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