Examples of confusion

Oh, my poor momma!

Although I mentioned she has been in a better mood lately, I also think her confusion is increasing noticeably. It's hard to tell small changes because being with her every day gets you used to her quirks and how she communicates. But there have been some pretty major confused exchanges with her the last week or so that make me think she's getting worse.

I don't want to in any way seem insensitive to her by posting details here, but I do think it's important for me to describe a few of these situations so that other people with loved ones with dementia can understand what kinds of things to expect.

• Yesterday was the first time she showed confusion about my identity. She asked me out of the blue what my married name was. I told her I never used a married name, I have always used my birth name B____ (which is the same as her last name). So she said, "Then you're not my daughter?" and I had to remind her that I was.
• She cleaned the inside of the dishwasher today. Someone had put a cup in there which dripped some coffee into the bottom of it. I explained that the dishwasher cleans itself every time you turn it on, but she insisted on doing it anyway.
• She needed my help getting the washing machine started today. She didn't seem to know how to use the controls and couldn't recognize which container the detergent was.
• On a recent walk, for the first time she didn't recognize a road that she has been on over a hundred times.
  

The things described above are all new developments. Some of her daily symptoms that I have quite gotten used to include:

• She obsesses over many things. She takes walks about five times a day. She never thinks she has enough milk or bread in the house and always insists on buying more even when we already have too much.
  
• She is hyper-meticulous about housekeeping.
• She forgets words for things, and often substitutes German words (her first language) instead of English. Sometimes she'll halt mid-sentence, and get so frustrated not being able to find the word that she'll just say "Oh shit!" and get angry. It's usually best to help her finish her sentence and not draw attention to it.
  
• She has phases of napping excessively. Sometimes 15 minutes after a long nap she'll announce that she's tired and wants to take a nap, not realizing she just woke up from one. This messes up her sleeping patterns.
• She worries excessively over small things that normally don't matter. For example, she will lose sleep worrying about replacing a burnt out lightbulb. This is because the process of replacing it is too complex for her (find a ladder--> remove the bulb--> figure out what kind to buy--> remember to buy a bulb--> figure out where to buy bulbs--> figure out how to get there--> remember which light was burnt out--> find ladder again--> screw in new bulb). It's just too daunting.
  
• She uses a calendar to remember everything, but usually has trouble reading the calendar and figuring out what day it is.
  
• She gets very stressed about preparing family dinner. She seems to be okay making herself something simple, but if all three of us are eating she gets overwhelmed and sometimes gets anxiety attacks, even though me and AC usually make it. She insists on helping, but gets frustrated.
  
• She gets panicky if there are more than a few things in the fridge or pantry, especially things she doesn't recognize.
• She can't understand complex sentences with more than one idea. For example, any sort of instructions have to be explained one step at a time after each step is completed.
  
• She can hardly make any definitive decisions at all. Even simple yes/no questions such as "Do you like this TV show?" she answers in a convoluted way like "Well I can't really judge because I'm not familiar with these actors" (although she is). She almost never gives a straight answer about anything.
• She repeats questions and stories often, sometimes repeatedly in close succession, but usually spread out over several days. One of her favourite stories to repeat is about a dog that was so jealous of its family's newborn baby that it would turn its back on it. I swear she's told this story about 40 times since I got here 2 months ago, and she always thinks she telling it for the first time.
• She has a short attention span. She likes to change TV channels frequently. During a movie she'll have to get up and pace around the house or find a little chore to do. Interestingly, I have seen her read a book for up to an hour at a time, but she has to be really in the mood for it.
• She is suspicious, resentful and angry a lot, mostly towards me. I have to be extremely careful about how I say things or propose things to her to make her agreeable. A lot of her anger comes from the frustration of not comprehending things.
  

Some of the things she is still really good at include:

• Housekeeping -- although she often uses very odd methods and inappropriate tools or cleaning products.
• Personal hygiene -- she doesn't like anything to be dirty or messy, including herself and her clothes.
• Preparing simple meals that she is familiar with -- sandwiches, scrambled eggs, boiled potatoes, stir-fried meat and veggies.
• Safety awareness -- is paranoid about leaving the stove on, always locks doors, won't walk by herself after dark, won't walk alone on trails where there are not many people, won't open the door to strangers, won't talk to strangers on the phone.
• Stays active by walking -- however I think this is obsessive and causes her to burn more calories than she can consume most of the time. Also a possible risk of falling or getting lost.
• "Faking it" -- she is amazingly good at pretending she understands what's going on. She speaks very vaguely in conversations so that her confusion is not always apparent. She will laugh along with others, although she doesn't know what's funny. She sticks with things and situations that are familiar as much as possible, where it's less likely she'll get confused. She also has very lucid moments when she makes perfect sense (a glass of red wine helps!).
• Playing with children -- her personality has become so childlike that she has more fun with kids than ever. I think she feels safe around them because they can't judge her behaviour.