Dear Carol: My mother has Alzheimer's and has been swearing up a storm. She's rude at times and is getting harder to take anywhere because she makes a scene wherever she goes. She is on Aricept and an anti-depressant, but we feel she needs something more to help her. My father is a saint and cares for her, but it's getting harder every day. What can we do? - Olivia
Dear Olivia: This behavior is not uncommon with Alzheimer's disease. It's especially disconcerting to the family if the person behaving in that manner is a formerly sweet person who never used coarse language.
People with Alzheimer's disease suffer a huge amount of frustration. Not only is their short-term memory deteriorating, they often can't make sense out of their surroundings, and many suffer from generalized paranoia and other frightening symptoms. They also tend to lose social inhibitions.
It's heartbreaking for people like your dad who see a once "ladylike" wife turn into a "fishwife." This is your mother, so it's painful for you, too.
From what I've read, the issues with swearing and other distressing behavior can't be completely chalked up to the loss of inhibitions and frustration over situations. Most people experience this as the disease progresses, but not all become so aggressive in language and actions.
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There is still so much to learn about Alzheimer's and other dementias. Researchers are now finding that many people with dementia have multiple types. Different types of dementia affect different parts of the brain. Could this explain some of the differences found in how people with Alzheimer's behave? More research will need to be done to find out.
Meanwhile, you have your situation to cope with. Your mother may benefit from a combination of Aricept and Namenda, two drugs commonly used together. You could ask her doctor about that.
Also, keeping her away from anxiety causing situations when possible may help. Anxiety is something that could set her off. Many a sweet person who never swore in his or her life starts to swear a blue streak as the disease destroys their personality. You and your dad have lots of company with this issue. Hopefully, a combination of talking over her medication with the doctor, and lowering her anxiety level may help, but these steps aren't likely to be a cure.
Remember that this isn't about you. It's distressing, as you worry about her dignity. I've been there, as have many of us. But this is no reflection on you, and sometimes we have to develop thicker skin.
Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com . She can be reached at carol@mindingourelders.com .
