My mom has Alzheimer’s disease and my dad is having a hard time dealing with her hurtful angry words. Does she mean what she says?
No. Your dad sounds as if he may benefit from Alzheimer's caregiver support. Alzheimer’s is a disease that causes regions of the brain to shrink and lose their function. As the disease progresses, different areas of the brain are affected. It often starts near the hippocampus, which plays a major role in forming our memories, as well as storing and processing spatial information that helps us navigate. This is why during early stages of the disease a person may end up at a neighbor’s house and not know why or how she got there. The disease also affects parts of the brain that help form and express personality, behavior and language. Before long, a loved one’s impulse control is severely damaged. All of those learned behaviors of being polite, not swearing, lashing out or undressing in public are essentially erased, which means your mom could say hurtful things but doesn’t really mean them. That’s the biological answer.
On the personal side, your mother is slowly losing her sense of “self” rather than unveiling some unruly person “kept under control” all of these years. One of the hardest things for some family members to understand is that those suffering from dementia are not deliberately being difficult. But because people with dementia can sometimes appear to be perfectly normal, it may be hard for your father to distinguish between when she is being “herself” and when her behavior is caused by the dementia. As a result, your father may think that your mom knows exactly what she is doing, which will only make him angry. People with dementia can easily become agitated. As a result, in a matter of minutes, your mom and dad will be in the midst of an unintentional firestorm.
Ask your mother’s physician to speak with your father about the disease and its stages. It would be very helpful if her doctor showed your dad actual brain scans showing the physical changes caused by Alzheimer’s. You can view PET scans and take a fascinating tour of the brain and how Alzheimer’s disease affects it by going to the National Alzheimer’s Association website at alz.org
and clicking on “Brain Tour.” A medical explanation will help, but it should be accompanied by a description of how the behavior of people with dementia changes.
It’s also helpful to understand the best ways to react to these changes. Staying calm, reacting with a soothing and reassuring voice and learning how to distract an agitated loved one are the best ways for your dad to react. If you cannot get a physician to tell him, then try another professional he trusts. It might also be helpful to use analogies to explain the course of the disease that would resonate with your dad (for example, explaining the workings of the brain in car terms if he’s an auto buff). Finally, your local adult day center would be an excellent resource, as they can provide necessary information and respite for your father.
You and your dad should also join a local Alzheimer’s caregiver support group, so you can learn from experts and other family members how to interpret and respond to your mom’s behaviors. To find a support group anywhere in the country, go to alz.org
or call their 24-hour Helpline at 1.800.272.3900 for assistance. You can also ask for a free copy of their Caregiver Notebook
, which offers tips and resources for caring for a loved one. Two excellent books that can help are The 36-Hour Day
by Nancy Mace and Peter Rabbins (Johns Hopkins University Press, 2006), and Learning to Speak Alzheimer’s
by Joanne Koenig Coste and Robert N. Butler (Houghton Mifflin, 2003).