Paranoia is one of the "classic" symptoms, and frequently leads to
abrasive (or "nasty") interaction with others.

You may get no diagnosis more definitive than "dementia."  The paranoia
I mentioned above, however, could easily exacerbate her aggression
towards her family.  I would suggest this is more likely to be the
disease than her old nasty personality, however.

You mentioned a "senior living situation" above.  If this does not
include medical care for her, you might well want to rethink your
options.  Some assisted living facilities, however, do offer medical
care (the Dowager is in one such); if that is her "senior living
situation," you might check on what else the company offers.  If they
don't offer medical care, then, yes, "institutionalizing" her may be
your only choice.

You might keep in mind, though, that if she has had to move out of her
old house into a new environment, all this may be almost as hard on her
as it is on you.

Baird

There are probably a million reasons for that kind of nastiness.   Let me
try and find a few for you.  The first one is paranoia.... they think that
their kids are trying to "make me out to be crazy" for some nefarious
reason.   They think that since they can't remember where they put their
bankbooks or their money or their jewelry, that someone has come in and
taken it.   They are losing their autonomy.   People are talking to them and
acting with them, as though they were crazy, making their decisions for
them, moving them or their belongings here or there, without their knowledge
(even though you may have discussed it in detail, they don't remember the
discussion).

But besides all that, there is some genuine nastiness that comes with the
illness.   They forget who their loved ones are and think it is a stranger
who is being overly familiar with them.   They feel they are on a visit that
they are going to go home from, but they don't know how to get back to their
familiar home (even though it may be a childhood home long gone in time).

So those are just a handful of reasons.   Think carefully and find out if
her nastiness is connected with depression, because VERY often it is.   When
my mother in law went on Zoloft, an antidepressant, she became relaxed and
much happier, and stopped the nastiness at least to some degree, where it
was possible to live with her and care for her without some feisty and even
physical reactions.

There are real reasons for the depression, and the depression itself is a
real thing.   Brain chemistry goes all awry with alzheimers.  The person's
actual physical brain is shrinking and atrophying.   There are changes
associated with that, and they often manifest as personality changes and/or
depression, or even delusions.

Please tell your dear wife, that it absolutely isn't her fault, and it isn't
personal.   She may possibly be regarded as an intrusive stranger, not
really recognized anymore, by your mom.   This is a physical disease of the
brain.   All sorts of weird behavior can be expected, and indeed should be.

One time my mother in law began yelling at me rudely, thinking I was some
stranger who had her in a car, and who wouldn't take her home fast enough.
It was the most hellish ride of my life.   I kept telling her who I was and
it did no good, she had no idea who I was.   I had taken her with me on a
visit to my family in NJ to keep her out of my husbands hair while he did
some work at our house, and she was going ballistic with me a hundred miles
from home!   Thank goodness, after a hellish ride, I finally got her home
and she told my husband (whom she DID recognize)  that some strange woman
had her in a taxi and was driving her all over the place and was refusing to
take her home.   He told her that was no 'strange woman,' that was Evelyn,
and she just looked at me strangely and went to bed.   The next morning she
again knew who I was and there was no problem at all.

It's a strange disease.  I know it is hard, but you just cannot take this
stuff personally.   No matter how it hurts, it isn't about you, it is the
twistings and turnings of confused thinking from a truly sick brain.   Tell
your wife, that if she goes away for a day or an hour, or returns again the
next morning, it will be a clean slate again.   If there is something GOOD
to say about the manifestations of this disease, it is that they do forget,
again and again.   And that is also the BAD part of alzheimers... they do
forget over and over again.   There were times when we'd had serious words
with one another, and the next morning ..... GONE.   There were times I was
grateful for that.   Dealing with alzheimers is a lesson for us (who do
remember), in how to let go.

Hi Bill - personality changes go with the territory. She also will be
losing her inhibitions and understanding of social niceties - she'll
say whatever comes into her head, and won't be able to stop herself,
much less realize the impact the words may have on others.

They often have very limited insight into their own situation or
behavior, no matter how blindingly obvious things may seem to those
around them.

The brain damage also means they can't reason, much less remember, so
the world is a frustrating and stressful jumble. Agitation and
outbursts (called catastrophic reactions) are not uncommon,
particularly when they feel stressed (tired, hungry, sick, too many
demands being made on them, too much going on around them)too many
deemandtoo much elenen

I know it is very hard, but you just can't take it personally. One of
the hardest lessons in dealing with dementia is to know the person is
past the point of doing things on purpose. The old labels of mean,
stubborn, being difficult, trying to annoy etc. - all those need an
intact brain to pull off all that conscious plotting and scheming. You
have to put a new spin on their behavior and accept they are doing the
best they can with what their brains will allow. So, as your wife has
likely discovered, arguing and reasoning get you nowhere.

Its crummy.

Mary G.

You have gotten some good answers.

Yes, AD and dementia patients often have a mean, nasty and/or paranoic
stage. Never take their remarks personally because the person making them
has a broken brain. Do not waste your time trying to make them acknowledge
their rude behavior or recognize the wrongness of their actions or words.
This won't happen because the part of the brain that accomplishes this type
self analysis is also probably broken beyond repair. And yes- ignoring their
insults is very hard to do.

Remind yourself and your wife that these mean stages are usually temporary
and often the next stage (at least with vascular dementia) is often
child-like and agreeable behavior  - much like a puppy that knows you are
the person who feeds them and  is therefore usually willing to try and
please you as best they are able. That's not much to look forward to but it
beats staying pissed off and angry about a situation that you can not
change.  AW