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

6 answers | Last updated: Oct 25, 2016
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 Answers

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.

Community Answers

Chris115 answered...

You also may want to consider if your mom could be so irritable due to unmanaged pain with the post herpetic neuralgia. i worked in hospice for years, and I had a lung cancer patient who was 65 yrs old, but mentally challenged. He got shingles-the nurse who discovered this told me "Richard says he has no pain"- I couldn't believe it, so i saw him the naxt day- his Mom said his behavior changed, he wouldn't get up, refused some of his meds. I used a "Face" pain scale used for children and Richard pointed to the most unhappy on this scale. When we got pain med for him, his behavior improved. shows this pain scale. Also, I have had hospice patients who, when they get close to death, become very demanding and hard to deal with, I am no expert, however, sometimes I felt like the patient was "pushing" people away, so it might be easier to leave them when they passed on. Bless you all for caring for your mom. Maybe she should be allowed to do what she wants now to be comfortable and happy.

Daizie answered...

My mother was doing the same thing. It was getting to be a real drag to go up to see her because I knew what she was going to be like. She also did guilt trips all my life on me so this was not good for me. Her memory is bad and she has now admitted that she is afraid. She doesn't understand that she drove her friends away. She tells me I am taking their side. She has become more reasonable now. Depression YES. Dad died in 1997 and she hasn't forgiven him for it. She misses him. She has also fallen a few times with her trick knee. I think she has hit her head in the falls but she says no. That can also cause problems.

Jboone1408 answered...

I am a nurse with Home Instead Senior Care and I agree that a geriatrician would be helpful at this point. You need someone who can look at all of her health concerns to determine the factors that are influencing her behavior. The geriatrician will use assessment tools specifically designed to capture the presence of dementia, depression as well as check her oxygenation levels, diabetes control. From this comprehensive assessment a treatment/behavior plan can be instituted. Another thought is to make sure that the caregiver that is coming in to help is coming in at the most stressful time of the day to take the pressure off of your sister (sounds like mornings in this case). If your mom gets to the point where it is difficult to transport her to the doctor, a Geriatric Care Manger may be helpful. This is a nurse who can be the liason between client, family and doctor and they offer a wealth of support for families caring for their elderly parents.

Chicotime answered...

Hi there, I am not a Doctor but I do nurse the elderly mentally ill and have had much experience of this behaviour. Has Mom had the simple tests, for example, urine sample, tested for infection. (A UTI, urinary tract infection). Infections in the elderly, whether chest or urinary, are paramount in getting down to the reasons for altered behaviour. This does occur in many elderly patients of mine. This simple test is carried out as formality, to rule out infection. I do nurse people with Alzheimers and other forms of dementia, please, if you have not done so already, try and get a urine sample, put into your GP surgery and await the results. If Mom does have an infection, some of the behaviour problems may be due to this. This is very common. Mom may be depressed also, but if it is an infection of some kind, things may be improved with antibiotic prescription from GP, thus finding out what is happening with her behaviour. You can act from there. Maybe if the results come back negative, you can seek help from a Gereatric/Psychiatrist Consultant, who specialises in this field of Alzheimers and various other Dementias in the Elderly. Hoping and praying this is JUST an infection and life will go on as usual and Mom will gradually improve. Mom doing well to get to 97 years young. My word she is a fighter. Best of luck, hope my input is helpful. Glenys.

Willam parker answered...

I want to state facts re: my wife's Alzheimer's and hen ask a question. She has had the disease for about seven to eight years, and has been professionally diagnosed, and of course the disease has progressively gotten worse. She is on the medication - Namenda. She is still at home. The worse thing I face at the present time has to do with her incontinence. However, it is not directly the incontinence, I understand she can not help this.

It is her stubbornness about putting on her Depends. She either completely refuses to wear them or can take up to an hour or more walking around or sitting, holding the Depands and saying, rather defiantly "I AM putting on my panties." You can imagine what the results are of this behavior. On the other hand when we are going out, say to eat, which she likes to do, she can put on her Depends in seconds. She has, though out life, been strong willed which is not always bad, in fact at times important and right.

Lately, I have been putting on her Depends: "put your right leg in, now your left"¦" this seems to work. I Don't know how long this will last. She still wants a degree of independence and I don't want to take that away any more than necessary. She displays similar behavior with dressing. While she can get very defiant and somewhat irritable when I tell her she needs to put on her Depends, etc., she is generally not too much like that. In many ways she still has her sweet spirit.

Could someone give me some idea how to deal with this problem? The problem stated above is VERY frustrating and causes all sorts of problems.