DM personality change after being widowed, worried it will lead to dementia. What can I do?

[WeekendInNewEngland]

My poor DM is early 70s and was sadly widowed 18 months ago. Since then she’s lived alone and although I thought she was coping amazingly, it’s becoming clearer that her anxiety and rumination on negative thoughts are causing issues and a change in her behaviour.

She has become bitter and angry about issues with her neighbours (some minor, some less so but definitely aggravated by her response to it) and has sent a couple of quite unhinged letters to them. She would not have behaved this way previously but I think her vulnerability now is causing her to be defensive of her property. She has told me she’s been losing sleep, and she goes over things again and again in her head as well as talking to family members about them. I am trying to help her practically as much as I can but easy, compromise-type solutions are rejected and she seems to want war and revenge instead.

She sees friends maybe once a month if that and has few interests other than gardening and watching GBNews and getting angry about what it tells her. I would love her to join a group, start going for little walks, maybe even get a little job as she is healthy and able. I have experienced loss and anxiety myself and know the benefits of meditation, mindfulness and gratitude but feel I can’t urge her to try these without sounding terribly patronising.

I know that studies have shown that negative thought patterns, lack of sleep and isolation are all linked to dementia and wish she would realise this and try to change her patterns. There is dementia in her family and her own sister went down such a familiar course of ruminating, negativity, bad sleep and staying in not seeing anyone before developing dementia and I don’t understand how she doesn’t see that she’s going the same way. She does eccentric things now that she would have joked about her sister doing just a few years ago.

Has anyone experienced similar and been able to encourage a change in behaviour and lifestyle with a positive outcome? I don’t think she has dementia now at all but I fear that’s where she’s headed if she carries on.

Because it’s the only one she can affect? She can’t change her genetics or sex, she already doesn’t smoke, drink, have high blood pressure or diabetes. But she could possibly change her thought patterns (I’ve worked hard to do this myself), socialise and exercise more.

That was certainly the case for an Aunt and Uncle of mine. Uncle had supported and covered up much of what was going on with Aunty. He died very suddenly and everything fell apart pretty quickly.

I agree this is very common especially in loving long term relationships where there is such deeply embedded support from a spouse that others, even family members, do not recognise when this has tipped over into caring responsibilities. Also there can be an element of wanting to keep it quiet, common erroneous public perception of dementia being what it is (that it's a personal failing in some way, caused by not being sociable/alert/happy etc enough)

Yes, this is one of the cruel parts of the disease, that we can't control whether or not we get it. It would be wonderful if we could do away with it simply by not having negative thoughts; sadly this is not the case.

OP there's a significant link between untreated hearing loss and an increased risk of dementia, with the risk rising in proportion to the severity of the hearing loss.

I would push for her to get the hearing loss sorted out.

OP, there are a lot of use of the words 'may' and 'could be' in that article. I think you are pinning a lot on maybes.

I know quite a few people who have/had dementia despite having active social lives, including my mother and my MIL. I am approaching 70, I don't smoke, and I don't have high BP or diabetes. I would love to think that by continuing to socialise and exercise I could stave off dementia, but tbh I think I would be kidding myself. (But I'll be happier doing those things so I'll do them anyway.)

I also felt a stab of recognition at your mention of your mother's health anxiety and GP visits. One of my mother's early dementia symptoms was increased health anxiety. She was constantly at the GP, because she knew 'something' was wrong but she misdirected that anxiety onto a cough being lung cancer, or reflux being heart problems.

Of course that may not be the case for your mother, and I hope she accepts your suggestions.

It can be a bit of a chicken/egg situation though. If dementia sufferers start suffering from negative thoughts as a very early symptom, how could you prove without brain scans that the thoughts were a result of the dementia rather than a cause?

I don't think negative thoughts cause dementia, although someone with a resolutely depressive and negative outlook on life might well start showing symptoms earlier than someone who kept positive, simply because they didn't care as much about the impact on others.

I was about to post to say U3A
its a brilliant organisation, offering a range of interest and social groups
many people who join do so after bereavement of spouses, and are looking for company, support etc
ive made brilliant friendships since I joined 5 years ago -always someone to call to meet-up for a cuppa if having a lonely day.and that’s on top of a very busy social life because of groups I attend

Ok, dementia could be at play here…but in first instance rule out plain old depression.

depression isn’t sitting in a corner, unengaged and passive. It can make people over ruminate and over process. It can make people angry, irritable.

also, do you, op, or mum know about grief pathway? If not do please take a look and share with mum….it sounds like mum may have got caught in “ anger” phase and strolling to get passed into acceptance. Even her being able to see what she feels, and may be too ashamed to share with you, is an absolutely normal, can be healing in itself.

there is help out there for older people process grief. Would she be up to talking to such people about her husband, how she feels now etc and get some help with acceptance

if she has depression, then the relatively small act of putting one foot in front of another, ideally outside, every day, is now known to have very good benefits. And it certainly won’t harm her if she doesn’t have depression. Is that something you can encourage or participate with her in…it doesn’t have to be for long..l15 mins each day round block is a good objective initially. Recent research is giving clearer models around use of SSRIs so perhaps not first approach. But if walking doesn’t help then GP, if she’ll go for help

id throw in here that post menopausally, anxiety has massive effect on some women. It may be when her dh was alive he was sounding board, validator, and filter on that anxiety. Now he’s gone, there’s no one to validate, ease the fears etc, and it’s all coming out. That may be more a Gp discussion in managing anxiety on her own. It’s not too late for hrt even, if that’s a factor she’s now struggling with.

As I posted in response to another poster, I can’t promote U3A membership enough. It helped me massively. Gave me a weekly cadence to attend my interest groups, get out house, talk to someone, have a bit of fun or at least distraction from over ruminating.

Dementia is mostly lifestyle related and genetics play a small part.

Whoa. You're very wrong there. Where did you read that?

You can try and help your mother's state of mind, but you can't prevent dementia. Not yet, anyway.

And as for the hearing issue that a PP mentioned - there may be correlation, but no causation has been proved. Same with social isolation.

also, do you, op, or mum know about grief pathway? If not do please take a look and share with mum….it sounds like mum may have got caught in “ anger” phase and strolling to get passed into acceptance

The "five stages of grief" model has been widely debunked:

https://www.psychologytoday.com/gb/blog/laugh-cry-live/202303/stages-of-grief-the-harmful-myth-that-refuses-to-die

I think the model is helpful in terms of explaining a “change curve” that applies to any monumental change we experience as humans, that we don’t welcome.

i think this article paints a simplistic view of debunking something very prescriptive. Most searches on grief pathway state it is complex, that it is not a linear pathway. Same as any change pathway. I haven’t read anything myself that says “you WILL feel this, then this, then this”!

but at a basic level it is helpful for people to know it takes time to process grief, that emotions and thoughts will be hard to process at time or make sense of ( why do I feel angry?) and that the loss will never disappear, we just get to point of being able to accept it better ( imhe grief and loss doesn’t leave, you just get used to it more so it doesn’t hurt as much).

if people don’t know anything about change curves, it can be helpful as a starting point. I also pointed out to get bereavement support from professionals.

But even calling it a "change curve" implies a direction. Whereas grief is not like that. And that particular models states "These are the stages you will go through", which is just not accurate for many people.

OP, it may be that your DM was always like this, (or increasingly like this), but when your DF was alive her behaviour was mitigated by him.

Sorry if that came across clumsily and offended anyone. What I meant was, some people assume dementia is genetic and if we’re going to get it there’s nothing we can do about it. But experts now seem to be saying there’s lots we can do to reduce the risk or stave it off, if not prevent it. Inherited dementias only make up a small amount of the total. There’s lots we can do to help ourselves and as someone with dementia in my family I find that comforting.

I have an interest in brain health due to a neurological illness I have myself so I read and listen to a lot of experts talking about this kind of thing. For example Dr Rangan Chattergee’s podcast which is excellent and has lots of episodes that touch on this.

https://podcasts.apple.com/gb/podcast/feel-better-live-more-with-dr-rangan-chatterjee/id1333552422?i=1000587930099

I don’t understand how she doesn’t see that she’s going the same way

Because she can't. That is the nature of dementia.

OP, kindly, I think you need to face facts here.

And first things first - have you got lasting powers of attorney for her? It is really important that you get both kinds, while she still has capacity.