Posted by: Gina | 2009/07/08

Dementia/brain hardening

Dear Cyber Shrink

I wrote to you many moons ago about my dear mom, she is now 59 and after years of alcohol abuse, self medication and spirals of depression and meds she collapsed two years ago. The road was long to get her ' back' . Adult nappies, taught her to eat again, walk again, talk etc. out of 3 top private clinic in Jhb, the diagnosis was made that she had a hardened brain and nerve damage. After a year she was nearly herself again, and she stopped drinking all together. The psychiatrist put her on Wellbutrin and Rivotril and up to June the 6 she was ok, just under immense stress with having lost her house to the bank. Then is all went haywire, she is down to 40Kg' s, shaking, not sleeping a wink even with sleeping pills, intense paranoia, repeats herself over and over for days, become obsessive over the smallest things. Her brothers and sisters in CT flew her there as they thought she just needed " someone to be kind to her" . After 3 weeks they have said they cant take it any more and want us to come to CT to collect her. (like a package!?) They have taken her to see another Psychiatrist and he has said that its def brain hardening and nerve damage and she needs to go into a home. What do I do. Where do I start looking, do I try a convalescence home first to see if she can again recover.I feel like I' m abandoning her in her darkest hour if I put her in a home - but her ' new'  personality is just awful and nasty and its a constant nightmare. I stay in a flat with my sister and my fiance, and when the first incident happened I was not pregant then and could help her more then.
Any assistance on where to start will be so appreciated.
Kind regards , Gina

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Our expert says:
Expert ImageCyberShrink

I know, oh so well, how difficult this can be, as my own dear mom developed dementia, though without any alcoholism or other self-inflicted components. Now, dementia is a real diagnosis, but hardening of the brain I don't know of, perhaps a doc's attempt to describe dementia. ANY form of dementia would be made worse by alcoholism, so maybe her improvement related to stopping that. But it's odd that her decline after June 6 was so sudden and rapid. That might be worth the same doc's who know her previous state, investigating further.
Chronic alcohol abuse causes brain damage of some specific types, and though this may be improved by some specific vitamin supplements ( this needs to be cautiously planned, as the wrong vitamins could make the damage worse ). I'd also wonder, as does Liza, about the possibility of more self-medication including abuse of the Rivotril or something else, if she has been able to get hold of such meds. This needs to be checked and excluded or dealt with.
The CT family sound typical of those well-meaning people who have never realistically dealt with such problems. Its always far more difficult than people think. Unless any proper specialist can offer good reasons to expect a significant improvement, its not realistic to expect one. It really does sound as though she needs long-term care now, in a home experienced and equipped to deal with this. Discuss this with her psychiatrist(s) for advice. Putting her in a home is a thought that some of us feel very averse to, but if it provides her with a level of cae she neeeds and you can't provide ( and believe me, over the course of years it can be appallingly difficult to manage nomatter how well-intentioned you are ) might be kind, and quite he opposite of abandonment.

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Our users say:
Posted by: Liza | 2009/07/08

With this change in behaviour - can you be sure that she is not self-medicating again due to stress? Rivotril has a huge potential to be misused. (I' m talking from personal experience here!) It also causes terrible memory problems after long term and/or high dosage use. This could be the cause of her repeating herself.

Losing your home to the bank is also a very high stress event. It' s bound to cause all sorts of ' off'  behaviour with someone already predisposed with dementia. Caring for someone with dementia is also a full-time job. Will you be able to do this over a long term? Don' t think about it as abandoning your mother if you put her in a home. It means that you' re getting help for her that is much needed, but that you cannot provide.

Perhaps her behaviour is currently such that she doesn' t need a convalescent home, but rather a short stint in hospital to stabilise her condition. Her psychiatrist should be able to suggest what the best thing to do would be.

Good Luck

Reply to Liza

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