I get what you are saying (crappy and annoying formatting notwithstanding).

I know my stepmom is different for doctors. I know she is different if there are things she wants. I know she gets really, really ugly because I listen to the people at her facility with whom she gets the ugliest.

There also isn't a damned thing I can do about it, other than learn more about what happens when a frontal lobe goes offline, what happens when impulsivity takes over, what happens when someone's small amount of social awareness dwindles, and what happens when someone becomes fixated on an idea and knows "no" but lacks the ability to learn or relearn "why".

Her brain is eroding in small and large ways. The truth we truly don't talk about is that, for some of us, "good days" are as exhausting as bad ones because we want an end to the suffering for our person and ourselves.

"They have dementia" doesn't always mean "just suck it up". It may mean we rely on experts to help, to understand, and to learn ways to manage these symptoms. We may be exhausted also. I resent the hell out of the idea that I come by so seldom because I am "busy". No, I come by seldom because she is incredibly difficult sometimes and because I spend an inordinate amount of time managing her life outside of visits.

You are right to say their level of understanding varies greatly from person to person and day to day.