How can I tell if a behavior is due to dementia/Alzheimer's or is just a personality trait?

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How can I tell if a behavior is due to dementia/Alzheimer's or is just a personality trait?

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Hello all, My husband and I have been providing care for my 88 year old MIL for the past couple of years. I have been on an emotional roller coaster these few years. How can I tell if she's being passive aggressive towards me or if it's something due to dementia? For example, I was told by the home health people that she can (and should) do a few things around the house. A physical therapist came to the house in the beginning. He said she should get up and walk around a little every hour. He eventually gave up on her. An occupational therapist came a couple of times and she gave up on her, too. My MIL got to my house and sat in my chair and has been there ever since. I got really angry in the beginning b/c I was being told by home health that she should be included in household chores, etc. and I tried to include her. She refuses to do so much as put her dirty dish in the sink and leaves it for me to clean up. I thought maybe this is due to dementia after a while and started being less angry. Then, I was sick earlier this week, so my husband was doing dishes in the kitchen. He told me his mother came in there and asked him what she can do to help! Infuriating! I'm so confused. I could write a ton more. Hopefully I'm getting the gist of what I'm trying to ask across. Any insight is greatly appreciated. It's been very weird and very confusing. I'm 44. Hubby is 49. It's been quite strange to have this experience of caring for someone for which I'm literally half her age.

Alzheimer's & Dementia Dementia Behaviors Mom

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One thing that I learned as I read about symptoms of cognitive decline and dementia was that as it progresses, it often results in what is described as "Loss of initiative." The person loses the ability to get an idea and act on it. So, they may sit and stare at an object like a newspaper, but, not have the initiative to pick it up and read it. They may watch the same tv channel for hours, because they don't have the initiative to change the channel. They may see food on the table, but, not have the initiative to eat it. They have to be instructed to do these things or they just don't think of it. This was so difficult for me comprehend at first. It became clear the more I read and saw it in person.

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Not everyone person who has dementia/Alz is the same. As time goes on you just kind of try to figure things out. Sometimes they make you angry, bewildered, sad, and then there may be something that makes you laugh (believe it or not).

Their "new normal" changes and yes sometimes you don't recognize it at first so don't feel guilty. Other times, it's what they want (being pampered and taken care of hand and foot). Don't put yourself through waiting on them (unless you have to) because no telling how long you'll end up doing that.

My sister was a provider years ago but one of the things she told me when we started to see changes in my Dad was: men they favor the girls and women favor the boys. That has held true for not only our family but other families I know as well.

When my Mom started to show symptoms she stopped doing anything for herself and would not do anything for me. We would get into shouting matches because I was not going to tell her what to do. I'm pretty sure it was more than just that: aging process, she controlled everything and everyone, you remind her of what she is not anymore: young, she is no longer the queen of the castle) If my brothers told her to do something she would do it without a problem. I didn't let up though. I would continue to tell her. She stopped having the shouting matches with me. I guess she realized I was not backing down. My mom has always been stubborn. That didn't come with the Alz. I do respect her though and don't use any foul language or anything like that but I am firm with her. I also want to add that I'm more patient than most but have became stronger and so I do not always let her have her way. I try to keep her to a routine and it has helped her. They are little things like her meds, taking a shower, going to bed at the same time every night. To get to where we are now took a little over a year and it was hard. I really had to work through my own emotions to get through that. All of this has not been easy, I'm tired and sometimes angry.

For right now she is more receptive however I know that she will continue to change and I will have to figure out how to deal with her. This is a little calm before the next storm starts brewing.

Bottom line: No easy answers. I've been taking care of my Dad for 8 years now and both him and my Mom are so different. I deal with them differently.

I hope that since your MIL lives with you that you are comfortable bringing in a provider or a sitter. Someone that will give you and your husband a break. You need that. You can't focus on more important things when you are just living day to day caring your MIL's needs.

Hope this helps.

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If she asked her son if there was anything she could do to help, then its a pretty clear indicator that she is "with" it, and aware of impending chores. She may have felt even bad or guilt when she saw him doing dishes. I think her age is biggest obstacle, but with that said, there are still things she can do and really should do to help out, and give her self worth plus keep her occupied a little bit. I like the prior suggestion of the son handing out a few little chores to do. She'd be more likely to do it, coming from her son. I know how you feel, and its not easy!! Better start asap!! Or it gets to late to hope for help. Although age and health have to be predetermined factors in the situation.

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Have others view and draw opinions as well as yours that know the person

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When people like your home health care tell you you SHOULD do such and such, they are giving general advice not advice specific to your situation. You could ask them how do I get her to do chores when she refuses. They will have no answer. There's a thing called initiation. It's the leap from thinking about doing something and starting the action. This is hard in both dementia and depression. Teepa Snow videos on youtube address this and many other things. Very helpful, wish I found her sooner.

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Laughablelife: Instead of second guessing what is going on with her health (because you could or did drive yourself crazy thinking about it), get her seen by a neuorologist who can give her an M.R.I., which is the gold standard to detect for Alzheimer's.

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I have a question.....what difference does it make if it is Alzheimers or a personality trait? Regardless of which, if there is abusive, nasty behavior, IT MUST BE STOPPED AT ONCE BY ANY MEANS AVAILABLE. No one, and I repeat no one, regardless of reasons or relationships should be subject to nastiness and abuse, etc. If it cannot be controlled and if it is beginning to destroy who and what you are and affective you and your family's daily life, then there is only one solution - assuming you have tried everything possible, then place them where they are safe and cared for and live your own life to the fullest before it is your turn to be old. If you don't do that, I feel sorry for you and you should feel no guilt for doing this. It is a matter or survival - for YOU.

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I had a female relative who would grab my breast when ever it was in reach. This is abuse in a healthy person but not in a demented person or in a two year old child. There is a vast difference in responsibility for one's actions. I would take their hand and return it to their lap and say no. When they went for my breast I would block their hand. I did this with the demented person and the two year old.

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Se wants to feel useful. Find a chore for her...??

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There are over 50 types of dementia. Alzheimers is 100% diagnosed after death. You cant be 100% sure. Just do the best you can with the specific symptoms displayed... approached from the front is a good idea. It is said a true alzheimer patient t may get scared-angry when approached from the rear or where they cant see you. Elderly lose their peripheral vision so always approach from front anyway. You're doing great.

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I'm going to focus on the practical here. If this lady is offering to do chores for her son, then any request for her to work should come from him. I know it's annoying, but if you focus on the goal of getting her to contribute, this may be the way to go. Ask your husband to assign her a specific set of chores rather than random requests. All interactions regarding chores should come from him.
It's very hard to separate dementia from personality. Dementia causes a change in personality. Reasoning, judgment, predicting the consequence of an action, self control are all degraded by dementia. Why do YOU do dishes? You can predict that unwashed dishes will pile up until there are no dishes to put your food on. You have self control, so you wash dishes rather than doing something more fun.
Please be careful not to let this situation have a negative effect on your marriage.

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Mom puts on a show for the doctor, but guess what? He caught on because he's going through the same stuff with his own mom!

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You may never know that answer. Is it the dementia or personality trait. But, maybe at this point it doesn't even really matter anymore. It just is what it is, and you and your husband hopefully can figure out a way to do what's best for her and yourselves also. All of these journey's are different, but still fraught with difficult situations to try and figure out. The more you know the better-there are some great resources out there, this website being one of them. Read about showtimers-apparently it is a real thing! I've seen my mother, who can't remember from one minute to the next, behave remarkably coherent at times depending on who is around. Of course, a few minutes later it's done, but many of those people aren't around long enough to see that part. The dementia brain is such a puzzle, with no seemingly logical way to connect the dots. Good luck to you.

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Whatever your relationship has been with your MIL over the years I can tell you "rising to the occasion" so to speak isn't uncommon at all in the aging cognitively impaired world. My mom does it all the time and it can be very frustrating! It is incredible how much better she can suddenly be as soon as the doctor walks in or how much cooking and cleaning up she can do when my youngest brother (the one she doesn't see all the time) visits. She does it for any visiting nurse, therapists or anyone evaluating the need for help (Ugh!) too though so they all say "I just don't see what you are talking about she seems perfectly capable to me" now mind you it's not just me it's the brother who is around more too who see the need. The problem is you need to spend more than an hour with her and sometimes more than a day or two depending, she has always been good at "covering" she just can't maintain the cover. The other side of it I know too is that the more comfortable she is with someone, the more she feels comfortable letting her guard down and doing what she wants, rising to the occasion or visit takes a lot out of her and isn't something she looks forward to. Now it might be a backwards complement but the fact she is willing to behave so badly with you mat very well mean she is just comfortable, doesn't feel like a visitor with you, kind of like a teenager who you get complements about how helpful, what a perfect guest they are and your first though is "are you sure your talking about my child"? It may be that in her old habits for lack of a better way to say it, she thinks of you as being like a daughter, cooking, cleaning and picking up after the household is a given and being waited on a rite of passage but having her son doing those things is not wrong but out of the norm so she steps up to help? Kind of a natural reaction, she isn't thinking it out it's just an automatic. Again my mom for instance will make this show for me sometimes if I'm not feeling well but I live 4-5 hrs away so I'm not around all the time (just by phone and FT) but she doesn't perk up and do this "show" thing when I come to visit the way she does for my brother and she gives me more of a hard time than she does the brother who lives closest and I tag team with. Pisses me off sometimes but I've learned not to be hurt by it so much, I really don't think it's a conscious thing or on purpose and it's probably more one of those backhand complements. For instance she loves her sister very much (sister is younger) but she dreads her coming to visit and can only stand having her around for a couple of days, she has no problem with me sticking around for weeks, in fact she finds ways to get me to stay longer if she can. It's not because she loves one of us more it's just that she's still able to put on a front for her little sister or feels she should/wants to but she doesn't feel that need with me. Maybe your MIL is just more comfortable and secure with you than you think. She doesn't feel the need to impress you, she still has that need sometimes anyway with your husband.

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Perhaps it is Time to Think about Putting Mom in a Facility Here, dear, This is Not working out. It is not fair to you nd if your hubby loves you and you want some wedding bliss, Time to put Mom somewhere where she can Get What she really Needs...Dementia only grows worse.

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Facilities do not give the care they need........in home private care is the best.

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You Tube has videos of Teepa Snow. Watch them. They are very informative & entertaining. You'll learn a lot from her.

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Oh YES! Everyone on this support group should watch all of her videos. Those videos are possibly more helpful than this group. (Opps, don't tell anyone I said that!)

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I’m so sorry for all that you are dealing with. They say each person’s experience with dementia is different. I have found that as it progresses, each week, each day, and eventually each hour is different. “Professionals” are always telling us my parents should do more. Between their pre-dementia personalities and the dementia itself, I know that is not going to happen in any consistent way. And in their mid to late 80’s I have decided to let them live their lives on their terms, whatever those terms may be at the moment. I used to say “as long as they were not harming themselves.” But if what they are doing in some way hastens the end, even that seems merciful at this point. Now I just look to prevent pain or discomfort. You mentioned that when you thought it was dementia you found yourself feeling less angry. I have had the same experience, and so I quit trying to figure out what was “intentional” and what was dementia, and for my own sanity just attribute anything that might be irritating to the dementia (assuming there are no signs of a urinary tract infection). It truly is a strange, difficult, confusing road to be on. You’ve been through so much in your life. I wish you pace, comfort, and strength as you navigate this latest challenge.

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My Mom has Dementia, and does now use a walker. Because if her Diabetes, fully insulin and it is a challenge to keep her numbers stable, I decided to put her in Assisted Living. She is more than capable of going to go get ice , and keeping her area picked up in her private, expensive room. She does not lift a finger. Also when Physical Therapy comes in she only cooperates with the males. I know my Grandmother favored her boys as mom does. I am her only daughter and we have always been real close. I feel the male/boys thing has been carried on from decades ago because the males brought home the money . Also she gives me a tougher time than anyone. My mom is 82 yr old. I get hurt, angry but let it go. With Dementia they can be quite argumentative and you will never win. I accept it , don't agree with it but have sort of understood this is normal under all circumstances.

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Stay, my hubby lets me use him to deal with mom, since to her I'm still the kid, I guess. If HE says it, she's much more likely to do it (he's 15 years younger than me - lol!), so if I'm having difficulties with her, I enlist him or tell her he thinks it's a good idea - which he then agrees with. Mom's and my relationship has been up and down my whole life, so it's a great blessing to have a middleman that she respects; I just make use of that.

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What I learned is that your MIL still knows she is a guest in your house....you are the Lady of the house. Her son is her son....and we all know how mom's just love their sons.....tell her it's "Tom's" job to do when he comes home from work..... poor thing he'll be so tired...does she want to help him get his chores done today... he'll be so happy. I know as I am just the daughter, Mom torments me....the hired part-time help gets all the cooperation....

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Has she been to a neurologist? This is the next step to get an actual diagnosis. They can be in the early stages and actually "hide it". My mom would be good for 15 - 20 minutes and then the repetition questions would start.. It is a horrible disease for the person that has it as well as the family watching them deteriorate...

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Dementia is a progressive desease. Early stages are hard to know what is going on. My Mom got overwhelmed easily. I would get mad because she didn't listen to me but listen to my disabled nephew with a neurological problem. My reasoning was good. He needed to be patient. After her Dementia progressed I realized the first thing that goes is the ability to reason, processing and comprehension. Short-term memory. Then they seem to go back in time. Forget they were married, had kids. Mom acted like a child. When the dementia hits the part of the brain that controls breathing and heart, the person passes.

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Thanks so much for this info, JoAnn29. I guess that's why it's been so confusing. Maybe it was early stage before or something. I'm not sure. Maybe she is progressing to the middle or something...or maybe I just didn't know what I was dealing with until recently. Yes. I've noticed the ability to reason gone. Also comprehension and processing. I have used to use hand gestures to communicate what I mean sometimes...like asking if she wants a drink. MIL doesn't talk that much anymore...just sits and watches TV. It's weird. She used to be a very talkative person. Some days she is very talkative and conversant, but not very often anymore. So, it's hard to tell what she remembers and what she doesn't. I was wondering what makes them pass. Thanks for sharing that. It's sad, but we have to be prepared.

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LaughableLife,
It really is difficult to tell what's going on with seniors sometimes. They often do seem quite contrary and difficult, however, I will share with you that I had a family member who was acting odd and inappropriate. She became very difficult, even though, I was helping her a lot after her foot fracture. She insisted on laying in bed and using adult diapers, even though there was no need for it. She was perfectly capable of getting up and using bedside toilet. She also refused physical therapy. The home health care workers and therapists told me they thought she was lazy and selfish. NO ONE realized that she had early dementia. Her brain damage was causing her to act that way. No long after she got it really bad and is now end stage dementia in a MC. I wish then, that I knew what was going on with her. It's just hard to tell sometimes.

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Sunnygirl1, Yes. I'm thankful to be learning from others that this does sound like dementia. I always thought that people with dementia didn't understand anything anymore...forgive me. I grew up with a father with mental illness and a mother who worked with mentally retarded people for a living, so that's what I have experienced. Dementia is an entirely different world and realm for me so I have no idea what is dementia and what isn't and I'm not finding the information online very helpful in understanding what exactly dementia is. I wish I could find a video to watch or a book to read that did a better job of understanding. I watched one documentary where a lady was not able to talk or feed herself. I thought, well, MIL can do that...

It's so confusing! Yes, doctors in the beginning said MIL only had mild cognitive impairment. They are just now saying it's noticeable that she has dementia. It's super weird.

yeah, that's exactly what I had been thinking...MIL is just lazy. I don't understand why someone with dementia will just sit and watch TV? The things I have read have them wandering and getting into things (I guess it's better I'm not dealing with that!). My MIL just sits there. My grandmother had mild dementia...she would do things. She would just forget that she did them and think she needed to do them again.

Thanks for the response and insight!

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LaughableLife, how much and what kind of care do YOU provide for mil? Do you help her bathe, go to the bathroom, help her transfer, etc.?

How much longer do you think this will go on for? With her attitude, I would be strongly suggesting (perhaps insisting) that she be cared for elsewhere. Does H have any sibs? Or what about a facility? Does mil pay you for her upkeep and the caregiving services you provide?

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Hi, CTTN55, right now, I'm just tolerating her hogging up my living room and my favorite recliner. I fix every meal. She can thankfully still go to the bathroom on her own and wash herself. I know that might change one day.

I did try to insist that she be cared for elsewhere, but it's really expensive where I live. My husband is an only child. I'm just going to have to suck it up and work through it. I'm not willing to lose my marriage over it. I have no idea how long it will go on . She's about to turn 89. It's really hard to tell if she will live several more years or just a few more months. I have no idea.

When she first got here, I thought she was going to pass soon. It's been almost 2 years...so, very hard to tell.

you make good points!

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I think maybe the therapist saw thru her. I think she never liked the idea of you being #1 in her son's life over her. Now she is in your home, she is going to show you who is #1. Yes, its a passive agressive thing. My MIL was very good at getting her way like this. Oh the things I could tell you.

My husband bought a house before we were married. MIL made the drapes and would pick up things to decorate it. Her tastes were not mine. So after we married, DH said I could do anything I wanted to the house. So, I started replacing the things I didn't care for. Sconces were a big thing then. So I had a set in the living and dining rooms. DH and I had just come home and were in the dining area when my MIL walked in and perceeded to take my orange candles out of the sconces and replace them with white. Then she walked out. Really! We stood there dumbstruck. To this day, I don't think she saw us standing there. And the gull! I took the white ones out and put my orange back in. I should have returned the white ones but I just put them in a drawer. My DH may have said something to her later in private, not sure.

So my answer, I think its a personality thing. My MIL did the same thing after a UTI and she was in rehab. She refused therapy or when she did participate she wasn't into it. We were there from 8am to 5pm everyday. She wouldn't get out of bed. She had the boys feeling sorry for her. I went into the room ahead of everyone else one visit and she was at therapy. Her roommate, a nurse, told me MIL had sat up, ate all her breakfast and carried on a conversation with her. The day before the boys were feeding her a milkshake. I did nothing for her while we were there. She was playing it for all she could. She wanted out and thought her boys would get her out and care for her. We all lived in different states, so that was not an option. 8, 12, and 18 hrs away, we being the 18.

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Aha. Thank you so much for the reply, JoAnn! That's some good insight. I never thought about the home health therapists seeing through through her. My therapist (psychotherapy type) saw through her, too! She's been helping me process this situation for the past year and a half. What you said is exactly what my therapist said as far as being number 1. I was so very confused. I thought we were all like a little family. Now I know that she just tolerated me all of these years (I've known her for 20+ years). She was also leaving her banana peels for me to pick up, etc. She even threw her dirty diaper on my living room floor. I wondered what stank all day. When I finally figured it out, I was livid and I yelled at her b/c she just kept doing it. I guess she finally got tired of me confronting her about her behaviors b/c she started throwing her banana peels away and she hasn't thrown another dirty diaper on my floor.

I have sympathy for someone with alz/dementia, but I have no experience with it, so I don't know what she knows/understands, what she doesn't. I have given up the fight with the dishes. I don't care. I'll just pick it up myself. I'm always in the kitchen anyway. Maybe my husband had a talk with her. I don't know. I fix every meal she eats. I know she can't, so I don't mind. But, she wouldn't even acknowledge that I gave her food in the beginning. She would just see me put the food next to her and say nothing. My husband would get her a burger and she would gloat about how good it was later. I'm guessing it was to infuriate me. It worked at first. Now I just let it go (thankfully I can).

I guess what is saddest for me in this situation (which my therapist has helped me realize and process) is that I don't have the relationship with my MIL that I thought I did. And, it's not just changed due to alz/dementia. What I thought existed never did. It's painful and it hurts.

And, I'm sorry for what you went through with your MIL. I can't believe she tried to decorate your house! I had to teach my MIL that she isn't going to boss me around in my own home...or at all. She went through this phase where she would stare at me every time I walked by. She's in my living room 24/7 b/c we have nowhere else to put her. She can't walk up the stairs and refuses to try. I had to stare back at her until she quit.

I feel bad about that stuff, but I could not let her try to boss me around in my own house. In the beginning, I was fixing breakfast once. I was fixing eggs. She told me one morning that she would have oatmeal and not eggs. I was already fixing her oatmeal that day, so I gave her oatmeal, but she thought she was going to have me waiting on her hand and foot.

I later told her I'm not fixing 2 or 3 different meals. She will eat what we are having in our home. I told her this isn't a Denny's! The nerve! Ugh!

How can I tell if a behavior is due to dementia/Alzheimer's or is just a personality trait?

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