Could Mom's bad behavior be the start of Alzheimer's? And what type of doctor should we see?

A fellow caregiver asked...

My sister has been taking care of our 97 year old mother in her home for over 2 years now. Mother is becoming increasingly difficult to take care of because of stubborness, not cooperating and geing argumentative and bossy. On days when she is like this she will refuse to get out of bed, is very demanding and generaly uncooperative about everything once she does get up. This extends to the caregiver who comes 3 days a week. Usually this behavior last one or two days. Now it has been going on for over a week straight. My sister is at her wits end and I am afraid is near an emotional breakdown. They are in Texas, I am in Virginia so I can't be there right now. Is stubborness and being mean acting a sign of alzheimers? She has very little short term memory but is certainly aware of all that goes on around her and comprehends everything well. She works letter word puzzles very well and quickly and demands that the TV be on all the time she is awake. She has diabetes, is on oxygen, and suffers from post herpatic neuralgia. She can walk but doesn't like to so it's difficult to get ther to take nurse ordered walks 4 times a day. Would a geriatrician be helpful at this point?

Expert Answer

Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of Aging Studies, University of South Florida, Tampa, and visiting professor at the Third Medical Faculty, Charles University, Prague, Czech Republic. Twenty-five years ago, he established one of the first dementia special care units.

The geriatrician's input would be certainly useful. If your mother has a short-term memory deficit, she is most likely developing Alzheimer's disease. However, that may not be the main reason for her behavior. She may be refusing help and doing activities because she is depressed. Depression is very common in Alzheimer's disease and responds well to antidepressant treatment.