Alzheimer`s Disease/Dementia

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Question
Hi, my grandmother has been showing signs of what I think might be dementia for almost a year now. At first it was slight and didn't happen very often at all. My family just took it as old age. My grandmother is 86, will be 87 in July. After a couple of months with rare occurrences of asking repetitive questions and forgetfulness it started to happen more often and she started getting confused at times. When she went to the doctor several months ago my grandfather told the doctor and they said it might be too much potassium because of the medications she was taking and her diet. Then for a while it seemed better. Now when she has episodes she is confused, she screams at my grandfather and my cousin who is living with them now. She says that they are moving things and stealing things. Then she starts hiding things, like the keys and the check book. When she overheard my grandfather telling my mom what was going on she got really upset. She starts acting like everyone is out to make her think she is losing her mind. Nobody knows what to do. My mom wants my grandfather to take her to the emergency room since she can't seem to get a doctors appointment any time soon. She has an appointment with the neurologist on April 9th, but my grandfather is really worried about her. Lately she has gotten up in the middle of the night to supposedly take the dog out, but then she ends up falling and the last time her glasses fell off too. She was struggling out there by herself and I don't even know for how long. My family and I don't know what to do. We all think she needs to see a doctor asap so that they can help. We want to know if this is dementia and if so what is causing it. Could it be because of her age, medications or something else altogether. We also want to know how to handle the situation, when she gets all upset my grandfather doesn't know what to do and just calls my mom for help. My mom hasn't a clue what to do either and my grandparents live 5 hours away from my mom and myself. My uncles lives closer to them, but doesn't seem to be much help and my cousin hasn't clue what to do either. Do you think this is dementia and could it be just because of her age? If so, what should we do? Could we just take her to the emergency room and tell them what's going on?

Answer
Hello Courtney:  I'm very sorry to hear of this dilemma with your beloved grandmother.  I know the entire family is upset about this.  There are no easy answers because it seems your grandmother is pretty stubborn and may refuse help of any kind.  You could take her to the ER, but you may hit a brick wall when she refuses to help in any way and refuses care.  Certainly if she falls again, she should be taken to the ER and have a brain scan done.  It COULD be that she has a type of dementia,but it's also very possible that she's a bit dehydrated, or her meds are causing a problem as they have in the past, or it could be a bunch of other issues going on.  It's imperative that she get to the doctor--a neurologist would probably be best.  Tell her the visit is to be sure her meds are the right ones rather than you're concerned about her memory.  Tell the doctor's office in advance you would like a dementia work-up and why (the symptoms you're seeing) so you don't have to have that conversation in front of her and get her upset.  Maybe putting additional locks on the doors so she might not be able to exit the house at night would help.  Certainly, have extra people staying there would also help.  It's important to not be telling her that she's losing her memory or she's constantly forgetting things. Maintain her dignity, take the blame for things and apologize to her.  Try to keep her in a happy frame of mind by doing things she enjoys doing. Your grandfather is likely taking the brunt of her anger and paranoia and it's important that he get some time away from her.  It's also imperative that he not argue with her or try to orient her.  For example "I'm sorry, dear, I may have picked up your wallet and put it away somewhere.  Let me help you look for it now and I promise I won't do it again--I'm so sorry."  Even though he never touched the wallet, he has to get her calmed down and not argue with her.  My first book "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" is written for family caregivers.  You don't yet know if she has dementia, but many of her actions are dementia-like and I feel that book would help all of you with many of her issues.  You all need to become educated about whatever the doctor decides is the problem.  Then, once you have some answers, you all may need to be changing the way you talk with and interact with her in order to keep peace in the home.  My heart goes out to you Courtney, and I pray you and your family will soon have some answers.  Hang in there, you will find some help for the issues.  

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner

Expertise

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.

Experience

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.

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

Publications
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"

Education/Credentials
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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