QUESTION: My 83 year old mother has dementia. She is presently living in a nursing home. She seems to be disgruntled most of the time. It is impossible to get her interested in much of anything. I take her for very long walks every day. I am particularly concerned with her use of very foul language, especially in such a public setting.PLEASE HELP if you can. Thank you.
ANSWER: Hello Mary:
I'm very sorry to hear of your mother's declining social graces and I'm sure that is very upsetting for you.
It's not unusual for this to happen in dementia. First, I would ask the staff whether or not she is acting and reacting the same way with everyone around her. If she is, then it's a sign that the dementia is destroying the areas in her brain where the social graces reside. Those areas that tell us it's not nice to curse in public, or take off your clothes, or a multitude of other things that our brain without dementia would put the brakes on. There is not much you can do about it other than ignore it, or ask her to please stop or you will have to leave. You would have to continually do this as she will forget.
If she is NOT cursing or being disgruntled around staff all the time, then it would appear it's happening because when she sees you or other family members, she may remember she wants to go home and sees you as the reason she cannot--so she's upset every time she sees you. Please try not to be embarrassed because the staff are quite used to this sort of thing. Either way, it's important for you to always remain smiling and happy--even if you have to kiss her goodbye because she won't stop cursing!
I would keep trying to find things that could catch her interest. Does she enjoy pets? If so, can you bring one in to visit? Would she accept a stuffed animal or babydoll and think it's real? Does she have access to a large photo album? You could look at it together and remember (for her) some great times--taking care to not ask "Do you remember who this is?" Just allow her to look and you could say something like "I remember when that was taken--that's me, and that's you and Dad." to help cue her. If she disagrees, let her be right and go on to the next one. Music is huge with many elders and she should have access to her favorite tunes in her room, but possibly an ipod with ear buds would work as well. Oftentimes, what the elder refused to do in the past, can now be enjoyed, so don't discount things you've already tried.
I wish you luck Mary as you help your Mother move forward on her dementia journey.
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QUESTION: Are you aware of any medication that may help eradicate this behavior? The staff has had to remove my mother from the dining room and the activities room because of the very foul language. Her dignity is being compromised. It is heartbreaking.THANK YOU!!
Hello again Mary: Okay--now I understand how bad it is! In order to "eradicate" this behavior, she would have to be "zonked" out with a strong anti-psychotic drug--which is not desirable. Since I'm not a doctor, it's hard to say what medication would be a good choice for her--has Namenda been tried? It has a very low side effect profile and can help reduce agitation, so could possibly help reduce the language problem. I would ask if an anti-depressant could be tried before an anti-psychotic since they can often take care of behavior problems in elders with dementia as well as the anti-psychotics but without the side effects. Ask that whatever is tried is started at a low dose and slowly increased. It's always a guessing game when it comes to meds and elders with dementia, so you may have to try several before you can find one that helps--but most likely won't resolve the problem entirely. As her dementia progresses, and the brain damage worsens, this behavior will likely go away. I'm so sorry you are dealing with this issue Mary and I hope you and the doctor can come up with some med options to try. I wish I could be more helpful. Cindy