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I usually bring my mom out of her assisted living care home back to my own home for the summer. My Dad passed away in 2018 from Alzheimer’s and I didn’t want to leave her behind especially in hurricane season. But this year is different. She has changed and or taken a turn for the worse.


She’s usually been very happy to leave the AL home, and come here where she can participate in the day to day goings on, but this year after we returned on Wednesday night (less than 48 hours ago) she was non-stop complaining about everything, accusing everyone both her caregivers, and myself of steeling from her, and telling all of us she’d rather be in the AL home. With one caregiver leaving as a result of her accusations, and the other barely hanging on, I agreed to send her back to her home, where she claims the food and everything else is better. She was extremely aggressive and verbally abusive. Frankly I grew up with this narcissistic behavior and have no tolerance for it at this point in my life.


It reminded me of what my father went through, and after I googled it I was shocked to learn that there’s a link to the two diseases. Any one else have this situation?

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mterpin,

Your mom's conduct is quite similar to my mom's. She's been diagnosed with both vascular and Alzheimer's dementia, which is sometimes called "mixed dementia." Keep in mind dementia can have multiple causes, vascular dementia being caused by a restriction of blood flow to the brain that starves it of oxygen and said to progress more rapidly than Alzheimer's, which is thought to be caused by accumulations of proteins in the brain that slowly kill brain cells. No matter the cause or progression, both conditions result in the same thing: death of brain cells and brain shrinkage, eventually leading up to death.

Mom's condition seems to have characteristics of both: sometimes slow progression followed by a sudden drop, followed by a leveling off followed by another drop. It's hard to predict how she'll progress, and trying to stage her is difficult. Mom has good days and bad days, but one thing is certain: she progresses. Residents of her memory care unit seem to share many of the same symptoms regardless of the cause: memory loss, confusion, paranoia, agitation, anxiety, cognitive processing difficulties, speech, etc. I think it depends a lot on which areas of the brain are affected by whatever disease they're experiencing.

I hope this answers your questions a little bit. Mom's dementia was the first I'd ever encountered, and trust me it's not like I expected! (Honestly, I don't know what I expected).
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Let’s jump past the “link to the two diseases”, and movie right to”management”.

Your very kind perception of not to “leave her behind”, has progressed in her dementia to a need for consistency and structure without variation or change in routine.

Dementia and ALL THE GERIATRIC DISEASES progress on an erratic time table (so NO timetable). If you are able to stay with her IN HER MOMENT you will find her conduct less distressing TO YOU.

Her “narcissistic behavior” is really not what’s happening in her present life. It’s her damaged brain, reacting without filter to whatever comes or goes at a given moment.

”Extremely aggressive and verbally abusive” were part of your childhood that have left you with painful memories. For YOUR WELFARE, allow her present conduct to be what happens in the moment for you both.

If she’s now “at home” in her residence, how she reacts to you MAY return to her prior placid reactions to you or may not. If she continues to do things that disturb you, leave.

When you return, you may find that things are more peaceful. If you return to another tirade, leave again.

YOU have done what a good child does. You found a pleasant, comfortable, safe place for her to live, and she appreciated it. Then for what you felt was a good, kind reason, you removed her from it.

Don’t let her complaints, rage, hostility, abuse become part of your present. Leave them in HER past.
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mterpin Aug 2021
Hi Ann,

One of the things the AL home told me in the beginning was to leave her be, and not feel like I had to visit often. That may sound very hard to those who are blessed enough to have healthy relationships with their parents, but for a narcissistic parent/daughter relationship it was very sound advise.

After my Father passed the whole dynamic changed between us, perhaps because she felt venerable (and I was the only family she had) or perhaps because she no longer saw me as competition for my father's attention. Either way, I got to spend time with her, and she was )for the last few years) the mother that I had when I was a child.

Of course when she reverted back this last week, I had no choice disengage.
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Alzheimer's Dementia...Vascular dementia. They both are dementias. The brain is damaged in one way by Alzheimer's and another by Vascular problems.
And a person can have BOTH types of dementia.
The result is the same.
Mom will be happier if left in her own environment. This means not talking her out for months at a time. Sometimes not even for hours at a time.
And mom probably should not be in Assisted Living but in Memory Care.
The big problem with AL is that she can walk out of the facility and wander off.
With MC she would be in a wing that is locked so that she can not leave without someone going with her. (and generally only people that have been designated as ones that can sign her out. )
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mterpin Aug 2021
I'm very lucky with the Al home she's in. They take in mild cases of dementia, and do the whole gambit of MC all levels through hospice. When my Dad had Alz, they were staying in MC.

OT, but has anyone seen the movies "The Father" or "Elizabeths Missing?" Both are stories of dementia patients through the eyes of the patient.
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People that suffer with any of the dementias, do not do well when taken out of their daily environment, as you are discovering. They thrive on routine, and when that is disrupted, all hell breaks lose.
You are wise to return her to her facility, but like Grandma1954 said, it may now be time to move her to memory care, as she will only continue to get worse. Vascular dementia is the most aggressive of all the dementias, with a life expectancy of only 5 years, so she's going to need more help soon.
My husband died from vascular dementia 11 months ago today, after being diagnosed in July 2018,(although he was showing symptoms a good year before that)so I am all too familiar with the rapid decline that comes with it.
I wish you and your mom the very best.
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mterpin Aug 2021
Thank you for your reply, and my condolences for your loss. My Mom has been on the "slow boat" with Vascular dementia for many years. I was lucky enough to get her into the Cleveland Clinic here in Vegas in 2016 where she was formally diagnosed. This week has been a real awakening for me. Every year when I come back to Vegas I've been bringing her with us primarily to give here a break from the boredom of being in a home.

This morning at 6:00 am I put her back on the flight back to Puerto Rico along with her two caregivers. It took a village to get her to and through the airport. (There were 5 of us). My hubby and I waited to make sure the plane was in the air before leaving the airport, and by now she's made the connection.

When I came back from the airport I went and pulled the sheets off the bed, and low and behold most of her meds were in the bed. She had been faking taking them for the last two days. What a positive difference they made on her.

That said, the disease has taken a huge toll on her well-being, and I can definitely see a steep decline. She's now Sundowning as well. It's a sad thing to bear witness to.
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Well you have your answer, leave her be. When/if she needs to go to MC, then you can deal with it then. Like the other posters said these diseases are progressive, eventually leading to death.

There will/may come a time that she won't remember you at all.

Sadly you will have to face the fact the mom, you knew, (good or bad) is gone.

Prayers to you.
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I don't know if you would call it a link between VaD and AD, but the two can co-exist. It's called mixed dementia, and it's what my wife died from. VaD is normally the result of oxygen deprivation to the brain caused by recurring mini strokes over time. Obesity, smoking, clogged arteries, especially the carotid, high BP, high cholesterol, a brain injury from an accident, and many other factors can contribute to VaD. So leave her in the facility and do your research on VaD,
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We are all in uncharted territories, but you are right in that they sadly all progress toward the same end. As I mentioned in a previous post, my Mom had a workup at the Cleveland Clinic in 2016. They determined that the part of her brain that was affected was responsible for judgement. Surprisingly I was told that the damage had occurred over a 15 year period. She did have blocked Coorarted arteries within that period.

Now, I think the Alz is definitely kicking in as she never had some of the new symptoms before this.
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