KellyEaton50 Asked October 2017
How do you learn to be patient with an 84-year-old woman in perfect health, who acts like she is 2 years old?
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My mother-in-law lives with my husband and I in our home. We took her in 7 years ago as we thought she had Alzheimer's. Recently we had a huge amount of tests done due to the fact that after being a speciality nurse for Alzheimer patients she didn't seem to fit the mold. Well come to find out she has a REMARKABLE BRAIN! No signs of Dementia or Alzheimer's. We are at a complete loss as she acts like someone who is the last stage of Alzheimer's. Any suggestions are welcomed dearly.
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Many years ago one of the children in my family went through a battery of tests to try to understand why he couldn't perform in school. The conclusion was congratulations!, it wasn't dyslexia or ADHD, and he was very intelligent. Uhm, thanks, but he still can't seem to get a grade above 50%. (sigh)
Just because they have ruled out ALZ or any other dementia shouldn't mean they can send you home with no answers. She is clearly impaired, if it isn't dementia then what is it, and how do you deal with it? Insist on an answer.
How did they determine that she is not suffering from dementia? Did they do brain imaging, basic neurological testing AND 6 hours of paper and pencil neuropsych testing?
I friend reminded me yesterday about a story I told her during my mom's workup for dementia.
The neurologist gave my mom all the basic tests; clock drawing, remembering three words, etc. He then asked her to write a sentence. My mom wrote a very coherent sentence, but I noticed that she didn't put a period at the end of it. A felt a frisson of dread at that moment; 12 years of Catholic School education and no period at the end told me what I needed to know, although EVERYONE else, including mom's regular doctors thought that she was "sharp as a tack".
The cognitive testing --6 hours with a neuropsychologist, testing intelligence, reasoning and sequencing, among other skills, showed that mom was no longer able to live on her own and manage her life. She was diagnosed at that point with Mild Cognitive Decline, which sometimes advances to dementia; in mom's case, she had stroke a year or two later, which caused Vascular Dementia.
I hope that you get your answers.
Has she seen a geriatric psychiatrist?
Wow, Barb. I noticed a few years ago that my mother wasn't making total sense in her written communications, and she is like your mother was -- Catholic school education and a stickler for spelling/grammar. I haven't seen much of her writing lately, but I'm sure it's worse.
My mother would never agree to any paper/pen testing. As long as she is deemed to be mentally competent, there will be none done. No consult with a geriatric psych, either, and no meds for her anxieties and obsessions. Sigh...
I'm assuming this wouldn't be the same as someone with poor grammar who doesn't use periods at all, something like James Joyce's "stream of consciousness" style? How is the distinction made between someone with poor grammatical style and someone who doesn't use periods?
This is interesting.
For a lot of people, writing a sentence and NOT putting a period at the end might not be a big deal. For someone like my mom, given the stringency of her early education and given the fact that she completed her BS at the age of 81, her clinical team had a pretty good idea of what they were comparing to--someone of average intelligence of better and someone who was used to paying attention to details.
For my mom, it was a subtle change in her "executive functioning" and ability to sequence a language task. It's also the sort of thing that is part of "things you do without thinking" track; to me, I knew that it meant that there were going to be findings, and that they were not going to be of the "oh, your brain is fine" sort.
Your mother is/was someone special - to complete a BS at age 81 - WOW!
And thanks for sharing the rationale behind this.
For everyone, she was reluctant to do the testing, initally. (Actually, she had been part of the norming group for this rehab center, 20 years earlier).
She said to me; " If they tell me I'm crazy, I won't believe it". I said , "mom, they are not going to tell you that; they just want to figure out what is going on in your brain right now"
That comment alone (about "not being "crazy") told me that she was no longer processing with a "full deck".
The good thing was that the testing demonstrated to Bro and SIL that what was going on with Mom was real and not "something she was doing to herself".
And kept me sane.
Thank you for your comment about your Mum forgetting something as little as proper punctuation being a red flag. I feel like I am tilting at windmills with my brother regarding our father. Bro does not see the little red flags, disregards them when I mention them.
Dad had a stroke and was involved in a remote post stroke program to check on cognitive changes, what improves/declines over the year after a stroke. Dad "passed" with flying colours, yet mixes up tomorrow and yesterday in normal conversation. He told me a long involved story about visiting a neighbour in hospital last winter and who also was there visiting. When I spoke with his neighbour, he told me the hospital stay had been 10 years ago.
My LO has Vascular Dementia. It was revealed by MRI, but, I wasn't too surprised, because Primary had already diagnosed, AND I looked through my LO's recent checks and found one where her writing looked like a foreign language. It was odd letters mixed together and it didn't appear to be her writing, but, IT WAS. Pretty sad, but, revealing.
You may want to have her tested for HE (Hepatic Encephalopathy). Ammonia can build up in the blood which effects the brain and cause many of the symptoms you described such as confusion, mood changes. This is a serious condition that can lead to coma and death if not treated. It's not commonly tested for unless there is known liver disease. See the American Liver Foundation's HE website to learn more: http://he123.liverfoundation.org
Hope this helps.
Cathy
PBC Patient & Advocate and Caregiver for our 85 yr old mom
My mother in law was exhibiting bad behavior: accusing people of stealing, severe depression, moodiness, anger etc. My husband and I think she has dementia. Other family members do not, since she has a history of being mean and combative. Her sons call her the Prima Dona Drama Queen who enjoys being the center of attention. She has always been this way.
Who knows. Get her evaluated; when I was concerned about my mom, I had a geriatric assessment done at the local hospital. Try to find a doctor or facility that provides this service.
At the time, there were only a handful of large public schools (Guilderland, Colonie--especially Shaker High, ? Columbia, ? Schalmont, ? Burnt Hills-Ballston Lake, ? Bethlehem Central) that had a meaningful gifted and talented program and might be able to provide a proper education for a highly gifted student (the ones without ? marks are schools I know could, the ones with ? I suspected could). Gifted and talented programs were designed for students with IQs between 120/125 and 150--they generally do a poor job of accommodating students with IQs above 150. Many parents ended up sending their highly gifted student to private school (like Emma Willard School, St Agnes, Albany Academy / Albany Academy for Girls, Simon's Rock of Bard College, Miss Hall's School) because they did a better job by them. (I know Emma Willard School, St Agnes and Simon's Rock were good places for highly gifted students, the others I suspect are based on friends who went there).
I would *strongly* recommend that you explore the web site sengifted.org. It is *extremely* common for people who are highly gifted to be misdiagnosed with Asperger's Syndrome. It's important for you to understand the personality characteristics of the highly gifted. Normally functioning highly gifted individuals share many personality characteristics with those who are autistic, it takes someone who specializes in working with the highly gifted to determine whether someone like your son has autism as well. 40% of highly gifted individuals also have learning disabilities (I have an IQ over 150 and am dyslexic), and yes, highly gifted individuals can be on the autistic spectrum, but the highly gifted are often misdiagnosed as autistic.
Article from Psychology Today blogger: https://www.psychologytoday.com/blog/saving-normal/201303/giftedness-should-not-be-confused-mental-disorder
Interview of Prof. James Webb about misdiagnosis of highly gifted individuals: http://www.gcgtc.com/services/projects/the-1st-gifted-awareness-week-germany-2013/june9/interview-with-prof-james-webb-usa/
Yes, it's commonplace for highly gifted students to do crappy in school--and flunk out. You'll read all about that on the sengifted.org web site.
We drove to a family event; the directions were screwed up by construction. We stopped and asked and the folks said "drive about three miles down the road and look for the sign for the church".
DH drove three blocks and pulled to the side of the road. He said 'we're here". I asked "where are we?" He said "we're here; folks in the suburbs don't know about distance".
OOOOOkay. I encouraged him to drive the additional couple of miles, wondering what was going on.
The next day, he had a cardiologist appointment. He called me from the office.
To make a very long long story short, he had a nearly 6 MM aneurysm in his aorta and his aortic valve was leaking. Let me tell you, lack of O2 to the brain diminishes all kinds of thought processes!
While I am sure you are frustrated with your situation, please understand that that is not the same as the last stage of Alzheimer's. I wish my mom could be her judgmental, self centered, arrogant self again.