Hi all. I care for my grandmother (87 yo) only one night a week. However a few of the rest of my family (about 4 of them) take turns to make caring for my grandmother a 24/7 thing. My grandmother was diagnosed about 3 yrs ago and has been in the same stage the entire time. She has shown no differences that I can tell at all. I'm not even sure now if she has AD. I was wondering if I could get some advice. She was diagnosed right after my grandfather passed. As soon as she came home from the funeral, she stated that she was not in her house and wanted to know where her house was and why all her stuff was in this strange house. My family immediatley made an appt for her. They diagnosed her with AD on the first appt.

Let me give you some background on my granmother before she was diagnosed. It is hard for me to tell if any of the symptoms listed apply to her as she has never driven before. She hasn't worked for the last 40 years. Her husband did pretty much everything (including cooking) except for light housework. She doesn't go out. She has been paranoid all her life. When I say paranoid, I mean, she has always thought that someone was going to break into her house, try to rob her, etc. She has always hated to be alone. Once (before I was born... over 33 yrs ago) when my mom was visiting her, she told my grandmother that she was leaving to go run errands. My grandmother didn't want to be alone and told my mom that she would kill herself if my mom left her.

My grandmother is a sweet woman, but she "has a heart attack" pretty much every day. She knows everyones name... even my new husband of almost 2 years. I recently started a new job about 4 months ago and she asks if I'm still working at my new job and gets the name of it right every time I see her. She can reason really well... when told that she would have to leave her house with someone to run errands, she states, "I'm not leaving... can you call so-in-so to come and stay with me? Do AD patients reason like this?? I am at my wits end. She could stay by herself, as she can cook, clean and do other every day tasks with no supervision. She's never forgotten to turn the stove off, etc. In fact she is very adamant about things like that and double checks to make sure of those type of things. The thing is, she gets scared and starts having a "heart attack" if left alone. She will call someone else if you are 5 minutes out the door. Or worse, she will call the police. Any advice would be helpful as this is turning our family upside down. As it is, only 2 in my family left even believe that she has AD anymore. Everyone else thinks that she just don't want to be left alone. We are frustrated and tired and I need someone to tell me how to deal with my family. They haven't even gotten a 2nd opinion. I'm sorry this is so long, I am just looking for answers somewhere besides from my family. Thanks in advance.

If you are unsure of the diagnosis getting a second opinion is always a good idea. Others have suggested in addition to mental status exam, mri and pet scan. A good neurologist would be the place to start. One of the good things about assited living is that there are always many people for company.

It is not easy to diagnose AD and it is not unusual for there to be a diagnosis of AD and then a couple years later, it will be changed to something else. The incident after the funeral could have been stress, but it does sound like a second opinion is definitely in order. If there's a university or large hospital around w/a memory or AD clinic, try going there. A neurologist who specializes in brain disorders, a geriatrician, someone more than the family MD who has experience and training in this field.

Hello there,

What is interesting about what you have written about your grandmother is that some of the signs(not recognizing her home, being afraid of being left alone, paranoia) are symptoms of Alzheimer's, however the majority of what you have written is not typical.
1. The rapid onset after the death of your grandfather. If your grandmother has Alzheimer's, you would have noticed a slow progression of confusion and memory loss eventually leading to her not recognizing her home.
2. Her short term memory is intact which for someone with Alzheimer's would not be the case.
3. Individuals with Alzheimer's have trouble with judgment and reasoning; if your grandmother is able to reason really well that is another strike against her having Alzheimer's.

Several things come to mind. You stated that she has been paranoid for a very long time. That lends me to believe there may be some other mental illness going on. Obviously not knowing the situation from her point of view, her fears of being left alone might be anxiety related as well. The last thought I have is what occurred after the death of your grandfather. Oftentimes in elderly individuals, grief and depression are manifested in what sometimes can be confused with Alzheimer's.

I agree that she needs to be re-evaluated by a neurologist. If you need help finding one or you have any other questions, feel free to give us a call anytime at 1-800-272-3900.

Thanks!

Shelley P

Shelley has given excellent advice. I am an RN, and my mother presented with unusual behaviors and symptoms also.

First, not all dementias are Alzheimer's, there are many different kinds of dementia. There is even a condition called, "Dementia Induced Psyhosis", it is all very complex.

If this were my mother, my starting point would be to make an appointment with two specialists.
One would by a Psychiatrist who specializes in Geriatric Psychiatry. Your local medical center could advise you as to who has this specialty. Just ask for the Medical Staff Office.

OR . . . if there is a GeroPsych Unit at a local hospital, a social worker or charge nurse could tell you the names of such a specialist and perhaps even tell you who they feel is most excellent.

Secondly, I would also make an appointment with Neurology at the same time and get a thorough Neuro workup.

It took both specialties to obtain a proper diagnosis with my mother, and it was a relief to know what we were dealing with. Without a diagnosis, it's like being in a foreign country and not being able to speak the language and not knowing the laws of the land.

My gut feeling from what you wrote, is right along with what Shelley had to say. The abrupt onset, her history, how she is presenting at this time, all point to a high probability of mental illness.

I wish you the best.

The ability to reason and make rational decisions based on sound judgment are referred to as executive function. It is an entirely different entity than memory loss which is typically the first thing to go, that and orientation to day, place and time. The individual's ability to retain this skill is not atypical by any means until later stages. Its acceleration depends on the individual. Everyone is different to a degree with regard to symptomology. Still,it is said that an environmental trigger activates the genetic predisposition. An emotional disruption of this magnitude would certainly qualify.
However, a trained neurologist can almost readily recognize the symptoms as we know them to be now via a battery of tests. A second opinion could hardly hurt.