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Alzheimer's Disease often compromises ones independence even at its early stages. Initial symptoms such as short term memory loss or disorientation often concern family members and friends enough to precipitate their involvement. This begins the transition of 'independence' into 'interdependence' and is the most difficult phase as caregivers are challenged to balance their loved ones 'autonomy' with their need for 'protection'. At this time there may be a tendency to 'over protect' with families assuming responsibilities that the individual may be able to still manage independently. This can result in a 'learned helplessness' and lower ones sense of self esteem and control. It is recommended that a differential assessment always be made: that is, evaluate what your loved one can maintain control over and then assist with what he/she cannot manage effectively. This phase of 'interdependence' will gradually change as the disease progresses but the individual's strengths will be nurtured and his/her dignity retained.View Thread

When an individual suffers psychotic symptoms they often become fearful....and defensive. They believe strangers are trying to hurt them and will last out. They truly believe what they say (like your mother accuses you of locking her up) and may become oppositional or aggressive. Their goal is to protect themselves from harm. Caregivers need to respond in a way to reassure their loved one that he or she is safe and secure. If you need to 'enter the delusion' then you may do so as long as the delusion is not harmful or dangerous. If your mom expresses feeling locked up, you can apologize to her for this and see if you can help her feel more free. She may be expressing to you that she feels locked up in 'herself'. When she acted out on your sister, try to assess what might have precipitated her anger. There are times where you can redirect or reassure and the agitated moment will pass.
If the symptoms persist and pose a danger,, as your doctor observed, a treatment is needed to provide your mother with a sense of comfort and security. Drugs like zyprexa, seroquel and risperdal, among others, have been successful in treating these symptoms. Bottom line, you need to perceive these symptoms as pain- emotional pain- requiring 'pain management' and that is the purpose of these drugs.They do need to be monitored because of potential side effects and dosages titrated under supervisionView Thread



This problem can become a 'quality of life' issue and that is where the caregiver must make choices. "Should I restrict my loved one's diet because it may cause medical problems or should I look away and let him/her have some enjoyment" is the dilemma.
Some helpful strategies include daily dietary monitoring, keeping nutritious food visible on the shelves (even transferred into boxes of more desired foods!) and buying low fat and low salt foods and snacks only. If the 'undesired' food is not available, it will not be eaten. The one strategy to be avoided is trying to reason with your loved one in order to change her/his behavior. Advice and counseling can agitate and will probably be forgotten.View Thread

Is it possible to modify her room so she can safely clear the drawers or closet? Sometimes these aimless behaviors give comfort to someone who is confused. If they do not pose a major risk factor, and she cannot hurt herself, perhaps she needs to perform these tasks. It is rare that a Nursing Home or an assisted living offer this type of safe freedom but perhaps she can have that at home.View Thread

It is also suggested you contact the liocal chapter of the Alzheimer Association for both education and support. As you said, you do not need the extra stress and you will learn how to cope with your dad's behaviors. Many groups offer bilingual services too.View Thread

The restlessness, or 'agitation' as it sometimes called, can usually be ameliorated by activity or a low dose of a sedating drug. The latter option should only be chosen if the restlessness is very disturbing to him. Meaningful activity is the best solution and often a day filled with physical exercise, cognitive games (i.e. dominoes, cards, blokus), walks in the neighborhood, or a Day Care Program will decrease his nervousness.
His incessant questioning, however, will continue. It sounds as though his immediate memory deficits are significant so he cannot hold on to your answers. There are strategies to help with this too. Since you do not visit that often, you could make up a scrapbook with pictures of your home, a map, your family and any other items he obsesses on. Write a caption under each picture and his caregivers can use this daily to 'trigger' his memory; you can update this when you visit to perhaps redirect him when you are with him.
Silence with a person with dementia can be a meaningful time too but you may need to use a calming strategy (for instance music in the background, holding hands for touch). We so rely on verbal communication that when one loses their ability to dementia, caregivers must identify alternatives ways to communicate. An Adult Child Support Group could give you some ideas and recommendations in this area. ({www.alzheimerassociation.org}).View Thread

Relocation is a process (vs. an event) for older adults with or without dementia. There is a honeymoon period where they are getting used to the new setting and people. Once they settle in, they begin to mourn the loss of their original 'home' and the adjustment period begins. This could take any length of time depending upon the facility and staff and the coping skills of the older adult. Dementia, of course, complicates matters.
The word "home" has different meanings at different stages of dementia. At the early stages it usually denotes the place the person is living at or for someone who just relocated, it would signify where they just came from. At more moderate stages, it could represent an earlier setting- perhaps where they grew up- rather than the immediate setting they came from. I would suggest you begin by trying to understand this before acting on her request. Reality perception of a moderate stage dementia is usually quite impaired so perhaps your mother's dementia is more early than moderate? Namenda might have some effect but will not usually result in a moderate dementia patient becoming 'sharp as a tack'.
You could try an alternative before taking the risk of bringing your mother back 'home'. One suggestion is to present her with a scrapbook of large pictures of her last 'home' and see how she responds to them. These may help her with 'closure' if this is the home she is referring to. She could point out the belongings she wants and keep her 'home' close to her. If this is not successful, you could risk the 'homecoming' as long as you have a plan for her return to the facility....and special 'party' or 'welcoming event'. After that, you will need to see what happens. It sounds like she needs to feel the 'comfort' and 'familiarity' of home so as she continues to experience these feelings in her 'new home', her longing for the past will progressively dissipate.View Thread

Instead, a response that is supportive can be effective. You can apologize and say how much you loved the rings and wanted to see if they fit and give them to her at that moment. If they are valuable and dear to you, you can retrieve them later and put them away not to wear in front of her. The same with the watch....or the next item she fixates on. You could buy her the type of item she is obsessing on and see it that helps. Maybe give her a jewely box with costume jewelry. If these delusions escalate, you may need to consult her physician. She may need a low dose of an antipsychotic drug to ease her anguish. Paranoia and delusions need to be perceived as painful symptoms that require treatment.View Thread
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