Different behaviour when watched-monitored question

[Gulshan]

hello ,
my MIL about 68 years is between stage 5/6 .
Fortunately we can afford a nanny to attend to her most of the day. Nanny has created a heaven like environment for mil. Medications and food served at correct time, takes her for walk in the park, assists if needed in bathing etc.
Iam noticing that all Alz hallmark symptoms do not manifest when she knows she is being watched and attended to. They only happen when she is un-monitored. By symptoms i mean wandering around the house, rummaging for food, not washing hands after going to toilet etc..She never does this when she knows someone is around and watching. Is this expected and is this as simple as just never leaving her alone and having an attendant for her 24/7 ?
Thanks

 

[Isabella]

I would be surprised if someone with dementia had enough insight and control to change their behaviour to something more socially acceptable just because someone was around. However having said that, my mum once announced her late parents and school friends had been in her room with her and when asked if she'd told the doctors (she was in hospital at the time) said no because 'that's what they're looking for'. Very strange! I've often wondered if anyone else has come across this. People on here often say their loved one is good at putting on a front when they want to. I don't know what the answer is but perhaps the bright side is that at least there are times when the symptoms are less challenging to deal with?

 

[Mango]

I think it is reasonably common...

My Mum can present very well when we visit our doctor every couple of months.

My sister rang me when Mum visited her (first time they had seen each other for a couple of years) and her first words were, "Gee, Mum can put on a really good act!"

Luckily both doctor and sister can see through the surface, "I am just fine" presentation...

 

[ASH74]

My FIL always behaves in certain ways with me.....he will change his clothes, wash, will attempt the laundry ......not done for anyone else .....he didn't originally do this ( we had battles over washing etc) but I think I have now "conditioned" him so that he sees me he knows that this is what is expected. I know that the rest of the week he behaves differently!

He has also put on some amazing displays for doctors! Charm personified! Not one aggressive outburst. The rest of the time.....well!??!


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[halojones]

hello ,
my MIL about 68 years is between stage 5/6 .
Fortunately we can afford a nanny to attend to her most of the day. Nanny has created a heaven like environment for mil. Medications and food served at correct time, takes her for walk in the park, assists if needed in bathing etc.
Iam noticing that all Alz hallmark symptoms do not manifest when she knows she is being watched and attended to. They only happen when she is un-monitored. By symptoms i mean wandering around the house, rummaging for food, not washing hands after going to toilet etc..She never does this when she knows someone is around and watching. Is this expected and is this as simple as just never leaving her alone and having an attendant for her 24/7 ?
Thanks

All the time I am with mum and keeping her in a routine etc she is much better, its the comfort and support that helps, as she is not so confused about daily living,I take care of it all..but what I have noticed is that if I am not around then within a couple of days she will very quickly slip back into old bad habits..

 

[Katrine]

I agree with ASH74 and halojones, if the person places trust in their carer they will become accustomed to being guided to perform routine actions. It is easier to focus on the task if they don't feel stressed. Someone they trust is in control of the situation so they don't need to waste mental energy on dealing with negative emotions.

I also notice with both my mum and MIL that they copy the behaviour of the people they trust. This mimicking of normal actions keeps them grounded in feeling OK about things being as they should be. When they are on their own they get more confused and anxious because they don't know what they are supposed to be doing; there is no-one there to reassure and guide them.

If you have no short term memory you very quickly lose the context of where you are and what you are doing. Hence rummaging through drawers, dismantling appliances, wandering from room to room, putting on many layers of clothes, etc. The person used to be able to create their own sense of order and context. Now they need someone to take the lead for them to follow.

I also recognise the scenario of putting on a performance. For a short while the person with dementia summons all their intellectual, emotional and physical resources to behave as normally as they possibly can. And don't we all do that, to be accepted by other people, and to preserve our dignity? It is not a dementia 'behaviour', IMO, it is a social instinct.

 

[Lindy50]

I could not agree more with your post, Katrine

Your description pretty much exactly fits mum's behaviour and my role as her carer. It also explains why it's so hard for another person to step in and give me (us ) a break....it takes time to build up that relationship of trust.

Lindy xx

 

[Gulshan]

Thanks all for your responses. very helpful. As the disease progresses we are constantly adjusting and tweaking her environment to make life easy. And yes, i always wonder whether we do these things to make our life easy or theirs.. regards

 

[halojones]

I agree with ASH74 and halojones, if the person places trust in their carer they will become accustomed to being guided to perform routine actions. It is easier to focus on the task if they don't feel stressed. Someone they trust is in control of the situation so they don't need to waste mental energy on dealing with negative emotions.

I also notice with both my mum and MIL that they copy the behaviour of the people they trust. This mimicking of normal actions keeps them grounded in feeling OK about things being as they should be. When they are on their own they get more confused and anxious because they don't know what they are supposed to be doing; there is no-one there to reassure and guide them.

If you have no short term memory you very quickly lose the context of where you are and what you are doing. Hence rummaging through drawers, dismantling appliances, wandering from room to room, putting on many layers of clothes, etc. The person used to be able to create their own sense of order and context. Now they need someone to take the lead for them to follow.

I also recognise the scenario of putting on a performance. For a short while the person with dementia summons all their intellectual, emotional and physical resources to behave as normally as they possibly can. And don't we all do that, to be accepted by other people, and to preserve our dignity? It is not a dementia 'behaviour', IMO, it is a social instinct.

Very well explained katrine,this is exactly how it is for us, but I think for some people who are much more advanced then maybe this wouldn't apply anymore, but just having the reassuring feeling of being cared for is so important