Expert: Paula Damgaard - 1/23/2011

Question
Hi. My mom (61) has Alzheimer's (stage 6 maybe?) & is physically still very healthy. My dad is able to care for her.  However, she recently got a UTI and became fearful of him & when in his prescence was anxious & fearul to the point of shaking.  During this time, she came to stay with me.  We got her on antibiotics and the UTI has cleared up (7 days later) but her symptoms/behavior toward my dad has not changed.  She eventually did not want to stay with me either so we had to put her in assisted living facility.  She has been there for 6 days.  My first question is..is there still hope that she can forget about the negative connotation of my dad with the infection fully clearing?  (could it be delerium that could take up to 1 month to recover from)  Second...how do we go about taking her from the assisted living...we don't want to do more damage than good, but we would like to get her back home if at all possible. We were thinking we would just try her back at home and see how it goes if she responds positively to my dad when we go visit. Although I read in another question that we should maybe wait 2 weeks before we visit as it has only been one so far.  Thanks so much for any help!! :)

Answer
Hi Chris,

Her behavior is not uncommon with a UTI.  If she is still having these behaviors even after the antibiotic is finished I would suggest you take another sample and have it tested.  It may not be gone yet.  

The question about taking her back home again, is a tricky one.  Your mom is going to need a lot more care as she continues through the disease.  How well is your dad?  Do you know that 75% of caregivers get seriously sick and/or die before the AD patient due to the amount of stress in taking care of them?  Your dad may say that he can do it, but can he really?  He has to be about the same age as your mom no?  We aren't really built to be taking care of adult "infants" (as that is what AD patients become at the very end) when we are ourselves elderly.  

If she is happy in the assisted living, why not leave her there and then take her out for day visits and occasional overnights?  This way your dad always gets a good nights rest and he can build up his energy levels so that when she does come home he can focus on her for that time period.

I would hope that she would get over her paranoia once the UTI is really gone, but there are no guarantees with this disease.  Again this is another reason to leave her where she is.  It is very stressful and hurtful to live with someone who constantly accuses you of doing or being someone you are not.  

Waiting the two weeks allows her to become acclimated to her surroundings.  Otherwise when you go to see her she may lash out at you and accuse all of you of doing things you never did.  Some do this some don't but since your mom is already paranoid, I wouldn't test it.  

Hope this helps. Good luck. I know this is very hard!  Paula