Does anyone else notice this sort of passivity and inability to say whether they like something or not?
My mom's cognitive abilities are definitely going downhill. She had a stroke about a year ago that left her semi-paralyzed and in a wheelchair with 24/7 home care. She was always very opinionated/stubborn and some of that continued for several months after the stroke.
She is still oriented in time and place and when she was in the hospital recently she was deemed able to make her own decisions. I'm not sure how she fooled them. I would say she is not. She has become incredibly passive. When I ask her where she wants to go for dinner, she says she's not sure and I should choose. When I ask her if her food was good, she'll sometimes say, "I'm not sure if it is or not." The only thing she has a strong opinion about is wanting to spend most of her time in bed, aside from when she eats or goes out (not very often). She says she's not depressed. Frankly, I would be depressed if I were her. Her QoL is minimal.
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I know its hard to see your mom like this. It is not uncommon for patients to suffer from depression after a stroke. I would also try and have her meds reviewed. I feel like doctors underestimate the side effects of all the medications mixing together.
My father suffered a stroke and it was hard. He was very withdrawn. The meds were changed and he seemed to be improving, but then he got stubborn and said he wanted no meds. And that contributed to his decline. The last year of his life he was so indifferent. It was my fault. He was dying. He had heart failure and his body was shutting down. I had no clue, I fully expected my dad to recover. I know its not easy. I feel for your mom and you.
Now that mom is parked in a wheelchair, I've noticed a steeper decline in her and lately she doesn't seem to even scoot much in it - she's losing her words and sometimes doesn't make sense and this is just since May or so - although she can still find her cuss words
While she enjoys eating, she won't say what she wants unless I offer up a choice of two items and I think she would be quite content for me to spoon feed her
Of course, she'll be 94 soon too
Another resident in her facility is quite volatile and even her private caregiver keeps her distance but for awhile she started using her walker albeit with effort and her mood and personality were transformed - I was sad to see her back in her wheelchair last night
"Apathy is one of the most common psychological problems associated with dementia. Just over half of all dementia patents are emotionally blunted and lack motivation and initiative".
A " study involved 176 patients with Alzheimer's, vascular dementia or mixed dementia. 82 per cent of the patients with changes in their white matter were apathetic, while 58 per cent of all of the dementia patients were apathetic.
Given that apathy reduces quality of life for patients with dementia and increases the risk of institutionalisation, a great deal of research is under way to find a treatment. Treatments that do not involve medication, such as increased physical exercise, cognitive stimulation and massage, do not seem to work"
"Some studies have shown that the medicines currently used for Alzheimer's can have a positive impact on apathy in other types of dementia too," says Jonsson. "Other medicines may also be of interest, but we need to carry out more research in this area.
Years and years ago my grandmother was in a nursing home in her 90s, with what was then called senility. Her oldest daughter visited her daily. When Gram was awake, she sometimes only made sense if you could figure out which family story was the context. She slept a lot. Aunt said she'd smile and sometimes even chuckle and once in a while talk to family members, "You can take the wagon, Loren." Aunt said that she didn't want to get that old herself, but who knows what the quality of her inner life is?
If your mother isn't moaning in her sleep, or restless, or apparently in pain or distress, who knows what the quality of her inner life is?
As for her being competent to make her own decisions, on a practical basis that doesn't mean a lot, does it? Nobody is apt to ask her if she wants to buy or sell stocks. A doctor may explain that a feeding tube (for example) is an option and ask if that is what she wants, but from what you described she'd be more apt to defer the decision to you.
Come to think of it -- I don't much care what's for dinner, either. As long as it's edible, it doesn't much matter. :-)
Yes, it IS hard to watch your parent decompensate. No matter what your relationship with them, it's sad. I know now I can never have a real, adult, meaningful relationship with my mom, she's just too far gone.
LOL at the "trying to get mom to drink".....well, they say we always get our wishes, just never in OUR timeframe!
Mother is much more passive now too--and that's good. I was the "target" of a lot of her anger and I do NOT know why. Never will, either. Yet, I still go take care of her, when I'm not in timeout (currently am, which is fine by me). The dementia makes dealing with her easier b/c she cannot remember so much stuff that things that she used to focus and obsess over.
And yep, when mother gets repetitious about reminding me of something---I do want to scream. Sometimes I will leave Post-It's all over her house telling her "I will pick you up on Saturday at 2". Just so she won't fuss.
I'm terrified of dementia. No one in the family has had it, so far, grandmothers or gfathers....so maybe it's just mother. All the women live forever, but with a lot more dignity and grace than mother has. I guess it's a crapshoot.
GardenArtist, you may be right. She is done with planning for the future (though she would never say so). For a while post-stroke she enjoyed food - especially dessert - and always had a vodka (or two) on the rocks. This is a woman who had huge appetites for all of the above her entire life. When she ordered plain OJ for the first time in my entire life last night, I was actually worried. I spent my entire childhood wanting her to stop drinking! Now I am encouraging her to have a drink!
MidKid, I am very grateful that she is not one of screaming, nasty parents I read about all the time on these boards! That must be so awful. The hard part is that she has become so sweet and vulnerable that my heart aches all the time for her.
Golden, I don't know if she has dementia, technically, or not. When they assess her, they agree her short term memory is the biggest issue. She most certainly is not playing with a full deck. I feel so guilty because she called me like 6 times the other day to confirm I was coming over at 2 and I started yelling at her : YES-TWO!! I SAID TWO!!!
As far as QOL..if your mom is content, what does it matter if she has an opinion on where to go eat or what to do, leave her be. She hasn't got a great QOL, and I imagine that her thoughts are more in the realm of thinking "backwards" to when life was healthier. If she says she isn't depressed, take her word for it. Sounds like you maybe should be grateful she's calmed down a bit.
My mother could throw a temper tantrum like a 3 yo---complete with throwing stuff at you, if she felt like it, screaming, crying, threatening suicide constantly--I honestly am GLAD she's kind of "lost it" b/c she doesn't remember being so hotheaded. She spends most days sitting in her kitchen at the table, spying on neighbors and waiting for the mailman. She goes out 3 times a week., twice to Bingo and once to the grocery store. She shops incessantly from catalogs and every day gets more junk in the mail. I guess she's happy enough.
Personally, I would rather die young than have the QOL my mother has. But she seems content, for the first time in her life. I'd say, just let things be. Enjoy that she's not angry and stubborn all the time.
Our priorities and concerns are vastly different from those of our aging parents. We might be thinking about what to fix for a meal; they might be thinking of their family members who are now gone, how much time they have left, what their current illnesses are, how they'll manage to get to the bathroom or the next doctor appointment....
As you write that you think her QOL is minimal, I think that observation is insightful into why she's not interested in selecting a restaurant or whether the food is good. It's just not on her priority list at this stage of life.
This isn't a criticism of your observations; it's just hopefully an explanation into a phenomenon that I suspect many of us have observed.