Expert: Paula Damgaard - 8/7/2009

Question
my grandmother is 81 and in Fe 09 she had acute multiple strokes was in the hospital for 3 moths and ever since never been the same in the hospital she would sometimes say things that made no sense but now that she is at home its like everyday she claims that not her house i an my girls live with her but sometimes shes fine all of a sudden she looses it and doesn't know who we are and she tries to hit us saying we kidnapped her i spoke to her Dr he said its dentinal and then the visiting nurse says she has manic depression i really dent know what to do anymore i have two other aunts but they really don't want to deal with the situation when they see her like this and dent help out much and i just cant seem to find it in my heart to put her in a nursing home please help me as him writing  you him in tears him falling apart

Answer
Emily,  your grandmother is neither in denial or manic depressive.  She has had serious damage done to her brain from the strokes.  These strokes cause damage to whatever area of the brain that they hit.  Sometimes they can recover from the damage sometimes not. But it can take up to two years for recovery.  

Also in looking at her age, it is quite possible that she also has Alzheimer's disease.  The strokes which caused a great amount of stress to her brain could be the push that was needed to bring the disease out in the open.  In other words your grandmother may have been developing AD, but very slowly and not so that you would notice, but when the strokes happened they speeded up the arrival.  

The fact that somedays she knows you and some days she doesn't is very typical for people with AD.  Your best way to approach this is not to argue with her when she says things that aren't true.  Agree with her! If she wants to tell you the sky is purple say what a beautiful color!  Lying is ok!   As long as she isn't in danger, there is no harm, but you have to work with it.  Come up with ways to make it seem like SHE is the one that had the idea. This will keep her anger and aggression down.  

She may be depressed, no doubt, this is not an easy disease, so she may need an antidepressant.  My guess is you need a new doctor.  One who specializes in geriatrics or dementia.  I don't know where you live, but if there is  a University hospital around I am pretty sure they will have a geriatric department.  Call the local Alzheimer's Association in your area and ask them for doctors they know in the area.

Good luck!  I hope this helps.  Take care of yourself.  This is  a lonely caregiving job!  Paula