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Alzheimer`s Disease/bipolar combining with dementia


My mother, who is 79 years old, has suffered from bipolar disorder since her early 20's (before they even knew what bipolar was).  She has been on lithium most of her life and has done fairly well.  Now she is also suffering from dementia.  What happens when a person with bipolar disorder gets dementia?  What can be done to alleviate the suffering?  She is extremely anxious, agitated, goes to bathroom constantly, eats very little, doesn't want to leave her room, doesn't watch TV or want to talk, etc.   She is in assisted living now.  Does she need to be in nursing home?  Medication?
My sister and I want to be good advocates for her and do what's best.  Can't bear to see her suffer.
Thank you.

Hello Bonnie:  First, I apologize for the delay in answering your question.  I thought I had answered it, but apparently my computer sent it into cyberspace somewhere!
I'm so sorry to hear of your mother's dual diagnosis-I'm sure it's very frustrating for the entire family and it's hard for her to understand what is going on.
I believe the first order of business is to be certain she's not suffering from any type of medical illness such as a urinary tract infection.  Also, is her genital area being irritated because of loss of estrogen and maybe she would benefit from a very low dose of estrogen cream that would alleviate the feeling like she needs to urinate all the time?  They should check her thyroid to see if that is still functioning well.  
It is very difficult for me to say whether or not she would need to be in skilled vs. assisted living--only her physician can answer that accurately.  Be sure everyone around her is focusing on doing things that she used to find pleasure in.  Is it music, is it animals or babies?  Possibly walks outside with a family member would perk her up.  That being said, her psychiatrist or neurologist should be consulted about a possible medication adjustment.  It's extremely difficult when an elder with bipolar disorder gets dementia because you can't always tell if it's the dementia causing the issues or the bipolar disorder.  They can, however, try a medication adjustment to get her anxiety under control so that she will be more comfortable. Appetite stimulants can be tried if she is losing weight and the medications have been adjusted.   
Don't give up hope that answers can be found.  What doesn't work today could work a month from now. You and your sister ARE being good advocates just by seeking answers from other sources. Give her lots of TLC so she knows how much you care, and push for the needed tests to determine if there are other issues going on and even if there are not, then medications for the bipolar should be adjusted and an anti-anxiety agent should be added.  
I wish you much luck Bonnie as you and your sister move forward with your mother on her journey through dementia.  Cindy  

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner


As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.


I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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