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I have not been able to find an answer to this question. Can someone with dementia who is angry and delusion at the beginning of the disease become gentle and compliant later as the disease progresses? I hear stories about how a gentle person can become angry and violent but I haven't heard of any longitudinal study of the opposite.

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My mom has her moments of both, but she always has. She is toward the end, but is physically healthy so will be with us for quite a while ;-)
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My mom has her moments of both, but she always has. She is toward the end, but is physically healthy so will be with us for quite a while ;-) hopefully.
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I have heard of and seen many cases where patients mellow out as the disease progresses. Especially when someone has an easygoing personality as their baseline they may go through phases of agitation or aggression in the moderate stages (often triggered by frustration or the environment) and then go back to being calm and content.
People who "always had to be the one in-charge" tend to get more angry and frustrated in the mild stages as they feel they are loosing control. This can continue through the moderate stage but eventually tends to burn out as they understand less of what is going on.

What the caregivers do with the patient makes a big difference as well. If the caregiver uses good communication techniques and adapts the environment in a way to help the person have a sense of control they often calm down. Delusions are often a passing phase that may stick around for 3-6 months but are rarely static. They change with the disease and situation.

Sometimes you get a person who has always been a difficult person but as the disease progresses they get nicer. A good example of this is the mom in the movie "Confessions of a Dutiful Daughter". The mom had never accepted that the daughter was gay. As her disease progressed she became more accepting and came to adore her daughter's partner.

In the advanced stages of the disease most patients tend to withdrawal and become more quiet. It may be harder for them to follow instructions as they have more difficulty with comprehension. In general they are less likely to act out. Because of this you tend to see a peak of caregiver stress from difficult behaviors in the moderate stage.
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Wow, it is encouraging to read the responses. I am hopeful that my husband will be less angry at me as his disease progresses. Oh, the irony of that statement...
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Yes. I have two family members who had alzheimers and were difficult, angry and unpredictable at the beginning and during the progression of the disease off and on. As their speech faltered and they did not want to eat (or forgot how) and became more confused, it seemed they began to just "relax" if you will... because they could not process thoughts or even feelings and became more gentle and accepting... That was later when they could not get around or even "want" to go or do things... Kind of a "twilight" state which I have also seen in many seniors I helped care for, closer toward the end.. Everyone is different of course but with my family members, the most difficult and sad times were the earlier stages of the disease when they fought against most everything and were scared or so confused about their changing self and had such paranoia. That was the hardest. Good luck and May God bless all of you.
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Yes, they can go either way. You usually only hear the horror stories of dementia. I was a caregiver to a lady who had been very difficult and demanding in her younger years ( as described by her children), but with Alzheimer's she was quite sweet and easy-going.
The book, "The 36 Hour Day", is a wonderful resource for caregivers of patients with dementia. In my own experience keeping days on a routine....predictable, being in their surroundings, and not changing routines....all of these things will go a long way. Frustration occurs more frequently when they feel stressed, or forget how to do everyday activities. Reminding them that it is no big deal and telling them how you forget things too also helps.
If you are the primary caregiver, have a backup person and take breaks...you will need it! Prayers for you.
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So glad to read these comments, and yet so sad too.
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My Mothers spirit seemed to fade and she got quiet. The voices in her head stopped and she seemed to give up. The meds made her not care and she slept a lot. I was happy she wasn't tormented anymore, but sad that I had lost my Mother. I also think the brain quiets down when the disease progresses.
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I hope your situation will become one where the dementia patient becomes more gentle. My experience has been the opposite. My mother, who was a tiny, gentle, caring person, became combative toward my father, who was her caregiver. She pulled a knife on him. My husband threatened me that if I didn't take him home from the nursing home, he would die. I couldn't take him home, and he died peacefully in his sleep. He won.
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YES. Mine did. Mother is 96. I dealt with the angry unappreciative side for several years (as I worked full time) but helped her daily through 3 decades of delusions et al. She was very high strung her whole life. She is very disabled now...severe dementia..blind..wheelchair..in memorycare now. ..but for the past year she has changed to sweet and appreciative. But I hung in there patiently through the bad years and am happy that the final years have become kind.
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Worried, I'm not sure what's appropriate for him and you but on some threads people talk about adding or changing meds to help with agitation or whatever you're noticing. Maybe you can speak to his doctor about it. I don't know if my mother has dementia, she's 85 and diabetec, but she's got some kind of brain decline and yes I'm noticing her being less aggressive, less often. I think and hope that for some, their sense that they're weaker can sort of defeat their typical stance of power... sad to say those words, but it's sort of what I hoped for. Good luck :)
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Kudos to LizRoxy24 for mentioning the documentary "Confessions of a Dutiful Daughter". Not sure how available it is any more (if not it should be), but it won awards for a good reason. It actually puts you into the shoes of what this whole situation is like for a family caregiver and the patient. It helps so much!
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YES!

Wellbutrin changed our lives.
Wonderful morher all her life but became gentle, affectionate and sweet - BEST years of my relationship with her. It was a blessing to have the last ten years to remember. Her life would have been so much happier if she had been taking Wellbutrin all her life (if it had been sold back then).

There is some correlation between depression and memory loss and I feel antidepressants may have helped her memory (no scientific proof, of course).
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My mom was always an in-charge, independent, strong woman who could also be very strong willed, set in her ways and difficult as times. I was so surprised at the change in my mom's personality for the better in some ways. I have heard and read the horror stories here of loved ones cursing, striking others physically and being plain mean and was so grateful that instead of that route, my mom became a pussycat. Of course she was understandably frustrated as her memory and capabilities were failing, but she didn't direct that towards us. She was always grateful for any help she could get by me and her hired caregivers. It was heartbreaking to see her cry (a lot) and to doctors pleading for help. She always said thank you and never yelled or cursed at anyone (not that she ever did this before her illness either). She definitely mellowed out. My mom was not a very affectionate person but towards the end she was frightened and I would lay in bed with her during her naps and she would hold my hand. It was so sad to see this strong ox of a woman become childlike but if the inevitable change in personality could go either way, we were fortunate that she went the gentle route. Of course this is just my story, but my personal opinion is that there is so much unknown about the brain and it's all a crap shoot and it's difficult no matter what. So buckle up it's not an easy ride, but we'll be here for you! Best to you.
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Lizroxy24 gives an excellent answer. When my father-in-law was in the throes of dementia, he had his moments, but until he made a remark that made no sense, you wouldn't even have known. He remained a gentleman in the true sense of the word. His lived in his own world, his family-owned business, and the staff of the nursing home even went so far to set up an "office" for him in his room, giving him junk mail to open and "deal with" as though it were important business mailing. My mother-in-law was just about the same way. If they had their nasty and combative moments, I never saw them. My mother, on the other hand , was accusatory, delusional, dramatic and angry until the disease progressed to the point that she was in a coma-like sleep and then passed away.

I know now that the anger and drama I saw from my mom was a magnification of what her personality had been all her life, as was my in-law's. My mother's anger was not aimed at me but at life in general and what turn it had taken and "done to" her. I felt sorry about that as well, but I had done nothing to cause it. Guilt feelings and feelings of sadness to see my mom like that were inevitable, but as long as I made sure she was well cared for and safe in her facility, I didn't let those feelings overwhelm me.
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The Men with Dementia can be angry and controlling (especially if they always were) but then, they cry more, or act silly and quiet down.
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My mother-in-law has FTD. She used to throw a tantrum once a day until 2 years ago. She had a stroke. While transporting her to the hospital via ambulance, her left arm was somehow broken. She was confined to bed for 4 months until she was totally recovered from the stroke. She was on the following medications: Memantine 15mg (Dementia), Mirtazapine 30mg (Mood), Ramipril 2.5mg (Blood Pressure), Diltiazem 60mg (heart rhythm disorders), Pradaxa 110mg (Blood Thinner), Bupropion Sr 150mg (Dementia), Atorvastatin 10mg (cholesterol), Pantoprazole 40mg (Stomach). Since then, she was confined to wheelchair. We decided to place her in a long-term care facility but visited her every day.
She became very quiet and mellow since her release from the hospital. She does not remember how to walk. She can only eat non-solid food. She does not know how to talk anymore. BUT HER MOOD IMPROVED. SHE NO LONGER YELL OR SCREAM AT US ANYMORE. The caretakers at the long-term care facility told us she is a model resident, never scream and never complaint about anything. Last year, we requested the Psychiatrist to delete the mood and memory lost medications from her daily medication list. The Psychiatrist agreed to try it for 2 months but told us to monitor her behavioural changes. We observed no change. She is still quiet and mellow even without the mood and memory lost medications. It has been a year now and hopefully she will continue with her good behavior until the end.
My advise is always observe, consult with the doctor if necessary. Adjust medications on a trial and error basis until we found what we and the doctor think is the best for the patient. In my own opinion, the less drug intake the better (if it is possible and agreed to by the doctor).
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I have both parents, both 92, both with dementia and alztimers, both with foot heal servere wounds. mom one foot dad both feet, they drag and drag their feet on the bed even with the booties over and over again at night until their skin was rubbed right off to almost the bones. had visiting nurses coming everyday for three months and they didn't clear the feet up so it was both into the hospital, both are incontinence, both bedridden, both don't really know where they are or even who I am, and I know people aren't going to believe it but I got their hospital bills and they both were exactly to the penny the same. mom is so sweet to the staff at the hospital it makes me sick. mom is the angry one. takes everything out on me . demands things, yells , screams, you name it .if its negative she screams it to me. mom wont help roll over to make it easier to change her diapers, or try to hold her cup for a drink etc. yet my dad is the kindest person you would want to meet. does every thing he can to help me and if he cant he tries his best and it always helps me enough to get done what I need to. hes sweet and loving and thanks me everyday for taking care of him with so much love. why the difference I don't know but I always do mom first as to get the negative over with and then I go to dads room and enjoy every minute of the time we have alone as I don't know how much time is left. why the difference I really don't know......
my husband has Parkingsons Disease and he is the one that has the mood swings. nice, mean, friendly, nasty, loving and many more. before I go into his room I pick around his door way and say hi honey and I wait for the reply before entering as so I know what I can say or do not to tick him off.
tis life and I must except the good with the bad. I can honestly say that there is not a dull moment in my house 24/7..................
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Worriedspouse...You have a lot of good answers here on this post, and they are varied. That is the way of the human being, i.e., we are all the same and all different. I would say remember this. Your loved one is very afraid. This is true, especially at the beginning, as they know something is going wrong, but they don't know what it is.
I remember my mom saying is a very sad and worried voice..."I think I have a problem". She knew something was terribly wrong. Five years later, she was dead from Alzheimer's. Also, those with the disease are uncertain as to what is going to happen to them. I took care of my mom for many years and then, when I could no longer help her on my own, placed her in a wonderful nursing facility for the last three years of her life (she died June 2, 2017). But, I always made sure she understood that she was still loved, and I would see her most every day. I would give her plenty of hugs so she knew she was loved. Eventually, she became calmer and more used to her surroundings. Sometimes she would still become agitated and fearful, but those were more rare. What I found was that the more I could visit her on a more regular basis, she seemed to be better. If, due to work, I would miss a couple of days, I would find her more agitated. So, I pushed myself to see her most every day. I would take her outside of the facility and take her on rides in the car and movies and so forth so she could experience a more "normal" life outside of the nursing home, if only for a couple of hours. (Note: Near the end, she could not go to movies, as darkness is hard on a person with Alzheimer's and makes them afraid, and she could not follow the movie plot and would just sleep in the theater). If you have not placed your loved one in a nursing home yet, this is something you must consider, as it will become much harder as the disease progresses, and you will need a team to care for your spouse. When you do, take your time to find a good facility. If you walk in and it smells bad, then turn around and walk out, as they are not doing their job. Also, get with an attorney who can protect your assets, too. This is very important when it comes to pay-down for Medicaid. There is much to consider. Always remember that your spouse has a disease. It truly is a disease and is not who your spouse it. Try your best to be kind an loving. Be good to yourself as well. Hang in there.
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My father's dementia is progressing but it seems that the angry episodes are beginning to fade away. I'm not sure if thats the medication or not though. The serequil is supposed to do that as well. He seems to get frustrated and get quiet a bit more now but we will see. He is still trying to be in control but its kind of a back and forth thing for him. Time will tell.. God bless you guys..
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my mom became a very loving person... At the memorycare place this past year progressed she has become and even more caring and personable person... Looking after other residents . Before she got ill she was not nice and very judgmental.
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Wow, this topic is very interesting!

Mom was very combative towards Dad and some with me, but she was sweet when she calmed down. However, Mom was very sweet at the nursing home and became friends with her staff and other patients. All of the staff loved her. Mom was a people person.

Now, Dad, in other hand… He is so unpredictable! 😂 He can be sweet, humble and goofy when he's in a good mood! When he's confused, aching, or frustrated, he gets angry and starts blaming with me or other person for no reason. I learned to leave him alone until he calms down. He usually apologized afterwards. However, I believe that he'll going to get worse with his anger as he progresses.
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I would give my soul to the devil if I could have my old mom back. I miss her very much including her occasional temper. As her disease progressed she became more and more passive and quiet; all she wants to do is sit and sleep.
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ALZ tests every emotion we have. He does not remember any member of his family yet shows anger if we try to communicate with him. He does not give the caregivers a hard time (at least none have told us of any issues). I am glad he is in a good facility with good and caring personal. This disease is not only costly but heartbreaking.
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Not necessarily. In fact, my foster dad was fighting his 'handlers' in the nursing home. I'm not sure if it's just part of the disease or if it's just how he was with or without the dementia but I've never really seen him fight until he landed in the nursing home because they were manhandling him very roughly
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I don't have a lot of experience yet with anyone with serious Alzheimer, but a friend of mine has a mom who has it for 10 years at age 85. What i saw in her face was intense fear. She would hear me speak and try to put together a response, but couldn't. This was heartbreaking. I can't imagine anyone with advanced Alzheimers being violent or nasty, but again, I lack the experience.
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My husband was diagnosed with dementia last December, and Alzheimer's was confirmed in June. One of the things that alerted me that something was wrong was he was a lot easier to get along with. He is just in the beginning stages and we will see what the future brings.
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My mother had always been an accepting person, a get-along person though very anxious at many times. She went through mild dementia well for a few years with the assistance of 24/7 care from two caregivers. When she had more physical problems, I took care of her on my own 24/7/365 which meant that I was running non-stop over 18 hours a day which left me little time to supply the social side that Mom also needed, though her physical condition improved a great deal. Mom did become angry toward the end of that 3 years, but when she was moved to a high-level assisted living/dementia care facility (now about $7500/mo) she became their best sweetie and lived for another 4.5 years in their care which was worth the cost, though it drained her assets as well as a chunk of mine. I think that there was enough gentle caregivers, other people, and activity around her to be interesting though she didn't often join in herself. One thing of major note, was the role that UTI's played in Mom going off the rails in various ways -- becoming more demented and angry very quickly and then recovering to a better steady-state after successful treatment of the infections.
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One of my family members was a person of whom almost no one spoke in positive terms. After he was diagnosed with dementia, he developed a pleasant personality. So it can happen, but behaviors in individuals with dementia can be quite unpredictable. I had a patient who was a very polite and "proper" gentleman who became focused on women's breasts. Bottom line: one never knows with certainty how dementia will manifest itself.
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My Dad was always a gentle person, but became even more so as dementia progressed. I slowed it down considerably (his VA doctors concurred) with diet and supplements. I gave him sub-lingual methyl cobalamin (B-12) and antioxidants like Alpha-Lipoic Acid and L-Carnitine and also Niacinamide (not Niacin). He started out when he lived with me wanting only coffee, donuts and hot dogs, primarily, lol. I gave him lots of really good salads with lots of different veggies in them and he got to loving those and asking for them. I also fed him bean enchiladas (the fresher, stackable type) - homemade in the crock pot with fresh lettuce, tomato, onions and a little red chile and of course, chicken, fish, beef - but no pork. His sugar addiction dropped as we rarely had desserts and he rarely wanted anything sweet. Diet made a HUGE difference in the dementia. I watched everything I could find on the subject and researched some independent studies. I noticed that B-12 made a significant change in his moods. At first, he was moody, but I recognized it as primarily a dietary problem, as I used to have the same reactions when I was younger and saw the correlation early on in myself. My Mom had characterized him as a "weather vane" for years when it came to moodiness, but with diet, he greatly stabilized.  I would say he became quite constant in his general frame of mind.  At one point, he began to feel very gentle towards animals and asked that we "not eat dead animals" anymore, so we did that (but we still had salmon). Sadly, he passed away at 86. He was a very gentle man whom I will always remember fondly. He had been strong as an ox in his younger years, a WWII Marine - but became frail with time.  It's hard to see that transformation, but aging and death are inevitable despite all one does.
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