06/19/2009 - Questions and Answers

Behavioral problems and won't seek help

By: Mark Castleden



My mother keeps having personality swings which are especially distressing for my father, since he is recovering from a series of strokes. She refuses to seek medical help because she is afraid that she might be diagnosed as having Alzheimer's. What can we do?



You do not mention how old your mother is, or how long she has had her symptoms. We would also need to examine and carry out some investigations if we were to give you specific advice, and therefore our advice is only general in nature. Of course it is possible for her to have Alzheimer's disease, or indeed some other form of dementia, but without a careful examination of her psychiatric ability, we do not feel we have enough information to make or exclude that diagnosis with certainty. It is true that people with confusion can have periods of relative normality, but it would seem that your mother's condition is always extremely mild.

It is so easy to suggest that any old person who is a little bit abnormal in their actions could have dementia, and the assumption is that if they have dementia, they also have Alzheimer's disease. We should therefore make sure first that she really is confused, and not just emotionally unstable. If she is confused, the cause of her confusion needs to be found. Alzheimer's disease is only one possibility. There are many causes which are completely curable, although there are others, of course, for which one can do nothing. In such cases, if one cannot cure the condition or treat it specifically, one should ameliorate the symptoms.

So, from your mother's point of view, we would suggest that it is in her own interests absolutely to have a correct diagnosis. The making of the diagnosis is entirely passive for her, and she does not have to have any treatment that is suggested after a diagnosis has been made if she does not wish to have it. It really would be unwise to embark on any specific treatment such as Aricept or even herbal medicines which are not placebos, without a good accurate diagnosis.

If the condition in your mother has only started since your father had his strokes, then it may well be a reaction to that, and she might recover if she was given the correct treatment. It may be, however, that she had the condition before your father had his strokes, and that his ability to look after her covered up any deficiencies that she had.

You can see, therefore, that the first essential is to make a diagnosis, and for that, your mother really must go and see a doctor who specialises in older people with her condition. Perhaps if you try and take it stage by stage. You might say, for example, that you would only go and see a doctor in his own office first of all, to see what he/she said. If that stage went OK one could perhaps proceed to investigations, and if that was OK and they were indicated, then specific treatments.

You need to reassure your mother that everything is being done for her sake, and her health is paramount to you, and what a terrible shame it would be to miss a treatable cause of her condition, or to miss using some medication that would alleviate her stress and disturbance.

Created on: 04/26/2000
Reviewed on: 06/19/2009

No votes yet