My mom is 79. I have noticed memory loss, repetitive speech, losing items and angry outbursts for the past several years. Her husband has spoken with me several times about her behaviors. Everyone he mentions dementia screening, she becomes explosive. He managed to get her to primary physician for an assessment under the guise of a medical issue. She blew off the mini-cog and then became enraged at the doctor (according to husband).
I speak with her by phone almost each morning. I live 3 hours away. Today we were having a normal conversation... then she seemed to think I was someone else... and started talking about me to “the other person.” No one was in the room with her. Being startled... I said, “I’m Sunny... I’m married to Alex...” She seemed to catch herself and attempted to laugh it off (her usual defense mechanism when she can’t find something or remember something). I think she realized I noticed this alarming part of the conversation. Later, she called back... saying, “This is your mother...Sunny’s mother.... I’m not crazy...”
Please send me your thoughts on this. She truly thought she was talking to someone else. It was like a light switch went off and I was someone else in the middle of the conversation.

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The getting enraged at the doctor and husband and anyone who suggests this is typical of the behavior. Someone NOT having dementia would say "Really? Am I doing that? Let's get to the doc so I can get tested, because I am having a hard time believing that". The elder knows they are beginning to lose it. They are deperately afraid, afraid it will get noticed. Afraid of what will happen to them. The family needs to sit together with Mom and say that there must now be testing. BEFORE that can happen the husband needs a diary of things that occur and YOU and other family do as well. Then the intervention of saying "These are the things that are happening and this is the next step, a neuro exam so that WE CAN GET YOU HELP if there is anything, and if there is not anything we can all relax." Of course we all know that there IS no help, but at least scans might show some changes indicative of what kind of dementia this is. You are all aware it is coming, more like it is HERE. So now it must be addressed. Mom isn't going to like it so just start there when you sit down with her; say "You aren't going to like this. Be assured that we are concerned, and we are not happy about it either. But this is the fact and this is what is going to happen. Time for Dad to get any POA papers done now while Mom is still able enough (and she IS able enough) to express her wishes. You don't have to be mensa grade to do POA papers; you only have to know what you are doing. You know this is here. Now it has to be faced. If Mom will not see the doctor without literally being dumped into the ER, then you and Dad should visit the doctor after a month of diaries and incidents to see what he/she suggests.
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I wonder, Is there any benefit to getting a dementia screening? My husband never went for the tests. They are humiliating and degrading for those who have lived such full lives.

You know it’s dementia. A test isn’t going to offer much except confirmation. You’ll figure out her “level” by interacting with her. Some days it will change, sometimes she’ll cover it up. That’s how it goes. It’s not easy.
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Arwen31 Jul 2020
Wise words
My 82 year old mother started behaving similar when she was 76. That was six years ago. I was the only one who noticed it, or rather the only one in the family who brought up the possibility and I still am. My dad wants to avoid it even though the signs now are unmistakable. I give your step-dad a ton of credit for facing this. With a proper diagnosis, even though heartbreaking, allows you clarity in how to move forward. When my mom thought I was someone else on a phone call and actually began talking about me to that person was one of the more scary moments and this disease literally hit me in the face.
It seems you have experience with this disease in your family, but it always helps to find support in how to accept the reality of this disease, stay connected to your loved one, and also to keep yourself well. Teepa Snow has some videos that I found quite helpful. Prayers to you, your step dad and your mom.
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Sunnydayze Jul 2020
Thank you Gingermay. My experience sounds extremely similar to yours. Yes... today’s conversation hit me right in the face...she was talking to me... then I was someone else! Thank you for sharing your story with me.
I hear you! However, sometimes folks can be well behaved in public places, so I applaud your mom's husband in trying this method.

Uultimately, this is very much HIS issue. Does mom have POA for finances and health set up? Does she have a living will that tells you what her end of life wishes are?

That might be a hook into a less fraught could say you've been reading Atul Gawande's book On Being Mortal and you are setting up your POA and hopes she has done the same.

Sunny, there are some people we can't help, no matter how much we love and care about them. Be well and take care of yourself.
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Sunnydayze Jul 2020
Thanks again , Barb. I am in deep caring for my dad as his durable POA and overseeing the details of his life. You are right no matter how much you love and care for a is not always cupcakes and sunshine!
Thank you so much, Barb. I just had to move my dad to an AL. He was diagnosed with LBD. His doctor told him he could no longer live at home. He almost electrocuted himself. Back to my mom...parents are divorced... you made a good point about a fear from the past. Her grandmother was institutionalized in a mental hospital for vascular dementia In the 50s-60’s. (The family always said she just lost her mind). My own genealogy research discovered her reason for admission. My mom’s dad lived with Alzheimer’s for about 6 years. He had to be placed in a nursing home, though he was well cared for.

My step-dad is trying to set up a “double” appointment for the both of them with a neurologist without her knowledge. I can imagine the fit she will throw once she’s in the exam room.

She can become so angry and enraged... it is difficult to have any conversation about brain health.
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Your mother apparently knows that something is wrong and is afraid of what it might be.

There are things that might be treatable; normal pressure hydrocephalus, certain kinds of brain tumors. She might be having TIAs and bp meds might help with that. But she can't find any of those things out if she won't cooperate and see the right doctors.

Because she is afraid she will labelled "crazy". And then what? Dumped in an institution of some kind?

I often find that with folks who resist diagnosis and treatment that there is a long ago story of a relative who was carted off to a mental institution or other horrible care facility. In our parents' day, it was totally typical for parents to be told to institutionalize their "defective" children as toddlers and never speak of them again. I think there is a whole lot of hidden trauma in that generation from those sorts of actions.

That being said, you can't care more about your mom's health than she does, can you? You can try talking to her about the fact that you won't abandon her, will always see that she gets good care (DO NOT PROMISE that you will never put her in a NH; "I'll find you a good place, mom" is how I would word that).

If you can have a conversation (best in person) about "what about this whole thing with your brain makes you scared, mom?" "Please let us help you to find out what this is and let's get it treated" "What is your plan for your care if this gets worse, mom?" will give you some insight into her thought processes and level of reality.

Assure her on the "crazy" part--have a brain that isn't working properly isn't "crazy" but resisting finding out what is causing it might be very foolish.

One of the tougher conversations I had with my mom happened when she was 65, younger than I was now. She had her first mammogram and they found a lump. She went into mental lock-down and decided that she was going to be a "good patient" and only have one anesthesia, have the biopsy and possible mastectomy all in one go. But it was 1986 and that's not how things were done any longer; she was remembering the oncologists she had worked for at Memorial Hospital denigrating the female patients who wouldn't be "good girls" and just have their d@amn mastectomies without asking a lot of questions.

She also was insisting on going to a poorly rated local hospital when MSK was only 40 minutes away.

After trying to convince her and getting nowhere, I said in exasperation "mom, you are too smart to do something this stupid". There was a sharp intake of breath and I think she may have hung up on me. But she agreed to go to MSK and do things the RIGHT way.

Maybe you can try something like that.

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