Expert: Mary Gordon - 7/31/2007

Question
If a person with Alz. keeps hurting your feelings, intentionally or untentionally, do you have to keep exposing yourself to the hurts? What if someone had an illness that caused them to stab people. Would you have to keep going around then to get stabbed even though it was an illness?

Thank you,
Julie

Answer
Julie, I don't think you need to see her face to face, if in this phase she's hurting you. However, you have to get to the point where you look at her as what she is - irrational, out of control, paranoid, and unable to stop herself. You can't take anything she says personally. Its like making a kid take a bath and having them say you are a poo-poo head, and they hate you. They don't mean it, but they have no brakes on their mouths. Its not HER that is saying this stuff - its a damaged vestige of her, that can't think through how she's affecting the very people she needs to survive.

Seriously, as per my prior e-mail, get her into a home, and just coordinate her care. You do not have to be near her face to face - but this stage will pass off and she will be less agitated and more docile. She can also get onto medications which can mellow her out considerably - reduce her hostility and agitation.  

I know you are feeling desperate, but at bare minimum, see if you can get her checked in for respite care and an assessment to see if even a short stay elsewhere with expert eyes on her, and maybe trying some other meds while she is there can help.

She is your mother, and she is sick - and not sick in a way as other diseases. Its no different than if some thug had come along and hit her in the head with a shovel, and she became a totally different person in the aftermath due to the brain damage - its not her, you can't hold her accountable, and since you can't change what she's doing right now, you have to change the way you look at it.  She's being hateful, and it may seem aimed at you, but its not. Think what the world must be like for her - a totally terrifying jumple that makes no sense, where she is constantly confused, overwhelmed, frightened. They are under extreme stress trying to hold it together to even do basic everyday things.


I don't know how she was diagnosed, but she may also have a frontal lobe dementia rather than Alzheimer's. Frontal Lobe Dementias like Pick's disease, can cause dramatic personality changes including loss of inhibitiions, so they say and do whatever comes into their heads (i.e. the pastor suddenly starting to swear like a sailor or proposition all the women in the congregation).

You need a break from her for sure, to get some perspective. Its not personal!
She is no longer your mother - she is what is left of your mother, and she is dying, and will continue to dwindle and vanish, and the verbal aggression will go away.

There was a tiny elderly lady called Jean in my mother in law's Alzheimer's ward who had been a school teacher in Scotland, and apparently, a very refined, kind lady. Her dementia turned her into quite a character. She'd curse and swear, accuse the staff of trying to poison her, throw things at them (including chairs almost as big as she was). It wasn't the real Jean that did these things, because the real Jean was gone due to brain damage.

NO, you absolutely don't have to visit her or spend time with her, but get her into a facility, and then you won't have to worry. You can just coordinate what goes on, and only drop by for very short times to check on things occasionally.

Get a copy of the 36 Hour Day - it will help you with all of this.

Sorry you are in such distress.

M