Mailbox Response

The question was submitted 28 January 2010

Subject: CARE SUPPORT TO DEMENTIA PATIENT

My mother-in-law has dementia since last quarter of 2008 after a minor stroke (unknown to us). This was confirmed after she had her brain scan in 1st quarter of 2009. She is presenting under treatment and regular check up.

She has suicidal thoughts once in a blue moon. This started when she is reminded to do something and she forgot. She will start to blame herself for being useless, giving trouble to those around and felt she should go and die. When you answered her why she should think this way and let one worry. She instead replied “you want me to go and die, I will go”. I was surprised to hear that.

She has problem in preparing her clothes for bath. She will stand at the wardrobe for a while and do not know what she needs to do despite note pasted to inform what she needs to bring to take her bath. When she takes her bath, it was within few minutes. She did not use soap at all. This includes brushing her teeth without toothpaste. She started to have body odour few months back.

Please advise what stage of dementia she is in now and how she should be treated. She is taking Galantamine 8 Mg for about 8 months.

Answer from DementiaNet

Sounds like the patient does have moderate to severe vascular dementia although further evaluation is needed to ascertain that.
She also seems to have symptoms of depression (i.e. feeling useless, wanting to die) that may require treatment.

I would suggest that she sees a psychiatrist with a special interest in dementia or older person (i.e. old age psychiatrist or psychogeriatrician) They can be found at CGH, IMH or in private practice.

The answer was published on DementiaNet 29 January 2010