Dressing and diagnosis queries

[Jo T]

Hello.

I haven't been on since Christmas when I contacted you as I was in a bit of a state about my mother. Her condition had been deteriorating and we were having problems getting the specialist that she had been refered to to prescribe Aricept for her. Fortunately mum's GP is fantastic and very on the ball, and got another referal for her and, second time around, Aricept was finally prescribed. That was over three months ago, and although there has been little, if any, improvement at least there has been no significant decline.......However, my step-father has reported that he is finding it increasingly difficult to deal with my mother's refusal to wash and change her clothes. Last time I spoke to him he said that she had not washed or changed her clothes for a week, and just refuses point blank when he suggests that she does. I have read your fact sheet on this but just wondered if anyone had experience of this at such an extreme level. He can't even try the trick of putting fresh clothes out when she goes to bed as she sleeps in her clothes (and shoes!) on top of the bed, on the cat blanket that is at the bottom of the bed. He is finding this behaviour increasingly bizarre and difficult to understand.

The other query is this: when mum went back for a repeat prescription of the Aricept after the initial three months, the specialist re-did the memory tests and she scored exactly the same as she had done before. The specialist then told Tony (my s-dad) that he thought that mum may be suffering from 'cognitive decline', as well as possibly AD, as she was able to write a sentence that made perfect sense with no problem at all. He said that if she was suffering with AD she would not have been able to do this. Cognitive decline seems to be a very vague, generic term. And how can she have AD as well? Surely AD involves cognitive decline? I am confused! The problem is that when Tony goes to see the specialist he doesn't ask questions. I will see if I can arrange to go with them next time but in the meantime can anyone shed any light?

Many thanks

Jo

 

[Sheila]

Dear Jo, welcome back, nice to hear from you. I can understand the concern your stepfather and yourself are having about your Mum's behaviour. If she is sleeping in her clothes it is even more difficult. My own Mum did a stint of that, I found if I ran her a bath and then just casually told her, "Oh Mum, your bath water is getting cold, are you soon going to hop in?" She would think she had run it herself and, as she hated waste, she would toddle off to have it. Course, soon as she was safely in, I popped in to "check" if she needed any help and quickly removed the clothes and replaced them with clean ones! Later, when she had someone in to bath her, we did the same, removed them once she was in the bath. It might work, you could give it a try. I also think you are right in thinking of accompanying them to see the specialist. It is often difficult to think of what you want to say when you get there, this might be what happens to your stepfather. I used to write it all down and refer to my notes. Hope you can get things sorted soon on both accounts. Keep posting and let us know how you get on. Love She. XX

 

[HeatherR]

Hello Jo, Cognitive decline is very much part of AD! It is the measure that is used to map what happens to brain function and is part of the diagnostic tools that are used in diagnosing dementia. Another term that is used as a similar measure is a decline of IQ.

What is strange is the odd comment from the specialist regarding sentences! Dementia is different in every single person, it attacks different areas in the brain so we all have very different symptoms, and we are all at different stages. Whilst I have only just been diagnosed with Early Onset Alzheimers I am still able to rattle the keys on the computer and produce a reasonable response full of lots of sentences (or at least I hope so!!). Do go and talk to the specialist and ask him to explain what he means. Good luck.

Heather

 

[connie]

Dear Jo, sorry to read about the problems with changing clothes etc. We have not gone down that road yet.
Cognitive behaviour, not sure about this one.

Lionel will write such things as: I am not GA GA yet. or an obscure quotation.
Always foxes the consultant, but they have never queried the diagnosis of AD.

Don't know if this helps..Love Connie

 

[Jo T]

Thanks Sheila, as always you come up with a simple yet effective piece of advice! My mother too hates waste, and also always does her best to cover up that she may not know what people are talking about, or that she has forgotten something. A combination of these factors may get her into the bath! We are going up to visit this week-end so we can give it a try....I will let you know how we go!

Connie, it sounds as though your husband has a great sense of humour....I think I would like him! And Heather you certainly can still rattle those keys. Thanks for your comment....I definately need to hear it first hand. God knows it is a difficult enough disease to try and understand at the best of times!! I will let you know what he says, although I don't think that they have another appointment for another six months or so.

Take care

Jo x

 

[blue sea]

Dressing problems

Hi Jo

I had very similar problems with my dad when he lived with us (he is now in a nursing home). It got to the stage where he insisted on sleeping in his clothes and getting him to bath / wash was almost impossble. I found it helped sometimes to deal with him like a young child - saying 'it'll be bath time soon - do you want a cup of tea (bscuit ot whatever) before or after your bath? Sometimes this worked sometimes it didn't ! Then I would just run the bath and be brisk and jolly him along. When he got more resistant the best I could do was change and wash him in stages - perjhaps slip his shirt off one morning, his trousers the next - rather than trying to do it all at once. He seemed to feel afraid of being cold so had to work fast. to replace garments with fresh ones. Found it easier in the end to actually dress him rather than try to get him to do it. I would distract him by chatting about what we would do next as I changed him. I did find once he went into a home that the carers were actually better at this than me but it tends to take 2 of them to dress / undress him. They have to pick their moment to get him to have a bath and to shave him - often he just flatly refuses. This is a really difficult stage to deal with. I found I did have to treat dad more and more like you would a young child - which obviously you don't want to do. It is really hard for both you and your stepdad - I would get all the help you can from social services. Your mum's needs are complex and you will need more and more help to deal with them. In your mum's world how she is behaving is normal and no amount of reasoning will change her view but sometimes a few white lies and little 'tricks' can help.

Thinking of you
Blue sea

 

[daughter]

Hi Jo,

My Dad has had AD for a few years now but he can still read out sentences from a magazine.

Regarding bathing, I've mentioned before that when my Dad was still living at home, Mum used to put the music on and 'dance' him into the shower. It used to work most times. Yes, it's worth trying anything to get round the resistance. I hope you have some luck this weekend!

Best wishes,

 

[Fran]

bathing

Hi Jo

We were having a lot of problems persuading Mum to wash and as for hairwashing, that was a total impossibility. Eventually Dad agreed that we needed professional help as, apart from Mum not wanting to bath, physically she is so weak and frail now, it was proving very difficult for us to actually get her in and out of a bath. Luckily we have found an excellent carer who comes in twice a week and, because she wears a uniform, Mum responds to her better than to Dad and I.

Unfortunately her arthritis is now becoming another factor so we are waiting to hear from an occupational therapist to see if there are any aids which might help - I do hope you are able to make some progress with this particular problem - its a constant battle isn't it!

Best wishes.