What triggers Dad's dementia ups and downs?

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What triggers Dad's dementia ups and downs?

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My father has dementia but lives at home with my mother and he can generally handle day-to-day tasks such as getting himself showered, helping around the house and yard. My mother is very depressed and, I think, verbally abusive to him. She also drinks. Some days (or multiple days) she drinks and spends most of the day in a napping fog in an easy chair or closed off in the bedroom. I have noticed a pattern over 2 years: she ramps up the verbal abuse, drinking and napping. He starts to get confused about who she is and where she's been. He starts to refer to the "New Mary" and the "Old Mary", and the "Big Mary" and the "Little Mary", thinking there are two of them, and this new, nasty one is not his wife. Then he gets paranoid, calls her a scam artist who is squatting in his home, asks what happened to his wife, and then is prone to wandering. Does it seem reasonable that her behavior could send him into these confused states? Otherwise, he scrambles names but is not generally confused about who family members are in relation to himself. This pattern started in 2015. Any thoughts are appreciated!

Alzheimer's & Dementia

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The type of behavior that you describe often occurs in people who have dementia, not matter where they are residing. However, what would really concern me is the supervision that dad is not getting him. He may be able to perform some of his daily activities, but, he still needs supervision and support. Plus, he doesn't need verbal abuse from her. I wonder if she understands how dementia works and that his name calling and delusions are not his fault. While mom may be overwhelmed and sad about his progression, he still requires proper care. I'd discuss it with her to see what needs to be done. I'd have to insist that he get better care.

People with dementia have good days and not so good days. And sometimes they have sun downers behavior, where they seem to become more confused or agitated in the afternoon. He likely isn't feeling too good about things if mom is not supporting him or calling him names.

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I noticed my Father's mood is affected by TV shows, other people's moods, and the amount of sleep and diet. But when his caretaker is in a bad mood and is upset about dealing with care he gets upset too. He tells her to leave him alone and talks back which escalates to a fight. Care is a big enough job but dealing with everyone's mood makes it harder. A caregiver suggested keeping the Hallmark channel on, playing music, making sure you smile when talking to them because sometimes they don't grasp everything that is said but the understand facial expressions and tone.

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Good points. Not everyone is cut out to be a caretaker of a person who has dementia. If they are not willing to learn about the condition and how to do it properly, with a smile and proper attitude, then I'd explore other arrangements. It's difficult enough under the best conditions. If she's antagonistic, then, he's only going to suffer more.

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As Sunnygirl stated. 'not everyone is cut out to be a caretaker of a person who has dementia'. My father-in-law has memory loss, and is hard of hearing. My mother-in-law says he is confused, but speaking with him, I do not get that, but that he does mot make good decision because of not remembering some of the factors. On the other hand, I assess that my MIL makes poor decisions with all the facts, but denies cognitive problems, (her husband and daughter say she never could make good decisions) but she wants to care for my FIL. When she does has a night where she can't sleep. It is very noticeable; my FIL is depressed and she is abnormally affectionate. If we are alone on these days, he often tells me she has been nasty to him. They do not want to leave their home. Fortunately, they are able to afford home health care. This has improved both of their emotional and cognitive status. She can still feel like she is caring for him, and the caregivers are able to diffuse any frustrations.

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God bless you all!
Caring for my Mom with Alzheimer's and my MIL with dimintia was the hardest thing I've ever done ! They were totally different.

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You have 2 people with depression.
Your Mom, she is loosing the man she fell in love with, the man she married and had children with.
Your Dad, how can anyone that has any form of dementia NOT be depressed at some level.
Your Mom is "medicating" herself with alcohol.
Your Dad is right...there are 2 women in the house. And that makes it even more confusing for a man that is slowly loosing bits and pieces of his mind.
If there is a way you can get your Mom to see a doctor that will treat both the alcohol and the depression that might help.
If it can not be or she does not want help maybe the best thing for your Dad would be to place him in Memory Care facility where he will get consistent care. All I can tell you is that this will get worse not better. Statistics show that often the Caregiver dies before the person that they are caring for doe. This is due to stress and the fact that Caregivers do not take care of themselves. So it is very possible that your Mom with pass before your Dad based on alcohol abuse and not taking care of herself.
This must not be easy for you to watch both parents disappear. I hope you can get through to your Mom.

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For my Dad it was triggered by stress.

If there was a nurse and a therapist in the home on the same day..the stress was too much for him and he would go off like a fire cracker. You could see it building up.

Also, when he got tired he would slide off into a fantasy world.

Sadly, his fantasy world was not nice place... paranoia and panic. Full "sundown" in other words.

There really wasn't any way to keep all stress away. He would get stressed out if he didn't understand what was being said around him, even when he was not part of the conversation. He would be stressed if he was not the center of attention. With Mom recovering from a stroke and having speech therapist in the home every day...by 3pm each day it was a mad house.

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You didn't say how old your parents are, but I think they both may have dementia. The stress of caring for him may be way too much for her. Sometimes when my meds are not right, like from a different company with different fillers, I find taking care of mom is just too much. Had to get my meds straight and now I am okay. I am in my 70's and mom is 97.

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My parents are 75 (mom) and 78 (dad). Mom's drinking/depression has been a decade-long situation and she's been put on anti-depressants twice but stops taking them after a week or so. They have long-term care insurance but my mom refuses any home health care (even though the insurance would pay for it). Dad had an occupational therapist coming into the home last fall but my mom cut that short and told them they were an "intrusion" into her home. She says, no one else coming in for stuff, even if it is to help them out. I know dad's situation is tough but honestly they are in about the best position they could be in - nice home that is paid for, lots of money in the bank, "Cadillac" long-term care insurance, good access to local doctors and health care. Her choice is to stew in a pity party 24/7 and it seems to be detrimental to the situation in all respects. Thanks to all for your comments! Oh, and I did speak with my dad about maybe living somewhere else. He says no matter how mean she is to him he wants to stay there with her and he chooses not to leave his home.

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When my dad was dying of heart failure, the home healthcare nurse was called in and set up a way for dad to shower on a bench in the bathroom, he was not allowed to go downstairs to that shower. she removed the throw rugs. As soon as she left mom would put the house back together the way she liked it. Dad would sit on the stairs to go down one step at a time to shower. I didn't know that was happening till I went back to their state to help them. I really wanted to bring them both here, but neither wanted to go. Their house was paid for and they had savings too, but they wanted to do nothing different. Change is the scariest thing for older people. After he died, my son moved in to help take care of my mom. But it was too much for him, and he brought her to me much against her wishes. She has been cared for well by us, but she isn't easy to work with because her dementia has progressed a lot. She doesn't want her hair fixed or cut, hates the shower. But is still have to do these things, but it takes a lot out of me. I hire home care so my husband and I can get away every few months, but she seems like a scared cat when I get home. It is just hard. Good luck.

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You say your mother drinks and is verbally abusive to your father. First of all, I would take every single ounce of liquor and DESTROY IT. Do they live with you in your home? If so, tell your mother in no uncertain terms that if she ever touches a drop of liquor again, she will be out on the street to fend for herself. And also let her know if she ever abuses your father again, this will be the same outcome. You may need to make plans to remove her into a senior apartment complex away from your father if you care about him. Yes, she dan push him "down the drain". Do not let this happen. He may have dementia but he does not need to be abused by her.

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Riley2166, just curious. How do you think an adult child can go about removing her mother from her mother's house, when neither her mother nor her father want that to happen? Seriously, many people on this forum would love to know how to go about that.

Sudden and total withdrawal from alcohol can be very dangerous, depending on how addicted the person is.

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Upstream, look up capgras syndrome. This is an identified specific kind of delusion where the person believes that something familiar, like a spouse or an apartment or the kitchen, etc. has been replaced by an impostor.

I have not had any experience with this, but I've heard others talk about it in support group. One member reports that her husband will say, "You're not my real wife. Send her in here right now!" Sometimes if she leaves the room and comes back with a sweater on, or some slight difference to her appearance he will accept her as genuine!

In your poor dad's case, his wife really is sometimes not herself!

I just mention capgras to point out that there really is something in the brain that can cause this.

Could you possibly negotiate with your dad? You'll support him staying with his wife IF he will allow help into the house. Between his dementia and his wife, he might have a real hard time doing this, but it is worth a try. If you can get him to agree to this, have a discussion with both of your parents (when Mom is sober.) Ask Dad if he is willing to have help come in. Ask if he wants Mom to cooperate with that.

Is there any non-family member they might listen to? Long term friends? Their insurance agent? A clergy person? Someone they used to play bridge with? Do you know of any of their friends who have help coming in? Any who have moved to assisted living? Often family, especially adult children (who are still seen as children) are not taken seriously but a peer might be.

Keep in touch here.

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Don't expect this to get better, as it will get worse. Two people have dementia.

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Sounds like mom has caregiver burnout. Drinking, being irritated, resentful, and anger are all signs. Being a caregiver for someone with dementia is hard - you never, ever get a break.

Both parents obviously need help. Maybe you can call social services or hire a geriatric care manager who can help you out. People in these fields have seen it all and can offer you some guidance. Sometimes parents respond better to nonfamily members. I would start there.

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It sounds like your dad is needing more care than he is able to get from your mom. Your mom is possibly burnt out and trying to deal with life that is changing around her by drinking. I might be wrong but it sounds like she's trying to cope and doing it in a not so great way. Your dad is going to eventually need more and more care. I live with my grandma and care for her. It gets harder and harder and someone will need to be there to care for him through it. If it can't be her or you, then perhaps a facility where they specialize in this.

As for your dad, all people who have dementia have up and down days. There are some days people are right on target and other days where they can't seem to function or stay grounded at all. That's why caregiving is so important. The bad days are the ones where the person needs the most caring for. They probably aren't eating right, can't keep up with the house work, can't remember what to do next and are really eventually going to be a risk to themselves not on purpose but more so due to be confused.

Dementia is hard to watch and even harder to understand. My best advice to you would be to talk to your mom. See if she won't admit to what she is feeling so you can get a handle on what is going on with her. Tell her you understand she's trying to handle a hard situation and you want to help but you also know she can't care for your dad if she's drinking so much and really needs caring for herself. Hopefully the conversation goes well and you can see if that really is the case of her being depressed and self-medicating with drinking.

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Thanks all for responding! I am an only child. Parents ran off most family and friends a long time ago (they have always been fairly anti-social). No church, no hobbies, no clubs, etc. That's part of the problem - they became shut ins about 10 years ago (while still in their 60s and very healthy) and started picking at each other and arguing all of the time. Both drank heavily (I mean starting at 7 am every day). Dad understands that he is on medication and cannot drink so he quit about 3 years ago. My parents worked hard, saved money and took excellent care of their health. Somewhere in their mid 60s they threw their hands up in the air and decided they were "too old" to pretty much do anything. They went downhill fast from there. A good learning experience: A negative attitude about aging can blow the best retirement plans!!! I honestly, previously thought they would be active until they hit their 80s. I think the drinking and shut-in nature of the last decade accelerated my dad's mental decline and the overall decline of their health and marriage.

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This is a very sad situation. Your Mom is an alcoholic and that is not going to change but only get worse. It's good that your Dad quit drinking but it's not good for him to be abused by your Mom.

If I were in your shoes I would get your Dad out of that house ASAP. Is it possible he can live with you? If not I would look into assisted living (hopefully close to where you live). Some places are really nice where your Dad would have his own apartment and you can visit him often (these type of places are not cheap but you stated your parents have money) and your Dad would get the care he needs.

If you decide on this option you will properly have to see an elder care attorney to help set this up. Keep in mind that your Mom may not react well since she will lose her punching bag.

Abuse is abuse and it's not healthy for your Dad.

Wishing you the best,
Jenna

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Upstream, you've just triggered a memory that I haven't thought of for years.

I turned up one lunchtime at my parents' house - happened to be passing, they weren't expecting me - and found my dad alone in the kitchen looking hangdog, and my mother was somewhere upstairs. "I'm glad you came," he said. "I was just going out to buy some cigarettes, now I can cadge one off you instead." I just goggled at him - he'd given up smoking altogether years before, and heaven knows how long it had been since he'd bought a packet. "Actually, I am a bit pissed off," he announced. Defiantly, that's the only word for it. Defiantly.

Of course I asked if there was anything wrong, or if I could help, and what had happened, but I couldn't get a further word out of him; and when mother came downstairs she wasn't saying either. Frosty, I'd call her.

Clearly, they'd had a row. But normally if they had a row, mother would go off and cry, or ring one of us children or her sister. This was different. It was about something private, and personal, and deeply important to both of them.

The point being, that our parents have a life as a couple that we don't know anything about, precisely because they consider it none of our business. And though children tend to be endlessly curious (within limits!) about their parents' relationship, on account of it was existentially important to us, there are still going to be whole swathes of history we don't discover.

I wonder what happened between your parents, or between them and their social circle, those years ago.

In fact, I wonder if there's a whole book in it!

But meanwhile, what to do... Have you had any luck getting them to think in more practical terms lately?

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First of all, your Dad is going to have way more ups and downs, that's just part of dementia. You may experience him blaming you or your Mom of stealing, moving things etc. this is also 'normal' for dementia. Some become verbally and/or physically violent as part of their disease. You mom's drinking will be very unhelpful as she is already verbally abusive to him. She may become physically abusive, also. Have you thought of that? Is there someone (in authority) like a priest or a doctor that your mom will listen too? They are both going to need a lot of help and sooner rather than later. I think I'd suggest that a placement for your dad would be a good thing for both of your parents. You might be able, then, to convince your mom to stop drinking else I'm afraid you have a very rocky road ahead of you. In the best of situations dementia is a terrible disease but with your extenuating circumstances this will be very hard on all of you. Please consider very long and hard before you make any decision of taking one of your parents into your own home for care....it will become a 24/7 never-ending job for you. At the moment please see if you can convince/bribe etc your mom into accepting help in the home. For all concerned this will help in the short term. I send you my blessings and wait to hear more about this. Lindaz.

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