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My mom was diagnosed 10 years ago and my dad has been primary caregiver. They've been married 52 years. But she doesn't recognize him anymore. And she really don't like him and we think she is afraid of him at night. Its awful:(

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This is certainly very, very sad.

How much does your father understand about dementia? How is he taking her new attitudes?

It may be that as she no longer recognizes him as her husband he reminds her of someone else in her life -- someone that she didn't like and/or was afraid of. Try to help Dad not take this personally and not take it as rejection. This is the disease causing these behaviors, not the woman he's been married to for half a century.

Would it be better for them to be separated ... for her to be cared for by professionals in a care center where he could visit her frequently and for long periods, but not to be responsible for her daily care? Would she feel less frightened and he feel less rejected in that case?

Doing what is best for both of them is a huge challenge at this point. I sincerely wish you as much success as possible.
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What was your mom diagnosed with 10 years ago?

There is a type of dementia called Lewy Body Dementia that this could be a symptom of. I cannot remember the exact name for this, but it was listed as a symptom when I was reading about the disease.

Another symptom of this dementia is that they no longer recognize their own possessions. My mother has this symptom, but not the lack of recognition of people - yet. But she will look at a chair and say "Where did that chair come from?" and you say "Mom, that's your chair. You've had it for years". And she'll argue up and down that it is not her chair, someone has taken her chair and put another one in its place.

If you google it, there is a Lewy Body Dementia Association online that has a whole lot of info about this disease. It is related to Parkinson's Disease, in that these proteins called Lewy bodies, develop in the brain. Exactly where they located within the brain determines whether the patient gets Parkinson's Disease or Lewy Body Dementia. And of course, a patient can get both.

And, a patient can get Alzheimers Disease on top of all of the above!
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Prosopagnosia is the name for the symptom of not recognizing a familiar face.
(No wonder I could not remember the word)
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To try to assist with the fear your mom has of your dad try to figure out what is triggering the fear. Is it a certain time of day, approach, during care, in certain rooms in the home etc. From gathering this info it will help you assist your mom and dad to have a better living situation. Once you figure out triggers work around the triggers and try to avoid or engage differently to ensure a better outcome. Also when your mom does not remember your dad it is best to not push reality and let go and go where your mom is. If she thinks at that moment that your dad is a stranger than it is best for your dad to engage her as a "stranger." I would also put a photo/story book together with pictures from their life to use to try to assist with gentle reminders of her life as she welcomes this technique known as reminisce. You can tell through her body language and tone if the photo book is going to work at that moment. You may need to approach over and over again. Always remember that they are leading the dance and we are blessed to dance with them each day. Another way to look at it is to let go of your reality and enter theirs.
Wishing you strength, courage and happiness with those in their days gone by,
Deanna
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