My mother changed totally. She became very aggressive. Short tempered and angry a lot of the time. She was physically weak but still managed to get I to physical fights with another lady in the nursing home. This lady was much the same as my mother and actually they were first cousins but obviously did not recognise each other. As the disease progressed the aggression faded though and she became more peaceful. My mothers progression was different as it was vascular dementia although we just refer to get as Alzheimer's as most people did not get the difference. She was physically very weak as the pump function of her heart was very poor. She was given two weeks to live after a massive heart attack but lasted five and a half years.

I'd agree that in the early stages the anger and agression is the worst. I think it's because they know something is wrong and can't do anything about it. For example they know they want to make a phone call but can't find their phone book. Or they find the book but can't find the person they want or they can't remember how to dial the number. Simple things become major difficulties.

How long the whole thing takes depends on the person. If there are other medical problems if could be quicker. One thing to remember is that no one dies from dementia...they die from the complications or other diseases. Most will have falls or injuries which lead to complications. The decreased activity will lead to infections and skin problems and fluid retention. Then it becomes a spiral as these problems advance the brain impairment which leads to more problems.

One thing to consider is how your mom and you would want to treat these things. These days many people decide that they do not want to prolong their life since they have lost their mental function. It's important for you to clearly understand what your mom wants and to make sure you have the legal documents to allow you to make these decisions. A health care proxy is necessary (POA does not cover health care) and should include a mental health clause.

Another thought...make sure your immediate family is also aware of mom's wishes and your intentions. When mom is in the ER is not the time to tell you siblings that you are withholding treatment.

My dad was definitely more hostile in the early stages of dementia. Now he has mellowed out and is quietly happy most of the time or just sleeping at lot.

Ive worked in many elder care facilities and all I know is dementia is dementia no matter what you chose to call it. Every person is completely different and I dont think there is any way to predict exactly what will happen.

My Dad had been pretty mean all of his life so I was not surprised that it esclated as his dementia became noticible.

What I was TOTALLY shocked by is the way he turned into this loveable little pussycat further in! I guess we are lucky that thi mean part of his brain was the first to go!

I think the person's basic personality has a lot to do with how they react toward dementia, but all types are bound to be frustrated in the beginning! How could you not?

I mean everybody forgets where they put the car keys from time to time so imagine how it would feel to begin realizing this is much more serious and is likely to get worse and worse!

I see it all when I go to visit dad too.

All different levels of acceptance are displayed.

The staff is AMAZING with directing attention away from anger frustration and bacd behavior so very little is seen.

A little harder to create this at home by yourself though.

I would say try to keep some sort of social life going for her if at all possible.

They are very aggressive in the early stages. I imagine it is like a 2 year old who wants to seperate from mommy but knows full well they can't survive without mommy. That creates temper tantrums.
It has to be very frustrating to be all grown and not remember things and know you can't remember.

Those who were nasty seem to get more nasty for awhile.
Then later, they live day to day and wake each day forgetting what happened yesterday. I know from going to care centers that they gradually get to live one day at a time.
If you can get mom thru the nasty times, it will eventually be like caring for a young child who can talk but not remember yesterday.
Look forward to the times when each day is new to mom.

Please just be safe. Woman to woman is safer than man to woman because of closer strength comparisons. but a woman enraged in confusion can still cause serious harm.
You want mom to be safe with you. That means you have to be phsically safe from harm. If she gets aggressive (physically) and injures you, it could be out of your hands.

Sorry, my uncle attacked my aunt and then the state stepped in and took him away. I still wish she had put him in care before he harmed her. So we could have the choice to visit him at will. SO I guess my advice is colored from that. Still, if you can keep mom home with you by preventing her injuring her, then my experience will not be in vain.

Patience is the most important thing here because it is not the behavior of the parent that you know and love its like when your teenager is moving through adolescence (same kid but different character)

I am not patient in my opinion. I have felt forced into being so or acting this way all my life.
Youngest of the family and 8 years younger than the rest of the pack...
and a pack of wolves they always were toward me;Jealous of the baby syndrome and still. I did make sure ALL knew Mom was combative and each has battled with her since Dad died. I stayed out of it. Best thing I ever did though sad to watch mom suffer their lack of knowledge. Never mind, I am just angry toward my sibs for being jerks.

After time, I became more at peace with life and learned how to wait out life's scenarios. Not sure this is being patient but is closer than before :)

Wow Peanut, you describe my Moms heart and dementia now early ALZ. She was given 6 months and is on year 15!!!

I do see that the brain is not able to manage what it did even 3 years ago. Mom has all we can do to be comfortable at home now. That helps. She and Dad also made out their directives and put them in place at the hospital. Dad was DNR though they did 3 times in time for us to know he was passing away. That always seemed odd.

P

Peaceful the hospitals can be tricky. Even though the papers are on file you need to make sure the nurses and doctors know and understand your wishes as well. Also find out what the hospitals policy is. When you are admitted you agree to abide by their rules even if they conflict with your wishes...this is particularly true in Catholic and religious hospitals.

For your father it is possible they knew family was coming and thought you would want one last moment. Many people feel strongly about this. Or you just got a medical staff who wanted to play hero...ugh why does this all have to be so complicated??

Tigg, thanks. I will look into the advanced directive mom has on file and policies.
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Did they do something for your dad they were not supposed to? When I was still working as a nurse I saw an awful lot of stuff being done to people that were supposed to be DNR.

Is the directive DNR or are there modifcations that are allowed like no compressions just meds or is it ok to intubate and ventilate as long as the heart was still beating you must be clear about what you want(in writing) because the hospital is trying to avoid being sued.
When I talk to my mother about her nasty moments it always works out that she just hates that she is now dependent when just a year or so ago she was "working" and going to the casino

Note about Dad:
I never looked into this but wondered if Mom could have changed his
DNR wish? Because he stopped breathing and the hospital put him on a vent.He was ok after a few days.
Several months later he was hospitalized because Mom could not care for his needs at home and he became bed fast. During dialysis he coded two days in a row. Eventually too weak for the treatment and he became a hospice patient in the hospital. Too weak to transport so he died there. Mom by his side and my sleepy head in a courtesy room (empty bed elsewhere in hospital). I had been up forever and he was in a peaceful coma. I was OK with this. We were all at peace.
So, looking at all this...no one contradicted his treatment and Mom ran the show. I always knew what he had said " No Efforts..just let me pass" Guess this is how Mom "interpreted" as his POA

Most DNRs specify no life preserving measures if there is not expectation of recovery. So resuscitating someone who needs a pacemaker is considered OK. Same if the staff feels that the code is due to something that is correctable. If you are dehydrated and bp drops they will bring you back and pump fluids.

But it's a fine line. If dad was doing fine and coded because of something correctable it's right that they save him. And staff usually doesn't want to have to make that decision so until hospice is brought in they will usually do whatever they can.

MY MIL had been in the hospital for 6 months slowly getting worse. She had multiple problems including being a long term dialysis patient. One afternoon the doctor felt her oxygen level was too low so he ordered a breathing tube. They called my SIL who was her proxy and she told them on the phone not to do anything until she got there...well she gets there 20 mins later and she had the breathing tube and was in ICU. The hospital didn't care about the DNR.

Something else that we learned over the next week is that each hospital can make their own rules that supercede your DNR. This was a Catholic hospital and when you are admitted you agree to their policy which is very anti-DNR.

We all need to be smart consumers even when dealing with health care. Check out your hospital ahead of time. Get the legal stuff in order. Talk to your loved one to make sure you understand their wishes. And talk to the doctors so that you understand their philosophy. And find out what your hospice options are in your area.

I will see about hosp policy w DNR. Especially since it became a research/teaching facility.

Thank you for advice on this.
P