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The worst issue my mom has now with dementia is loosing track of time, not knowing what day it is, confused about meal times etc. However, there are little things she does that I'm wondering if they are part of the dementia: 1) She tells me the "people in her AL dining room are are old and ugly." (she is 84) 2) She will talk about people being fat and yet she is 208. 3) She will hone in on something about the way someone looks such as their teeth or nose and comment about it. Not directly to them but inappropriate none the less. 4) When the aide comes to bring her meds in her AL place, they are in plastic packets, with the name of the meds listed. She saves these empty packets and got very mad when I tried to throw them away. 5) Walking down the hallway she might notice a scuff on the wall and then proceed to tell me "this place is such a mess. The baseboards need to be painted, etc." The place is nice and clean, in my opinion. 6) Extremely worried about how she looks, if her navy blue pants are blue or black and if they precisely match the color of her shirt. All of these things have been going on for awhile but I really didn't think it was dementia but could it be? Or is she just odd?

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So, your mom has been diagnosed with dementia, right? So has my mom. I saw a CAT scan of her brain a year or two after her diagnosis. My goodness, there was more empty space than brain! I gained an appreciation for how "broken" her brain was.

Is there a geriatric psychiatrist who can see your mom? In my experience, these folks can sometimes work wonders with meds, ameliorating mood, obsessions, agitation and depression without causing excessive drowsiness.
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It's difficult to say why your mom may be making odd comments, but since she has dementia, it's quite likely that has something to do with it, especially if she didn't used to be this way. (You might rule out infections, medication reactions,etc.)

I know how my mother has acted for all of my life, so if she was calling people names, making a big deal out of nothing, then I would take it that the dementia was causing it. It sounds like she is quite observant. I might use that to her advantage as she sounds able and willing to discuss what is on her mind. That can be a good thing. I would just ask her lots of questions and let her describe anything on her mind. It should be amusing.
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She actually does not have a diagnosis of dementia. During a recent hospital stay, a neurologist came into give results of a MRI that was taken to rule out stroke. In any case, the neurologist said she "probably has some early dementia" but was a rather off the cuff remark. Because that is not why she was in the hospital, I did not pursue it further. That was 4 months ago and clearly she has confusion (not every day) and these other odd things. She sees her primary care doctor in a few weeks and I'm going to discuss it with him and see about getting a referral to another doctor that can offer some help. And Sunnygirl, I did ask her about the comments regarding her AL place and she just kept saying "It's not perfect here." And the saving of the med wrappers I'll bet is a way to control her situation. She used to take her own meds, and had cards that she made herself all over the house that said what each med was and when to take them. She doesn't have those now since they are given to her so saving the wrapper is the only documentation she has.
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ALG, I have found that people who make rude comments about how other people look do that because they are not happy with how they, themselves, look. So making fun of others makes them feel better.
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It sticks in my head, my mothers comment when my brother and I took her to see the nursing home we were considering for her. After we left I asked her what she thought - she just made this skrewed up, sour face and said "no". So I asked why - what's wrong with it? Moms reply "it's a pig sty". Trust me - this place is far, far from a pig sty. It's only a few years old and is very posh - hard wood floors, vaulted wood beam ceilings, large stone fireplace in the main common area, another smaller fireplace in the library, beautifully decorated with attention to detail - it more resembles an up-scale ski lodge than a nursing home. Plus it is very clean with absolutely no smell of urine or that old people smell. But the killer part of her comment is my mother has always been very messy, cluttered and frankly, half a notch away from being a complete slob! I now know it was the dementia talking. Mom could not articulate any better than that and her inability to reason made it impossible for her to see how ridiculous her statement was. It's kinda like when mom use to do what I called "fill in the blank". Mom couldn't remember something and didn't want to admit it so she would just make something up. Like the time she fell and the IL people didn't discover her for about four hours - she started telling people she passed out - falling and was unconscious for 15 hours! She doesn't comprehend how totally outlandish the things she claims are. Perhaps your mother is trying to seem alert and still with it but these comments are the best she can do. Is she able to carry on a typical conversation anymore? The answer to that may be the key to this new behavior.
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If I were you I would try to see a doctor that can discuss the MRI findings more thoroughly. Many years ago my mom had an MRI because she was having TIA's, our GP told me her brain "lit up like a christmas tree" and sent us off to see a specialist in stroke prevention. The MRI findings were never fully explained or mentioned again. It wasn't until I joined this forum that I understood that many mini stokes or TIA's lead to vascular dementia. You need to insist that someone sit down and show you what caused that neurologist to make such a statement and what that means for your mother.
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If possible, have her primary care physician refer her for an assessment by a neuropsychologist. Her responses to qustions and activities are compared to others her age who are not cognitively impaired. My mom had two hours of assessment activities and we had a follow-up consult with a 12 page report given to us and to primary doc.

A thorough assessment is needed to obtain a relatively accurate diagnosis. The diagnosis is needed for present and future medical, legal, and financial decisions.

My mom fought me the whole way and and even threatened to jump out of the car when going to and from the assessment appointments...but things are calmer and we now just refer to the results as "the short term memory problem".
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Yes, I'd make a list of your observations and discuss them further regarding the MRI with a Neurologist. The doctor should be aware of what you are seeing, such as the confusion, odd behavior, post it reminder notes around the house, etc. They may recommend a neuropsychological evaluation, as described above. If she is up for that, it could answer some questions regarding what is really going on.
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My mom was diagnosed with severe dementia (probably alzheimers) last October and she does this kind of thing too. She saves all receipts. She had her po box keys changed and had the new ones and the old (not working one) on her key chain. I took off the non-working one and threw it away. She got it out of the garbage and kept it (she might need it). When we walked in the neighborhood, she would comment that these people keep everything so clean, but those people are so dirty (she would then point to the dry leaves which had fallen from the trees or the wind had blown there). She has always been critical of other peoples looks but she is more vocal about it now.
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yes yes my mother did all you said.
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