My mom with Alzheimer's only acts "normal" around family and friends, why does this happen?

1 answer | Last updated: Sep 14, 2017
A fellow caregiver asked...

Mom is 96 and has what I would describe as "moderate" Alz. I realize that most can recall long-ago events better than more current and this will be random - but mom's behaviour is a little different. She literally can be 1000% herself if/when friends drop in to visit and people would NEVER and I mean NEVER suspect or see her "crazy" behaviour. I sometimes think people think I'm the abnormal one when I try to describe what she is REALLY like when with me alone or with the respite caregiver alone. (The relief caregiver sees the same thing. Mom will be difficult and then one of her friends will come to visit and she turns on a dime to totally rational, normal, "in-her-right-mind" behaviour. Then, a friend will leave and mom IMMEDIATELY goes back to her whiny, crying, depressed, confused, etc. etc. behaviour. Again, I realize that Alz. patients can remember some events but this is different; she can be totally with the program and absolutely turn on a dime as soon as her friends/relatives leave. WHAT AM I DEALING WITH HERE???????? She can/will keep up with the conversation and be like she was years ago then IMMEDIATELY fall apart after friends/relatives leave.

Expert Answers

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

I'm sorry to hear about the challenges that you're dealing with regarding your mother. However, several questions come to mind. Is this a relatively new behavior for your mom, or has she previously been diagnosed with some form of dementia? Has your mom been evaluated by a neurologist? Has she had a physical health assessment done to determine what it is she does or does not have?

Subsequent to a complete neurological and physical assessment, hopefully you can be told what it is your dealing with in this case.

It's very possible that your mom's behavior, which is not uncommon, is due to age-related dementia, which may or may not be Alzheimer's disease. Some elderly patients have the ability to turn their emotions and behaviors on and off to suite a particular situation. That is why your mom's visitors may not be seeing the same behaviors that you and the respite care provider are seeing.

While it may seem hard to believe, it's possible that the conversations that involve your mother and her visitors have been somewhat consistent enough in their content, that mom has actually developed responses to inquiries such as, "How are you feeling?" or "You look wonderful" that give the appearance that she's 100% on the ball. It's also possible that your mom is able to act "normally" for short periods of time when she feels it is appropriate to do so. But when the visits end, she quickly falls back into what you see as her more usual emotional behavior patterns.

As I stated, I don't know what it is that is driving your mother's behavior, but I can tell you that you're dealing with someone who in her own way is telling us that she needs a medical evaluation. I believe that your questions will be answered once you have had mom thoroughly examined.

Be sure that you document the odd behaviors and severe mood swings so you can explain her abrupt behavioral changes to the neurologist. Keep in mind that mom may try to convince the doctor otherwise by "being on her game" if in fact she is able to turn her behavior on and off. However, a good geriatric neurologist, armed with the observations you documented, should be able to provide a clear assessment of what's going on with your mother's behavior patterns.

The result of the neurological assessment may be a prescription to help your mom maintain more consistent moods, a referral to a psychologist for an evaluation and treatment for depression, or perhaps lead to the discovery of a physical problem such as a urinary tract infection, that once treated, clears up some of her behavior issues. I don't know which way this will turn out, but I do believe this is where you should start.

Best of luck, as it seems your about to embark on an interesting search for the solution to a challenging mystery.