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Old 06-18-2012, 04:54 PM   #1
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Mom's face doesn't show much emotion.

She lost her smile and as far as she goes is a small smirk. She will sometimes crack a joke but her face remains pretty much stationary. That goes for emotion as well.
I made a trip to visit her this past week. We went walking in the hall, when we returned, there was a man sleeping in mom's bed. Before she would have freaked, but all she did was turn her walker around and there was little to no reaction.
Is the loss of expression and emotion due to dementia or could she be depressed?

 
Old 06-18-2012, 05:28 PM   #2
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Re: Mom's face doesn't show much emotion.

It is probably the dementia... sorry to say. The lack of response to the person is her bed is not atypical. Your Mom walked out... My Mom just went to bed anyway! They stop perceiving situations like we do. She saw somebody in some bed. It was not a strange man in her bed. So she just walked away. We see a stranger in her bed which is upsetting. But if she wanted ice cream and somebody took it away from her you might get more reaction.

Mom has pretty much lost most of her expression. She will crack a smile at one of the cute younger guys that works at the facility or visits. She might show displeasure if the desert on the table is not for her. But for the most part she just is.

Glad you got to visit with your Mom and hope there were some good memories to take back home with you

Love, deb

 
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Old 06-18-2012, 07:10 PM   #3
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Re: Mom's face doesn't show much emotion.

Thanks Deb.

I didn't feel the trip went well and mom was more despondent than usual. When mom is stressed about something she complains about bladder burning and falling. We have to watch because she's had UTI's in the past so usually if it continues, they do take a test to make sure she doesn't have an infection present. Also she had both arms bandaged up with tensors but as far as anyone knows she didn't fall.
With the bladder burning I feel it could be dehydration. She doesn't drink anything but a little coffee and no one can make her, even if you set it down before her, if she doesn't want it, she won't drink it. She refers to the pain mostly when there is talk about getting her out for some fresh air or taking her out. When her adult children come to visit from afar, we like to try and get mom out a bit. All the sudden she can't go because of this pain and that pain. I did get her out but she didn't like it and was complaining about the pain and wanted to go back to the NH, so a few minutes later we put her back in the car, and the complaining stopped all together. I think she was relieved when I was leaving, lol.

 
Old 06-18-2012, 07:44 PM   #4
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Re: Mom's face doesn't show much emotion.

Dorri, please don't take it personally. That is just the way it is. We like to go out. We like new and different places and things. Those with dementia like familiarity and routine. I am not surprised that she doesn't want to go out. It's a big scary world out there which she is not unfamiliar with. She doesn't have the ability to explain her fears so she complain about the pain. Many times emotional pain is expressed in physical pain.... or tears. Mom would burst out in tears when we took her out. So next time instead of taking her out into your world try joining her in her world.

My Mom goes out but only on the facility bus.... and they usually don't get out. A quick stop for ice cream is a treat while they sit snugly among the other residents and staff they know so well. The last time I took Mom out myself was over a year ago to go to the doctor. She squeezed her eyes shut the entire trip and acted scared and lost. Then the tears came. That is when I called Hospice and their in house doctor. Mom uses tears because she can not say the words.

So listen to what she is telling you.

Love, deb

 
Old 06-18-2012, 08:35 PM   #5
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Re: Mom's face doesn't show much emotion.

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Originally Posted by Gabriel View Post
Dorri, please don't take it personally. That is just the way it is. We like to go out. We like new and different places and things. Those with dementia like familiarity and routine. I am not surprised that she doesn't want to go out. It's a big scary world out there which she is not unfamiliar with. She doesn't have the ability to explain her fears so she complain about the pain. Many times emotional pain is expressed in physical pain.... or tears. Mom would burst out in tears when we took her out. So next time instead of taking her out into your world try joining her in her world.

My Mom goes out but only on the facility bus.... and they usually don't get out. A quick stop for ice cream is a treat while they sit snugly among the other residents and staff they know so well. The last time I took Mom out myself was over a year ago to go to the doctor. She squeezed her eyes shut the entire trip and acted scared and lost. Then the tears came. That is when I called Hospice and their in house doctor. Mom uses tears because she can not say the words.

So listen to what she is telling you.

Love, deb
Thanks Deb, you are right, I need to listen and observe more.

 
Old 06-19-2012, 06:17 AM   #6
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Re: Mom's face doesn't show much emotion.

I think I will have to agree with Deb on this one (as usual). As things progress there is a great impassivity you will notice. My aunt is not there yet but is a lot more passive than she used to be. Gradually this awful diseases snatches away so much. This is tough because in addition to feeling like we lost our loved one even more, it is so hard to figure out what they might be experiencing (are they anxious, in pain, depressed, scared? How can we know if they aren't expressive.)

I think once a person loses a certain ability to express we can still learn to perceive a little of what they are feeling, especially fear of pain. Sometimes I notice the aides and nurses at my aunt's NH react to the slightest signals - a clenched fist, for example, a squint or a tight facial expression. They know maybe that is all that person can express but they check to see if something is wrong.

I think if you have concerns you should talk to the staff to see what they have observed in her recently.

If it does turn out to just be progression, I suggest learning about that new phase if you are not already familiar with it, and give yourself a chance to feel sad or bad about it. It is a downer when someone we love seems to be progressing.

Quote:
Originally Posted by dorri View Post
She lost her smile and as far as she goes is a small smirk. She will sometimes crack a joke but her face remains pretty much stationary. That goes for emotion as well.
I made a trip to visit her this past week. We went walking in the hall, when we returned, there was a man sleeping in mom's bed. Before she would have freaked, but all she did was turn her walker around and there was little to no reaction.
Is the loss of expression and emotion due to dementia or could she be depressed?

 
Old 06-19-2012, 06:27 AM   #7
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Re: Mom's face doesn't show much emotion.

Dorri, please do not take these things personally at all.

If she complains of pain when it is time to leave, that could be her way of saying that she does not want to go out.

Also try not to be upset if you mom sometimes seems relieved when you leave. Those with dementia rely heavily upon routine, to an extent that we with full control of our minds and senses find hard to comprehend. The director told me that during the spring and fall there are some residents they try to keep from facing the windows because they get upset at the changing of the leaves. They look out and see something different and it proves upsetting to them. She said that is why in one section of their outside deck they use only evergreens!

Sometimes, a visit disrupts their daily routine. My aunt is still at the point of having some more lucid times during which she loves for to visit, but when she is having a bad period, the truth is that sometimes she cannot wait for me to go. Sometimes I find her in the group room just sitting staring into space, but after a few minute she tells me I have to leave because she has appointments and goes back to sitting there just staring into space, which makes her feel happier and more secure. In addition, whenever there is a new resident, my aunt goes into a kerfuffle; she gets very scared, is convinced that each new resident is a criminal, from prison, or from a mental institution; I think this is her way of expressing that she is afraid.

Anyway, neither not wanting to go out or wanting nor being relieved when you leave is something you should feel in any way responsible for. It is just part of this.


Quote:
Originally Posted by dorri View Post
Thanks Deb.

I didn't feel the trip went well and mom was more despondent than usual. When mom is stressed about something she complains about bladder burning and falling. We have to watch because she's had UTI's in the past so usually if it continues, they do take a test to make sure she doesn't have an infection present. Also she had both arms bandaged up with tensors but as far as anyone knows she didn't fall.
With the bladder burning I feel it could be dehydration. She doesn't drink anything but a little coffee and no one can make her, even if you set it down before her, if she doesn't want it, she won't drink it. She refers to the pain mostly when there is talk about getting her out for some fresh air or taking her out. When her adult children come to visit from afar, we like to try and get mom out a bit. All the sudden she can't go because of this pain and that pain. I did get her out but she didn't like it and was complaining about the pain and wanted to go back to the NH, so a few minutes later we put her back in the car, and the complaining stopped all together. I think she was relieved when I was leaving, lol.

 
Old 06-19-2012, 06:53 AM   #8
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Re: Mom's face doesn't show much emotion.

My FIL can still smile although he is in severe stage. He basically stopped talking a lot last Sept. Then he only speaks a few words. When he saw me Sunday, he was able to ask about me because he likes women. He does not talk much to my husband. Overall, he can still express something. If he is mad, he is loud in one word! Like yelling! When he closes his eyes, you cannot tell what he wants but I do know he wants to escape so he closed his eyes in the activity room...
Sunday when we saw my FIL, he still was quite expressive but only facial and by gesture... It is hard to know what he wants so we tested by asking some questions: stay here? go out there? He even lifted up his right hand telling us he wanted to go to the yard at the front! It depends on his mood. Sometimes he is alert and sometimes he is just tuning out.

I am sure your Mom can still show some expression like closing her eyes or talking one word too loudly and etc. I don't know what it would be like if my FIL stops smiling. But I guess you need to search all the clues among her behaviors or actions to try to guess what she wants. I am sorry now you have a hard time to read her expression.

Take care,
Nina

Last edited by ninamarc; 06-19-2012 at 06:54 AM.

 
Old 06-19-2012, 07:11 AM   #9
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Re: Mom's face doesn't show much emotion.

Actually it is kind of difficult to read my FIL's face now. He is like a baby or toddler now - his face is either glad or numb. He can change his mood so fast like a baby. Not even sure he knows who we are - he just likes us as his "family" who visit.
At one minute, he wanted my husband's hat and wanted to exchange it with the other hat from the NH. Later on, he insisted to have more cookies (after 3 big ones.) He can still use his hands to show what he wants.
Does your Mom try to tell you what she wants by doing some gesture or short talk?

I think one reason they don't express is that they are tired. They don't realize they need to express or smile and etc. as the brain is not telling them to do so anymore.
Indeed it is hard to read: sometimes my FIL is either mean or suprised/happy. The mood changes so quickly. He dose not know how to appreciate my husband but he wants him.
The first time I saw my FIL stopped talking and just sat there, I felt maybe he really had nothing to say! He just waited for the caregiver to wash him and put him to bed.

Like a baby, he would not know he needs to express like an adult. So it is not personal.
My FIL can still go out to the front yard but now he does not go outside for shows or parks anymore. He is used to where he is. He is also self-centered.
Don't take it personally - Mom is in her own world. Just try to see what she wants from her world.

Hugs,
Nina

 
Old 06-19-2012, 08:34 AM   #10
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Re: Mom's face doesn't show much emotion.

Thank you so much Deb, Suzy and Nina. It's hard, because there are many miles between us so I am not there everyday to observe her. The next time I go I will try to be more alert to mom's facial expression or gestures and more in tune with her needs. Thankfully mom is still able to walk and talk and tell us what she wants to a certain degree. Although she talks, she no longer can get into a conversation. she no longer has the connection with her family. She never asks about my husband or the kids/grandkids anymore? She knows I'm sick, my daughter had surgery, but she no longer asks how we are doing, those kind of things. I made her up a photo album of the children, she enjoyed it but kept asking repeatedly who the children were. In these ways we have lost her. A good way to explain it is more than half of mom is no longer there. She's with us but part of her is gone. I did notice that she isn't trying anymore, if there is even a simple thing to do, she'll say "you do it"

This time I noticed that even with her hearing aids on she was like 90% without hearing. I would have to go right up to her ear to ask her or tell her something. I'm hoping that it's the hearing Aids so it can be fixed. I suffer premature hearing loss, so know how it affects a person and isolates them and I know even with mom, when her hearing Aids are working she is so much more with it and intune with things around her. Just say that it helps.

Last edited by dorri; 06-19-2012 at 08:39 AM.

 
Old 06-19-2012, 08:35 AM   #11
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Re: Mom's face doesn't show much emotion.

Quote:
Originally Posted by dorri View Post
She lost her smile and as far as she goes is a small smirk. She will sometimes crack a joke but her face remains pretty much stationary. That goes for emotion as well.
I made a trip to visit her this past week. We went walking in the hall, when we returned, there was a man sleeping in mom's bed. Before she would have freaked, but all she did was turn her walker around and there was little to no reaction.
Is the loss of expression and emotion due to dementia or could she be depressed?
I think we all assume your Mom is in late/severe stage. The person with dementia will stop walking/talking/eating in severe stage and she would lose the facial expressions and smiles. If she is in severe stage of dementia, then this is just the way her brain is. It fails to tell the face to show anything.

About depression, my FIL has been depressed since early/moderate stages of Alzheimer's. Now he still takes antidepressant, but this is not about severe stage. The facial expressions have to do with the way the brain works.

Hugs,
Nina

Last edited by ninamarc; 06-19-2012 at 08:37 AM.

 
Old 06-19-2012, 02:34 PM   #12
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Re: Mom's face doesn't show much emotion.

Hmmm...where do lost posts go, oh well, this is the dementia board so here goes again.
Thank you all for the replies.
Mom is still not in the severe stage, she talks and walks, her eating well, she says she doesn't eat but she didn't look that bad when I was there and I seen her eat pretty good. It's her short term memory that is gone.

What comes first the chicken or the egg, so is it with the brain and dementia/Alzheimer's. Is it that these conditions affect the brain and memory or is it some fault in the brain that causes these conditions in which case it makes perfect sense that it would have affect on expression and emotion.

Nina, sorry I haven't much time to read on past posts, is your FIL in a NH or is he still mild enough to be treated at home? We tried that route at first to keep mom home but found she needed 24 hour care.

Hugs
Thanks

 
Old 06-19-2012, 02:41 PM   #13
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Re: Mom's face doesn't show much emotion.

Yes Dorri, this is typical progression of the disease. As the plaques and tangles invade different part of the brain our loved ones will lose their ability to empathize and connect with others. They will forget the younger generations first. Mom loves the great grands but has no clue they are her great grands. They are just children and she loves for them to be around. Most days she doesn't know the grand children and many days she does not know me and I am there at least 4 times a week. She does talk about me as if I was a young child. A few years ago she would get angry at me because she thought I was not doing as I should... as a teenager. I guess I could say she knows me but not as the person I am today. Along with this they become very "ME" oriented. It is all about what they need and want in the moment. Conversation is difficult to follow especially if more than one person is talking. If there is auditory processing decline she will not hear words... or may only pick up a few words. This leads to misunderstanding and confusion. It is easier just to say... "You do it!" It is not that she doesn't want to... it is that she truly can not comprehend and process.

Yes, hearing loss can cause a problem with understanding verbal instructions and communication. It is simple enough to check a hearing aid. Just stick it in your ear and see if it amplifies. If it is working and she is still not understanding then there could be damage to her auditory processing. Mom doesn't hear well and does have a working hearing aid. Even with the hearing aid she does not comprehend what is said to her. She doesn't like to wear it so I do not push her to wear it. I know her auditory processing is damaged. When you talk to Mom what she hears is similar to a foreign language that you have no understanding of. She gives you a blank stare or just says OK because she has not a clue what you said. It is not her hearing but her brain that is not working right.

Yes, this disease does take our loved ones a little bit at a time. But even when she is not sure who you are, you know who she is I do hope your next visit goes well. It is difficult not to see Mom for a while and then realize just how far she has declined since the last visit. I hope your next visit is soon

Love, deb

 
Old 06-19-2012, 07:14 PM   #14
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Re: Mom's face doesn't show much emotion.

Thank you Deb, I hope so too. I'm praying for that.
I did check to see if the batteries were working and they were. Later my sister was saying that her HA's have a small button on them that can be turned up and down. Maybe she was fiddling and turned them off, but could she have been with it enough to turn both of them off. Hope it's as simple as that, but something tells me that's wishful thinking.

Deb, even though your mom lost a lot of communication and recognition abilities, does she still have moments, hours or weeks where she is better. Have you ever thought that your mom was getting better? The question applies to the others as well. My mom went through so much, and just when we figured she was getting worse, she would come back and be better for a while until the next time she would slide downhill again. Even my sister would comment at times that we almost got the old mom back. What I'm noticing in her is those better spells are getting less and less, and they are getting to be very short lived when she does get them. It's been a long while since she has had a good spell. It meant a lot when she was using her phone for communication since we are in different provinces, now she won't pick up her phone at all, she won't respond to messages, and while she does have the phone numbers written down where she can see them, she doesn't connect with them. That source of communication has been cut.
I question how they can have better spells if that part of their brain is damaged where it can no longer recollect what she just did? So many questions? I also notice that she doesn't bring up stuff from the past like she use to a short year ago. She was diagnosed with dementia with a component of Alzheimer's so maybe both short term and some long term memory is going as well.
I HATE DEMENTIA/ALZHEIMER'S! I will be sure to write when she does have a good spell.

 
Old 06-19-2012, 08:11 PM   #15
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Re: Mom's face doesn't show much emotion.

Dorri... yes yes yes and yes

In the early/mid stages of this disease Mom did just that. Mom would have good days for a while and then it would all seem to go downhill then back to the good days for a while before another downhill. If you chart them the down hills will come more often and the good days will not be quite as good as the last. It's more like a roller coaster ride instead of a straight line down. That is one of the reasons, especially in the early stages, we miss the symptoms. Mom got lost at the beach and there was nothing else we could point to until months later when she got lost coming home from the cabin. Two bad days in months. How do you connect those? As it progressed she would have a bad day maybe once every week or 10 days.... or a few bad days and life was good for a couple of weeks. It makes you doubt what you believe. You see the bad days and know but the good days make you question.

How does it happen... because the brain is not linear. If Mom needs to remember how to get home the brain may try to figure it out one way today and miss it totally. The next time the brain does it another way and it works well. That is one reason they say learning something new will help delay dementia. Learning creates those new pathways that the brain needs when one is shut down by plaques or tangles. It's like driving to another town. You can go the usual way or you can find several other ways to go. If there is a traffic accident on your usual way you can take another road to get to the same place. Eventually all the roads/brain pathways are blocked and they completely lose that ability. The brain is amazing at adaptation and that is why you see the roller coaster of ups and downs in this disease.

Memory is affected in stages. Current memory goes first because the ability to develop those new memories is one of the first abilities that goes. At first it is creating some new memories but misses other. Eventually it misses them all. Then the part of the brain that retrieves memories is affected. The memories are probably still there but the ability to retrieve is lost. From time to time the might grab a memory... but to becomes less and less. They can also confuse memories on the time line. They may have their parents as middle age with great grand children

Hope that helps

Love, deb

 
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