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The Busy PT's Guide to Finding Balance

Dementia and Personality Changes

Published March 23, 2011 6:17 PM by Janey Goude

People with dementia, who have never been known to curse, suddenly begin using foul language. Science explains that the dementia has caused a personality change. In this case, experiential knowledge causes me to question science.

I've witnessed a number of people with advanced dementia. They cannot carry a conversation. They may have moments of agitation. But their personalities haven't changed. They continue to express the core of who they are.

So, I wonder if the personality changes aren't really changes at all. Could it be that, for the first time, families are seeing the "real" person: who the patient is when no one is looking? Has the dementia simply severed inhibitions that have allowed the patient to keep up appearances all these years?

And, finally, I wonder... what kind of dementia patient would I be? Would my family see the person they've come to know, or would they witness a "personality change?"

4 comments

Dean,

Very interesting story about Woody Allen and your patient!

You bring up a good point of how fear and the loss of control can manifest.  It is amazing how calm a patient - dementia or otherwise - can become when we give the patient some control back.  I feel next week's blog coming on...

Janey Goude March 26, 2011 5:42 PM

Ruth,

Glad you were on the receiving end of a positive change.  Very interesting perspective.  Reality has its own set of challenges to be sure!  

Janey Goude March 26, 2011 5:35 PM

I have often pondered this same thing. I worked with a woman once who was demented beyond the ability to speak, but smiled constantly and would giggle at many things. The only thing that made her frown was the mention of Woody Allen (She was an actress and had worked with him). I learned after her death that she had been involved in an amazing number of philanthropic ventures but never let on who the donations, aid, or assistance came from.

I'm now watching a relative of mine decline into frustration, anger, and fear. This is someone who ran a large corporation, who is used to saying "jump" and hearing "how high?" as the response. He was trained at an early age that men don't show fear, but I suspect he is feeling lots of that as control slips away. Perhaps the anger and "disruptive behaviour" is really the only way he can manifest his fear.

Maybe the actions and displays we see don't really reflect the emotions going on underneath? Another example that nothing is ever really that simple.

Dean Metz March 24, 2011 1:15 PM

From our experience, the dementia changed a fiesty woman into one of patience, affection and optimism.  What a nice surprise!  Maybe everyday stress masked her true self for many years.

ruth March 24, 2011 12:29 PM

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