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I'd to hear from caregivers caring for someone with acquired brain injury and/or dementia. What are the biggest challenges for you in terms of your loved one's behavior? What do you need help with to effectively manage the behavior?

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For me, mom is in the mild/moderate stages of her VaD (Vascular Dementia) so we are just beginning to trek up that mountain.
Right now, I would say it's the repetitive nature of our conversations. I know it doesn't seem like much; she's not soiling herself, she's not babbling into the wind... she's not roaming the street at night...but... I'm not used to it yet, I guess. Maybe that's why it comes in stages; so the caregivers can get "used" to it as it progresses...
Today mom and I were... wait for it..... you guessed it... Shopping!
And she mentioned 3x in one hour that she liked a particular item (pillow! candleholder! rug!) all because they are her favorite color and she kept saying I like that color, it's my favorite color. I love the color...
It may not seem like much, but compile that with asking the same questions and forgetting the same explanations about the same stuff on the same day...
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The hardest part is trying to reason with someone about the behaviour. You can't reason with them. The brain is not wired like it used to be. If they are doing something which endangers them, sometimes you do have to intervene. This causes much stress! I
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Norestforweary - you hit the nail on the head. There is absolutely no reasoning with someone with dementia. Mom is incompetent in a hundred ways and we could never trust her to make a decision, balance a checkbook, remember what she did 5 minutes ago. But to her mind she is in complete control of her faculties, and the truth (to her) is anything she wants it to be. There is NO reasoning with her, five minutes later she wouldn't remember it. And she can lie better than any three year old - she is quick to come up with the answer and lie and believes it herself. Its heartbreaking because it isn't like dealing with a three year old you can distract and finally put your foot down. You are dealing with a mentally ill adult who was once intelligent, and retains some of those abilities.
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I am looking after my MIL with dementia, her complete lack of judgment keeps surprising me, recently she was out standing in the driveway because her healthcare aide got lost and after she gave her directions she thought she would wait for her, she is in a rural area and it was very very cold, she could barely walk, yet there she was, far away from anyone, wearing light clothing, early in the morning, out there in the ice and snow, it just boggles my mind.
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btw, the diversionary tactic i used recently, was to first, step away briefly to get a breather, went back and collected our dishes (we were eating dinner), then suggested we walk up and the stairs for exercise (indoor stairways that she won't traverse without someone being there with her). after a couple of "rounds" she's back to "normal"--the happy-go-lucky mom living for the moment.
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I'm in agreement with the people who site the inability to reason - that coupled with extreme stubbornness. My mom was always very stubborn- no one told her what to do! Once the dementia had shifted into second gear she became an immovable brick wall. So - mom would do things that were just nuts and totally unlike her "old self". I would try and talk to her - use reason and common sense to try to get her to change her behavior or a wild idea she got in her head - she would fire back with some off the wall, nonsensical reply - and I would again, try to get her to be reasonable. It was the proverbial "beating your head against a brick wall". And of course, the more I tried - the deeper she dug in, sometime even taking the behavior or notion one step further. The hard part for me was finally accepting that this previously smart, smart woman was no longer able to have intelligent thought or reason. Once I accepted that - which took learning about the disease- things became just the tiniest bit easier.
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They are not the same person. Some days they hate you.
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for me it was the accompany-ing ocd. in their simplicity they see no reason why they cant sit on their behinds and use your energies to make the world a flawless place. their obsessing over what aint gonna happen can put some real tension on the household.
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I agree with what captain and norest wrote -- obsessive delusions are the hardest. They want us to do something to solve a problem that doesn't really exist, and they often do dangerous or expensive things to deal with it themselves. Then there is the anger when we don't fix the problem. It is strange how someone can forget most things, but remember a made-up reality for years.
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My mother in law who has dementia lives with us. There are a host of issues to deal with as a family. She is incontinent,paces all day long,has lost the need for hygiene,and is fixated with the kitchen. We have tried to explain to her she needs to wash her hands after using the bathroom . She doesn't believe there is a need. This leads to the kitchen where she is constantly wanting to handle silverware,plates,glasses,etc. If it isn't that it is her version of washing dishes which consists of rubbing food residue off and running under cool water ,and putting them away. We have given her projects to keep her busy,but she puts them down and heads to the kitchen . Then she starts asking what do you want me to do over and over. She has asked this question on some nights at dinner upwards of fifty times. I have asked her why and she says you didn't give me the answer I wanted to I keep asking. We ask her to not do or handle any dishes or silverware. The minute we turn away she is into it. When we ask her to stop she gets angry and storms out. Five minutes later she is back in the kitchen not remembering a thing that happened and the questioning starts again what do you want me to do. We are all stressed out as we are her sole caregivers. My wife has a brother here who has no contact with his mother and another who is only around on weekends. The second brother will take his mother out to give us a brief respite. We don't know where to turn.
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