Ask Miriam – January 2022

Published On: January 5th, 2022Categories: Ask Miriam
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Dear Miriam,

My parents live in the back house on our property, and I live in the front house with my husband and two school-age children. A few years ago, my father, who is now 82, started getting confused and would wander away from the home. We even had to call the police a few times in order to find him. He was diagnosed with Alzheimer’s, and my mom, who is 78 years old, is not in very good health herself – she has high blood pressure, arthritis, and diabetes. Whenever my husband and I visit them, my father is cheerful and able to carry on a conversation. You almost wouldn’t know he has dementia. However, my mother tells me that when the two of them are alone together, he is completely irrational, won’t do anything she asks, tries to leave the house (he thinks he is going to work), and is angry that people are “stealing” from him. Why is he fine with us but not with her?


Dear Perplexed,

Being a full-time caregiver can be an exhausting job, and it’s even harder psychologically when the person with dementia you are caring for is able to present well, or appears almost normal, especially to other people, perhaps for short periods of time, yet have serious issues with cognition and behavior at other times. The caregiver may even start to doubt that the person has dementia and think that he is simply faking it.

There is still so much that we don’t know about the brain, but it is common for people with dementia to have what we call “fluctuating capacity.” At different times, the person may be less confused and better able to make mental connections. It can vary by time of day, from day-to-day, or even longer time frames. Their cognition may also be influenced by the presence of pain, illness, frustration, or sadness. They may also be motivated to try to please certain people.

This does not mean that the person does not have the underlying disease and that the disease is not affecting the brain. It means that it is important for the caregiver to accept that the brain does not process information normally, and that as hard as it is, different behaviors will appear at different times.

It sounds like your mother would benefit with some breaks so she can have some regular times to herself and relief from some of the stress. Perhaps you or your husband can plan to take your father out for a few hours each week, whether it is to the park, for coffee, or some other activity he would enjoy. Encourage your mother to take care of her own health as well, making sure that she sees her doctor regularly, gets enough sleep, and takes her medications. In addition, consider whether bringing some help in to the home or looking into an adult day program, for your father, would be helpful.

Supporting a primary caregiver is a very important role. For more information, please reach out to our Helpline at 844-435-7259. Questions for Miriam can be e-mailed to


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