Expert: Margot RN BScN CGN - 10/11/2006

Question
I believe that my 82 year old mother has dementia, I have been caring for her now off and on for years. She forgets she has told methings and then repeats herself. Now when we talk she has gone into talking aobut dying. This is getting to me as she has been doing this for a couple years. I have other siblings who for their own reasons ( she is mean to them) won't come around, so I am left to cope. Is this natural for a person of that age to be increasingly more interested ( for lack of a better word) in dying? Also she has started telling me to do things which I don't feel needs to be done is this also natural? I love her dearly but she doesn't want to go to a nursing home or assisted home so I feel she should be home where she is comfortable. She won't let me get anyone in to help her, nothing I do is right, no matter if she tells me she wants it done or not. Is there actually any help groups or online help for caregivers? I can not find any thing on dementia ie: symptoms etc, can you help answer these questions for me? thanks for any help you can offer me. I spoke to her doctor once as she forgets to tell him things, he said she has dementia. again thanks Sherrie

Answer
Hi Sherrie and thanks for writing,

I'll try to answer your questions to the best of my ability.

First of all, yes it is normal for older people to accept death and some chose to talk about it, and some start to give things away or tell those close to them what they'd like to do.

The most important early indications of dementia:


1. Forgetfulness with effects at work:

Most people sometimes forget names or appointments. If this happens more frequently and inexplicable states of confusion also occur, this might be an indication for a decline in memory function.

2. Difficulties with familiar activities:

People who are very busy are sometimes absent-minded and for example forget the pot on the stove. People with dementia possibly not only forget the pot on the stove but also that they have cooked at all.

3. Language problems:

Most people sometimes experience difficulties in finding the right words. Dementia sufferers often cannot remember simple words and instead they use inappropriate fillers which makes it difficult to understand the sentences.

4. Problems with spatial and temporal orientation:

A lot of people sometimes forget e.g. the day of the week or they get lost in unfamiliar surroundings. Dementia sufferers might be in their own street and no longer know where they are, how they got there and how to get home again.

5. Impaired capacity of judgement:

People not always choose clothes suitable for the weather. Dementia sufferers sometimes wear totally inappropriate clothes. For example, they wear a bathrobe while shopping or several blouses on top of each other on a hot summer day.

6. Problems with abstract thinking:

For many people running a bank account is a challenge. Dementia patients can often neither recognise numbers nor carry out simple calculations.

7. Leaving things behind:

From time to time almost everybody leaves their keys or a wallet behind. Dementia sufferers however might put things in completely inappropriate places, such as for example the iron in the fridge or a watch in the sugar bowl. Afterwards they do not remember where they put them.

8. Mood swings and behavioural changes

Everybody has mood swings. People with dementia may have very sudden mood swings, often without discernible cause.

9. Personality changes:

With advancing age the personality of most people changes a little. People affected by dementia may experience a very pronounced personality change suddenly or over a longer period of time. Somebody who is generally friendly, for example, becomes unexpectedly angry, jealous or timid.

10. Loss of initiative:

Nobody continuously works with the same motivation. Dementia patients sometimes loose the zest in their work and the interest in their hobbies completely without enjoying new activities.

from: www.dementia.com

There are several good support groups for Caregivers, and I strongly suggest you call the Social Work dept at your local general hospital and ask for their contact information. Also ask about Adult Daycare Centres.

As for your Mom refuses care assistance, sadly this is all too typical and you need to know when her care needs are more than you can safely provide for and when her safety is compromised. You need to reach out and get help, even if it upsets your Mom - you are the rational caregiver and may have to make some decisions that can be very difficult and painful.

You can also talk to the doctor about medications, many can be very helpful. There are meds that can slow the progression of Dementia symptoms, some for agitation & anxiety, and some promote sleep.

I hope this has helped and I wish you all the best, you have a difficult challenge ahead and I hope you take advantage of all the support available in your area.

Wishing you both all the best,

Margot