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Old 04-26-2012, 05:00 PM   #1
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Some insight and opinion needed, please

I am looking for some insight and opinion. It concerns my wife, Lucy, who is 52.

Our family has started noticing personality changes beginning 4 or 5 years ago. She has become withdrawn, preferring to stay home rather than out. She used to be extremely extroverted and very much a people person. Within the past 4-5 months, we have noticed increasing short-term memory lapses. She would often ask the same question 5 or 6 times, particularly questions relating to family events, etc.

We have also noted something very odd in the way she interprets things we say to her. For example, one evening I was describing how the coyotes seem to be congregating in the ravine behind our house, and "suddenly the ravine seem to lit up with their collective baying, waking me up". To which she thought for a moment and asked, "it is because their eyes lit up when you shined the flashlight at them?" This and other instances seem to say that she is taking my words literally, when it was usually clear that I used them in a figurative sense. In another instance, I was describing to her my recent business trip. It wasn't that complicated: I dined with two different persons on two different nights - Jane Doe on Night One at a seafood place, and Joe Blow on Night Two in an Italian place. Half an hour of explaining later, she was still confused. Whereupon I gave up. It wasn't that important anyways.

Should there be a need for concern over something like this? As I mentioned, there seems to be a noticeable difference in these "communication breakdowns" in the last few months.

 
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Old 04-26-2012, 07:22 PM   #2
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Re: Some insight and opinion needed, please

Luau... if it was my spouse I would take her to the doctor for a complete physical exam, blood work, MRI, and MMSE (Mini Mental Status Exam). There are conditions that are treatable that affect cognition but there is also EOAD (Early Onset Alzheimer's Disease). If the MMSE score is not 29 or 30 then ask for a follow up with a neurologist. It may take a while to get a proper diagnosis but it will be worth it to know for sure what is going on. There does seem to be a cognition problem but the only way to find out what is going on is from her doctors

Love, deb

 
Old 04-26-2012, 07:58 PM   #3
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Re: Some insight and opinion needed, please

ditto and i hope you find some kind of answer

 
Old 04-27-2012, 07:47 AM   #4
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Re: Some insight and opinion needed, please

I definitely agree with the above.

I hope she goes along with it, but you have to get a full evaluation.


Quote:
Originally Posted by Gabriel View Post
Luau... if it was my spouse I would take her to the doctor for a complete physical exam, blood work, MRI, and MMSE (Mini Mental Status Exam). There are conditions that are treatable that affect cognition but there is also EOAD (Early Onset Alzheimer's Disease). If the MMSE score is not 29 or 30 then ask for a follow up with a neurologist. It may take a while to get a proper diagnosis but it will be worth it to know for sure what is going on. There does seem to be a cognition problem but the only way to find out what is going on is from her doctors

Love, deb

 
Old 04-27-2012, 09:08 AM   #5
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Re: Some insight and opinion needed, please

Is she menopausal? That also could be the problem - particularly considering her age....or at least part of it.

 
Old 04-27-2012, 12:15 PM   #6
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Re: Some insight and opinion needed, please

Quote:
Originally Posted by Titchou View Post
Is she menopausal? That also could be the problem - particularly considering her age....or at least part of it.
No. She is 8 years beyond menopausal. Might there be a latent effect?

 
Old 04-27-2012, 03:12 PM   #7
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Re: Some insight and opinion needed, please

i have not heard about that one

 
Old 04-27-2012, 03:46 PM   #8
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Re: Some insight and opinion needed, please

Quote:
Originally Posted by Luau View Post
No. She is 8 years beyond menopausal. Might there be a latent effect?
I am not sure menopause has to do with it. The repetition of questions and loss of info. about the dinners are surely signs of dementia.
However, either way you need to have her doctor checks on her. Get a neurologist or psychiatrist to test her memory problems. Verbal test or MMSE or pet scan/ct scan/MRI and etc. She needs to be diangosed first.

Sorry your wife has memroy issues.

Regards,
Nina

 
Old 04-27-2012, 06:10 PM   #9
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Re: Some insight and opinion needed, please

Quote:
Originally Posted by Luau View Post
No. She is 8 years beyond menopausal. Might there be a latent effect?
Not that far out unless she was on HRT and recently went off it. The not going out is a huge symptom of menopause. That's why I asked. Either way, a physical is in order.

 
Old 04-28-2012, 06:19 AM   #10
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Re: Some insight and opinion needed, please

Thank you, everyone! I fully agree that it is important to get Lucy thoroughly checked out. She has had physicals and thorough blood tests to rule out metabolic causes, such as electrolyte imbalance, hormone issues e.g. thyroid, pituitary, & adrenal, the usual liver/renal functions, etc. She balked at the next step, which is MRI. In fact, the appointment was scheduled twice, and twice she canceled the last minute.

There was a very disturbing episode a week ago. I was telling her about another upcoming business trip. That was Tuesday evening. I remember sitting together after dinner relaxing in the living room. We talked at length the trip logistics, e.g. departure/arrival times, where, when, why, etc. It seemed a very nice little husband-wife chat. Next day, wednesday late morning, she emailed and then we chatted briefly by phone. She was looking for clarification on our checking account status. In closing, she asked me to give her the precise trip itinerary. I replied that the information should be in our shared Google Calendar, and that I had to run off to a noon meeting. All seemed very normal, up to that point.

Next, all hell broke loose. Here is what happened next. A few minutes later, maybe just a little after 12pm, my phone buzzed while I was getting ready to start the meeting. It was Lucy. I texted her saying that I couldn't answer phone because I am in meeting. For the next 45 minutes, there were 2 or 3 more calls from her, leading up to 1 very angry voicemail, which was followed up by a long, angry email. The gist was that she was very angry that the itinerary information was NOT in the Google Calendar, and she went on to accuse me of not wanting her to know the details of my trip. And "if I am such a ***** about it, she will pack her bags and take a trip on her own during that time to visit [one of her sons]." After the meeting, around 1pm, I tried calling her at home. She hung up on me several times, and then she just didn't pick up. I sent her an email, explaining (and) apologizing that I had neglected to switch the itinerary information from my work-related calendar to a Google Calendar that was visible to her. She called up a few minutes later, still extremely agitated. I finally calmed her down by 1) reminding her that the whole trip was arranged only yesterday; 2) that we had discussed this at length after dinner; 3) that I keep many appointments on a different calendar was because she repeated complained that I clutter our shared calendar with too much stuff, which impeded her from seeing anything useful. Again I had to apologize that it was my mistake for telling her the itinerary info was moved to the shared calendar when it wasn't. And again I stress that the whole thing was only planned in the last 24 hours, while the actual trip was a month away. The phone conversation ended with her being a little less angry, but still plenty agitated. I thought I just go and consolidate what progress I've made and not push my luck further.

Here's another weirdness. When I got home that evening, she greeted me as if there was nothing, absolutely nothing amiss. It was like the whole episode was fiction, except that I have the emails, voicemails, and phone log to show that it did happen. After dinner, I broached the topic again. She was casual and understanding, saying that all is well and that she should have expected that it might take a little while before I get the information on the calendar. That was where and how the whole thing ended. I ain't going back there again!

 
Old 04-28-2012, 08:15 AM   #11
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Re: Some insight and opinion needed, please

Luau, yep you need that MRI. Did her doctor do any type of memory assessment? How did she do on those? If not please request a referal to a neurologist who specializes in cognition.

What you describe is typical of someone with cognitive losses. They actually do not remember things that happened. It's not like you and I forget. With prompting we can grasp parts and pieces of that buried memory. With them there is no memory to grasp. It is gone... never to be retrieved. Anger is typical. Because they have absolutely no memory of what we are telling them then we are witholding information, being deceptive, tricking them, or otherwise acting in a way that is unacceptable. They KNOW they haven't heard that information because it is not in their brain and if we say they have.... we get anger. On top of that, the areas of the brain that control social behavior and self control are some of the first to be affected. So when these incidence arise, they do not have the social rules and self control to deal with the situation appropriately. They have trouble expressing themselves so you get anger and agression. All the explinations in the world will not being back that memory that did not file in her brain. So not going back there is a great idea It's like traversing a mind field. You never know what has disappeared from their reality.

It defintely sounds to me as if there is a cognition problem.... and that has to be checked out completely. Medical appointments can be scary and confusing. Not to mention that she may not think she needs it and knows nothing is wrong. Therefore you need to take the lead and not let her continue to cancel the appointments. My heart goes out to you both and I truly hope it is something fixable... but you do need to know for sure what is going on!

Love, deb

 
Old 04-28-2012, 09:58 AM   #12
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Re: Some insight and opinion needed, please

Luau,
The way Lucy exploded is just normal for people with dementia.
My FIL has severe Alzheimer's. Back in 2007-2010, he always forgot what we told him. One minute he said he wanted to go home to the sofa in his own house, the next minute after he sat down in his couch, he was content and it was like nothing happened! At first I thought he was satisfied but I then realized he forgot about it, that is all.
Sometimes he knows but sometimes he doesn't.

What happened to Lucy is just normal. She would accuse you for all kind of stuff and then later at the end of the day, she would forget that she did that.
Probably at this point she remembered somehow. It is like on and off. When she forgot, she got upset. When she was calm, she forgot about the fuzz she made. No way you can remind her that she did all that!
You are a fine husband and you did everything you can to stop her agony.
You are so patient!
I can understand that you don't want to go back to the fuzz. We don't either. When my FIL claimed that people wanted to kill him in the hospital, he was very mean and said he forgave us! Well, later on, he thought he should die and etc. Now he no longer talks about that.
They do change quickly. Yet sometimes they remember something important for 3 days like the stuff about the money. e.g., my FIL remembered longer when we took away his checkbooks! It depends on what he thinks is important. Later on as he got sicker, he does not remember what he said 10 minutes ago!

Hang in there. I am sorry to say that it would happen again. Maybe you should simplify things for her so it is easier for her to trace. e.g., instead of google calendar and etc., just write a simple schedule on the regular calendar on the wall or the desk.

Take care,
Nina

Last edited by ninamarc; 04-28-2012 at 10:00 AM.

 
Old 04-28-2012, 01:58 PM   #13
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Re: Some insight and opinion needed, please

Thank you for your responses, Ninamarc and Gabriel. I was beginning to think that I was going nuts. Living with Lucy, sometimes I feel like I stepped into The Twilight Zone ... music and all. Then just as abruptly, I emerged again.

Here is something I really need your advice, on the assumption that Lucy has some element of dementia (Yes, I know... she hasn't been formally diagnosed). This has been troubling me greatly in the past half year, and I am really at a loss at how to behave. On several occasions the past half year, Lucy has suddenly accused me of sexually or physically abusing her. When I asked her when these incidents happened, she was not specific, but referred to accompanying events 5 or even 10 years ago. 99.9% of the time, she has been just fine with me. It was just those 3 outbursts in the last half year, which were usually precipitated by something else equally as puzzling to me as the incident about my trip itinerary. Just to be perfectly clear here, I did NOT abuse her. Never. I know that the usual way is to go along with their delusions, but this is something I am having great difficulties. Your advice and insight, and how I can handle this are really, really appreciated. I am not handling this very well in this regard. For most of her
other antics, I can brush off. However, this is one thing that is getting to me personally and causing me great anguish and resentment. In truth, I am not sure I can take much more of this.

 
Old 04-28-2012, 03:15 PM   #14
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Re: Some insight and opinion needed, please

You have to understand that if she in deed does have dementia... and it is sounding more and more like there is cognitive impairment, then there are going to be accusations that make no sense to you. It is a trick of the delusional mind that comes up with these things that are untrue. Short circuits and miss fires create a reality in hr mind that has no similarity to what is real. Sometimes there will be things that strike a tender nerve in your being. We just have to become very thick skinned, brush it off, and remember it is the delusions of a demented brain speaking to you. As we have said... there is no way to convince her that she is wrong. No matter what my parents said to me I always gave them back the following.... "I know this scares you and I am so sorry you feel that way. I promise you that I will do all that I can to make it better in the future." This is not an admission of anything but rather acknowledging that they are fearful and upset with a promise to help them. Validation and hope... that is what most of us want in life and what dementia patients need. This is one reason we do not argue with them or tell them how wrong they are. If you remember that as bad as these statement hurts you... can you even imagine what emotional turmoil this disease is causing for her. That is what gets me through those really bad verbal outburst. Also remember that once the outburst is over it is forgotten by her. It is you that is left with the baggage of remembering. So try to stay in the moment and not hold on to the past. It's not easy by any means but it does get a little easier with time, practice, knowledge, and experience. Hang in there... and keep typing.

Love, deb

 
Old 04-29-2012, 08:10 AM   #15
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Re: Some insight and opinion needed, please

Luau,

I am sorry Lucy thought of abuse in her delusion.
Indeed the people with dementia do have imaginary strange thoughts regardless of the reality.
For example, my FIL has always thought his younger son can help his own career and extend his work. Well, my FIL worked all his life and has emeritus professor title but he can no longer work since 10 years ago. But over these years, he kept telling my husband to offer work and discuss his work... All in his field. My husband is a professor as well but his work cannot offer his Dad anything at all. Not even the same field! My FIL's own colleagues all left but he continues to think he works even in the nursing home! I tried to explain to him but never worked and he hated me for that. He thought I blocked his career!!! His career is long over.
The only gain is my FIL can listen to my husband in terms of caregiving (my FIL never admits we only caregive him!) He moved to the NH near us in 2010.
He is in severe stage and may not survive for another year.

I am afraid Lucy may continue to remember this "fake abuse" for a long while. Of course, I hope there are other things that can distract her and she will forget about it later. It depends on how important it is to her. My FIL forgot that the hospital "tried to kill him" but he never forgot that my husband should work with him. He still said "You...and ... I ... together." 2 weeks ago. This meant he wants to work!!! (He cannot walk/talki/eat on his own!)

Try your best to distract her. Explain the fake abuse would not work. She needs to forget it herself when it is her time to forget.

Please don't take it personally. I took it personally about my FIL's obsession of work with my husband but in the end, it does not matter anymore. (I suspect he had mental issue long before Alzheimer's.) My FIL in fact thinks I tried to stop his career!

Really, you need to have a thick face. However, it is hard because friends may believe her!! Neighbors may believe her! She would look like she is normal and genuine. Make sure you explain to the people close to you in case there is misunderstanding for the normal people to take it for real.
It may help if you ask your relative to prove it but she may not believe it. Don't be too upset by that. It is the disease.

I do feel for you. I know what it is like.

Regards,
Nina

Last edited by ninamarc; 04-29-2012 at 08:33 AM.

 
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