Recognizing the Signs

A friend of mine works in hospice care in Alaska where she is the director of volunteers.  She often mentions patients who are in stages of dementia or Alzheimer's Disease.  Because Mom has been diagnosed with moderate dementia, she shared with me several documents, including a list of symptoms to expect, stages and care needed, plus things that family members can do when visiting with loved ones who are exhibiting these traits.

As I looked at the first document which included traits to recognize the progression of the disease, I focused on the first 6 that were listed and how those apply to Mom.

1. Difficulty remembering appointments - Mom has had trouble with remembering her doctors' appointments, even if they are written on all of her many calendars and even if she is reminded several times.  We noticed this specifically when we took her to her appointment with Dr. Sardar on Feb. 9.  She couldn't remember the time, when we would be there, and how she was going to get there.  Gary told her that all she needed to remember was that we would take care of it.  Just be ready in the morning.  One of the therapists told me that this is normal for dementia patients.  They can't process too much at one time.  Telling a dementia patient over and over again the same information, in steps, such as "we will pick you up at 9:30 for your appt at 10:30 and then we will go to the lab at 11:00 and then to lunch and then to another appt at 1:30" just confuses their minds.  They are lost after the first step, then block it out.  This is happening with Mom.  What Gary told her "We will take care of it.  Don't worry about it." is the best thing to do.
2.  Lose track of time  -  We have noticed this happening with Mom also.  She would read well into the night, falling asleep in the chair.  She didn't remember how long she had been in the hospital, what day it was, what time of day it was.   Of course having her blinds and drapes drawn at home would be confusing as well since the entire house was in a state of darkness.  She also talks about the past (as in her childhood) as if it were just happening recently.
3.  Not storing information - Mom does have trouble remembering things that have been told to her recently.  She knew that the furnace people were coming to check her furnace because we had to leave and return to Wooster to meet them.  She then asked the next day what we had been doing, with no mention of what happened with the furnace.  We didn't mention it either, but it did seem unusual that she wouldn't have asked about it.
4.  Accusatory or paranoid - This has been happening for a long time, and now we can put a 'this is a trait of dementia' with it.  Mom accused Gary of stealing her lawnmower.  She was going to have us arrested for cleaning out her refrigerator.  She told Greta that there was no way her house was going to be sold!  She was always worried about the girls touching anything in the basement. She couldn't find a picture and thought that Blaine had taken it.  The list is a long one.  However, now since we know it is a trait, we can let those accuasations bounce off and not respond to them, caulking them up to the dementia.  Much easier to deal with.
5.  Way-finding problems - This is knowing how to do things, how to solve problems, a test of being able to do something the process to do it.  The nurses at Woodlawn said that Mom had difficulty with small steps of things to do, such as preparing for bed.  Even though the clock test seems silly, it is a way to observe Mom's methods of doing something simple, like telling time.  Putting blocks on pegs is a way to test motor skills.  They may seem like simple tasks, but they are indicators of skills that can be developed, that may be weak, or those that have diminished to the point of disappearing.
6.  Unable to separate fact from fiction - Mom has been doing this for several years too.  Her spin of fabrication from factual information has been out of control for some time.  The story about Greta and Kent's stop at a hotel and encountering possible drug deals outside of their room in the parking lot was then inserted into her stay in Lafayette for Landon's adoption party.  Kent's going to Indianapolis for his cousin's funeral was changed to include my reserving a hotel room for him and her insistence (even after my denial that that happened) that she was told just that. The little men with hooded sweatshirts that poured out of a clown car and ran all over the neighborhood.  All of the heavy breathers who called her.  Recently she thinks that Gary told her that serving pureed food in rehabilitation facilities was against the law.  How to react?  Smile, nod, and change the subject. Move on. Don't argue.  Don't try to explain.  Don't point out that she is wrong and why.  Just move on.  Dementia.  Again.

While the diagnosis of dementia is sad, and I don't like seeing the effects on my mother, it gives us a reason for Mom's demeanor, her actions and reactions, and her outbursts.  For me it is calming to know that this is the reason for her anger at me, for her confusion, for her lack of remembering things.  She has claimed for years that "No one told me" or "That's not what they told me!" when asked about something or when being challenged about information.  Most likely the dementia has been a problem for many years; it just had never been evaluated and diagnosed.