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Posted: November 28, 2005

Practical Caregiving

Why Is She Making Those Sounds?

What do you do when your elderly loved one says things or utters sounds -- and then doesn't realize it? Or curses and denies it? That's what's bedeviling Dawn, who wrote me asking advice. Let's see how we might help:
Dear Jean:
I am 40 years old and take care of my partner's 79-year-old mother. My partner works outside our home, and I am the caregiver 24/7.
My question is this: how can I stop, or should I try, the constant moaning and groaning whenever his mother moves any part of her body. I continually go in and ask about pain, which she vehemently denies, and says she isn't making any noises at all. Let me mention that these are not just soft moans and groans, they consistently wake someone up in the house other than myself.
During daylight hours, she uses expletives constantly for most movements and again denies any pain or even speaking. It has become a real point of contention around here, small or silly as it may sound. Her son and our daughter (and myself someday) need to get some uninterrupted sleep, and her constant noises and sounds make it impossible.
Any thoughts? Her diagnosis, among many other things is multi-infarct dementia and very early Ahlzeimer's.
Respectfully submitted,
Dawn B., Walker Valley, New York
Dear Dawn:
First of all, you need to understand the difference in multi-infarct dementia and Alzheimer's disease. I went to the website of the National Institute of Neurological Disorders and Stroke. They described multi-infarct dementia as, "a common cause of dementia in the elderly, occurs when blood clots block small blood vessels in the brain and destroy brain tissue." They described Alzheimer's disease as, "a progressive, neurodegenerative disease characterized in the brain by abnormal clumps (amyloid plaques) and tangled bundles of fibers (neurofibrillary tangles) composed of misplaced proteins."
What this boils down to is that there may be some steps you can take to prevent more damage from the multi-infarct dementia, while the Alzheimer's disease will continue to damage the brain. There are medications that might slow the progress of Alzheimer's disease, but there is not a cure.
How she acts depends on what part of the brain was most affected. Doctors now believe that when you have either a form of dementia or Alzheimer's, the other one will follow. I wrote three columns on this subject. You can find them here: 
 What I found is that there may be several reasons for your partner's mother's noises. They may be an indication of her being uncomfortable or of being in pain, they may be a normal thing for her or they may be a sign of depression. They may also be self-soothing. In other words, they may simply make her feel better.
The first thing you should do is get a complete physical examination for her. She may just be uncomfortable, or there may be a physical problem that you are not aware of. Make sure they check for a urinary tract infection. I was told that's a problem she may not be able to recognize or express to you.
A major change in her life can cause her to decline, such as a move from her home of many years into your home. Sometimes that decline will be permanent, and sometimes she may improve -- with time.
Since she doesn't realize she is the one saying the expletives, the best thing you can do it go along with it. Say something like, "That was a bad word. I wonder where that came from." You might even be able to laugh about it with her. Arguing with her will only make her upset and wonder what is wrong with you. Her brain is doing strange things, and to her it is someone else saying those words.
Some of the things you should check are to make sure she isn't too hot or cold, she isn't in any physical discomfort, she doesn't need to go to the bathroom more often, or she doesn't hurt. When she is asleep, reposition her in bed occasionally.
Finally, would it be possible for all of you to take shifts in her care so you can all get a good night's sleep on a regular basis? Being a family caregiver is stressful and it seems to lead to a lack of sleep. If you can find a way to take turns with her care, you all will feel better and do a better job of taking care of her.

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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