Dear Mary,

My mother was diagnosed with Alzheimer's in 1996, and I have been caring for her since that time. To give you a little bit of information regarding her, she is now 91 years old, has high blood pressure but maintains a great blood pressure with medication, is prescribed Synchronic for a thyroid condition and Lasix for congestive heart failure. The only recent medical problem was GOUT, this past August. This occurred while in respite care for one week, while I attended my son's wedding in Massachusetts. She has always been a rather quiet, shy and quiet woman. She was never very active which may explain the following. She does not like too much stimulation and likes to be left alone. She stays in her room, rocks in her rocker and watches television most of the day. Her favorite show is The Animal Planet. She was an animal lover her entire life, so she finds much joy in watching the various animals, smiles, talks to them, and looks quite peaceful. The problem is she doesn't want to do anything else! I am not complaining, but at times, I would like to get her up, stimulate her in other ways, or get a bit of exercise, etc. She played the piano most of her life, loved music, and use to listen to it very often. But in the past two years I find she searches endlessly for the button to turn off the volume on the television or the radio. Also, she gets annoyed if I accidentally drop something, or if the phone rings. Hence: she seems to dislike noise of any kind.

I write you because all of your suggestions are so sensible and I make attempts to interact with her, but to no avail. Also, she doesn’t like to be touched. After bathing her, which is a chore because she loathes water, I put on lotion and she grimaces and yells, "No." She immediately attempts to wipe it off. Now, to be honest, Mom was always very modest and I understand that and am extremely gentle, but she yells at me and tries to hit me. At times, I am able to distract her with my wittiness or silliness and I try that often when changing her Depends. Sometimes it works, other times it doesn’t.

When she was in the nursing home an aide attempted to put lotion on her and she slapped her face, so she no longer put lotion on her! It's a chore to keep her clean and healthy. Do you have any suggestions?

I hope you don't mind my lengthy email! Thank you in advance.

I can think of a few reasons why your mother reacts the way she does to bathing. You’ve said she doesn’t like noise of any kind so the noise from running water in the tub or shower may frighten her. The fact that she has always been modest is also a key point. To bathe her properly, she has to be as ‘naked as a Jay Bird’, so to speak. She may also feel cold and insecure. Have a tub/shower bench in the tub and use a hand-held shower wand. Be sure the bathroom is well lit and warm. After removing her clothing quickly wrap her in a thick terrycloth robe warmed from the dryer. Gently guide her to the bathroom while talking soothingly about old times. Allow her to keep the robe on while in the shower. Using the hand-held shower wand and a soft sponge mitt with soap inside, start at her feet and gradually work your way up. Discreetly open one side of the robe at a time to wash her body. It’s OK for the robe to get wet, just ring it out and hang it in the shower to dry. Avoid having to moisturize her skin with lotion by using olive oil soap. It can be purchased at a health food or organic bath store. When done, quickly remove the wet robe and wrap her in a large, warm, fluffy towel. Remember to keep talking soothingly to her during the whole process. Also know that a good soaking isn’t always necessary. In fact, too frequent bathing causes dry skin. A sponge bath at the sink can be just as effective.

As for activities, if she has never been active before don’t expect her to be now. Let her enjoy her quiet routine that she seems to enjoy. You might ask some friends or relatives to bring their pets over for a visit and encourage your mother to take a visiting dog for a walk with you. God Bless.

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Dear Mary,

I’m afraid I might have Alzheimer’s disease. I’ve had severe medical problems for the past couple of years and haven’t been able to get my life back together. I’m only in my mid-fifties, but have trouble remembering things, am short tempered, and down right nasty. I cry easily and find myself not wanting to go out anymore. My friends and family have noticed a change in me and are very concerned. They want me to see yet another doctor but I’m afraid of what he might say. Do you think I have Alzheimer’s disease and if I do, what can be done?.

I can’t tell you whether or not you have Alzheimer’s disease and you should not assume you do. You have been through a lot recently and may be suffering from depression. Depression can masquerade as dementia because the signs and symptoms are sometimes the same. Another possibility for your behavior is side effects of medication. Either problem is fixable and your symptoms can be reversed. Don’t wait any longer to make an appointment with your primary care physician. The unknown can be more frightening than the known. Good luck.God Bless