Is my mother's behavior typical of old age or dementia?
I have recently been in a situation where my Mom's doctor gave her a prescription for Aricept...after doing the Mini-cog test. He said she has dementia, gave no other explanation except to say that this is "typical" of a woman her age. I find this unsettling, as I know alot of elderly that are not going through dementia...so how is this typical? I felt that he just hustled us through the 'drill'..and never checked her for any other symptoms.
Since then, I have made other appts., with other doctors, and am waiting to find the results of these visits.
Another issue is that her obsession with hoarding, and also collecting things off the street when she goes for a walk. Her obsession is not just annoying - but also an unclean habit, that she gets very aggitated if I question her. And when I do ask her (yes, I do ask her nicely)...she claims I am persecuting her, and acting disrespectful.
Other habits have surfaced, and with the hopes that the new doctor I am taking her to...can perhaps address them. One of which, is her strong inclination to want sweets(!). She tells me she eats (normal food)...but never seems to be hungry when I fix her meals. She eats like a bird, is very underweight, and yet; when it comes to candy or ice cream! After eating sweets - her mood swings are obvious, and she gets aggitated, angry and begins little arguments. It got so bad, I finally left the house to avoid more upsets.
I'm sure this has not been totally noticable from her current doctor - he is not viewing her on a regular basis...so I'm taking her to someone who handles geriatric issues (not a Gen Prac.), and possible Alzheimer symptoms.
I've made a list of her daily activities...and have noticed that she never seems motivated to do anything new...except wanting to follow me, or be with me ongoingly. So, with her diagnose of having short term memory loss...I am guessing this is part of her "new" personality, since motivation seems to lie in "wanting" to learn new things - but you can't if you have short term memory loss??
Look forward to anyone's feedback. Juliana in New Jersey
Expert Answer
Unfortunately dementia is often dismissed as "typical" of the elderly. Whereas some forgetfulness is common as we get older, persistent short term memory loss and confusion are not part of "normal aging." Rather, these are indications of Alzheimer's or a related dementia. It's particularly disturbing that your mother's doctor minimized her symptoms. It's also unfortunate that as readily as doctors prescribe aspirin for a headache many will prescribe Aricept for memory-loss without taking a patient through a thorough physical to eliminate conditions that mimic dementia, such as vitamin deficiencies, low-grade infections, drug interactions, and dehydration, all of which can be very subtle and can occur even with the best of care. These conditions will affect a person's mood, behavior, appetite and memory. Most are reversible or can at least be minimized.
We can only speculate why some people obsess about collecting things that most of us would consider worthless. When elders are living with and dependent on their children, they may be trying to recreate a domain of their own, by surrounding themselves with stuff. Another reason could be that human beings have a propensity for making order in their lives. Alzheimer's will often exaggerate old habits while also making it difficult for a person to turn off their compulsion. We can help them with distractions of equally enticing substitutes.
In your mother's case, her obsession is collecting trash off the pavement. Trying to persuade her that this practice is unsanitary, or outright filthy, is a fruitless exercise, only resulting in her getting upset with you. As you've discovered, admonishing or arguing with a person with dementia simply does not work.
Regardless of her reasons, apparently collecting is important to your mother. Instead of trying to convince her to stop, you can "join her." If she's concerned about cleaning up the environment, you can both don rubber gloves and work on it together. Rather than admonishing her, compliment her for being so considerate of her neighbors.
On the other hand, if she's picking up items because she finds them interesting as keepsakes, treat this as a perfectly normal activity. Provide her with a container or a special space for her collection and help her clean the items when necessary. As the container or space fills up, you can discreetly discard items a few at a time. You will find that it's much easier to keep the peace when you honor her choices. If we assume she's collecting all this stuff as mementos, you may also succeed in redirecting her by providing her with alternatives. Help her make scrapbooks or "fiddle boxes." These are simply boxes with collections of found objects that can be sorted, fingered, counted or admired. (Shoeboxes work well.)
It's a concern that your mother is losing weight, but rather than arguing with her, explore compromises that will satisfy both of you. Elders often have a strong preference for desserts, candies and other goodies. The ability to smell and taste wanes as we age, leaving the sense of sweets and spices the longest-lasting, so your mother's attraction to desserts and other sweets is not unusual.
Alzheimer's disease and most other related dementias affect a person's sense of her physical needs; she may no longer be able to tell whether she's hungry or full, so when she tells you that she has eaten, she's not trying to fool you, but since she doesn't feel hungry, to her mind she must have eaten recently. You can help her by making mealtimes special: her plate needs to look appetizing, because the wonderful aromas of a favorite meal are no longer present. You may also boost her appetite by using red dishes. Try to share meals with her as much as possible. You can also substitute a lot of her "sweets" with the sugarless versions.
Alzheimer's affects a person's ability to initiate. She often needs someone to help her start either a conversation or a project. You're busy doing things and your mother's incapable of coming up with projects for herself, so it makes perfect sense that your mother wants to follow your example. You can ask her to help you with what you're doing, whether it's laundry, housework, and cooking or paper work. Don't worry about the outcome. Your objective is not to achieve a specific result, but rather to give your mother a sense of purpose and enjoyment, so whatever she's able to do, thank her for her help.
It's a myth that people with Alzheimer's cannot learn new skills, although it may take them a lot longer now than before. Give your mother the time to state her wishes and find one or two projects that you think might work for her. She may be really enthusiastic and help you set up and then do nothing except sort out the supplies. Don't worry about it. The sorting has become the project and the accomplishment. (See "fiddle boxes" above.)