Caregiver's Home Companion Caring for someone who has trouble hearing the phone?
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Posted July 16, 2008

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Elderly Behavior: Recognizing Alzheimer's Characteristics

Q. My mother is 82 and has been diagnosed with Alzheimer’s disease for about 10 years. She lives in a special care unit in an assisted living facility. She is alert some days, but more days she is sleepy and acts like she just can't open her eyes. She acts like she can't get the spoon to her mouth to eat. On days like this, I panic because I'm afraid she is getting sick, and I struggle with whether I should try to take her to the doctor or not. She recognizes me -- some days she talks coherently and some days she mumbles.  

My question is: Is this normal? I have never known anyone with Alzheimer’s, and I am my mom's only caregiver. I work, care for a family and her, and struggle with what is the right thing to do. Basically, I just want to be sure I'm doing the right thing and know that someone cares about me too!  

Clara R., Hickory, North Carolina.

A.

The key here is the pattern of her good days and bad days.  Although her rapid fluctuations are not typical for Alzheimer's, they are not unusual either.  

Just like anyone else, patients with Alzheimer's can have days where they feel well and days where, for whatever reason, they don't feel so hot. As long as she follows her usual pattern, there is likely nothing wrong.  Over time, as the dementia worsens, you can expect her bad days to become more frequent.  

You might consider talking with her doctor to see if your mother is ready for hospice care.  Hospice (some states also have "pre-hospice" programs) will provide additional services for your mom and more support for you. You would have access to a nurse who can help you understand your mother's condition better, and social workers and chaplains who can help you process your emotional grief about your mother's decline. 

At the very least, consider joining an Alzheimer's disease support group. The list of groups in your area can be found at www.alz.org or by calling 1-800-272-3900.

This answer is provided by Dr. Vivian Argento, a trained geriatrician and member of the geriatric medical team at Bridgeport Hospital in Bridgeport, Connecticut.  Dr. Argento is an expert in memory and medical problems affecting the elderly and serves as a clinical instructor at the Yale School of Medicine at Yale University in New Haven, Connecticut. She’s also a consultant both in and out of hospitals and cares for patients in various locations, including nursing homes, assisted living facilities, and in their homes via a house calls program. Dr. Argento can be reached at pvarge@bpthosp.org.

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