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Sudden splurge of Compis Mentis

Discussion in 'I care for a person with dementia' started by Glokta, Sep 21, 2019.

  1. Glokta

    Glokta Registered User

    Jul 22, 2019
    61
    After presenting as confused, aggressive, resentful, and angry for the last 8 months or so, my mum has suddenly become almost compis-mentis again. Took her to see a physio last week and she held a coherent and relevant conversation, full of confabulation but very believable. Since then has been constantly harping on having her knee replaced, which there is no doubt she needs. I have been told by her GP she will not be offered one as she is unable to comply with physio and refuses drug treatment, (although in her head she is complying). She is also really angry with me because I have taken control of her finances (her spending on inappropriate and expensive items over the phone had endangered her meeting her monthly financial commitments). She’s so lucid at the moment I’m finding it difficult to justify my action. I’m the only one with such responsibility, because only me and my brother are involved in her care (she is not well liked) and I have POA. I feel exhausted and resentful about this situation, especially as I have discovered me and my siblings are being excluded from family events (a wedding and the death of an uncle in hospital - we were only told after he had died) because the family do not want her to attend, and we have been “tarred with the same brush”.
     
  2. Moggymad

    Moggymad Registered User

    May 12, 2017
    383
    Female
    Similar exclusion (adult daughter & son not liked by other family members)has happened to a friend of mine & as their mum she has felt a bit ostracised from family events & is very hurt by it. The daughter & son are not the least bit bothered by being excluded. Funnily enough I found once my mum was unable to come with us to birthday meals etc our nieces stopped inviting us as well. We were the ones who used to take her. I found that hurtful but it has become unimportant to me now. Perhaps you can question why you are not included, to get it off your chest at least, & see if there is a way forward that doesn't have to include your mum. Would she mind not being included? Family dynamics have always baffled me more so since dementia has been part of it. I hope you can resolve issues amicably.
    I haven't experienced the lucidity your mum is currently showing so I hope others who have will be able to comment further on that.
     
  3. canary

    canary Registered User

    Feb 25, 2014
    10,576
    Female
    South coast
    Im sorry for your confusion @Glokta
    Its actually quite common for people with dementia go go through a phase where they seem almost back to normal.

    The brain is like a huge road network where you get for A to B along neurones that are rathe like roads through the brain. With dementia it is like the roads are being constantly bombed and become impassable, but there is usually a detour and you can get round it quite easily. As more and more roads become impassible it becomes harder to find a detour and it takes a long time (the equivalent of getting from London to Bristol via Glasgow!), but if you find one then suddenly you can get to B again.

    Unfortunately, dementia is progressive and the roads are still being bombed, so after a while that route will become impassible too and eventually there will be no routes possible.

    These times of lucidity are both a blessing and a curse. A blessing, because we see the person who they once were and it is a time to treasure. A curse, because it wont last, but in the meantime we end up doubting ourselves, doubting all the decisions we have made and sometimes doubting the diagnosis.
     
  4. Glokta

    Glokta Registered User

    Jul 22, 2019
    61
    She feels that I’m punishing her by denying her the pleasure of buying things from magazines. The things she buys are inappropriate because if they are clothes they rarely fit (my mum is 4’11”, with an inside leg of 24”), or she buys gifts, which she forgets about, sometimes doesn’t even open, or plants, which are not suitable for her garden (last time she bought 12 streptocarpus in variety, and wanted me to throw them away when she realised they couldn’t live outside, £50 worth). She was spending £200 a month more than her income. I can’t let her do this. Although I don’t like her, she’s my mum and I love her. She presents good reasons for spending her money and she’s always liked to shop, it’s not a change in behaviour. The number of time we had bailiffs round when I was a kid, due to her spendthrifting. I’m sure she does feel punished, but I have to do what will protect her. I hate to see her limping around in pain, unable to take part in her favourite activity, ie, shopping, but I’m unable to get her to see that she needs to pay her rent, just as I cannot change her decisions about taking analgesics. Her recent coherence is baffling to me, her ability to argue and upset me has returned with a vengeance.
     
  5. Lladro

    Lladro Registered User

    May 1, 2019
    57
    Hi Canary, that is a great analogy and I can identify with it greatly. My wife has lots of moments of lucidity and it lulls me into a false sense of security. I have also had people say to me "your wife is very lucid, its hard to believe she has any problem" - If only they knew the truth...
     
  6. Rosserk

    Rosserk Registered User

    Jul 9, 2019
    267

    This keeps happening with my mum particularly between the hours of 8-11 am she appears quite normal. Eventually I think those lucid moments will disappear entirely.
     
  7. AliceA

    AliceA Registered User

    May 27, 2016
    2,426
    Well done, clearly expressed x
     
  8. SewHappy

    SewHappy Registered User

    Feb 3, 2019
    14
    My mum has times of lucidity too. The other day we were chatting in her care home fairly normally about what I had been doing. I took her to her room to try on some new clothes. She couldn't remember the way to her room and needed help undressing. These lucid moments are very random in their effect too.
     
  9. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,672
    Female
    You say she was lucid, but you also say the conversation with the physio was full of confabulation - so she sounded lucid, but actually wasn't.

    I don't think you need to justify taking control of her finances. In the earlier days you may question if you need to - I did too, I really didn't want to do it. But as POA you have to take responsibility for keeping a grip on her finances in the real world (rather than dementia world) so she can, as you say, meet her basic commitments. Whether she likes it is another matter, but you're doing the right thing.

    It's interesting the GP said she can't have a knee replacement because she couldn't follow physio instructions for aftercare. My mother fell and broke her hip last year so she had no option but to have the surgery (she's still mobile but her dementia is quite advanced). The hospital physios were pretty hopeless with her but CH rehabbed her afterwards and she got back to previous levels of mobility.
     
  10. Glokta

    Glokta Registered User

    Jul 22, 2019
    61
    Thanks to all of you for your replies. Sirena, hips and knees are two extremely different procedures, I know, I have had both. With hips rehab is rest, avoid overflexing the joint, gentle mobility. With knees there is intensive physio, which if not followed will lead to a knee that will not bend, so has to be remobilised under general anaesthetic. Surgery on a knee is the most painful of replacement surgeries routinely undertaken, and one of the easiest to fail. With a knee, given analgesics the person can still mobilise, albeit with difficulty, on sticks or crutches. With a broken hip you can’t, it’s too near your core, and the surgery is very successful, can be undertaken under a spinal and fail rates are very low. Nonetheless I think she will have to be referred. I fervently wish she had a hip problem!
     
  11. jugglingmum

    jugglingmum Registered User

    Jan 5, 2014
    5,192
    Female
    Chester
    My MIL (aged 88 at the time) had a knee replacement done without a full anaesthetic, you comment on hip being done under a spinal but a knee can be done that way as well.

    MIL didn't have dementia but wasn't very good at doing physio unsupervised and refused point blank to take any painkillers of any sort (brainwashing against them by FIL when he was alive) so SIL arranged for a private physio to come to the house everyday - MIL was only discharged under SIL's supervision (SIL lives in US so couldn't come over st away). If she can afford it, would this work - whilst not cheap, small fry compared to weekly care home fees.

    4 years on and MIL is still pain free - and mobility is better than pre the op.

    Edit - just read back further and based on comments she is renting and over spending might be she can't afford the private physio, but worth a thought.
     
  12. Dimpsy

    Dimpsy Registered User

    Sep 2, 2019
    220
    Female
    Reading your posts, you're right, it looks as if your mum needs guidance regarding her finances - whether she likes it or not!
    If you have a POA, it is your duty to organise mum's budget to keep her safe, secure and comfortable while she is still living independently in her own home.

    Will there be enough money left over from her outgoings to put into a separate account so that she can continue to treat herself?

    Don't fret that what she buys maybe inappropriate (terms of LPA - we might not necessarily agree with choices made but we must abide by them).If the account is capped, she won't be able to overspend but will still have the pleasure of buying without racking up debts.
    Just an idea.
     
  13. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,672
    Female
    That's really interesting, I had heard knees were more difficult but didn't know the details, thank you - hope I never have to find out for myself! My mother did have a general anaesthetic for her op, she can't follow instructions but the CH took that into account for her rehab, so they supplemented the help from NHS physios. Difficult to know what to do for the best with your mother, I wish you the best of luck.
     
  14. Glokta

    Glokta Registered User

    Jul 22, 2019
    61
    What we’ve tried to do with her money is ensure she has cash in her purse, she likes to have £200(!) but we’ve reduced it to £100, which she seems satisfied with, we take her shopping weekly, so she can buy magazines etc but taking her, for say, clothes is a nightmare because she’ll pick up anything that takes her fancy and then have a tantrum if you advise her not to buy something. If she picks up two of the same thing and you say, you already have that mum, she insists she wants two! Same goes for magazines, plants, ornaments, books etc. She gets lots of those online gift magazines, owl barn, pia, culture vulture, and if she has access to her account she will buy not one thing but lots of things, a jumper in every colour, a pair of earrings in every colour, you can see the pattern. If they don’t fit or she doesn’t like them she hides them. We’ve tried to stop the catalogues and she started buying things from the weekly magazines she gets, then you get a new rush of gift magazines. As for treating herself, we try but with her compulsive spending one thing is not enough. At the shop she routinely will spend £40 a week on magazines and books. The books don’t get read (the magazines sort of do) and she frequently chooses the same ones she bought last week. Going shopping with her now causes me panic attacks, and my brother refuses to take her.
     
  15. Helly68

    Helly68 Registered User

    Mar 12, 2018
    435
    I have had both knees replaced, and can confirm it can be painful but is well worth it in the long run. The physio is intensive to get the range of movement, we had to pay for private physio as the NHS stuffed up my referral.

    My friend is having to have his new knee manipulated in the way you describe above, as he had infections and couldn't mobilise so hasn't yet got the full range of movement, though like me, is relatively young to have this (I am fifty one) so after the manipulation he should be fine.

    There are risks and I can imaging dementia only makes everything harder. Might be worth seeking the opinion of somewhere like the Royal National Orthopaedic Hospital (where I went) they do a lot of specialised cases, though i think they would have the same issues with non-compliance over medication and physio. Dementia is also badly affected by anaesthetic as well....
     
  16. Dimpsy

    Dimpsy Registered User

    Sep 2, 2019
    220
    Female
    Crikey @Glokta, you've got to hand it to your mum, she is one serious shopaholic and what a nightmare for you!

    Yesterday I was reading @Grannie G's forward post from 24th January 2011 'Compassionate communication with the memory impaired' which has such a lovely flow and reminds us of the importance of kindness and dignity (if only!) and may give you some tips on how to approach your mum's frantic behaviour.

    So that you don't get upset, if you can stay shtumm to avoid tantrums in public and give your mum free reign to buy what she wants, can you keep the receipts and return the items for refund later.

    Does anyone know if you can apply reverse psychology to a PWD - along the lines of " I know you have a jumper like this at home mum, of course you should buy another if you want to, in fact, why not buy two just in case". Normal thinking would be should I / shouldn't I, but is this a case of a dementia brain not being able to make a rational decision - sorry if that sounds a bit waffley, need coffee!

    If you tend to shop in the same places, could you have a quiet word in advance with the staff? These days many shops (attractions, cafes etc) include dementia awareness training, here is the perfect opportunity for them to practise what they have learnt.

    If the pleasure for your mum comes in the 'getting' more than the 'having', if you smuggled out her collection of magazines and then presented them to her the next week as new, especially as you say she tends to buy the same sort, would she twig they had been recycled?

    I don't know what the answer is with the catalogues that come in the post, when my (housebound ) dad was alive, he was swamped with those and he spent a fortune on 'tat'. I hope other people can offer advice on that subject

    Just to add, and tying in with another thread regarding drawers full of knickers, the same was true for my parents, sorting out when mum moved in with us, we gave black bin bags full of packets of knickers and socks to charity. The well known company (vultures) who sell to the elderly seem to have had my dad's bank account details and once a month a repeat order of underwear would arrive. I wish I had known then what I know now, they fleeced him for hundreds.
     
  17. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,672
    Female
    If you have LPA, you can redirect all her post to your address (I'm assuming you don't live with her). Then you can edit it and give her only the things you want her to have. It also means you can intercept any 'threat letters' for unpaid bills. I did a redirect, but wish I'd done it earlier. However a letter gets sent to her own address informing her of the redirect, which you'd need to intercept.

    Another member had a similar problem with his shopaholic PWD, his wife I think. She used to regularly go to homeware stores like Dunelm and buy huge quantities of stuff (stuff which she already had). He would keep the receipt and next day he would return it all. Would that be a possibility, or do you not have easy access to her purchases? If you can do it covertly it's unlikely she'd notice things were gone, as clearly she doesn't know what she's got.

    If you can't do either of these things, there isn't much else you can do than let the shopping happen.
     
  18. Glokta

    Glokta Registered User

    Jul 22, 2019
    61
    I do return things sometimes but recycling the magazines would not work, as she folds them, drops them tears them, writes on or in them ... and then the dog wees on them. Lol.
     
  19. Glokta

    Glokta Registered User

    Jul 22, 2019
    61
    When I went today Mum was really down, head in hands. She said she’d been looking for a photograph of my Dad when he was on National Service, where he was sat on a cannon in Malta. It’s a photo I’ve heard of but never seen, but she was insistent that she had it two weeks ago and thinks she might have left it at a neighbours. I spent two hours trying to distract and jolly her along, we looked at other photos, it seemed to work until I left when after a long hug she said “if this carries on love, I won’t be able to remember your dad at all”. It so pulled my heart strings. I just sat one cried when I got home. No one deserves this awful disease.
     

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