khinson1 Asked July 2009

How do you have a parent evaluated for Dementia when they are unreceptive to the idea?

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I'm new to this community, and have read a lot of posts before finally registering. I am concerned that my mother may be in the beginning stages of Dimentia. I would like for her to have an evaluation. However, she is totally against the idea. Saying that she can handle her affairs and accusing me of trying to "control her life". She is in the hospital as I type this, being treated for a bad infection, and refusus to let me visit, saying that I'm just being "nosy". I get the impression that she thinks she will appear more "independant" if I am not there. She will have to be there for 3 more weeks, as she is being treated with IV antibiotics. Keep in mind that she refused to see a Dr at the first sign of any problem, and this hospital stay is a result of her trying to "treat" the problem at home. I have quite a few concerns regarding her health. However, the evaluation is my main interest at the moment. Can anyone offer any answers?

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Dear khinson1, never heard the fish/dog comparison one, but asking someone if they know where they are is standard. So is: Do you know who the Vice President is, the President, the name of the First Lady? And pointing to a watch band or stem, the doctor will ask his patient to tell her the name of it, or to draw the face of a clock. All standard dementia tests. Been through it many many times. They give them four items, tell them to remember the names, and that he's ask for them later, such as: apple, ball, pencil, book (or similar, simple things). These are classic questions. Or they'll ask what county she lives in. There's probably others, depending upon the Physician, and his or her background.

I understand your angst about Mom not being far gone enough for someone to notice. Not every professional is on top of this, but some are very perceptive. With early Dementia, the symptoms can come and go. Some people are better in the morning after a good night's rest, and grow progressively more symptomatic in the late afternoon and evening, as they tire. That can affect moods, emotions, and lots of things. Don't expect miracles, or for instant diagnosis for your Mom. But don't wait to talk to someone either, if you have compelling reasons to do so. Seek out a receptive, seemingly friendly nurse to approach cautiously, if you fear repurcussions from your Mom. You can go to a Social Worker's office, and not necessarily have to stand outside your Mom's hospital room. Tell Mom, "Goodbye," then ask the front desk receptionist to direct you there. Plead your case, privately, asking the Social Worker not to let your Mom know you shared your concerns with her/him. They may not be able to answer direct questions regarding your Mom's personal health information, but they may listen to you. If you know Dementia symptoms, you know your Mom's paranoia, and secrecy is one of them. A Social Worker can also give you an idea of what a Dementia Assessment might include, but probably can't give you specifics whether about your Mom without her express written permission. You can ask that a Social Worker approach your Mom about the subject of sharing information with you, and convincing your Mom it may be in her best interests to do so. You can request that a Social Worker share your concerns with your Mom's Physician. No guarantees this will work in your favor, or the outcome, but why not try? You may be pleasantly surprised. Hopefully, it will work for you, and not against you, but no guarantees, there, either. What have you got to lose? Praying for you...
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Cat Jul 2009
the difference between a dog and a fish would be a simple question that might be asked as an assessment question. They have to assess people's orientation to name, place, etc routinely each shift.

As far as healthcare, and many other topics go - I do hope it goes to a separate conversation thread where the previous posts can give the topic all of the attention it really deserves
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khinson1 Jul 2009
You all are great! I agree totally with your opinions on government run healthcare. And I do worry about the care my loved ones would recieve if the government were running things. Hell, I'm worried about the care I'll recieve. It is scary, but I guess we should focus on that which we can control.
So here's today's events. My mom allowed me to visit again today. I'm thinking mostly because I could bring her some things. She seemed more at ease than yesterday, not raging about conspiracies or anything. Actually, she seemed sort of lucid. She talked to me a bit about some strange questions she had been asked earlier in the day. She said it was a nurse, but I really am not sure. So tell me what you make of this. She was asked if she knew where she was? And this question that I think is so strange. "Do you know the difference between a fish and a dog"? Is this a normal assesment to find out if she is ready for discharge? I know you guys can't say for sure. But maybe one of you has heard these questions before and knows exactly what is going on. By the way, she is not so far gone that she wouldn't know the answers to those questions. Is that how bad she has to be in order for anyone to recognize that there is a problem? I'm hoping that someone noticed something and that is what provoked the questions. Probably wishful thinking. Still haven't worked up the nerve to talk to anyone for fear that she will find out about it. Maybe tomorrow.
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Will do when I come back online in a bit. Thanks for being an encourager, SecretSister. Whenever I type your name in response to something you have said, I really do feel like I have a secret sister in my heart! You are truly wise in your counsel, I feel. Thanks for being here.
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Go for it!
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Great idea to start a new thread on healthcare administration! Sorry for digressing, all.
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You, precious lady, have hit on an important issue. But the government wants total control! (Over what we can say, do, what we drive, where we work, how much money we can make and what we do with it. How we educate our children, and against all opposition.) It's a "money" belongs to the government mentality, and they want to tell us what they will do with our money. Do you get to choose how your parent's health care dollars are spent, and on what services. Insurance companies control it now. I'm not saying the government is all bad. But it is not doing what it was designed to do. It has overstepped it's bounds, and wants to continue, until it has control over every aspect of the lives of those who support it [them]. We are the government, in terms of: there wouldn't be one if we didn't vote them in. But how much voice do we, personally have over the decisions that are made? The system is grievous, and doesn't always work properly. How can we help? I don't have adequate answers. Many of us are so weary and distracted, we don't even notice when important events have occurred that will affect each and every one of us. I appreciate your concerns and voicing them. Some will not.

I am thankful for the medical profession, and that some of it is working. My parents are well-cared for, in my opinion, and a product of excellent health care benefits. So, I'll not complain too much about it.

I think we got way off track with this thread, though, and perhaps we could carry the current conversation to it's own post. I think the topic at hand centered around evaluating for dementia. I believe several addressed this, and hope the questioned asked was answered. If not, forgive us for the diversion, and post if anything is still unclear so your question gets the attention it deserves.
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I agree with you in terms of exercising our voices and not resting until we are heard. This discussion thread just reminded me of how vulnerable we are, not to mention our loved ones. The system is messed up now, and will entirely neglect the most infirm among us if the recommended changes are allowed to pass. Government needs to steer clear of the health care business. They are entirely ineffective in terms of regulating patient abuse and neglect now, much less quality of care, in spite of regulatory authority. The federal government does not need added control over our lives. They need to enforce current laws. If they do, patient care will instantly improve and spending waste will be significantly reduced. Now, wouldn't that be an awesome start to overhauling healthcare? Thanks for your kind words, SecretSister. We are all in our caregiving path together. I very much enjoy reading and learning from everyone here.
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Caregiverslight, your posts are always refreshing. Yes, God bless medical providers. And pray he gives them wisdom, too. You brought up an interesting observation. Can you imaging politicians reforming health care, and our loved ones being cogs in the machine? Protocol...versus caring concern and compassion. Economic-based decisions, versus need-related provisions. Scary thoughts! (Look at Canada.) As our loved ones advocates, we indeed need to be informed, alert, vocal and vigilant. Who will be making life changing decisions for your parent, spouse or child? Who will dictate how these needs will be met? Mercy, indeed!

When we are not involved, someone else is making those decisions. The squeaky wheel gets the grease, and the thundering drums get attention. Pray for wisdom and discernment, and don't be intimidated or shy. Speak up, and exercise your voice on behalf of your loved one's health care.
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God bless medical providers. Our stories and points are all proof positive that they are more than overwhelmed and sometimes not active listeners. All the more reason we need to keep our caregiving patient advocacy cymbals going to wake them up when they fall asleep at the wheel. Scary, isn't it? Then, there are the clinicians that take off at 100 miles per hour, family, or no family. God help us to be as clear-headed as we need to be when we are advocating on behalf of our loved ones. Can anyone imagine all of this under the new, super-improved healthcare government overhaul? If no one is listening now, government bureacrats will not be listening, I am convinced! Mercy.
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