Why is my mother with dementia acting so strangely?

A fellow caregiver asked...

My mother is 94, diagnosed with dementia, and on afternoon about every day talks about her mother and always want to go home, where she was raised. Her appetite is excellent but she is never hungry, give her food and she eats like a little piggy. She s still able to go to the bathroom, also, why do they want to pee in a bag or in the corner of a room?

Expert Answer

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.

My heart goes out to you. Sadly, I know what you're going through because like you, I'm providing care and oversight for my 90-year old mother who has mid-to-late stage Alzheimer's.

My responses to your questions are based upon the facts that your mom is very elderly and in the last years of her life and according to you, has been diagnosed with dementia. At issue here is your mother's quality of life. On some level your mother realizes that she is no longer capable of being the person she once was or doing the things she once did, and she is verbalizing that she is ready to accept her own mortality - she's ready to accept her own death.

This type of behavior is common among the group of seniors classified as "old elderly." Often, they are not getting much joy out of being alive, and in your mother's case, this is further compounded by her dementia, which, if I were to guess, is most likely Alzheimer's disease.

With Alzheimer's, many patients focus on a single idea and seem to remain "stuck" there. In your mother's case, that may be the situation with the almost daily discussion about being ready to "go home," which is her way of saying she’s ready to die.

Alzheimer's affects every aspect of a person's life including the brain's ability to communicate feelings of hunger. However, when food is placed in her mouth, the flavors stimulate her to eat and swallow. She may now need to be cued or reminded to eat as she no longer has the hunger impulse and may not remember that eating is necessary.

As for her unusual bathroom/toileting habits, that's again a function of behavior that can be attributed to dementia. She doesn't "want" to go in a corner, but doesn't realize that she's doing anything out of the ordinary. The solution, if there is a full time caregiver, is to cue her every so often that it's time to go to the bathroom, or redirect her when she starts to take action to head for the corner of the room.

Another approach is to place a portable commode in the corner of the room and allow her to use that rather than creating a confrontational situation. Having said that, continue trying to redirect her to use the bathroom is the best answer, but may not be the only solution to the problem. As her dementia continues to debilitate her, incontinence will eventually become the problem that replaces the current toileting situation.

By virtue of a diagnosis of dementia combined with your mother's age, I'm sorry to say that there will most likely be no change or improvement, and her condition and behavior patterns will continue to devolve and worsen.

The best things you can do are to provide her with the best care you can afford in time and/or money, and reassure her that you love her. Continue to spend as much time as your schedule comfortably allows. If she is living with you, be sure to make arrangements for respite for yourself. If she lives in a facility, discuss your concerns about her eating and toileting habits with the staff as part of an ongoing care plan.

The behaviors you are seeing are very common in elderly patients suffering from dementia. Good luck and God Bless You.