How can I cope with a dementia sufferer with depression?

[ExD]

We have enough trouble getting her to take the pills she is aready prescribed, so we'd really like some pointers as to how to raise her spirits as she seems determined to be miserable, rather than adding antidepressants to the list. Her GP says its all he can offer although we know from past experience that they only make her drousy.

[bowlingbun]

I'm not sure it IS possible to make someone with dementia happy, so many people here have to make do with someone being miserable, as if it goes with the territory somehow. Almost as if all the senses are dulled?

[Sally_1703123]

If you ever find out let us know. Ours is demented, depressed and wants us all to join her I think! Also nasty... then says she is lonely as nobody wants to visit her.

[jenny lucas]

To be honest, I wouldn 't bother trying. Especially if they refuse meds and then are nasty to you to boot.

I mean, why bother??

(That's slightly different from if they are depressed because they know they have dementia, but are 'doing their best' to alleviate it as they can - eg, taking their meds and being appreciative of their caring family!)

Some folk just don't deserve any effort to be made for them. Sorry ,but there it is.

[ExD]

You've all hit a lot of buttons - thank you for understanding.
This nasty, spiteful streak that seems to surface in so many dementia sufferers is so dificult to cope with, it makes you wonder if its been there all the time but is just surfacing now when they have lost the veneer of politeness they were taught as children. Some of the things she says would break your heart if you took them seriously. Beginning to think I'm getting depressed myself, must snap out of it.

[jenny lucas]

I probably did sound a bit callous, but I guess we have our limits. Looking after someone with dementia is dispiriting enough, and increasing hard work as the dementia worsens, so I guess having to be 'the court jester' and cheer them up constantly is just on the 'too damn much!' side when they seem to 'insist' on being miserable ,and expecting YOU to do something about it!

You raise the disturbing question of whether that 'spitefulness' is inherent but masked by social expectations, sort of along the lines of id/ego/superego....the idea that we would ALL be 'pure id' if we actually could get away with it!

That the 'spitefulness' is a form of the dreaded 'disinhibition' that dementia sufferers can show (I can remember David Baddiel the comic saying how embarrassing it was that his father with dementa became highly disinhibited around young female nurses...gross gross grosss!), but applied to 'personality' rather than physical displays....

It would be nicer to think that maybe dementia only unbalances our for-want-of-a-better-term 'Manichean' or 'Ying/Yang' mentality - ie, if we assume that we are all 'equally likely to be good or bad' and could go 'either way' in life (usually depending on how we are brought up of course!) (eg, could Hitler have been raised to be a nice guy etc??) - and that all dementia does is 'tilt' the usually balanced mind into the 'bad' side of the moral weighing scales!

Maybe another way yet is to think of dementia as bringing out (sometimes!) our 'inner psychopath'! Maybe that's akin to the 'pure id' personality (and in a way, I guess that who psychopaths are - NO concept of 'other people' at all!) (except as mugs and victims and slaves)

In the end, I suppose it doesn't really matter what the cause of the altered 'spiteful personality' in dementia is - it's how we deal with it.

I would say cut SOME slack (in the same way that someone in pain can be 'tetchy' so we cut them some slack!), but not excessively so at a high cost to yourself.

To my mind, if the bottom line is they can't be happy anyway, and nothing you do can make them happy, then why bother putting yourself out at all for a 'lost cause'????

[jenny lucas]

Sadly, none of the above addresses the upset we feel that someone we love and who has previously been loving, seems to turn into a 'malign 'form of themselves....really upsetting.

[ExD]

I suppose we should try to find some humour in the situation, but the hurtful remarks can bring out the child in us so easily - eg - she says something like 'well you always were a little shit' and instead of stomping off in a huff (which I'd like to do) I reply 'well it means I'm really good at cleaning it up then'.
But its hard isn't it?

[jenny lucas]

Hmm, I'm not sure slack SHOULD be cut too much!

One technique I adopted (finally) when I worked in a 'toxic office' for a while, where people were pretty nasty up front, was simply to 'reflect back'. I adopted a policy of simply reflecting back the behaviour that was handed out to me. If someone was polite and considerate and 'normal' so was I. If they were hostile and spiteful, I 'bit back'.

So, whatever the underlying 'cause' of your mum's horrible spitefulness -and that's a REALLY nasty thing to say to you, what she said!) - I don't think there's anything morally wrong in 'biting back'.

I would say 'if you speak to me like that I won't do another thing for you - so apologise and I'll get your lunch, or you can go without. Why should I put up with such cruel and unfair insults and rudeness form you when I don't deserve it!'

Or simply insulting her back. 'Takes one to know one' or whatever. (eg, 'and you're a vicious old bag!')

I certainly wouldn't grit my teeth and put up with it!

Maybe that's not a very 'christian' attidue, but I'm a real eye for an eye person! I'm not much good on making 'excuses' for bad behaviour! (which may just be stupid of me, if those with dementia are truly 'beyond personal moral control' of their behaviour???)

[ExD]

Well yes, I'd like to answer back with an equally cutting remark - BUT she's not going to 'learn' from it is she? She's incapable of learning (a toddler can learn, she can't) it might make me feel better in the short term but it won't stop her from saying these things again and again if she feels like it. She's a 'toddler' now, soon she'll progresss into being a baby. She isn't going to be cured.
This sounds horrid, but I can quite understand carers in Care Homes getting cross and slapping their patients, it won't cure them but the carer may feel better.
BTW the 'little shit' was quite a mild rebuke - think in terms of - 'I never wanted you in the first place I always wanted a boy' and 'you're enjoying torturing me aren't you, you should have been in Hitler's SS' ......... I could go on. I've got used to ignoring them.
But thats a totally different issue from the depression which I think is caused because she know's whats wrong with her, and she knows she won't get better, and I think it's partly to blame for the insults. There are drugs for depression - don't they work for dementia sufferers?
Its a desperate situation to be in isn't it, for her as well as me - and probably you???? and you??????