My mother who is 82 has been declining for several years, it started with repeating herself and now has progressed into having what I call timeline issues. For example things she showered yesterday when it really has been two weeks. Do I confront her with the reality? I tried to talk about it and she denies anything is wrong. She refuses any medical tests including basic memory tests from the doctor so we cannot get an accurate diagnosis.
You can give her doctor the heads up before hand. I typed up a list of my observations to the doctor, so she would know what to look for when she sees the patient. The right doctor can conduct an office eval in a very calm and nonthreatening way. The doctor can also check for infections, medication issues, nutrition issues, hormone problems, etc. The doctor may be able to rule out other causes for the cognitive decline. And, if appropriate, he can refer her to specialist or place on medication if she would benefit from it. Some types of dementia don't respond to medication. She might resist, but, it just takes trying different things to get them to accept. Things coming from her doctor might be easier for her.
That's what I focused on with my LO. Her doctor wanted her medications administered correctly, proper nutrition, physical therapy, proper rest, etc. I reinforced that all of this would help promote better health and memory. So, even though, her doctor told her that she had dementia, she didn't really understand what it meant. And, I didn't keep mentioning it either, because, she would have forgotten it. Even when the neurologist told her that she had dementia, she just said that she didn't want to lose memories of her parents, but, she seemed to forget about it a little while later that day. She never mentioned it again.
So, even if you tell her, there's no guarantee that she will accept it, believe it or even remember it. So, to me, it just depends on what works for your situation at the time. Getting through each day with the LO being protected and cared for, is really all you can really hope to achieve. Getting a PWD to bathe, is often an ordeal and is addressed with different strategies. Having them understand, process, accept and work with you on things......I suppose it happens, but, I don't see it that often.
What you can do is tell her the doctor appointment she set a month ago is tomorrow or in a couple of days. That she wanted to make sure that she made her appointment because medicare wants to be certain she gets her annual exam, etc.
Redirect as much as you can.
Any time my Dad would call me saying he can't remember something, I would tell him I have that same problem, too. Told him that as we age that the file drawers of information in our brain are full, and sometimes the drawers get stuck :) Got Dad laughing so that made him feel a bit better.
So your doc tomorrow is liable to see through her ruse. They know people cover up because they're scared and/or because they really think nothing is wrong. If you can find some way to accompany the doc when he leaves the room (you have to go to the bathroom!) and give him the real skinny, you'll feel better. I even wrote a letter to Mom's geriatric general practitioner cautioning him about what she would do. The ones who care will hear you out and see through their cover-ups.
If she has you can honestly say since you will not go to the doctor for tests we don't know for sure.
But will she remember that? Probably not
If you tell her she has dementia will she remember that? Probably not.
She wants to know she is safe.
Her world is shrinking. She will be happier with smaller groups, with familiar places. Less noise and confusion.
Confronting her with reality...her reality is now totally different than your reality. As difficult as it is try to "go with the flow" and pick your battles. Dig your heels in when it is truly important. And you will find that there really isn't a lot that is TRULY important.
You can get aids that are great in getting someone to shower if it is difficult for you. The CNA that helped with my Husband while he was on Hospice seems to have the "magic touch" when it comes to getting people to shower or bathe from the stories she told me. (I asked because this comes up in the support groups I go to and I asked if she had any words of wisdom)
Recently she was evaluated for vascular dementia. I disagree when some say it doesn’t matter. Had it not been for the neurologist evaluation of her past CT s, we never would have known she’s been having strokes for years( even on Eliquis) and the med they usually use to treat memory loss can actually cause a stroke. Obviously, she can’t take that since she’s already at high risk for a massive stroke .
“I’m a strider, not a limper; I’m a shout and not a whimper.”
Seems to invite my inner Wonder Woman to take over while my inner Eeyore takes a long and restful nap.
Thank You!!
Anyway, some concerns about mother's obvious decline a couple of years ago and YS does a LOT of research and finds and schedules (with mother's permission) a full physical WITH cog eval.
Of course, mother cancels it the day before and is still seeing her ancient PCP. She is definitely failing, but we'd like to KNOW what to expect, or how far along this is. She can hold it together for a half hour then she's exhausted by trying so hard to remember anything.
There's absolutely no POINT in telling her she's showing signs of dementia--maybe she isn't, maybe she's just tired. I don't know. But we don't have any 'testing' so to speak, just a close lipped YB who will not share any of her health info with any of us.
IT's OK that she's forgetting. It's OK!! She thinks we're gonna stick her in a home and this will NEVER happen.
Personally, I would feel a little validated in my thinking if she had a cog eval and it came back that she's struggling--I see it, but my sibs are all MIA and they might step up just a skosh more if they knew mother needed more. As it is now, a phone call every month or so and they take her word for it that she's fine.
If not, then they need to come visit mom in her home for a week, with you leaving them together alone each and every day!
Seeing is believing.
Although our mom still lived alone, I was the one who spent more time on the phone and in person, so the brothers didn't see/hear what I did. For some time they also denied. Even after we had assessment done (nurse associated with the aide company we were considering), local brother didn't see how bad it was (and it really wasn't that bad yet, but certainly worse that he thought.) The non-local brother would call every Sunday and have the usual BS session until she did her usual "You're running up a big bill" and would proceed to end the call. Calls did not cost anything, mind you. But the "conversations" were never enough for him to have an inkling of a clue....
Of course the charade can't hold up over time and she is less able to hold it up as time progresses, so it became more apparent to them.... duh.
Even if you must stay whether they come for a visit or she visits them, stay in the shadows and let mom "paint" her own picture....
If you are the one handling her affairs, it would be wise to take her to her bank and tell her you would like to make life easier for her if it becomes necessary, like if she has to go to the hospital, by her signing for you to be her financial POA. Hopefully, you already are her medical POA also. That can be done thru an attorney and at very least be sure her doctors have paper that she signed for you to be involved in her medical decisions...and of course, then comes a DNR and/or a MOST form signed with her desires marked.
As far as showers...let her know you are there today and can help today. Sounds like she'll forget this tomorrow...so when shower time again, you can repeat your same story.
No point in making life hard or confusing for them. God, I know it's tough. My mom passed away in January as dementia also caused her to aspirate her food along with everything else it robbed her of. It took her approx 7 years to get there from when I noticed her forgetting things. I wish she was still here so I could "ground" her as well as join her world for a few hours 3 or 4 times a week. Her mother, her brother and others she wanted to see or call passed away over 20 years ago. So when she asked, I told her we would call after dinner or when that person is home from work...whatever! Just not that they died. 5 minutes later, its forgotten!
Stay strong and continue advocating for your Mom.
Our mother (almost 96) also asks about calling or going to see her mother (gone about 40 years) or, recently, asked if I see her much... I took a chance with a pre-planned "new" answer to that one - "No, she's gone to FL for the winter." She was deep in thought for about a minute, while I held my breath... Oh, they used to do that... I skated this time!
As for being truthful, in most cases it doesn't help. They may deny. They may get upset. Most likely they will forget!
If anything came up about forgetting, oh, she's old and is ENTITLED to forget now and then!!! BWAHAHA, sure mom.
I am concerned about your mom being alone. Our mom lived alone, and although it **seemed** she could take care of herself enough to stay, there was a LOT we couldn't see! Unless you are there most of the day, there is no way to really know. Once we took her car away, I had to take her on trips to the grocery store, but watch what she bought - more chicken mom? You have lots left in the freezer (even after I siphoned out the old and freezer-burned ones!) What became apparent after a few trips was that she WASN'T cooking (fresh veggies shriveled up unused, same chicken in freezer, etc.) She'd buy some frozen dinners, but not enough to last until the next trip! She would buy/ask for items that she actually had plenty of, but had put away and forgotten about. We tried bringing in aides, for 1 hour sanity/med check, with intent to increase the time as needed, but after a few months she refused to let them in.
We finally installed some cameras, so we could monitor comings and goings, we could see the OCD sun-downers happening at bedtime AND that she was wearing the same clothes day after day (one time 6 days in a row!) While wearing clothes over again is something I do, so long as it is clean, this was NOT the norm for the clothing queen!!! She would also never wear something with food stains on it before this.....
As far as what the attorney told you, it likely isn't state specific. It kind of goes along with what the staff tells us - you can't force someone, even in MC, to do something they refuse to do. They just have to get creative and coax the person into whatever it is (taking meds, showers, going to appointments, etc.) Mom was refusing to move ANYWHERE, and our EC attorney also told us we couldn't just "drag her out of the house." Not that we would do that, but you get the point. He DID suggest guardianship (we had the DPOA, HIPPA, wills etc done prior to this), BUT the place we had chosen for her would not accept "committals", which presumably is what they considered guardianship. This is how/when I ended up on this forum. The staff told us to 'just get her here, we'll do the rest...'
In the end we had to come up with a 'ruse' (she injured her leg/got cellulitis just before the planned move, delaying it. One brother drafted a 'letter' from the hospital's "Elder Services", which told her she moves to where we choose or they would place her. OH was she MAD!!! Reluctantly she went, believing it was temporary.
You wouldn't need to be quite so forceful with your mom... Perhaps suggest an extended "visit" with dad (seeing as they offered a bed, see if they would allow a week-long visit?) IF she agreed to that, get the MC set up, work with them on a transition plan, and bring her there from dad's NH instead of going home (plan it for lunch time, say we're stopping here for lunch. (Or just take her to MC for FREE lunch) Let them distract her and beg off to the ladies room and exit! They also ordered Lorazepam to keep mom calm - it doesn't require time to build up in the system and doesn't keep her drooling/lolling in a chair - it just takes the "edge" off.
It will be better to find a way to get her to a safe place before something untoward happens. Except for telling her neighbor she "bruised" her leg and the neighbor telling me, we wouldn't have known about the injury. If we were not planning to move her about the same time period, that injury could have killed her! She didn't have enough sense to have it checked OR tell one of us!!! It was about baseball sized on her shin - not a little scratch. If the neighbor hadn't told us, we could've missed it on visit (under pant leg.)
If the doctor is any good, s/he will know how to discreetly check mom's cognitive ability during the exam.
We just changed doctor's and I was a little surprised that the nurse tried to administer parts of the test (hearing aid was of minimal help, but it was MIA having gone through the laundry at the MC place.) My surprise was because this is year THREE living in MC! The doctor she had at the time prior to the move acknowledged dementia, however after 6 months of begging and pleading, I did not get ANYTHING from his office (I blame staff, not him.) Excuses, documents needed that I had already provided, etc.... Gave up on them (and it delayed getting Fed pension to grant rep payee status!)
Back to your situation - again, get a good full checkup. If she balks at that, tell her in order to stay enrolled in Medicare, THEY require yearly checkups! Make someone else the "bad guy." Every year the doctor office would require mom get checked before renewing her meds (another ploy you can use, if she takes regular medication - INSURANCE requirement!) I would have to use that as one of the "arguments" to get her going to the doctor appointments.
In the meantime, you don't need a name for what ails her (which she doesn't acknowledge anyway.) We never used ANY terms for mom in her presence. Dementia, in her mind LONG before dementia, was being "off your rocker", so that would NOT go over well! She was/is also a denier - "I forget sometimes, I'm old so I am entitled to forget!" In her mind, which she often told everyone, she was fine, independent and can cook. She felt she could waltz circles around those younger than her!!! Could she? For a while, maybe. At this point? Nope.
With short term memory loss (the repetition and time issues indicate that loss is real, you just don't know the cause), she won't remember what you call her issue or even that you discussed it, so why bother?
So, try to get that full exam done and proceed from there. Some people believe it if the doctor tells them, but again, she'll likely forget, so why upset her? The Dx is more for you, so you can plan ahead on how to proceed.
Psychologically speaking, if you tell her, you risk depression. She may even remain depressed (feelings endure) after having forgotten the diagnosis.
Some people, including doctors, are very intent on telling things. They have the feeling it will help their work (doctors can give their diagnostic, children can explain to their mother why they want to put her in a home, everyone rationalizing that by telling the truth, they are showing respect...) but it won't make things easier for long, and can break your relationship with your mother.
I had convince my mother to be assessed and the specialist absolutely wanted to ask the same questions about our recent past both to my mother and myself, in front of her, to make her "understand" that her memory was failing. I refused to answer, left with my mother, told her that I thought seing her ordinary doctor was enough, and said forever good-bye to specialists who want to use the caregiver against the patient, with no regard for their relationship. Other people I know had better experiences, so then again it all depends on your situation, the laws in your country and your relationship. Anyway with an Alzheimer patient, you can't escape the fact that you have to become an expert at lying, if you don't wan't to upset them, be it for great or minor issues. Good luck !