Expert: Michalene Peticca - 7/18/2007

Question
my dad is 69 yrs old. he was in a serious car accident in the 1950s, & has had problems regarding his brain since.  he has developed epilepsy (in the 1990's) & has had quite a few mini strokes & full strokes.  how many i'm not sure, as he tells me very little about his health.  currently, my mother is calling me often, saying how bizarre dad acts with her- is very angry (she wont admit this but she's been verbally abusive with him, so how much anger is health & how much is him fed up, I'm not sure), & he obsesses over odd things, like watering his lawn & some neighbors' as well.  Honestly, I'm not certain how much of what my mother says is accurate, & how much is her adding or deleting information from what she tells me.  But, I have noticed my dad's behavior becoming increasingly odd.  He is suddenly more forgetful than ever, does obsess about odd things (I'm a freelance writer & he tells me what I need to write about sometimes, for example) & his math skills, which used to be very impressive, are getting very bad.  He saw his neurologist recently who told him he was fine & my mother needed to be more tolerant.  His idea of a test for alzheimers was to ask dad to touch his nose with his finger, to repeat 3 objects the dr. listed & to list the current date.  Dad flubbed the date & objects, but dr. said he's fine.  I've tried suggesting he see another neurologist, but he said he's afraid of what the dr. might say so he wont.  I've suggested counseling, & he is seeing a counseler on the 25th but his primary care dr. recommened seeing him only once to determine if dad's depressed.  I've also suggested my mom seek counseling & she wont- instead she wants me to fix everything myself.  I don't know how, nor do I think it's my place.  Any advice in this situation??  I'm really at a loss...

Answer
Hello Cynthia,

Thank you for writing.  You sure do have a lot going on right now and i'm glad you are willing to try and help your parents.

From what you have given me as part of your father's history, i would strongly lean to the side of believing that his personality and behavior changes probably are due to continued trauma to his brain from strokes, etc.  Unfortunately with continued strokes, brain transmitters do stop "conducting" messages and changes occur.  It can be frustrating because medications cannot "fix" what is already dead within the brain.

I'm not a physician, but i would suggest a second neurologist as you've mentioned or one that is very well versed in Vascular dementia.  

Please have your father see his primary physician and get a good blood workup as well.  It is amazing what can occur from potassium, thiamine, etc. levels being out of sorts.  
From what you've described, i don't see the depressive type behaviors, although physicians are probably trying to narrow down what may be causing an elevation in his behaviors.

Please feel free to go on the Johns Hopkins website and search under Vascular dementia and gather more information there to see if this may be more what your father is experiencing.

Unfortunately i don't believe you'll be able to "fix" your father, but a greater understanding can be accomplished by understanding his current health and how you & your mom may have to Adapt to Him and possibly discuss future caregiving roles as his emotions/behaviors continue or become more pronounced.  

Best Regards,
Michalene Peticca M.A.