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I can't tell if my mother has dementia or she's just conning me again. She says she goes down into a state of confusion then comes back. She has personality problems and has always acted wierd. If she has dementia would she be aware of it and be able to report it to me? She is 91, frail, and lives alone.

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This is a common concern for caregivers and family members of loved ones with Alzheimer's and other forms of dementia. These conditions progress in different ways ways for each patient, and awareness of their impairment (and the true extent of it) happens to be one of the variables that is particularly hard for family to accept.

Those in the earlier stages of dementia may be able to sense that something is not quite right with their memory and recall, but they often try to hide these shortcomings from others or simply chalk it up to old age. As their cognitive abilities decline, they can become entirely incapable of recognizing that they are mentally compromised. This phenomenon is called anosognosia, and people often misconstrue it as a patient consciously refusing to accept their condition. Caregivers can become extremely frustrated by this dementia-related behavior, but it is important to realize that anosognosia and denial are two very different things.

For more information, two of our bloggers have written excellent pieces on dementia and awareness that may be able to help:

With Alzheimer's, Denial Isn't Always What it Seems
https://www.agingcare.com/articles/people-with-alzheimers-may-not-recognize-impairment-161439.htm

Dementia Patients (and Caregivers) Suffer from a Lack of Insight
https://www.agingcare.com/articles/dementia-patients-and-caregivers-suffer-from-a-lack-of-insight-196699.htm

Best of luck to you all.
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My husband had a traumatic brain injury at 20, a massive stroke at 51 and diagnosed with dementia at 55. It was very hard for me to evaluate his behavior because of multiple neurological issues. When things got to the point I could not have a simple reasonal conversation with him I knew he was in real trouble. He became very abusive, lied about the dumbest stuff, and constantly accused me of things I would never do and called APS and the police on me constantly with false allegations. It was impossible for me to determine if he was aware at all that he was totally losing it. How can someone that is "way out there" have it together enough to be so manipulative that requires planning and follow through?
We live in Texas where Medicaid is worthless. His family lives in PA where you get Medicare and Medicaid if you are disabled . It only made sense to move him back there where I know he will get excellent medical care. His family (they had not seen him in five years and knew little about the state he was in) put him in a nursing home immediately at 58 where he will remain until he dies. The main issue that haunts me every day is whether or not he is aware of what is happening to him. I pray that he does not have a clue. I haven't heard from him in almost five months. I took care of his every need for a decade and now he is in some other land. Prayer is the only thing that has kept me sane - and there were many time my sanity was questionable. Every day is still a struggle for me but I had to finally realize this was something I could NOT fix no matter what approach I took. I just pray everyday that God fills his heart with love and peace. This was the hardest thing I ever went through and no one came out a winner. Acceptance is so hard. Dementia is a cruel way to go through life for everyone involved. I will keep you in my prayers. Take care of yourself. It has to be your priority.
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Thank you, Carol. That makes me feel better as to how we are communicating.
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Vicki123, your mom may not be aware if her illness at this stage even though she likely was as she began the decline.

I don't see a reason to tell her. This seems to be the time when validation (going along with her) is the best route. Trying to tell her she has dementia and isn't thinking right will most likely only make her feel terrible when she really can't do anything about it.

Take care,
Carol
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Vetswife - about the brain supplements - it's hard to tell. There have been studies done at Oxford University in London that have found formulas containing B12, B6 and folic acid have helped reverse some symptoms of Alzheimer's disease. After two such studies this group of researchers are convinced that aging people should be on these supplements.

However, it's hard to know in what form these supplements were given to study participants. Not all supplements are absorbed well, and they may have used doses that non-scientists wouldn't feel comfortable using.

In the end, if you see no harm from what you've been giving him, you are probably doing okay. If the source is reputable and the amounts not huge, they are unlikely to cause harm. I'm assuming (maybe wrongly) that B12 is part of the mix and many elderly people are low in this vitamin because they don't absorb it well from food.

Take care,
Carol
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My 87 Mom has been diagnosed with dementia. My older brother is her care taker. She is able to take care of her personal needs and will fix her own breakfast. She has a PT twice a week for her gait and muscle strength. Her short term memory is almost nil. She makes up stories that we have to verify with each other. But she is as sweet as ever. When I try to remind her that she has known about something (in response to her saying "Nobody told me") she gets upset, so I have stopped. Do we try to tell her why she is experiencing these memory losses? I don't even think she is aware of her dementia.
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Do Brain Supplements work? I don't want to be trying to fool myself. My husband was diagnosed early dementia. He has been on a Brain Supplement for over a year now. For the most part he hasn't got any worse. I am praying that it really does make a difference! Has any one else tried Brain Supplements?
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So much depends on the stage a person is. In the early stages of dementia many people know that something is wrong. Later stages, often not.

And then, as you say, Java2012, there are what I call "moments of clarity" with many types of dementia. It's a brief time when they seem to "come back" before fading back into their dementia-destroyed existence.

Please keep checking back!
Carol
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My roommate has Parkinson's and Alzheimer's, she is a very smart woman but she has times I don't feel she is here but then she comes back and she can be very aggressive she accuses people of doing wrong things but she is the one who is doing things such as taking things, and at time not sure if she is lying or really does not know but again she can be very condescending
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In my mother's case, my sister noticed it first, being a psychiatrist. My sister had my tested for Alzheimers in 2000, and it came back negative for Alz, but showed that she had had small strokes that might be causing the dementia. We got her blood pressure under control (before I took over with her meds, she was not taking her blood pressure pills regularly). Over the last eight years she has had more and more memory problems, and did not recognize or admit the severe dementia that her boyfriend had. I think my sister was very sensitive to this issue and probably went overboard worrying about her at first, but now it is obvious that she has dementia and memory problems, and not using good judgment. When she started trying to make travel reservations and then charging things over the phone using her checking account number, and walking around not using her walker, I told her this showed that she wasn't using good judgment, then she got angry with me at first, then tried to cover up everything as she is angry at being in the nursing home and trying to prove that she can live on her own without help. When I was living with her she had to be reminded of all of her appointments, never really knew what day of the week it was unless I reminded her, and she would forget about eating meals and lose track of time and what time of day it was. What really scared me was sometimes she would get up in the night, think someone was out in the parking lot waiting to pick her up to go somewhere. I do not ever think that she will admit that she has problems, as she is strong willed, and is proud of being well educated and having her act together.
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Some times other than family members see it first-I had a friend who I could see what was going on but her family living with her did not notice until her husband died and she asked her adult children who was in a picture on the wall and it was her four grown children and that made them realize what was going on her husband had been able to deflect the truth even though he was a sick man for many years.
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maggiesue,
To be sure you need a doctor to determine if she has dementia and weather it is Alzheimer's or some other form. Once that determination has been made you will need to make some serious decisions regarding your mother's care. If she has a form of dementia that can be treated, you need to ensure your mother gets that treatment ASAP. It can open many more options than if your mother's condition continues to worsen and you are forced to provide 24/7 care. You do not give enough details to provide any specific tips but here a a few general one's I have learned from my experience:
1. Make sure your mother's finances are in order, that she has a will and a designated POA before her dementia pushes her past the point where she will be allowed to sign any legal documents.
2. If you have siblings, hold a family meeting to decide who will do what when the time comes to pitch in. The technology we have today enables even brothers/sisters living hundreds of miles away to participate in the caregiving process. So insist that everyone help out or you will be the stuckee (if you know what I mean).
3. Keep your mother in the decision loop as long as she is able/willing to participate, but watch out for Roll Reversal. This occurs when you know your mother is making irrational decisions but you do not feel empowered to make those decisions on her behalf because "she is your mother" and you were always taught to obey and respect your parents. At this point you become the Adult and she becomes the Child. You must do what's best for her regardless of how much she resists.
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My mum has dementia,she has been in hospital for 8 weeks,she is nearly blind,virtually deaf,She was admitted because she locked me out of the house,and said i was stealing from her,she rung 999,the doctors,etc,it has been going on for 3 years,this is her 3rd visit to hospital.
I am her only relative,and i have been at my wits end,according to her,i am a wicked daughter,and only want her money and her house,
no one likes her in the hospital,because she is so nasty.
They want to send her home,but i know she won't cope.
She owns her own house,and i am going to sell it,the proceeds will last about 1 year,as nursing homes for dementia are 600-1000 pw.
I feel the nhs has abandoned her,when you are old,no one cares.

I have never felt so alone,my dad saved all his life,and for what.

I don't want money,i just want her treated as a normal person,if she was a youngster,there would be outrage.

It feels good to put it into words.
I will do thing differently for myself and my husband,i never want my children to go through this.
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jazzsmom
That's great advice. My heart goes out to you. I'm so glad you are on the site so you know you aren't alone.
Carol
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My mom is 93 and her dementia has turned into Alzheimers. Most of the time she does not know who I am. One of the things you should do when you walk into a room where the demented parent is, is to say, Hi Mom, or Hi Dad, or whomever. I find that they fear most people in this state, but when you call them an endearing name like mom or dad, they relax and get some clarity if just for a moment. This is a cruel disease. I asked my mom, do you know who I am and she looked at me and said "Are you my mother". My heart cries out for her. For them all who suffer with this. May God watch over them all.
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In helping evaluate patients in nursing homes, many times the intermittent "dementia' proved to be TIA's (transient ischemic attacks) or mini strokes. I would strongly urge a comprehensive evaluation. Bring in a log of the times and length of episodes of the "dementia". Also, changes in blood sugars for some patients can cause problems, that’s why the time log is beneficial.
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My mother is showing signs of dementia and she always makes a point of saying something like there's nothing wrong with my memory or there is nothing wrong with my mind and she remembers things way different than they were. so I think they know for awhile and try to hide it until it just overtakes them.
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Yes, sometimes they do..and this is a personal experience with my father. Sometimes we will admit that he simply doesn't remember and at 87, it's only natural he doesn't remember. Other times, he will get defensive. It all depends on the day.
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My experience has been that the further these people progress in the disease, they fight the fact they have it. (my father did the same) I can still see my sister stamping her foot and saying, "I am NOT senile." Nobody had even said she was, and she saw fit to still defend herself. She thinks she can still drive, live alone, etc.....but she hasn't done any of that in almost 2 years.....so she is entering a nursing home this week. She's been assessed by a nurse 3 times (sister's tricky and can fool the best) who's convinced she needs 24/7 professional care to save her from herself. She used to admit she had a short term memory loss, but now it's also the long term memory too. She's 88 and has been alone her whole life until she came here to live with us, and it's been quite an adjustment for everybody...at last she'll be where she can get some help, as she doesn't believe in doctors either.
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In my case my mum does not realise she has dementia, she thinks she is pefectly normal, after months of battling with her to go in sheltered accomodation and to no avail, we have referred her to social services. Social services have reacted immediately and she was sectioned on Friday.
She beleives she is in a room full of people who are "not quite there" her words not mine i may add, and she thinks she is the normal one of them all, and she is going to have blood tests and then she is going home.
We have been informed she is "too far gone" for sheltered accomodation now and if she comes out of hospital it will be straight in to a nursing home, not home to her house as she thinks.
They do have quite clear moments of clarity maggiesue, my mum can recollect stories from way back when, but 2 days ago couldnt remember my name and called me another name (her dead sisters).
I am not sure if they can tell you when they have been in an episode and then back out of it, but if she is aware she has a problem it might help u more to get her treatment, unlike me where my mum is in complete denail and oblivion.
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Many people are aware they are having problems but try to cover it up. Some don't notice. At her age, she could have dementia and may have had for quite some time, but you indicate that maybe other mental issues have existed. Only a doctor is going to be able to figure this out. It sounds like she needs a evaluation.
Carol
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