Who are you?  And what have you done with my husband?

My mother saw my father as a calm man who never raised his voice in anger.  However, my father was a redhead with all the heat that went with it.  He would often get angry, especially when he was working. His anger would be occasionally directed at my brothers who worked more closely with him than I, but I certainly witnessed his temper more than once.

When Alzheimer’s tightened its grip on Dad, the fiery side came out and was now directed at even my mother. She was shocked!  Who was this man? Well, he was always there, she just didn’t see it. He hid this emotion from Mom and certainly never directed his malice towards her.

But here’s the thing. Dementia, in time, takes away decorum, control, social graces and inhibitions. These are learned traits and learned traits can disappear as cognitive impairment grows.

At the risk of oversimplifying, one could loosely compare it to that time you had a few too many adult beverages and got overly honest or to the child who blurted out something totally mortifying in public.

We’re talking no filter!

Personality changes in dementia can be very disconcerting; painful even. However, let’s take a step back and examine what exactly constitutes a personality change.

I was chatting the other day with someone who lives in my building. His question was, “can those with dementia suddenly start acting differently to what you have known them to be previously throughout life?”

There are types of dementia that effect the brain in particular ways causing physiological changes that lead to true altered personality such as frontal temporal dementia.

Knowing the type of dementia helps to determine whether behaviours are true personality change or, as is more often the case, a coping mechanism.

Dementia steals the victim’s ability to make sense of the world. It moves too fast; becomes confusing or overwhelming.

Everyone reacts differently.

Some might become aggressive as my father did.  Others become paranoid or suffer delusions making them distrust loving family members who they may or may not even recognize at any given moment.

Even an extroverted social butterfly might withdraw or drop into depression.

This is not a personality change as much as a response to a world that is no longer recognizable.

My personal and professional observation has been that these changes come in roughly four categories:

  • One, those who have been nasty all their lives become nastier as their dementia progresses
  • Two, those who have been loving and sweet become ever more so
  • Three, those who were, if not nasty, then distant or cold become affectionate and warm
  • Finally, those who have been lovely and nice suddenly become venomous.

Consider that the buffers have been removed.

Now you have the raw unrestricted emotion. Hence, the nasty gets nastier and the sweet gets sweeter.

But, what about the cold becoming affectionate or the nice… not so much.  A cold distant person uncensored can now allow feelings flow that they never felt comfortable expressing before. They become warm and loving.

person who was once “oh so nice”, now uncensored, lets their true thoughts fly.  You’re finally hearing their inner dialog.  Ouch!

Zebras don’t typically change their stripes so look closely and get an accurate diagnosis of dementia type.

 Marjorie Moulton, Executive Director
We Rage We Weep Alzheimer Foundation
and Dementia Care Consultant 
drmmoulton@werageweweep.com
https://www.dementiaconsulting.ca