Does this sound like dementia?

Discussion in 'Memory concerns and seeking a diagnosis' started by Envelope, Jan 13, 2015.

  1. Envelope

    Envelope Registered User

    Jan 12, 2015
    6
    My motherinlaw is 90 and in poor physical health. She lives in her own rented apartment but has the services of a professional paid carer on a daily basis. The doctor (she says) visits her weekly but I think that is only to check basic things such as her temperature and blood pressure. She adamantly refuses to go into a care home.

    She lives hundreds of miles away in another country where we are not fluent in the language. My husband flies to see her 3-4 times a year.

    What has prompted this question is the recent series of events. My husband had long-delayed surgery just before Christmas. We advised her three weeks in advance, that we could not travel to her country at that time, on the phone and in writing. We had to repeat this news 16 times (I counted) over a three-week period before she finally got the message. She then angrily called my husband "selfish" for not going to see her at Christmas. This is completely out of character.

    Over Christmas itself, when my husband was recovering from his operation, she showed no interest in that whatsoever and only wanted to talk about herself (because she had forgotten about it?). About a week later she started to phone every other day to ask if he was still in hospital. We have so far told her seven times that the operation was weeks ago and that he is back at work.

    Another incident which may or may not be true: she (allegedly) phoned her carer in the middle of the night to ask where she (the carer) was, as she (my motherinlaw) had to take the children to school. The children are now in their 60s. It seems a crazy story to me: how could she know who to ring in the middle of the night (the carer) if she has dementia? Or is that another symptom? Getting places and people and time-frames completely muddled?

    She also phoned her sister to ask her how her (the sister's) husband was. The sister angrily told her that her husband had died two years ago and slammed the phone down. My motherinlaw's reaction was that she did not know, nobody told her.

    My husband is equally adamant that his mother does not have dementia. He says 'look at the way she can recall events from 70 years ago in perfect detail, look at the way she remembers the house where I was raised'. But her short-term memory is only days or sometimes even hours.

    So is this dementia or old-age forgetfulness. We can not tell from here.
     
  2. Beate

    Beate Registered User

    May 21, 2014
    11,711
    Female
    London
    I am afraid, this behaviour has all the hallmarks of dementia, and remembering events from 70 years ago does in no way disprove it, as long-term memory is the last one to go. In fact, it's very typical for people with dementia to live in the past.

    Picture a bookshelf that gets filled bottom to top with books. Over time the bookshelf gets a bit unsteady and books start falling off the top - where books were added last. Of course books could fall off the middle shelf while some around are still standing. Now replace books with memories and the shelf is the brain. Does it make sense now?
     
  3. Envelope

    Envelope Registered User

    Jan 12, 2015
    6
    Many many thanks for your swift reply. Here are some more examples, which my husband still denies are symptoms of dementia.

    Last year she got into a terrible state with her finances and kept phoning us angrily to demand to know where the money had gone. At great inconvenience to himself, when he was not well, my husband flew there to try to sort it out. To cut a long story short, it was proved to her in the presence of her son and a nephew, with the Bank Manager, that her neighbour, the 'caring' and 'kind' neighbour, had been drawing hundreds of pounds in cash from her account every week. My motherinlaw had trusted this woman with her bank card to draw cash for shopping.

    My angry husband took his mother's keys and bank card from the neighbour and called her a thief to her face, then came home exhausted. The next day my motherinlaw had given the keys and card back to the neighbour.

    This week's alert is that she phoned to say she was going to visit the UK again. Instead of deferring this topic to his next visit he tried to explain why that is simply not possible as she is too frail to fly anywhere, now. After about ten minutes she angrily said "Why don't you just say that you don't want me to come?" She can not travel anywhere any more. She is on a zimmer frame and has multiple health problems. It takes her about an hour just to put shoes and coat on to get out of the apartment (and wherever she is taken is all wrong, anyway. She will then not understand restaurant meals with starter followed by main course. She will say 'why are you all eating?' when she didn't order a starter. If we ask the restaurant to provide her main course while we are eating the starter, she will then say 'why are you are all eating, I've finished' when we are on our own main courses.)

    It seems to me that she flips in and out of reality. Sometimes on the phone she is perfectly ok and able to have a conversation. Other times my husband has to tell her five times who he is.

    But he still will not have it. She does not have dementia, she's "forgetful".
     
  4. RobinH

    RobinH Registered User

    Apr 9, 2012
    266
    London
    Hi. Seems you have 2 problems. Your mother in law seems to have dementia, and your husband can't accept it. For him, perhaps get him to read up on the subject? Some people who've only ever known one person with dementia assume that everyone is the same, so when they encounter someone affected differently, they dismiss it. As for your mother in law, she is certainly at risk of exploitation, and probably needs to move into some sort of care. You don't say the country, but that is a big challenge. You should consider bringing her home, especially if her local language skills are poor, or if they fail in the course of the disease. Good luck.
     
  5. janey106

    janey106 Registered User

    Dec 10, 2013
    139
    Hi Envelope, most of these behaviours crop up time and again as dementia symptoms but as others have stated, there is no 'one-way' or order for it to manifest itself. Loads of info in Internet. The bottom line is, irrespective of a diagnosis, she is clearly very vulnerable to abuse by others and not able to self-protect or have insight. I agree with RobinH, your OH needs to be helped to face it, research on options in her own country and this one. Tough hard road, I'm on it. Good luck.
     
  6. Envelope

    Envelope Registered User

    Jan 12, 2015
    6
    Hallo Robin and thanks.

    In order: I can't see my husband reading up on it, since he's in such denial. Thinking about this, IMO it's been coming for over a year now, but he simply will not see it or hear it. The risk of exploitation has been nulled or at least minimised, as he and the carer have joint POA over his mother's finances and health, legally drawn up in that country. It is not possible to even consider moving her back to UK for multiple reasons. She emigrated from UK back to her country of birth about 15 years ago - her decision - so there is no language issue, for her, over there.
     
  7. Envelope

    Envelope Registered User

    Jan 12, 2015
    6
    Hallo Janey and thanks.

    I researched at great length years ago. Hours of research including contacting that country's Embassy here, and UK's embassy there. Hours of poring over legal issues in that country's language. This was regarding her moving into a care home either over there or in UK. It all came to nothing because she is adamantine in her refusal to go into a care home.

    To me, it makes no sense. If she were in a care home, she would have company instead of endlessly complaining about how alone she is. There would be people to pick her up when she falls down, which is often. Trained staff would keep an eye on her and administer all the various medications for all her various health conditions. She only uses her bedroom in the winter as it 'costs too much' to heat the sitting room - so why keep paying rent on an entire apartment?

    But we have found to the cost of our own patience and energy, that there is no use in trying to apply logic. She won't go anywhere else. So I gave up.

    My registration here was to try to find out if I'm the only one who suspects that she has (not might have) dementia. From what I've read so far, my surmise is correct.

    I have a question for anyone reading this thread: sometimes on the phone she is perfectly coherent and can have a normal conversation. Sometimes she does not know who my husband is, and cries out "Is that X? X is that you!" - X being a relative who never phones her. This upsets my husband, but by shouting his name repeatedly she finally realises who he is. He then just shrugs it off with 'her hearing aids are not working'. So, is this on-off recognition/awareness a typical sign of dementia? Many thanks.
     
  8. canary

    canary Registered User

    Feb 25, 2014
    10,526
    Female
    South coast
    So, is this on-off recognition/awareness a typical sign of dementia?

    Absolutely. When I visit mum at her care home she may know exactly who I am for a while and then turn round, look me blankly in the face and say "Im sorry, I dont know who you are" She will often flip backwards and forwards between knowing and not knowing who I am. At other times she will consistently think that I am her mum.
     
  9. Doug123

    Doug123 Registered User

    Jan 14, 2015
    3
    Hi, this reads like my Mum's Dementia & Alzheimer's. Virtually every other day, Mum tells me she has no money. Both my brother and my wife have separately taken my Mum to the banks and walked through her various accounts, even yesterday had the same heated conversation, with no success. My Mum's long term memory is excellent. she will tell the doctor about something that happened 40 years ago, however cannot remember what she had for breakfast.. Unfortunately it is dementia. Can appreciate that your husband is in denial as it is his mother, however dementia is a disease (a mental illness). Maybe your husband has a phobia around mental illness? It is a disease like cancer is a disease. He cannot ignore it and hope it will go away. The best way to address an illness is to seek a diagnosis and then a care plan can be put in place.(without a diagnosis there cannot be a care plan, both medical and social), hope this helps.
     
  10. canary

    canary Registered User

    Feb 25, 2014
    10,526
    Female
    South coast
    I must say, Doug, that I had actually considered dementia as a neurological disease (like parkinsons, or motor neuron disease), rather than a mental illness, as the damage shows up on a scan.

    Im not entirely sure of the definition, though.
     
  11. Envelope

    Envelope Registered User

    Jan 12, 2015
    6
    From this very website:
    ....................
    Early stage

    Alzheimer's disease usually begins gradually with very minor changes in the person's abilities or behaviour. At the time, such signs are often mistakenly attributed to stress or bereavement or, in older people, to the normal process of ageing. It is often only when looking back that we realise that these signs were probably the beginnings of dementia.

    Loss of memory for recent events is a common early sign. Someone with Alzheimer's may:

    forget about recent conversations or events
    repeat themselves
    become slower at grasping new ideas
    lose the thread of what is being said
    sometimes become confused
    show poor judgement, or find it harder to make decisions
    lose interest in other people or activities
    develop a readiness to blame others for taking mislaid items

    -----------
    I'd say she's already doing all of those.
    *Forgot despite repeated phone calls, that my husband was having an operation
    *Didn't get that information 16 times
    *Completely lost interest in that and then blamed us for not going there for Christmas
    *Finally remembered the operation and repeatedly asked if he was still in hospital
    *Had to be told this six times
    *Lost all interest in that and only wanted to talk about her wrist watch
    *Claimed that her watch had been stolen despite proof that her watch was the same watch it has always been............

    etcetera.

    I realise that this may sound brutally honest, but there is a limit to one's patience if neither the person affected nor her next of kin (my husband) will take any interest in the probable diagnosis and keep brushing it away. I am finding this exhausting and a complete waste of time and effort to try to help them. Whatever happens next, will happen next (care home and/or death).

    Many many thanks for all the replies, which are very much appreciated.
     
  12. janey106

    janey106 Registered User

    Dec 10, 2013
    139
    Hi Envelope, we have been trying to get her GP to recognise Mums symptoms for 2 years (but evidence of them 4 yrs plus) as all classic dementia symptoms and he is still refusing to diagnose; last visit with copious evidence last week. Same week the mental health team made 'probable diagnosis' but now awaiting brain scan. Even the professionals can't agree. As a close, caring, observant family, all capable of researching, reading and considering options, we are confident the brain scan will confirm Mum has one of, or mixed, dementia problems because there is just so much evidence; that's good enough for us. Sounds like you are in the same boat.
    Having said all that, you are right about logic going right out of the window .... Insight, reasoning, logic, rational decisions are things of the past.
    Our Mum can flit between recognition/not recognising etc very quickly but likewise has very poor hearing; whilst she genuinely doesn't hear everything, she also uses this as 'excuse' for not remembering (despite subsequent conversations about it). I found a very helpful link about the shift/swapping of symptoms on a site and will endeavour to post it to you tomorrow
    I'm beginning to think the real challenge is to keep own mental health well in this very confusing dementia zone.
     
  13. lavenderblue

    lavenderblue Registered User

    Nov 2, 2014
    23
    UK
    In ICD-10 (The WHO's International Classification of Diseases), dementia is classified under both Chapter V Mental and behavioural disorders and Chapter VI Diseases of the nervous system (the Neurology chapter).

    ICD-11 is in development and projected for completion in 2017/18. For ICD-11, dementia is also proposed to be coded under both chapters.
     
  14. Envelope

    Envelope Registered User

    Jan 12, 2015
    6
    It has just occurred to me that a good outcome for our next visit is that it goes badly. For instance, that she says something like "what are you doing here?" when we told her the day before that we are arriving in the morning. Or that she fails to recognise me and asks my husband where I am. Or fails to recognise him. Or accuses him of stealing her money. Or repeatedly demands to be taken home, when she's in her own apartment already.

    I am absolutely not being mean. But it occurs to me that if the visit goes badly - like that - he will finally see for himself, and finally accept that she does have dementia. He won't read up about it, or discuss the possibility. When I used to raise the subject (I have given up now), he would tell me to stop 'having a go'. He can be very stubborn, just like his mother.

    So if you feel inclined to, please wish us a "terrible" trip - along those lines. A terrible trip in my current world is that none of that happens, she recognises us, knew we were coming, and seems ok. Thence follows more months (more years?) of uncertainty, exasperation, and drain on our emotional financial physical and spiritual resources. All of us. Thanks in advance.
     
  15. lavenderblue

    lavenderblue Registered User

    Nov 2, 2014
    23
    UK
    I'm not permitted to post links yet, but if you put

    ICD-10 Version 2015

    into a search engine, you can access the electronic version of the WHO's ICD-10 "Tabular List" of disorders and diseases.

    Click on Chapter V Mental and behavioural disorders in the drop down menu for disorder categories (on the left side of the electronic platform).

    The small grey arrows will open all the disorders coded under this chapter. Click on a code block and the associated descriptive content will display on the right hand side of the platform and can be scrolled down to read all the disorders coded within that disorder block.

    The first block (F00-F09) lists "Organic, including symptomatic, mental disorders."
    Various causes of dementia are coded between the F00 and F03 codes.

    In Chapter VI: Diseases of the nervous system (the Neurology chapter), Alzheimer disease, Frontotemporal dementia (FTD), Pick disease and Lewy body dementia are coded between the G30 to G31.9 neurology codes.

    In the SNOMED CT clinical terminology system, which is used in many countries, the dementias are categorized under:

    Organic mental disorder.

    In the Beta draft for ICD-11, Dementia syndrome is coded under the Mental and behavioural disorders chapter, but the individual causes of dementia are coded under the Diseases of the nervous system (Neurology chapter) under parent class "Dementia disorders".

    Hope this is of help.

    Lavenderblue
     
  16. jeansandtshirt

    jeansandtshirt Registered User

    Mar 15, 2015
    2
    Your messages have opened my eyes.

    I have a mother in law who has, for several years, become more difficult and stubborn but friends have said how much she is repeating herself and forgetting the things just told to her. I have spoken seriously to my husband but he does not want to get too involved. It makes me angry that I feel I need to take this on - I have two parents of my own and thank God they are in good health right now - I simply don't want to get involved more than I am able - full time work - 3 kids - etc etc. However my mother in law is worrying me with her behaviour. Last month called me as she had been burgled - we were so confused - nothing was taken but the house was messed up as if someone was looking for something. Police came etc but at the time I felt it was 'odd'. She constantly asks the same question over and over, my young daughter does not want to visit now as she acts odd. She still recognises us all but says she has not see her son in a while - but he says he's visited. She sleeps more and more and her patterns are erratic. She is becoming more angry and agressive - not physically but shouts at us and is quite calous. She won't come out to see us - she will go to see my husband at work but has no interest in the children or family anymore. I am certain this is the onset of dementia - my fear is that it is further along than we realise - I know health and other issues will follow. What to do with a husband in denial?

    Your discussions have really helped me today to get more informed and prepared for the near future. Good to know you are'nt alone out there. Thank you

     

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