Speech and language

[Sterlingtimes]

If I Google the end-of-life stage for dementia, my mother will tick 11 out of 12 boxes. However, I am perplexed by her speech and language: she should be down to single words or phases.

Whereas my mother cannot receive or process oral information, she speaks at length, telling complex but implausible stories. Typical: "A white swan was flying around the building today. You can imagine the mess that it made. The men couldn't catch it, and they had to bring in the army. A marksman had to shoot the bloody thing." Or "I went swimming this morning. The only way they could get me out of the room was by standing me on the window sill. I had to dive. I feel much better for my swim".

How can someone in a terrible state tell a story with such good use of language?

 

[Yankeeabroad]

Short answer is yes.

My mom never lost her speech capabilities even when she was on hospice and EOL. She would tell stories like you mention (some were probably dreams) and ask my dad and I who the people were that she saw (some hallucinations) up until a couple of hours before she became non responsive.

Everyone is different.

 

[jugglingmum]

Everyone is different.

My mum was still mobile, was eating and drinking albeit losing weight and nothing of her, could engage in short conversations and was joking with the GP the morning she died.

We'd been told EOL and just in case pack prescribed. She became unresponsive and passed within a few hours

 

[Sterlingtimes]

Thank you, Yankeeabroard. It has helped me so much to understand that someone else has encountered a similar scenario. It is so difficult to be on this learning curve. There is an inner intelligence at work albeit that my mother is cut off from the real world.

 

[Sterlingtimes]

Everyone is different.

My mum was still mobile, was eating and drinking albeit losing weight and nothing of her, could engage in short conversations and was joking with the GP the morning she died.

We'd been told EOL and just in case pack prescribed. She became unresponsive and passed within a few hours

Thank you, jugglingmum. My mother has that end-of-life pack at hand. every visit is different. My mother has extraordinary strength given her condition: she has never had a serious illness, but her musculoskeletal system has been disintegrating with age. Your post is reassuring.

 

[Sterlingtimes]

It was only a year ago that my mother scored 73/100 on a cognitive test and exhibited no evidence of Alzheimer's or vascular dementia when she was scanned. Now, she is suffering from hallucinations, delirium, delusions and paranoia. She was diagnosed with mild cognitive impairment. Now, she is beyond having an examination by a psychiatrist.

Conversation is difficult to impossible, yet she speaks for much of the time. Yesterday, she told a story about her caregivers holding her in a fiery furnace and another about a tiger roaming the premises.

 

[Jaded'n'faded]

If I Google the end-of-life stage for dementia, my mother will tick 11 out of 12 boxes. However, I am perplexed by her speech and language: she should be down to single words or phases.

Whereas my mother cannot receive or process oral information, she speaks at length, telling complex but implausible stories. Typical: "A white swan was flying around the building today. You can imagine the mess that it made. The men couldn't catch it, and they had to bring in the army. A marksman had to shoot the bloody thing." Or "I went swimming this morning. The only way they could get me out of the room was by standing me on the window sill. I had to dive. I feel much better for my swim".

How can someone in a terrible state tell a story with such good use of language?

Your post made me smile - sorry! You could be describing my mum exactly, even down to the subject matter of the stories. Where do they get this stuff from? With mum there was a giraffe on the loose, a man exploding in the corridor, a truck driving into her bathroom (first floor!) etc. She'd also have a good answer ready if challenged - when I pointed out her bathroom looked perfectly OK to me, she replied, 'Well, it is now but it took them all morning to clear it up!' Sheesh.

Mum remained well and verbal till a few days before she died. No warning really - she was just 'off colour' and quiet for a few days. The doctor was called to check her but nothing was found. Then, after having a conversation with a carer in the early hours, she was found dead later that morning. It was a relief in many ways - she'd been in the CH for 3 years by then and I was glad she didn't last till the silent, bedbound stage. Like you, I had been waiting for her speech to go to indicate she was nearing EOL.

Enjoy the tall stories if you can...

 

[Sterlingtimes]

Your post made me smile - sorry! You could be describing my mum exactly, even down to the subject matter of the stories. Where do they get this stuff from? With mum there was a giraffe on the loose, a man exploding in the corridor, a truck driving into her bathroom (first floor!) etc. She'd also have a good answer ready if challenged - when I pointed out her bathroom looked perfectly OK to me, she replied, 'Well, it is now but it took them all morning to clear it up!' Sheesh.

Mum remained well and verbal till a few days before she died. No warning really - she was just 'off colour' and quiet for a few days. The doctor was called to check her but nothing was found. Then, after having a conversation with a carer in the early hours, she was found dead later that morning. It was a relief in many ways - she'd been in the CH for 3 years by then and I was glad she didn't last till the silent, bedbound stage. Like you, I had been waiting for her speech to go to indicate she was nearing EOL.

Enjoy the tall stories if you can...

Thank you for posting, Jaded. I can hardly believe that your observations are so similar to mine. I am sorry to hear about your mother. I understand your relief. I find this helpful.

Last week, my mother's bed turned into a car, and she was really to drive home: "Hand me the keys. No, it's alright; I already have them in my hand. It's OK. I can just reach the clutch. You jump in beside me, and Oliver [my son] can use the backseat. And get a nurse and bring her with us."

Some inner intelligence must be involved in concocting these often elaborate alternative versions of reality.

 

[Jaded'n'faded]

Last week, my mother's bed turned into a car, and she was really to drive home

That's a good one! My mother was - formerly - intelligent and articulate. She would have continued to dupe the medics had it not been for the content of her tales. Often they'd start off OK then go crazy:

Explaining she was in hospital because she'd fallen getting off the bus and hit her head, she replied, 'Yes, I know... but there was a plane crash and I was helping to evacuate all the children!' The medics told me that was just delerium but it didn't change over the following 3 years so I think it was just the way dementia affected her.

And that care home - no one would have wanted to be there, with all the atrocities going on! Men would come in at night and take their clothes off then do unspeakable things at the end of her bed, the chef had had his leg cut off because he was no good, David Thingie was there making a documentary and they wanted her to have a part, there had been weddings there every day that week and the children made too much noise, the place had burned down in the night and they took the dead people away in ambulances... I could go on, I won't!

Actually, one of the above was actually true - sort of! Someone in the assisted living building next door had caused a small fire so a fire engine and ambulance were called. But that was the problem I had. It's easy to smile about the wandering giraffe, put on my earnest face and say, 'Gosh, mum, who'd have thought it?' But when she said the girls (carers) had been hitting her or that she hadn't had anything to eat or drink all day, it was harder to verify if there was a grain of truth there. I'm sure those things never happened. Well, pretty sure...

 

[mhw]

My mum has everything in final stages apart from she's still eating ( although she does choke quite often in her rush to steal other patients biscuits if on the table and in reach) her speech was the first thing to go basically. She has frontal lobe dementia. In 2012 she started forgetting words half way thru a sentence, 2014 she would ring back after 20 mins and forget she'd rung and told you less than half an hour before, and then when you corrected her she'd either call me a witch for reading her mind ( still not admitting she'd already rung) or just be abusive and slam the phone down. By 2016 words poured out but we're totally random and had no relevance to questions or situation, and meant nothing, just a string of nouns usually and 'ooooo's' in between.
Shes still like that although as shes asleep 90% of the time obviously only for short outbursts and still totally nonsense.
About 4 years ago when she was at home, still pretty mobile and her partner was caring for her one night she got up looked at him and said 'I'm going to bed now'
That's been the only thing she's said normally in about 8 yrs.