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Keriana Asked April 2019

Are these early signs of dementia?

Hi so a few things have happened recently with my 91 year old lovely Mum. She has been getting confused with her medications and calls often to ask which ones she should take. We’ve sorted this out by arranging a pharmacist prepared pack to be delivered each week. She is also forgetting events that happened, like getting the results of her latest bone scan. Today, in hospital after a dizzy attack, she brushed her hair and then promptly pulled hair from the brush and just dropped the hair on the floor, she’s usually very fastidious about neatness. Her doctor wanted to do an aged care assessment to see if she should be still living alone. She got very angry, which for her is the cold shoulder and silent treatment. I was happy for this as she has been using her medi alert more often lately. After I went home, she told the nurses that she didn’t want that doctor anymore and requested another one, even though this doctor has been her cardiologist for many years and she always liked him before. We are scared that she will fall again when she is home alone and since she has severe osteoporosis the outcome would not be good. She is adamant that she will never go into care and tells everybody how wonderful her daughters are and that we will look after her. I have recently had brain surgery for an aneurysm and my sister is almost 70 and cares for her intellectually disabled son. We are both getting worn out and don’t know how much longer we can be running around after her, with all the appointments, shopping, bills and rushing over every time she uses the medi alert. We love her, she has been a wonderful, caring mother to all of us. I have another sister who is 71 and doesn’t drive, and two brothers who have their own health issues and really don’t do more than visit. I can see her demands increasing and am heart broken and at a loss as to the best way forward.

Erinm60 Apr 2019
Hi. The first signs I noticed, she did not know where to put dishes out of the dishwasher, She lives with me. So it was easily noticed. Next was washing all the dark and white clothes together, next was not sleeping in her room. But staying on the family room couch, with Fox News on all night and lights on, next was finding her notes on where I was, and what time. ( that’s extremely hard to deal with). Next , she stopped putting food away, then refused to bathe. Next, can’t write a check. ( but sometimes can). Next she won’t leave the house, can’t take meds without assistance, then the falls started. Wearing summer shoes in the winter, falling down the deck stairs, not telling me. Needing wound care , Sorry forgot to mention, zero short term memory. Now loosing long term. Walking around with pants unzipped. It goes on and on, But that’s her progression. She is on a waiting list for memory care. And that’s the best thing for her and for me. Because I can’t do this alone. Forgot to mention the dents in her car, Before she lost her license.
lablover64 Apr 2019
Erinm60, my mother's decline was almost exactly as you described. Forgot how to use the microwave, the TV remote, the phone, etc. Couldn't write a check or do her taxes. Auditory hallucinations started, then lying, then leaving the house in the middle of the night. Every new event was worse than the last until I began to fear for her safety and my sanity. I found the memory care facility and moved her there. I won't say it didn't hurt and I didn't feel guilty because that would be a lie. However, my sister and I agreed, Mom is much better off where she is watched 24/7, assisted with her meds, has age and ability appropriate activities, and socialization.
enderby Apr 2019
Your mother sounds like a wonderful person who is going through a hard time now. It is good she has the love of her family.
My father and my in-laws were all also wonderful in their twilights. It was good my wife and I were still strong enough to help them, even with two adult children who had their own serious issues.
My mother is the only parent left, and she is a true narcissist. Her cruelty is seemingly boundless now that she has lost many of her social skills.
Because of guilt, it was hard for us to place my father and in-laws, but it really was for the best. My wife still second guesses decisions we made for her parents when they were alive, probably because they were so kind, loving, and appreciative. My MIL actually loved the service at Assisted Living (AL), and we visited her daily.
I have my own health issues now, and I no longer have the stamina for my mother, even if I wanted to be her full time servant. She hates every place she lives, and I have moved her three times in two years. The last move was from independent living where we should never have placed her (she is not independent). She basically was kicked out for nasty and threatening behavior.
I can take care of her needs, but I cannot worry about her wants. It took five years of her cruelty to for me to finally drop the guilt and realize that my only duty is to make sure her needs are met. Happiness has to come from the person, it is not the responsibility of their children. Once I realized I am not the happiness fairy it was like a weight had been lifted.
Judyskid Apr 2019
Thank you.

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lynnm12 Apr 2019
You guys can only do so much on your own. Sounds like it's time for some outside help, even if she doesn't agree. May not be her choice at this point. And, if it helps any, I had a great Mom also. But you have to do what it takes to take care of her, even though in the moment, she may not agree with your decision. And anger dissipates, it's usually temporary,

Ahmijoy Apr 2019
Oh, dear. I am so sorry you have reached this point with your mom. None of us who are aging want to admit that we now need to rely on relative strangers for our care because we can no longer care for ourselves. We expect that our children will come to our aid, but sometimes that’s not possible. When people (such as your mom’s doctor) tell us what we don’t want to hear, we simply boot them out. After all, there’s nothing wrong with us and we can continue to live on our own like we did decades ago.

However, consider this. Is Mom’s wrath (the “cold shoulder) worth your constant fear and worry that something tragic may happen to her? You could have her tested for a urinary tract infection, but it’s quite possible she is showing signs of dementia. Only evaluations can reveal what is truly going on. Don’t bombard her with ideas of what she needs to do. She will only shut down. Can you hire in-home care for her? I suspect she will not understand that you and your sister have other obligations and cannot care for her. As a last resort, if things escalate to the point she is truly in serious danger of harm, you can explain to her doctors that she is unsafe at home and have her placed in a facility. This is less than an ideal situation but unfortunately may be necessary.

SparkyY Apr 2019
She could be suffering from "hospital delirium". I hadn't heard of it before but apparently it's more the norm than the excecption. Especially in patients over 65. And really sick elderly patients. From what I've read on it: when there isn't any dementia it's only temporary and the patient comes out of the delusional state when he/she gets back to familiar place. If there is dementia that makes the hospital dilerium worse but it's still temporary.
freqflyer Apr 2019
Sparky, that same thing happened with my own Mom who was in the hospital a couple days after a serious fall at home. This normally bright woman, in her 90's, was so very confused. Once she was back home, she started to be her old self.

The stats I have read said that 80% of elders get delirium when in the hospital, and 20% of very young people get it after having major surgery.
TaylorUK Apr 2019
For you all the best way forward is that she goes into an ALF. You may need to persuade her that she will be so much better off with other people for company, and someone on hand just in case she has a problem / fall etc. Or you may have to be firm and say, sorry we have our own health problems and cannot cope anymore, we love you but we cannot deal with your problems and ours. Whatever it takes.
Keriana Apr 2019
Yes that’s pretty much where we are at. It’s such a difficult time and I appreciate the support I’ve found here.
DILKimba Apr 2019
I want to recommend a book to you that really helped our family a lot. It’s not very long, but it really addresses a lot of these issues with love and compassion. it’s called “When Reasoning No Longer Works”. I ordered it for my Kindle from Amazon but you can get it other places. I think it may help you see the progression, and that she may be farther down the path than you think. https://www.google.com/search?q=when+reasoning+no+longer+works&ie=UTF-8&oe=UTF-8&hl=en-us&client=safari#imgrc=2OFEHDDTo3YOWM:
Keriana Apr 2019
Thank you I e read a lot of books when my father in law had Lewy Body but I haven’t heard of this one. Thanks
Ricky6 Apr 2019
I know that you are worried about your Mother falling and who would help her because she lives alone. Sooner or later you will need to decide how to get her help and decide that she cannot live alone anymore. Please note whether she lives with family or in a Nursing Home there is no fail safe place that will prevent all falls and it will happen. You just need to decide what place would be best.

Grandma1954 Apr 2019
If you or another family member can't care for her in her home or yours the options are limited.
Having someone come in. And this will mean 24/7/365 as she will need "care" around the clock. This does not mean you will have to hire a nurse or even a CNA. If you hire through an agency they will not permit someone that is not a nurse to give medications. But if you hire privately you can instruct someone to give medications. There are drawbacks to hiring through an agency and there are pluses jut as there are pluses and minuses hiring privately.
Another option is Memory Care. There will be a locked facility so she can not leave or wander off. She will be cared for around the clock. Usually these are more "home like" and as long as she does not need Skilled Nursing care she does not need a "Nursing Home"
If you decide that you or another family member can care for her at home realize that modifications will probably have to be made. Larger bathroom, if possible roll in shower, higher toilets, no stairs, no carpet, wider doors to fit wheel chair these are just a few things.You should see a lawyer that is familiar with Elder Law make sure you or someone has POA for finances and Health. It is possible that they may suggest that your Mom needs a Guardian.

If you figure it our with modifications to her house, property taxes, insurance, upkeep, gas bill, electric, food, caregivers...it might be possible that moving her to Memory Care might be the same financially as keeping her at home.

Not an easy decision.

Also know that falls happen anywhere. They can not totally be prevented, they can be minimized. Decline will happen sometimes slowly sometimes rapidly.
Think now abut how you want to deal with emergencies, she most likely will not do well in rehab.
It might be the time to talk to the rest of the family about a POLST (Physicians Order for Life Sustaining Treatment) it is much more detailed than a DNR.

Lizhappens Apr 2019
As others are answering, yes it is. And sounds like you have some hard decisions coming up. I think you’ve already known, it’s just really hard to face. Everyone involved has to go through their own acceptance “hump”. the beginning is denial, the hump is the realization and the fight, and the downside is acceptance and working the issues through. I’ll spare you my long list of comments and just send you a virtual hug and I’ll pray for the courage to do what you need to do. I know many of us will be supporting you along the way. get good advice, do your research and follow up regularly. Hugs!!!💕

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