
disease has.

Blessed be,
Baird
brianna_1938 - 07 Jul 2007 06:10 GMT
I find it puzzling the person with Alzheimer's knows exactly when to behave
or misbehave.  When there is an adult present he doesn't swear or call his
wife ugly names.  One thing he does do is accuse her of stealing "his" money
and he does that in front of whoever.
I guess I don't understand the disease well enough. But I believe with
support groups and advice from nice people like you will help me.  Thank you
for your responses.

Bri

>> Why do Alzheimer's patients have good days and are so very nice, the next
>> minute they turn and curse God and everyone else around them.
[quoted text clipped - 5 lines]
>Blessed be,
>Baird
Evelyn Ruut - 07 Jul 2007 13:51 GMT
>I find it puzzling the person with Alzheimer's knows exactly when to behave
> or misbehave.  When there is an adult present he doesn't swear or call his
[quoted text clipped - 7 lines]
>
> Bri

Dear Brianna,

They don't lose ALL their proverbial "marbles" at once.   My mother in law
retained the ability to be sarcastic and snippy for years.   It was one of
the last faculties to go.   She still maintained a very good social
personality and she knew exactly when to act very sedate and when to
aggravate the heck out of me.   People thought she was such an angel (which
she was in public), but she could be very difficult when the mood moved her.

The paranoia about thinking people stole their money is EXTREMELY common,
and many of us have been through that one.

Think about it;  Imagine how it is for them when things seemingly get moved
around without their knowing it, and things happen that they don't remember,
they never would imagine it is their own memory gone bad, they think that
logically, it can only be that somebody else came in their room and took or
moved their stuff.

They don't remember spending their money or giving it to someone, or even
putting it into the bank, so they think YOU took it, since you are the one
sharing the house with them.   If you thought someone came into your house
and stole your money, you'd speak up too!

Here's a not so funny tale..... My mother in law took her bankbooks to the
bank, religiously every month, because she didn't believe she would get the
interest on her money unless they stamped it in the book.   Now eventually
that bankbook would get filled up with stamp marks, so they would start up a
new one.   She saved this whole stack of old bankbooks, not realizing they
were punched through as dead bankbooks, since there was of course, only one
current one.    Somehow she imagined that the bank stole her money because
they only honored ONE of the bankbooks, the current one.

One separate bankbook in particular had a certain amount of money in it,
which she had transferred into the main account some time before.   No
matter how they showed her over and over again that it went into the main
account, she SWORE the bank stole her money.    It was a real problem and
she would show up from time to time at that bank, carrying on about how they
stole her money.   We took her to live with us somewhere around that time,
because she was losing it in a lot of ways, not just that one.

Don't take it personally.   It may be a good idea to REALLY take over
keeping the bankbooks and the money, because if the person is are forgetting
it, they might hide it somewhere and forget where they hid it.   My mother
in law did that too.   One day she was tearing the house apart nearly
hysterically unable to find her bankbook collection.   I remembered when we
first arrived, she'd opened one cupboard in the kitchen.  Would you believe
she had put the bankbooks in a stack of kitchen bowls in that cupboard?
That's where they were.

Signature

Best Regards,

Evelyn

brianna_1938 - 07 Jul 2007 21:15 GMT
>>I find it puzzling the person with Alzheimer's knows exactly when to behave
>> or misbehave.  When there is an adult present he doesn't swear or call his
[quoted text clipped - 50 lines]
>she had put the bankbooks in a stack of kitchen bowls in that cupboard?
>That's where they were.

Thank you for your note.  It really helps to understand a lot more.
brianna_1938 - 07 Jul 2007 21:25 GMT
>>I find it puzzling the person with Alzheimer's knows exactly when to behave
>> or misbehave.  When there is an adult present he doesn't swear or call his
[quoted text clipped - 50 lines]
>she had put the bankbooks in a stack of kitchen bowls in that cupboard?
>That's where they were.

I can't thank you enough for the information you have given me.  This is the
same thing that happens in this house.  My brother-in-law goes over and over
his bank book balances all the time.  He doesn't understand the last balance
and why was money withdrawn from that certain bank.  He is looking at a bank
book dated way back in 2003. It is very sad to see that he cannot figure it
out because at one time he was a whiz at figures and kept books like a CPA.
Dennis P. Harris - 08 Jul 2007 10:13 GMT
> I can't thank you enough for the information you have given me.  This is the
> same thing that happens in this house.  My brother-in-law goes over and over
> his bank book balances all the time.  He doesn't understand the last balance
> and why was money withdrawn from that certain bank.  He is looking at a bank
> book dated way back in 2003. It is very sad to see that he cannot figure it
> out because at one time he was a whiz at figures and kept books like a CPA.

remove the bank books.  if he asks why they are missing tell him
that the accountants/lawyers/estate planners needed them to
prepare taxes/financial plan/etc and they'll be returning them
"next week".  when he asks, tell him that they'll be sending them
back "next week".  after a while, he'll forget to ask, since the
books won't be there to remind him.
Evelyn Ruut - 08 Jul 2007 12:28 GMT
>> I can't thank you enough for the information you have given me.  This is
>> the
[quoted text clipped - 15 lines]
> back "next week".  after a while, he'll forget to ask, since the
> books won't be there to remind him.

In our case, my husband took them and told her he was going to "put them in
a safe place till she went home in a couple of days".   Every time she
asked, he said he had them and would give them back when she went home.
This went on for a long time.  Eventually she forgot she had them, thank
goodness, because she would obsess over them, all stressed out for hours at
a time.   It was non stop worrying.   At first we thought to ourselves that
she was at least busy and not getting into anything else, but it was not
happy-busy, it was stressed-out-busy.   She would exhaust herself and get
angry and paranoid, and accusatory over it.   THAT is why we finally decided
to take them and put them away.

Signature

Best Regards,

Evelyn

brianna_1938 - 08 Jul 2007 16:21 GMT
>> I can't thank you enough for the information you have given me.  This is the
>> same thing that happens in this house.  My brother-in-law goes over and over
[quoted text clipped - 9 lines]
>back "next week".  after a while, he'll forget to ask, since the
>books won't be there to remind him.

Dennis,
He would probably curse us all day long and then call 911.  He wouldn't want
anyone else handling his books.  He keeps them all tied up in rubber bands.
It would take at least 10 minutes to take all the rubber bands off, he has
them so wound up around his wallet and books.
Evelyn Ruut - 09 Jul 2007 01:09 GMT
>>> I can't thank you enough for the information you have given me.  This is
>>> the
[quoted text clipped - 23 lines]
> It would take at least 10 minutes to take all the rubber bands off, he has
> them so wound up around his wallet and books.

Yes, that is how my mother in law was too.   My husband didn't dare even
think about putting them away until she'd been here for quite a while, and
had been enrolled in daycare.   By that time she realized to some degree
that we were looking after her.   She was also on some medication at that
time, which mellowed her out a bit.   Another thing is that he is her only
child, and a man and she was used to backing off when a man stood his
ground.    You are better off waiting on doing anything with his bankbooks,
but it would be good if you knew what the account numbers are and what bank
it is with.   They are QUITE able to hide things and not know where they put
it themselves anymore.

Signature

Best Regards,

Evelyn

Mary_Gordon@tvo.org - 09 Jul 2007 04:14 GMT
If you have power of attorney, you could also go to the bank and get
NEW bank books started, and let him keep the defunct old ones. We had
a financial advisor who started helping my MIL with her taxes in early
AD, who later helped my husband get a handle on my MIL's assets and
estate planning. One of the first things she had my husband do was get
rid of many of my MIL's bank accounts. She had money in accounts all
over the place. So once they were consolidated and set up better, many
accounts had been closed out, we were okay with my MIL having some of
the old dead books.

Even after she went to assisted living, my MIL really felt the need to
have card  in her wallet, so we made sure it was all unimportant
stuff, like expired library cards, etc. It was amazing how many
valueless but important looking pieces of plastic and cardboard we
could come up with (this as the point where she really couldn't tell
the difference, much less used any of them). We couldn't leave her
with anything important or with value - the danger of loss or theft
was too great.

Although she didn't NEED cash, it was important to her to have some,
and we found that whether she had $5 or $50, it vanished at the same
rate, and nothing to show for it. Sooooo, we made sure she had lots of
coins and small bills, so she felt like she had money, since she
couldn't have told the difference between a stack of 1 dollar bills
and 20 dollar bills.

The one thing that is important is that you know what your brother in
law has in terms of documents, and you have record of all the
accounts, the policies, the certificates, all his ID etc. If there are
irreplacable documents in his hands, time to substitute some artful
fakes, so you can keep the important stuff safe. Its okay to be
sneaky. He won't ever agree that he is impaired, or that he needs help
etc. So, you do what you have to do, and white lies and a little
slight of hand are often required to keep the person's interests
protected.

Mary
A R Pickett - 09 Jul 2007 18:07 GMT
Mary wrote in part  >One of the first things she had my husband do was get
>rid of many of my MIL's bank accounts. She had money in accounts all
>over the place.

My father had 9-10 accounts as well.  The whole thing started when my mother
was still living and had become exasperated with my Dad's inclination to
just spend money no matter what the source and what the eventual need for
incoming funds might be.  By setting up accounts with varying names " H & A
account" "H account" and so on, my mother could keep a handle on his
spending habits (in the early days of his dementia) because he would follow
her desires for the use of the money by referring to the name on the
account.  (This makes only a little bit of sense to me, but it worked for
her, so what the hey)

After her death, this system rapidly fell apart, and since he was confident
with the call transfer process at the two banks he patronized he made
transfers almost daily.  His finances were a dizzying mess of telephoned
transfers from one account to another, all in a futile attempt to cover
checks and ATM withdrawals which he had made with no clear idea of how much
was available in any one account.  The insufficient funds fees were
considerable.

My sister got everything consolidated, and was working on getting the ATM
card out of his clutches when his final illness began.

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"Sometimes the facts threaten the truth"
Amos Oz, prize winning Israeli author

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Remove lower case "e" to respond

Dennis P. Harris - 10 Jul 2007 22:00 GMT
> Its okay to be
> sneaky. He won't ever agree that he is impaired, or that he needs help
> etc. So, you do what you have to do, and white lies and a little
> slight of hand are often required to keep the person's interests
> protected.

remember, it's not lying.  it's "loving deception" and is
absolutely necessary to keep them from being upset and obsessive.
it's the reason you don't tell them you're taking them somewhere
until it's time to get ready to leave.
brianna_1938 - 12 Jul 2007 05:22 GMT
My sister does know all the account numbers and the banks where they keep
their money.

He wouldn't think of going to day care.  His mind is not that bad off yet so
we cannot take him to day care. We wish we could so he could talk to other
people and have some kind of entertainment.

BRi

>>>> I can't thank you enough for the information you have given me.  This is
>>>> the
[quoted text clipped - 12 lines]
>it is with.   They are QUITE able to hide things and not know where they put
>it themselves anymore.
Dennis P. Harris - 12 Jul 2007 10:23 GMT
> My sister does know all the account numbers and the banks where they keep
> their money.

but if anything happens to her, who will be able to make medical
and financial decisions for him?  she needs to have him sign
durable powers of attorney so that she can make his health care
decisions and sing on his behalf on documents that require both
their signatures.  the POA should also name an alternate person
in case she is incapacitated or dead.  she needs to do the same
for herself, too.

she also needs to check the account info frequently to make sure
that he's not just pissing it away without her knowledge.
brianna_1938 - 13 Jul 2007 02:53 GMT
Hello Dennis,
They have a son who will take care of their business.
My brother-in-law cannot walk.  He is in a wheelchair and she has to drive
him everywhere.  Cannot drive and no one to take him to the bank.  She is
safe as far as he drawing money.

>> My sister does know all the account numbers and the banks where they keep
>> their money.
[quoted text clipped - 9 lines]
>she also needs to check the account info frequently to make sure
>that he's not just pissing it away without her knowledge.
Dennis P. Harris - 10 Jul 2007 21:57 GMT
> He would probably curse us all day long and then call 911.  He wouldn't want
> anyone else handling his books.  He keeps them all tied up in rubber bands.
> It would take at least 10 minutes to take all the rubber bands off, he has
> them so wound up around his wallet and books.

do it anyway, while he's asleep.  in a week or 2 he'll have
forgotten about it and will be much happier.

oh, and call your local police dept or dispatch center's NON
EMERGENCY number.  most modern 911 dispatch systems allow for
info to be entered for an address.  most often it's used to tell
fire or rescue personnel where the utility cutoffs are located,
or the location of hazardous materials.

you can, however ask them to enter info such as the fact that the
person at a certain address has a chronic medical condition like
diabetes or AD, or is on oxygen.  you should tell them that he
has alzheimer's, is easily confused, and is often delusional.

after replacing the door jamb the second time, i installed a key
safe next to mom's front door containing a door key and gave the
911 folks the combination so that they could unlock the front
door instead of having to kick in the lock when my mom called the
ambulance when she was short of breath and having panic attacks,
and my phone number with instructions to call any time there was
a 911 call to her house, so i could get there before the
ambulance left for the hospital.
brianna_1938 - 12 Jul 2007 05:26 GMT
He wakes up in the morning and that is the first thing he wants to see, his
bank books. He has not forgotten about them yet.
My sister has gotten on the phone to tell the operator at 911 not to send
someone out because her husband is ill.  But they always have to follow up
and send someone out. We have had the police come out so many times and it is
embarrasing.

Bri

>> He would probably curse us all day long and then call 911.  He wouldn't want
>> anyone else handling his books.  He keeps them all tied up in rubber bands.
[quoted text clipped - 23 lines]
>a 911 call to her house, so i could get there before the
>ambulance left for the hospital.
Dennis P. Harris - 12 Jul 2007 10:32 GMT
> My sister has gotten on the phone to tell the operator at 911 not to send
> someone out because her husband is ill.  But they always have to follow up
> and send someone out. We have had the police come out so many times and it is
> embarrasing.

She needs to ask his doctor to write a letter on his letterhead
telling the 911 dispatchers that he has AD and is delusional.
Make sure you get the name and mailing address for the correct
person to whom the letter should be addressed.
Tumbleweed - 07 Jul 2007 16:43 GMT
>I find it puzzling the person with Alzheimer's knows exactly when to behave
> or misbehave.  When there is an adult present he doesn't swear or call his
[quoted text clipped - 5 lines]
> you
> for your responses.

snip random bits out of someone's brain, anything coukld happen, and
frequently does.

If you had a randomly damaged brain, would you think it fair if someone
criticised 'you' for doing it, when 'you' is the person you *were*, with
various capabilities removed ...why dont you swear in pubic?  thats learned
behaviour, why dont you accuse someone of stealing from you in public?  more
learned behaviour. Now unlearn the latter by having that memory (which is
what learning is) removed.

Thats why the little kid says "MUM WHY IS THAT LADY BALD' out loud,  they
havent learned not to yet, so the adult doesn't, but that memory can be lost
by an Az sufferer, plus each and every other learned memory, all that social
cnditioning etc. Its not at all uncommon to read here of little old church
going ladies who suddenly start swearing like troopers and making sexual
remarks or similar.

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