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These diseases are not clean cut, like macular degeneration, for example. In cases where autopsies are performed, we find that half of the Alzheimer's diagnoses were incorrect. Even the stages of these kinds of diseases are gray areas that might be arbitrarily reclassified at any moment.
It would be an odd observation of the human condition though, if the end stage of a degenerative brain disease included the condition, "No longer able to construct a deliberate lie".
It is also possible that by the time he showed you the clean plate he had already forgotten dumping it and he really believed he had eaten it.
Lewy Body Dementia (which my husand has) is known for its fluctuations in cognitive ability. Sometimes he seems normal and an hour later he is definitely not normal. Some caregivers think at first that the patient must be faking it -- nope, that is the nature of the disease. While the fluctuations are very pronounced in LBD, they occur in other dementias as well.
Ishmael's observation that a large percentage of dementia diagnoses prove to be wrong on autopsy is correct -- but it is not a matter of the patients not having dementia, it is a matter of what kind of dementia they have. There is a strong (one might say desperate) push in the research arena to find biomarkers that could be used for diagnositic purposes. It would be great to have a blood test to be able to say this person has dementia, types A and B.
Until then, we spouses of dementia victims have to go with our observations and with the best guesses of experts.
Dealing with a person who has dementia, AZcaregiver, is indeed frustrating. Usually the things that are so annoying are not really within their control, as we think of control.
It is a very hard role we are cast in!
I went thru a long period where I was so angry and frustrated and tried to set her straight or scolded her for not telling me the truth...but for my sanity, I've gotten over it. I let all the small non consequential stuff go. I don't agree or disagree with her but let it go if its not an imminent danger to her or her well being. If it has to do with bills or appointments then I call behind her and check out then step in to help her take care of it.
I've tried to tell her she can tell me the truth, but I think her first instinct is self preservation with this disease so if that means lying, then she does it to make everything seem fine. So sad.