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Help - very dotty old dad has been told he hasn't got dementia...(41 Posts)
Well, thanks for that, unknown GP. Mind you, I'd seen this one coming, and I badly need the wisdom of MN to deal with it.
The main problem is that dad,75, has been showing signs of dementia - losing his way, forgetting daily skills, getting bad-tempered, repeating himself endlessly, since he was in his mid-60s. He drinks heavily in the evenings, which makes all the symptoms a lot worse. A lot worse - he monologues for 2 hours, loudly, and slaps anyone who tries to speak/go to the loo, f'r'instance.
But he presents brilliantly - he's practically a professional raconteur, charming, funny, well dressed and urbane. He's also way too young, still, to have Alzheimer's and he hasn't had a stroke ie no vascular dementia. He comes across normal to people who don't know him.
So I can see why the doc signed him off so blithely. The tests for dementia set the bar so low that a washing machine could pass most of them, grrr.
The issues remain, however:
1) how the hell do we find out what actually is wrong with him (I suspect alcohol has a lot to do with it)
2) how do we cope with his uncreasingly unpleasant behaviour. In the past ten years, he's done things, partic to me, that I wouldn't have tolerated if I hadn't given him the dementia disclaimer. Serious, taboo-busting stuff.
1. He may just be an alcoholic. A very nasty one at that: he SLAPS people? Does toaboo things to HIS DAUGHTER?
2. Read "Toxic Parents" and reduce/cut contact. You do not have to endure unpleasant behaviour from anyone - not even a parent.
Sympathy. Are you me? We've been trying to get my Dad diagnosed for about 5 years...
But he was/is very intelligent so can manage the tests just fine... And is very British, so won't admit to any weakness...
Not much help, I'm afraid....
I'm sorry, I have no advice but I don't think he's too young to have Alzheimers? My granny sadly had it for quite a few years before she died (she died aged 75). It is a horrible illness, I really feel for you.
My mum worked for this charity for a while, there is some info & advice on the website. Sorry I can't be of more help.
Yep, I suspect the drink has a lot to do with it. His brain goes after the first three glasses, it's as if he isn't drunk but brain-damaged - not making sense, etc etc. Is that drink?
has anyone looked into Korsakoffs?
Could you contact the local authority and ask for for an assessment?
Well, spot on - I've considered that's what he's got, but I always associated it with tramps in the park. How much do you have to drink to get it?
What makes you think he's too young for Alzheimer's? It can present in people as early as 40s....although that is quite rare. Has he been checked for uti at all? Urinary and kidney problems can cause quite dramatic confusion in older people, which clears up as soon as infection is treated. I suspect though, that in your dads case it is probably alcohol related.
I agree though that the tests are ridiculous, my own dad has been formally diagnosed with Alzheimer's for a couple of years now, is v forgetful, confused often, aggressive occasionally, and monologues at anyone who will listen all the time. Yet passes his test without fail...every time.
I reckon dad gets through a bottle of wine a night, at least. Is that enough for Korsakoff's?
Can someone go with him to the GP, describe the problems and his alcohol intake and ask for a referral to the local memory service?
The above is a link that you may find helpful re Korsakoffs. It is certainly not assocaited with tramps in the park!. Alcoholics come in all shapes and sizes, they're not all on park benches by any means. In your dad 's case it is very likely his alcoholism has caused his memory problems to arise.
Dementia doesn't only hit old people, it can hit in your 50's etc. too.
Korsakoff, from a bottle of wine a night? Could be, but how many people in UK drink a bottle and more a night?....
Best not to speculate and have him assessed at the GP's.
[how many people in UK drink a bottle and more a night?....]
quite a few! including ex military among others.
What are your living arrangements? Does he live with you for instance and how does he fit into the household re eating, sleeping, chores etc?
He isn't too young for dementia but it sounds like he may just be an old drunk. An older brain doesn't have the same resilience as a younger one so all the worst traits are exaggerated. If he has been horrible for 10 yrs, then I suspect he is now old and horrible rather than ill.
What are you hoping a medical diagnosis will achieve? Treatment for dementia is v minimal and won't really change his behaviour, esp if he is drunk. If he has capacity, he doesn't have to go along with any of it. Going with him to the GP may help as if he went on his own he probably didn't own up to half of it. Even if he does have dementia, you all have to live and cope with his changing behaviour which can be awful.
I think you are right to focus on your second question - how to cope with him. Dementia or no dementia, this is a much bigger issue for you. Actually knowing he hasn't got dementia could be helpful for you as it sounds like you have been excusing a lot of behaviour on the grounds he might be ill. Well, he almost certainly isn't ill, just horrid. So now what do you want to do?
Thanks - most helpful. All the worst traits are exaggerated - you couldn't put it better.
DF lives with DM who waits on him hand and foot - hyper old school. So survival is not an issue at the mo - but I think she is being worn down by him, as are we.
I need help on how to cope with a next of kin who can be so bloody. There's two areas: the day to day stuff with him monologuing for hours, relentless snob talk (he's an awful Bucket) and endlessly repeated anecdotes about himself, interspersed with snapping. He lives in a posh fairyland, and it's getting worse.
And the big stuff. As an eg, he's tried for years to disinherit me, on the grounds that their small terraced house - the 'estate' , cackle - should 'go to the son'. I mind about this, partic as I'm on the one who gets dumped with their care in old age.
He's also, ewww, eyed up my cleavage, up me kilt, etc etc. He makes my skin crawl.
Have you thought about having counselling yourself to process how you feel about this? His behaviour clearly dates back years but you still feel guilty about not looking after him in old age - even though most likely you won't end up with a penny for it.
He sounds like a classic toxic parent with your brother as the golden child, with added alcohol and age.
You really are in the territory of not being able to change him, but you can change your reactions to him but need help and support to do it.
I know someone who was diagnosed with Alzheimers a few days after their 50th birthday, so he is not too young. Becoming innapropriately pervy and aggressive was one of the things that made his wife take him to the GP in the first place, btw. My DH's gran had Alzheimers too, and she also became very sexualised, as opposed to the prim and proper snob she'd always been.
He could be suffering from MH problems - if you described his symptoms in a 30 yr old, say, that would everyone's first thoughts. Unfortunately, when someone gets to a certain age, any unusual behaviour is put down to senility or dementia. If they don't fit the criteria then, however, for either, then theya re basically sent away to continue being odd and making the lives of their nearest and dearest a misery.
To me - and I am not a HCP - he sounds like he has some MH problems, caused by, or certainly exacerbated by alcohol and some sort of senility too. Also, with many dementia sufferers, they suffer from something called 'sundowning', which basically means that they can appear normal(ish) through the day but undergo quite a change when night time comes and are very obviously suffering from dementia. This sounds like your father, but the fact that he is also getting blotto at that time could be masking it, ie you all think he is just drunk, whereas he might be drunk AND sundowning. Do you see what I mean?
Aso, did he go to the GP alone and come back to tell you all the GP said he was fine? Because he might be totally lying about what was said, have you considered that?
The main thing is, you and your mother can't go on like this. If he is that sleazy towards you, I worry aout what might be going on between him and your mother that she might bpnot feel able to tell anyone. You certaily do not have to tolerate the incestuous comments and attempts, even if he was diagnosed with every form of dementia and MH issue under the sun.
If you want a specialist assessment for dementia ask to be referred (by GP) to the appropriate services, likely to be Community Mental Health Team for Older People or a Memory Clinic depending where you live. They can then consider the situation and, if it's not straightforward, potentially refer you to a Clinical Psychologist who may do a more detailed 'pencil and paper' cognitive assessment as well as considering wider factors and your collateral history.
Korsakoffs is usually associated with extremely heavy intake of alcohol and someone wouldn't be able to 'cover' in the way they could with, say, Alzheimer's.
Yep, I suspect the GP saw a delightful old boy, touchingly concerned for his capabilities, in there for all of 3 minutes, and signed him off with a cheery laff at the latest anecdote.
How much can you tell a GP about their patient without the patient knowing you've grassed them up?
Corygal, you can phone and speak to the GP and express your concerns and your side of the story. They won't be able to tell you anything and it's difficult for them to act on it if you don't want him to know you called, but at least your side of the story would then be there on his medical record, so they'd be less likely to be taken in by him next time.
FWIW, I someone is able to pass the dementia tests and denies there's a problem, I would be very hard to prove that their capacity to consent was sufficiently impaired to get them assessed by the older perons mental health team against their will. Sadly, your situation is far from unusual.
Sorry you're going through this, it's enormously stressful
It sounds like you took him before so wouldn't be unreasonable to fill out the picture to the GP and then you both can consider it together. The screening assessments used by GPs (mini-mental state examination or equivalent) are easy so if people do badly there is probably an underlying disorder, but if they do well there still can be IYSWIM. They're not sensitive. You could take a list of problem situations to the GP which is all part of diagnostic procedure.
Generally speaking, there is no definitive diagnosis for dementia, it is all down to best estimates. However, specialists (of all professions) will know about the covering up and we can spot it easily (usually). However, we do sometimes have to wait and see how things progress. One of the measures of difficulty we use is whether someone can carry out 'activities of daily living' ie can they manage finances, take care of themselves etc.
And sometimes people have a co-morbid (additional) illness like depression or addiction. Sometimes ageing has a detrimental effect on personality and sometimes dementia can exacerbate pre-existing personality traits.
Courage you are brilliant. Trouble is, because Dad is waited on in better style than the last emperor of Rome by me mam, it's nigh on impossible to judge his living skillz because he doesn't do any of the stuff normal people do eg make cuppa. Never has.
Mum does everything from the garden through shopping to the finances. Dad does dress himself and he can put the telly on - both rather flamboyantly, but that's it.
Is there anything you know of that I could read to see what I can spot? Apart from the 'personality change', he lost his orientation about 10 years ago, and endlessly repeats himself, which I would class as dementia not drink. Am I right?
You may not be right. Alcoholism can also cause such problems to arise; memory loss can also occur.
Do you think your Dad is an alcoholic?.
You must be very disappointed in them (and that is an understatement). Your mother seems to be more than happy to act as her husband's enabler and your Dad is a lazy, letcherous old man and drunkard.
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