Expert: Cindy Keith, RN, BS, Certified Dementia Practitioner - 12/30/2011

Question
My wife of 30 years has been acting very unusual for over 6 months now. She is 50 and has a mother with AD and a grandfather who died of AD. She has a drinking problem and my children (daughters 22 and 20) and I have assumed that this was the cause of the unusual behavior. She is trying to quite drinking and we are making all steps we can to keep alcohol away but the behavior is still bizarre even when she is sober. She wakes up every night at 2-4 AM and can not sleep. She is back in bed at 7AM and sleeps until 11AM, gets up does a few things for a few hours and then goes back to sleep on the couch from 3PM-7PM, awakes for a few hours and then starts all over again. He sleep appears deep as it is difficult to wake her up but she does talk during sleep at times. She has developed a phobia of the large Kroger grocery store, escalators and driving. Things that used to be routine chores are almost overwhelming to her now. She is definitely depressed and has anxiety. I cannot think of much of anything constructive that she has been able to do. We have been blaming the behavior on alcoholism but am now concerned that it may be AD. There used to be some clear headed activities between drunks but now there seem to be few if any. I have been trying to get her to an MD for over a year. She keeps cancelling but I am hopeful that she will make an appointment next Tuesday. She has asked a friend to go with her and says that she does not want me there as "I'll stress her out". I have asked her to please sign the waiver allowing me to speak to the doctor after the visit.

Any thoughts or guidance is greatly appreciated.

Answer
Hello John:  I'm sorry to hear of your wife's troubling symptoms.  There is an inherited form of AD, however it is relatively rare.  The drinking would compound any diagnosis, but she needs to have a "dementia work-up" as soon as possible.  Her symptoms could be explained by many things other than AD and the doctor would rule all of those things out before making a diagnosis.  She definitely needs to have someone go to the doctor with her and provide the doctor with a list of the symptoms you're all seeing--perhaps one of your daughters would go with her?  A phone call or letter to the doctor may help also.  She cannot be trusted to tell the doctor what has been going on, nor admit to any problems with the alcohol.  The depression and anxiety are also compounding any other health issues, but she may be unable to tell the doctor just how bad it is for her.  It sounds as if she needs help and she needs it sooner rather than later.  Perhaps a family intervention would work to get her to the doctor?  If she continues to refuse help, she may have a crisis and end up being hospitalized, and I'm sure none of you want that to happen.  I wish you and your family strength as you struggle to help your wife during this painful time.  Cindy