When Grandma is not aging well?

[Lisa1970]

My grandmother, who is my children's great grandmother, used to be so wonderful, kind, patient, I even named my only daughter after her. She used to be the example of how a person should be.

Now she is rude, aggressive, verbally abusive....her age has caught up with her. I have been told by my sister who lives close to Grandma that Grandma does not even remember the interactions and things that happen when she is visiting here. I definitely think dementia has set in. She is 84 yrs old.

I like to believe that she would not be this way if her mind were working well, but it gets harder and harder to remember the good times. Then she got so out of control the other day that I ended up having to pick up my children and remove them from the house to get away from her. She is staying at a different relative's house during this visit. I have not seen her since and she is leaving on Wednesday. 

My daughter, who is 14, said to me, when we left the other day "wow, Grandma really does have age issues. ummm, Mom, are you going to be like that at that age." I just told her not to worry, but if I am, put me in a nursing home and don't feel bad about it." Which I am serious about that. My daughter thinks I will live with her in old age, but I don't want to think that I would leave her only with memories of me being mean, cruel, and aggressive. 

My other sister calls me tonight because our grandmother blew up at her daughter because, they were all going to go out to eat and had not left. My niece went to the bathroom. All of the sudden, my grandmother decided she had to leave immediately and got very angry at niece for being in the bathroom. Niece was only in there for a couple minutes, this was not a long bathroom break. But Grandma really lost it on her over it.

A couple weeks ago, she was looking at my boys and started talking about how defective boys are and how they are all missing something with their defective Y chromosome. Seriously, she said that right in front of my 4 sons. She also said on her last visit before that that I never should have had my last four children. I have 5 so this means I never should have had my daughter or any of the younger ones. My daughter was sitting right next to her. 

I do not think my children should spend any more time around her. I don't want them to only know her as a hateful person. My daughter is now asking why I named her after my grandmother. It really is sad. 

Suggestions? Grandmother leaves on Wednesday I think and hopefully won't be back until spring so we won't have to deal with this again until then.

[Smokering]

That sounds so hard. :( Until Wednesday, maybe you should have a talk with your kids about how Grandma doesn't really mean these things, how the dementia is making her act unlike herself, and so on. If you approach it with humour, maybe you can tip them a smile and a wink next time she says something outrageous and they'll go "Oh, it's just Grandma", rather than taking it to heart. 

[peainthepod]

I definitely would not subject my children to any more time with an abusive adult, dementia or no dementia. Explaining it away as dementia doesn't protect them from the hurtful words and abusive behavior. I think you should be entirely honest with them: your grandmother used to be very kind, loving, and sweet, but it seems that her advanced age is changing her personality and so you won't be spending much time with her anymore.

What a tough spot to be in. I'm so sorry.

[kathymuggle]

If you choose to see her again, I would not bring any younger children who would not be able to process things she says.

I might bring a teen if they wanted to go.  If  your older DD has had a long positive relationship with her grandma prior to dementia, she might want to visit with her -   dementia or not.  I can certainly see my older kids wanting to visit my mother, even if she developed dementia.   I would definitely lay out the option for a teen.

I would keep any visits short and have an escape plan - do not be left in charge of her, or dropped off anywhere without a car.

I would also work on keeping any happy memories alive for your kids - talk about when grandma did this, look at photos, etc.

[Jessnet]

I agree that you need to protect your younger children from grandma's outbursts, but with your older ones you need to explain that her behavior changes and lack of memory are classic symptoms of Alzheimer's. Grandma is sick; grandma is not an innately abusive person. Instead of ostracizing her from the family, you need to show some compassion for her illness and help her get medication and therapy.

My grandmother has been diagnosed with Alzheimer's. In fact, it wasn't her memory that tipped our family off to my grandmother's Alzheimer's condition, it was her radical behavior change. Like your grandmother, she went from a sweet, thoughtful person to an angry and paranoid woman. She would accuse us of stealing things and imagine fights that never happened. It was heartbreaking for everyone around.

Here's what we learned:

Get your grandmother on medication....NOW. There is medication out there for Alzheimer's that works wonders. We cried after my grandmother started taking the medication - we were so relieved we had our sweet grandmother back. This medication has also offered glimpse of the world from my grandmother's point of view (she can clearly articulate problems she is having on it) and how it could be affecting your grandmother:

With no short term memory she has no concept of time.

 - No it was not acceptable for her to yell at your niece, but unlike you, grandma has no concept of time. Was your niece in the bathroom for 5 minutes of 5 hours, grandma doesn't know.

With no short term memory she has no idea what has just happened to her or what conversation she just had.

 - She feels angry or frustrated and has no idea why. Should she have lashed out at your children, No. But she will look around and look for the most plausible explanation as to her feelings  and think 'hmmm...children are around, the children must be annoying me.'

Other things my grandmother has shared about Alzheimer's

*There are moments of normalcy where we have found my grandmother crying and telling us, 'please don't remember me the way I am, remember me the way I was. I don't know why I think like this now.'  Heartbreaking.

*With no memory grandma is entirely dependent on us to interpret the world for her. she has to TRUST us that we are doing what's right. That is super scary. When your brain is telling you one thing, but you have to believe your family, who are telling you another. example: Grandma doesn't remember putting her purse in the closet, Her brain is telling her someone stole it because she left it right there on the counter. She has to trust us that we didn't hide/steal it from her and that it's in her closest instead.

Quite frankly, with the attitude of 'let's ostracize her' as your solution to the problem, grandma is never going to feel safe enough to deal positively. Help her with her illness. Don't punish her for it. If you loved her enough to name your daughter after her, love her enough now to help her.

Yes, keep you children safe (and at a distance) but you, as an adult, have a different responsibility than to sit around and call her abusive.

Abusive people have intentions to hurt people, your grandmother, sadly, has no intentions. 

Edited by Jessnet - 11/16/10 at 7:09am

[eepster]

ITA with everything Jessnet said.

I want to add, that it isn't necessarily Alzheimer's, strokes and other illness can cause these problems too.  Some are more treatable than others, all need a Dr to be dx'ed.

I went through my GM and a grand aunt both having dementia (GM had suspected Alzheimer's, GA had multiple strokes.)  It is hard and frustrating, but it is worth not just writing the person off.  

You and your older kids can still visit her and realize that it is the disease and not her when she becomes belligerent.  also, once you have figured out her patterns, you may be able to time shorter visits from the younger kids so that you see her at her best.  People with Alzheimer's are often their most lucid and closest to their normal personality first thing in the morning.

[beanma]

Does she have a diagnosis? I agree that it does sound like Alzheimers or something else neurological like a TIA or mini-stroke. I'd urge your parents to get her seen/treated as soon as possible.

Your relationship with her will change, now, but that doesn't mean that you have to cut off contact. It may be better for your younger kids to only see her for a brief moment. If your DP is available when you visit DP might be able to take the younger ones out. Generally patients with Alzheimers do better in familiar surroundings when possible. It might be better to visit her in her home rather than her to travel. It depends on her caregiving situation.

You might view her cognitive functioning as you would a young child. When my dad was suffering with dementia (not Alzheimers) I avoided out-right correcting him when I could as that would make him defensive and could make him angry. I would stall, or change the subject. Using the PP's example of the stolen purse scenario, it's much like a little kid saying "Somebody took my toy! I left it right there and it's not there anymore. Somebody took it!" My response with a confused elder would be similar to my response to a frustrated little kid, though, maybe a bit more patient. "Hmmm... it doesn't look like it's on the counter any more. Let me look around and we'll see if we can find it. Maybe it got moved," instead of "Nobody stole it! What are you talking about?!". I just avoid directly contradicting them.

An older adult with dementia often feels belligerent because they feel out of control and feel unsure and are grasping at straws to help themselves feel in control. It's very hard. Please be sure to support your parents as much as you can. With young children it can be tough, but even a shoulder to lean on will be appreciated.

[Dar]

Yes, a full medical workup is definitely in order. She's not abusive... she's ill, clearly. I know how hard it is to be with someone going through this sort of issue - my grandma is 97 now and has been struggling with dementia for a long time, and my mother slipped into it in the days before she died of cancer -  but it really helped me to think of this behaviors as part of the illness, not the person. She doesn't really mean the things she's saying.

Also, traveling to a new place can be particularly hard on someone whose cognitive functioning is declining... she may not always rememeber where she is or why she's there, and that can be really scary... and people often lash out when they're scared.

I would tell your kids the truth - Great Grandma is sick, and she doesn't mean the things that she says, and it's very sad because we miss the way she was. Maybe it would help to show them photos of her from before she got sick, and home video, if you have it, or just tell them stories about how loving and kind she was.

[Jessnet]

Originally Posted by eepster 

I want to add, that it isn't necessarily Alzheimer's, strokes and other illness can cause these problems too.  Some are more treatable than others, all need a Dr to be dx'ed.

Thanks for adding that there could be other causes other than my suggestion of Alzheimer's. I  completely agree. There is no doubt from the description in OP's post something medically is going on. I can not stress what a difference medicine and therapy made in our lives.

In addition to understanding the anger is often a manifestation of fear and confusion, I also think (along with other PPs) that the OP needs to stop taking her grandmother's behavior so personally. OP is explaining her side in the post from a point of view as if her grandmother does these things on purpose and has normal cognitive functioning over what she doing - as if the grandmother looks at the OP's kids and decides, "I'm going to insult them by talking about their chromosomes". 

With elderly dementia this is just not true; they really don't function in the same world we are living in.  To punish grandma for her inappropriate outbursts by not visiting for the rest of the trip does no good - she doesn't remember why you are away!

Like PP's said, it helps to always remember it's the illness talking, not the elderly person. If it wasn't something the grandmother would have said years ago, it's not true now. Does that mean what the grandmother says won't sting from time to time? No, but if you can realize this is not "her" talking, you can get past your own hurt and provide her the compassionate and appropriate care that you hope you would receive if the roles were reversed. 

When you accept that it is not "her" saying this stuff you can laugh about all the crazy things grandma will say that are insulting and false.

Edited by Jessnet - 11/16/10 at 12:12pm

[PrincessWinnie]

We are going through this SAME thing. My grandmother is 85 and is definitely in late-stage dementia. My entire childhood and up until about 3 years ago she was the kindest, gentlest, sweetest person on earth. Truly the kind of grandma everyone wished they had. She was the "honorary grandma" to all my friends and she greeted anyone with hugs and compliments, even if she barely knew them.

Now? Ugh. It's not pretty. Since about 2007, she complains constantly, her short-term memory is completely gone so she complains she hasn't eaten dinner when we just ate 3 minutes ago, she fusses at my son for doing things he's perfectly allowed to do, says nasty and ugly things to everyone around her. Her inner monologue is gone so she openly makes nasty comments about people in public, like "Wow look at that woman she looks like something the cat dragged in" in a loud voice. She's taken up issues with..ummmm... people of color. So you can imagine how THAT goes in public (we rarely take her on an outing that doesn't involve a doctor's visit for this reason). When we watch tv she complains about how many "colored" people there are on the show. Ugh.

She says she feels sorry for me for not having any girls, yet she had 3 sons and I'm sure they don't appreciate hearing that. She constantly grabs my son by the arm and asks his name and how old he is. He's 6, he gets aggravated at having to answer the same thing over and over again, and it's veeeery hard to explain why she does that and how was once a truly wonderful and amazing person. It's a tough battle. We're not discluding her from a holiday or family meal - although sometimes it seems like it might be easier since she has no idea why she's there or what's going on - but it's getting stressful with kids around trying to shield them from some of the hurtful things she says.

[lalaland42]

Originally Posted by Dar 

Yes, a full medical workup is definitely in order. She's not abusive... she's ill, clearly. I know how hard it is to be with someone going through this sort of issue - my grandma is 97 now and has been struggling with dementia for a long time, and my mother slipped into it in the days before she died of cancer -  but it really helped me to think of this behaviors as part of the illness, not the person. She doesn't really mean the things she's saying.

Also, traveling to a new place can be particularly hard on someone whose cognitive functioning is declining... she may not always rememeber where she is or why she's there, and that can be really scary... and people often lash out when they're scared.

I would tell your kids the truth - Great Grandma is sick, and she doesn't mean the things that she says, and it's very sad because we miss the way she was. Maybe it would help to show them photos of her from before she got sick, and home video, if you have it, or just tell them stories about how loving and kind she was.

I agree with Dar here.

Also, you said that it a problem with aging and to some degree that is true but some people do not decline mentally before they pass at an old age. I don't say this to rub it in, but because I want you to realize that this is part of an illness. My grandma sounds a lot like yours, both in the past and the present. Last time I took my big kid to visit, she and I argued some and scared my DD (age 5) a little. I talked to her about how Great-Grandma is getting older and having memory problems and that scares her. And I tell her about my memories of Great-Grandma when I was a kid and how she held DD the day she was born.  

DH's Great Aunt, who was also an awesome person, did not decline mentally at all before she died suddenly at the age of 94.

It is profoundly unfair. 

One last thing, I asked someone if my Grandma even remembered me calling (I live on the other side of the planet from her) because it is logistically difficult to call her. That person said they think so, that even though she didn't remember me calling 10 minutes later, somewhere down deep she knew. So I went and called her. I got an email from my Aunt later that day saying that when we got off the phone, Grandma told one of the people working at her assisted living place that her granddaughter called all the way from Switzerland (where I really do live!). She cried for a few minutes about how special that was and then went on to have a good day. 

Even if your Grandma has declined mentally, I think that visits, calls and letters from you make a difference. It should also make a difference to your children to see how compassionate you are toward your Grandma, even when things aren't going so well for her. :hug And I am very, very sorry. 

[nextcommercial]

I would keep the kids away from her for her visit.  But, I'd also tell the kids that she's not who she was.  Tell them who she really is deep down, and tell them all the wonderful memories that you loved about her.  Show them pictures, do everything you can to show them what and who she's always been.  She's lived an entire lifetime being a wonderful person, but now she's sick.  Not mean.

[eepster]

Originally Posted by lalaland42 

One last thing, I asked someone if my Grandma even remembered me calling (I live on the other side of the planet from her) because it is logistically difficult to call her. That person said they think so, that even though she didn't remember me calling 10 minutes later, somewhere down deep she knew. So I went and called her. I got an email from my Aunt later that day saying that when we got off the phone, Grandma told one of the people working at her assisted living place that her granddaughter called all the way from Switzerland (where I really do live!). She cried for a few minutes about how special that was and then went on to have a good day. 

Even if your Grandma has declined mentally, I think that visits, calls and letters from you make a difference. It should also make a difference to your children to see how compassionate you are toward your Grandma, even when things aren't going so well for her. :hug And I am very, very sorry. 

Letters were wonderful for GM.  I could read her the same ones from her friends over and over again and each time it was like it had just arrived and she was hearing it for the first time.

[Dar]

Oh, yes! My grandma is not up to reading actual letters anymore, but she can and does read greeting cards with short notes, and she enjoys them very much. She keeps a stack of them tucked beside the cushion of the chair she sits in most often in her room, and she pulls them out often... and reads them over and over.

[LaLaLaLa]

My grandmother, who is 82, is going through a similar thing.  Her husband died five years ago, she lives alone, and she just hasn't been the same since.  At first she was kind of mean, and out of the blue she's decided that she and my father (her son-in-law) hate each other.  My father, who is the most gentle and sensitive and compassionate person, is somehow out to get her, and she'll say things like "well, I don't think I can come over, since F and I hate each other."  My dad has tried explaining he doesn't hate her, that he's never had anything against her.... no response.  Apparently all of a sudden he scares her, and she's made my mom swear that my father has never hit her.  He is, without a doubt, the most unlikely person to ever hit another person.  I've never even heard him raise his voice.

We've kind of passed through the angry phase and are now into a vague period.  My grandmother has lost a lot of words; in a conversation she's often struggling to pull up the right words, and she doesn't follow along as well as she used to.  She was very confused by my anniversary, my parents' anniversary, and DH's birthday, all occurring in the same month.  She used to be the kind of person who bought the appropriate gift that matched up with the years of marriage; gift-giving was always very important to her.

My kids aren't bearing the brunt of any of this; luckily my grandmother adores both of my kids, plus my brother's daughter.  She says the three great-grandkids are all that she's living for, and they are the main spot of delight in her life.

Parts of my grandmother remain.  She is the most talented piano player I've ever met, able to play nearly anything by ear and to improvise for hours.  She volunteers playing the piano a couple of days a week at her local hospital, and she thrills my kids by playing songs for them whenever we see her.

Mostly, though, the grandmother with whom I grew up is gone.  She was wickedly funny and mischievous, always letting me and my brother get away with things when she was with us, and she could get us laughing like nobody else.  She was always so kindhearted and fun, and I'm sad that she's descended into paranoia and delusions, and especially sad to see her targeting my father, whom I adore.

My mom is an only child, so she is dealing with all of the craziness.  She's started keeping a journal, just to have everything on record in case she ever wants to talk to my grandmother's doctor about maybe assisted living or something.  She's trying very hard to treat this as a disease, something that her mom can't help doing, but she can't help taking it personally when her mother is spewing nastiness about her husband all of the time, giving the impression that she NEVER liked him in all the 30+ years of their marriage.  It's hard because my grandmother doesn't cultivate friends, so the only one she talks to and vents to is my mom, and she's lost the internal censor that would stop her from hurting my mom's feelings.

Anyway, all this is to say that I understand.  And I'm so sorry.  And I'm living some of the same experience, and expecting things will only get worse, especially if my grandmother remains as bodily healthy as she is, while her mind deteriorates.  It sucks.

[camracrazy]

Wow, you could be talking about my grandma.

She helped raise us and is still a big part of my life. She has been taking care of my grandpa for the past few years with his medical problems and Alzheimers. He passed away last week.

I don't know if it is the stress of being a caregiver or what, but she has totally lost her internal edit button! A month or so ago she saw one of my childhood friends who used to spend a lot of time with me when I was with my grandparents. She said loudly, "She's put on a lot of weight, hasn't she?" OMG I just wanted to die. Grandma has also made off the wall comments like she thinks my sister is an alcohlic. I have given up responding to her when she says rude and hurtful things. She can also be manipulative and lay on the guilt trips like nobodys business. She is still good with my kids most of the time, though. It's hard to know what to do when someone has been such a major part of your life for years.