Columbia, S.C. – Sharon Langley lived in fear of her housemate, who tried to hit and bite her and threatened to kill her. One night, Langley had to pull a heavy dresser across the hallway to try to keep the other woman away.
The would-be assailant was Langley’s 87-
year-old mother, whose Alzheimer’s-type dementia has progressed over the six years they have shared a home.
“It was really awful,” said Langley, an audiologist. “I did become frightened of living with my mother.”
Caregivers like Langley dread what could happen with their parents – what allegedly did happen with Jack David, a Kershaw County, S.C., man with dementia accused of shooting his wife to death July 2.
Screening and early intervention are key to slowing the progress of dementia, said James Bouknight, director of geriatric psychiatry at the University of South Carolina’s school of medicine.
But family members sometimes miss the clues.
“Although I saw my mother regularly, I didn’t see it,” Langley said. “Other people called it to my attention.” Early signals of dementia include memory loss and suspiciousness.
“People can become quite paranoid when they’re demented,” Bouknight said. “They can believe that loved ones are trying to harm them. It’s pretty bizarre kinds of things, but they believe it.”
Langley’s mother fixates on finding her baby daughter Sharon. Not recognizing her daughter, she sees the adult Sharon as someone trying to prevent her from finding her child.
“It breaks my heart when she doesn’t remember me,” said Langley, who is in her 40s.
Alzheimer’s accounts for up to 70 percent of all dementia, but other kinds of dementia exist, such as that associated with Parkinson’s disease and AIDS.
The most important thing for families to do is make the home safe, Bouknight said. Remove firearms and never leave a demented person alone at home because he or she might create hazards by turning on taps and stoves. Never lock a demented person in a room alone.
Over time, Langley started understanding what was happening to her mother.
“I removed knives and anything that could be used to hit me,” Langley said. “I learned to anticipate when the behavior would start.” To keep her mother stimulated, Langley encourages her to watch television or cut out coupons using safety scissors.
Sandy Lyles, who lives in Chapin, S.C., said she also learned to accommodate erratic behavior from her mother, who has Alzheimer’s and moved in with her six years ago.
Before that, Lyles’ 82-year-old mother, Rose, had lived in Pennsylvania, with another of her daughters, and Lyles, 58, lived alone with her two dogs.
Early on, Lyles’ mother was self-sufficient, but as time went on, she needed more attention. Lyles said she has to be vigilant about making sure her mother – a woman who previously would not present herself to her family in the mornings until she had freshened up and changed her clothes – takes a shower and changes her clothes.
“She’s just a completely different person than what she used to be,” Lyles said of the woman she remembers ruling their home with a strong hand.
Her mother also has become more aggressive. On a recent weekend, her mother tried to strike her, and she often curses at Lyles, calling her names.
“She screamed and yelled at me when I was little, but not that kind of screaming and yelling,” Lyles said. “I want to say to her, ‘How can you do that to me? I’m the one taking care of you.”‘ Lyles said she doesn’t think much about the possibility that her mother’s behavior will worsen.
“If it comes, it comes,” she said. “I’d go for help and say, ‘What do I do now?”‘
For now, she has found a way to release her frustration.
“Sometimes I want to go off the deep end. I bang walls and slam doors,” Lyles said. “Then I look at her, and I feel sorry and I say, ‘She’s not the same person.’ I used to take it to heart, but I try not to take it to heart because I know it’s not her.”
Caregivers of people with dementia are four times more likely than the general population to suffer from depression, Bouknight said.
“These people often need treatment, too,” he said.
They also need to sleep so they can handle the challenges brought by caring for a parent with dementia.
“The number one advice for treatment of Alzheimer’s is that the caregiver sleeps,” Bouknight said. “If the caregiver doesn’t sleep, they can’t take care of the patient.” Langley doesn’t bang doors to cope, but she breaks things, things that are precious to her, an expensive watch, a vase, figurines she had saved from childhood. She also talks and plays with a pet bird.
And sleep is a precious and scarce commodity; her mother suffers from a syndrome called “sundowning.” The dementia gets worse, and her mother becomes more agitated, disoriented and suspicious, starting in the late afternoon and on into the night.
Langley said she went through a six-week spell when she couldn’t sleep because her mother’s condition was at its worst and she wandered around at night.
The doctor prescribed Prosom and Remeron, antidepressants, to help Langley’s mother sleep. The drugs have changed the lives of both women.
“She’s a lot less belligerent,” Langley said.
Doctors often prescribe sleep aids and take advantage of medications for other conditions that have the side effect of sleepiness to regulate the sleep cycle, said Bouknight, who also treats geriatric patients at Palmetto Health Baptist hospital.
In addition to medication, adult day-care services provide a measure of relief for caregivers.
“Thank god for the day care. It’s been a big help,” said Lyles, who drops her mother off at a day care every weekday morning and picks her up after work.
She said her mind is at ease during the day because she knows her mother is in good hands.
“We send them home tired, full and personal-care maintained.
Families can manage because they sleep well at night,” said Tammy Quarles, a nurse who for 20 years has owned and operated Columbia Adult Care Inc.
Quarles said she and other caregivers at the day care – which can accommodate 18 people – observe each client carefully and learn what might trigger a violent outburst. They watch body language and take note of any changes in a client’s surroundings or situation.
Aggression triggers for clients can include changes in medication or caregivers, or being around people new to them.
Langley has realized that playing along with her mother often helps reduce aggression. When she asks for her daughter, Langley will say Sharon went to spend the night with someone and they will pick her up the next day. Langley also drives her mother to non-existent places she insists on seeing.
“I see it’s really scary for her. I’ve learned to hug and comfort her,” Langley said. “It’s like I’m the mother now.”
