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FCC Week 3 – Video 2 and online learning

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Dementia and Diagnosis Objectives: Describe the difference between dementia and Alzheimer’s disease; know a few simple characteristics of the different forms of dementia and how late onset Alzheimer’s disease is diagnosed. Identify the characteristics of your relative who is living with dementia. Know what aspects of Validation will be helpful in enhancing communication with your [...]

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Lesson tags: alzheimer's, characteristics, checklist, dementia, diagnosis, phase of resolution, review of knowledge 2

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  • My mother has vascular dementia. She has had multiple small, continuous infarcts, which were discovered in 2008 with a larger stroke and subsequent seizures. Therefore my mom has left side neglect of her body. I believe this is why the doctors denied her dementia so long, they attributed all her ataxia and apraxia to the stroke. The vascular incidents have cumulatively led to cognitive decline, memory loss, anger outbursts, inability to read, poor eyesight and failing organs (kidney disease, feet like a diabetic without diabetes, hypertension, etc.)

    My mom is moving into stage 2. She has no sense of time. She can be in the bathroom for hours and not notice. If her bus comes before she is ready, they are “too early”. She repeats activities because she can’t remember she did them already.

    She thinks it is 1985.
    She bases everything on what she did then. “I always got up at 6 am and never got more than 6 hours of sleep so I don’t need to do anything different now.” She bases what she wants on how she feels NOW and wants it NOW and if 5 minutes later she feels different she’s angry you didn’t do it her way (which was her way 5 minutes ago, but not now). She prefers doing things in the order she remembers to do it, even if it doesn’t make sense (she says: Why do you ALWAYS insist on putting my underwear before my pants and shirt! I want my shirt first and then my bra!)

    My mom shuffles and bumps into walls and loses balance frequently. She “cruises” the rooms like a toddler learning to walk by grabbing onto the next available object like chair, table or couch. Sitting in a chair (orientation) is a monumental task but she can get up easily. Her lack of coordination and lack of understanding prevent her from being able to use assistive devices for walking.

    She can no longer read and has recently lost interest in the TV which was previously her primary form of entertainment. Now she spends most of the time (if not at her adult day program) taking her old jewelry and miniatures out of the box, putting them back in, switching boxes and repeating.

  • My father has been diagnosed with a mixed dementia: Alzheimer (late onset) and vascular. From what I understand here, it seems pretty accurate cause he has a variety of symptoms that seem to fit both types: short term and long term memory loss, aphasia, not being able to grasp certain simple concepts anymore like who is his family…
    I would say he’s in Time confusion: he doesn’t abide by social rules now and he’s pretty poetic in how he expresses himself. The other day he said: « I don’t have the loudspeaker to communicate from my world to yours ». He also doesn’t understand where he is anymore (the nursing home is sometimes his workplace, or a hospital, or the place where I live…) or what day or season we’re in.

  • I believe my mother (85 years old) has late stage dementia. She also displays elements of Lewy Body, particularly due to her REM sleep disorder like behaviors (having full conversations while asleep, or knocking her bedside table over, for example). Mom is in time confusion, and I wonder if her “picking” behavior (she is always scratching at her skin and picking at bumps, causing scabs) is a form of repetitive behavior. I continue to practice meditation every morning and recently found that if I awake my mother (she often naps twice a day, and sleeps for about ten hours a night so I have more than one opportunity each day) by gently stroking her head she arises in a much better mood.

  • I believe my husband has early onset dementia. He is just now 76 and some of his symptoms date back 10 years. He is in the 3rd stage ofrepetive motion and some withdrawal. He is ambulatory but has begun to shuffle and lean forward a little. He mainly stares at the floor or some other place when a conversation with others is begun. He may need to be reminded to look at me so that he can understand what is being communicated. Even then often times he does not understand. His nuerologist feels that he is very advanced in the disease.
    He has been diagnosed with Lewy Body dementia. He does recognize people but doesn’t remember their names. Sometimes he forgets who I am momentarily but recall comes back. He sometimes believes that we are dating as opposed to being married. We have been married 24 years. He has hallucinations and acts out his dreams while sleeping.

  • My best assessment is that Mom has late-onset Dementia of the Alzheimer’s Type. She is 95 years old and began to have short-term memory problems that were impacting her daily activity six years ago. Presently, I think that she has the first three phases of resolution at work at the same time.

    Malorientation: She knows who she is by name, and she knows her birth date. She always knows that I am ‘Robin’, but she doesn’t always know that I am her daughter. When prompted, she knows that she has three daughters; but has a hard time believing that we came out of her tummy. She wears a watch, so she always can tell you what time it is; but if the watch battery has died, or if she has put her watch on upside down, she’ll insist on the reliability of the watch’s incorrect time.

    Time Confusion: In the afternoon and evenings, Mom is often confused as to where she is. She’ll be sitting in her own apartment, and ask to be taken back to her apartment. She thinks that her apartment is mine or some other family members’ apartment, but not hers. She repeatedly asks the questions, “Where am I going to sleep tonight, whose apartment is this, how many people live here?”

    She knows that she is confused when she is asking these questions. We’re able to talk openly about this. It is only in the past six weeks or so that I have sensed that she feels deeply insecure and even a little fearful in the midst of this confusion.

    Repetitive Motion: (1) Mom uses a walker with a very nice pouch for carrying things. She’ll pack up the walker with various items (i.e. her purse, books, the remote control for her tv, glasses, shoes, slippers, socks, a change of underwear, a shirt or a sweater) and move them from one location in the apartment to another. (2) Sometimes Mom will communicate with short low guttural sounds. (3) I haven’t noticed this of late, but for awhile Mom would rub the right side of her forehead and temple persistently.

  • My wife has late onset Alzheimer’s. She was originally diagnosed with Mild Cognitive Impairment in September 2017 at the age of 78.
    She is the Maloriented Stage. She knows who she is, who I and her daughter are, time and place.

    She has lost her short term memory and asks the same questions repetitively. For example she is very concerned about safety and places items agains exterior doors so they will fall down if opened from the outside. On going to bed she will ask if the doors are close three or four times despite my confirmation they are locked. She will repeatedly ask our granddaughter her age and height. When my daughter will ask her if she ate, she will say no, forgetting she just ate – and getting me into trouble…

    Does she indicates any feeling of loss? Clearly, for example she fell and broke her right femur in June 2014 and since she has severe osteoporosis it took her bones a full year to heal. During that time she did not drive a car and was fearful start driving again. We are retired and now have only one car, I drive her where ever she wants but she was an excellent driver and enjoyed her independence. She frequently says that because she is no longer driving she is becoming Alzheimer’s. I tell her millions of people never drive a car (she grew up in Tokyo, Japan and never drove until she was living in the US) but that seems to have no meaning to her.

    While not recently, she has shown signs of depression and apathy. She would like to have friends (she had a close friend but she moved to New Jersey) but it is hard for her to form relationships.

    Trying to better understand her sense of loss and how they relate to stage of life, I can say that she grew up in Japan during World
    War II and shows a lack of trust in the world. She grew up in close family with three siblings but her father was frequently traveling with his job, demanding at home, and never saw her mother express much affection but that was typical for the time.

    She also struggled with creating her own identity. Japan is a country where it is hard to show one’s independence. In Japan there is a saying “Hakoiri Musume” which translates into English as “Daughter in a Box”. The term describes “a young single woman who leads a sheltered life with her protective family” as if she were kept in a box.

    She grew up in a society with that expectation. She was rebellious but it was hard to create her own identity. A prime example, she loved to dance and was accepted by a leading dance team but her father would not support her in that occupation.

    After a year of supporting herself working at a coffee shop she had to up her dream. Both dance and working at a coffee shop are called “Mizu Shobai” or water trade, euphemism for the nighttime entertainment business and looked down upon. Many of her team mates went on to become leading artists in song and dance. 1964 was a critical time to enter the entertainment business in Japan.

    After marriage we had two daughters in the first two years and she settled down to being a homemaker. She had occasional jobs but never a carrier.

    She saw that both of our daughters took dance lessons and while both are “hapa”, half Japanese and half Caucasian, and attractive, neither had interest in the entertainment business.

  • According to my assessment, my mother has late onset Alzheimer’s disease. She appears to be relatively early in the malorientation phase. Her forgetfulness and short-term memory issues have become much more noticeable over the past couple of years. One of my sisters now lives with her and she reports that she is very unreliable about taking her medications. Although she seems fully oriented when we talk to her, we have begun noticing repetitive questions and comments in our weekly phone calls. She is aware of her Alzheimer’s diagnosis and has told me she is quite sad and frightened about what lies ahead.

    My mother-in-law also has late onset Alzheimer’s, but is more noticeably disoriented at times and sometimes leaves her apartment and is unable to find her way back. Although she is still be quite lucid most of the time, her short term memory loss and repetitive statements are very noticeable. She sometimes does not know my wife and she sometimes gets angry with her caregivers. She is clearly dealing with a variety of childhood traumas and grievances, based on the themes of her repeated questions that often focus on her parents divorce when she was eight years old, then being raised by her mother and living with various relatives during the 1930’s.

  • According to my assessment, mom has late onset Alzheimers.
    The most common phase is malorientation, characterized by an obsession about running out of funds. She is also forgetting simple tasks. For example, we were at the dentist last week and the dentist asked whether she was using her electric toothbrush. She replied that she didn’t like it because the battery doesn’t last and she didn’t know how to change the battery. She had forgotten that the toothbrush has a plug in.

  • Good evening. I hope everyone has had a nice weekend.

    According to my assessment, my mom (age 69) has early-onset Alzheimer’s Disease with probable vascular dementia (due to a stroke in 2014). As background, there is a strong family history of Alzheimer’s (some diagnosed, some presumed) in our family.

    After reading through the phases of resolution, I cannot say that my mom is in a particular phase. Overall, her abilities are declining but she doesn’t fit neatly into the phase categories.

    She exhibits characteristics of time confusion in that she cannot tell you what day, month or year it is (if she looks at her calendar, she can tell the month but not the specific day or year). She talks about her childhood frequently, but understands that she is not that child and time has passed. She knows who I am and recognizes others, although she can’t place their faces to the names without seeing them. For example, she has shopped at the same grocery store for over 20 years and she knows many of the clerks who work there and talks to them each time we go shopping. She recognizes the CNA who visits for medication and meals, but doesn’t know her name. She recalls her doctors when I describe what they look like. And she recognizes buildings, neighborhoods as we drive to appointments or run errands.

    Mom can do most personal hygiene tasks herself (showering, toileting, tooth brushing, etc.) but needs prompts for some things and feels safer taking a shower if someone is in the house with her (either me or her primary CNA). Although she no longer cooks, she is able to feed herself when she feels hungry (I stock her refrigerator with prepped meals, fresh fruit, frozen meals, etc.)

    Recently, she has started exhibiting repetitive hand gestures such as twiddling her thumbs, or running her fingers across her pant leg. However, she is still verbal (although she struggles with word recall and intermittent aphasia) and can carry on a conversation with people. Unfortunately, she doesn’t remember most of the conversations.

  • According to my assessment, my relative has late onset Alzheimer’s disease. I would say that she has characteristics of both malorientation and time confusion. Sometimes she knows the where, who, and when, etc., and fiercely retains the notion that she is capable of her own care. Other times she is not oriented to time, place, or person, and will vigorously insist on her own reality. She sometimes doesn’t recognize her own apartment, is confused about time and sleep cycles, and insists on her notion of the time and date. She is able to communicate well with words.

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