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Coping with Mother-in-law

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Alzheimer's Disease
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Posted 4/11/2011 1:31 AM (GMT 0)
HI, Sherry, et al.

For a few years now we have been closely monitoring my MIL, who is showing increasing signs of AD.  It has gotten to the point of hiring 24 hr. care for her.  This is because of family dynamics that don't allow for any of her children to take this on full-time.  All of her kids are older and are involved in business of their own, and have responsibilities with their extended families.  She was recently taken to a memory clinic and the neurologist diagnosed her with moderate AD.  He seemed to think that she would need institutional care within a year.

She sometimes refuses to bathe, cannot recall if she has eaten or not, has gotten belligerent with the care-givers, cannot remember the names of her grandchildren, and has some notion that two of the sisters have already put her in a nursing home.  She is still in the same house she has lived in for 40 years.  She claims that the technology is there to duplicate her house, wall to wall.  This one has us baffled, but I guess the neurosis was planted some time ago.  It has gotten to the point that she started buying things for the "other house."  We returned them and tried to convince her that we are trying to take care of her by keeping her in her own house and getting the girls to help her.  Her response, "Oh, that's what you want me to believe, but I know better. I was in the other house yesterday with (name of care-giver).  You should come visit me there."  Whoa.  I asked her where it was and she replied that she would drive me there.  Sorry, no can do.  We have removed the car keys, checkbook,(a niece is being documented for elder abuse as she "borrowed "$3000.00 in December. 

We think this all started about 4-5 years ago, when the confusion started becoming noticeable. 

My question is this.  Are we looking at moderate AzD as opposed to senile dementia, or do we have a full-blown case on our hands?  She had an MRI last week that we are awaiting the results of.  What is the difference between mild,moderate and severe stages of the disease. 

Her outbursts have escalated to the point that the care-givers are calling  us to diffuse the situations that come up when she gets angry.  She's nearly totally deaf, so communication is difficult, if not frustrating because of all the yelling that has to be done.  In the research we have done, we think she's headed for a NH sooner than one year. 

If anyone on this site has some input, then it's more than welcome.  We'd love to get some additional insight as to what they think is going on in her brain.  We understand that all cases are different, but what do you think we are truly looking at as far as professional full-time institutional care is concerned. 

In the meantime, I'll keep an eye on the "other house" wherever it is.

By the way, I'm no strange to HW as I post at the Prostate Cancer forum.  Not regularly, but I check in frequently.  Thanks for the time.

Bob

Posted 4/11/2011 2:13 AM (GMT 0)
I'm sorry that you guys are having to go through this. AD is such a difficult condition to have, not only to the person that has it but their loved ones as well.

Mild AD - you might see signs of occasional forgetfulness or misplacing things. Forgetting where to go when you are driving at times. The emotions are still somewhat stable. You will still be able to live in your home and on your own. You know something isn't right but you can't place exactly what is going on. Or you think that it's a sign of getting older.

Moderate AD - things have progressed to the point where you can not live on your own anymore and you need supervision. You forget names and places. You forget to eat and bathe. You lose the "want" of being out and with friends and family...become a social recluse. Emotions are getting unstable and you start to get a bit paranoid.

Severe AD - This is the end stage. Your mind is gone. You don't know who you are. You become angry all the time or weepy. Eventually the body will shut down.

Of course there are areas in between these stages. But the point is to start on medication as soon as the person knows or someone close to them knows to slow the progression. The progression can be fast or slow. The progression is unpredictable.

Is your MIL on medication? If so what? Is she on a mood stablizer? My Gma was placed on Namenda to help control her emotions and it seemed to work for the most part. Btw, my Gma was also almost deaf and almost blind to boot so it was very tough on all of us when she lived with us. I made that decision to put her in an assisted living center after she was opening doors at night and hallucinating.

There is a lot of things that do not make sense when it comes to dealing with AD. Their memories are a jumbled mess so what they are talking about may of happened many years ago but they jumble up the memory with something recent.

It does indeed sound like AD unfortunately. And whether or not to put her in a home is up to the discretion of the care providers. If it becomes to dangerous for the in home workers or she becomes a danger to herself, you may not have any choice but to put her in a home. I really don't like the idea of putting a loved one in a home but sometimes there is no other choice. I feel they do better at home but you have to think of their welfare and of others at the same time. It's a tough call.
Posted 4/12/2011 4:04 AM (GMT 0)
My mom was diagnosed with AD almost 8 years ago and was put on Namenda along with Aricept and she is doing extremely well. Her disease progression has been very slow. She lives in assisted living and needs assistance with dressing, showers, medication, but she is able to get to the dining room for her meals. She has no interest in being social, although there are daily activities.
I think when we hear "moderate" we tend to think of someone who is not as far into the disease. These stages are very broad and can cover a period of years, depending on how quickly the person progresses. Once the person reaches end stage, they basically are not able to communicate any longer, lose the ability to walk and even sit up or feed themselves.
Posted 4/13/2011 12:39 AM (GMT 0)
Ladies, thank you for your replies. My MIL is diabetic, but has not been proactive in treating it. She is on a drug regimen to treat the diabetes, as well as Selexa for mood elevation. I don't think this is working as well as something else might, as she is angry most of the time, as well as depressed. She goes back to the neurologist on May 9th and we'lll go from there. Will let you know what the next step will be. Thanks again.

Bob
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