Could this be the beginning of dementia?


My mother has lived with us for 3 years. She is 83 and has a long list of health issues... none of which are terminal... just debilitating. In the past 7 months she seems to have declined rapidly both physically and mentally. She used to have her normal forgetfulness but now it seems to have reached a different level. Just this week alone she had a ct scan that i scheduled in the morning for later in the day. She needed to be there at 3:15...which i told her.... by 2:00 she was upstairs ready to go. She mentioned at some point that she had a hair appointment on Friday at 10..... it was Saturday at 1... and she had it written down on her calendar for Saturday at 1! She wanted me to pick up a refill prescription for her. When I got to the pharmacy they told me she just got it refilled 2 weeks ago. She even called it in but apparently didn't remember that she had already filled it. She looked at the date on the bottle and thought it said May so she called for a refill. Also, when she went to her hair appointment she forgot to wear her glasses. Who forgets their glasses and doesn't realize it? She's worn glasses since forever.

Should I be concerned about this? I'm not sure if this is normal or if we are now entering a different phase. I am very new to this caregiver role and feel we are early in the journey so I don't know how to recognize signs and symptoms of mental decline and fear that I am just overreacting. My sister was very concerned when I told her about our mother forgetting her glasses. That's just not like her. Any advice would be greatly appreciated and additional background supplied if necessary.

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My mom is moderately severe on the cognitive impairment scale, moving into severely affected. She will insist to her dying day she does not either need any help and get these ____ people out of her room. She might even situp and tell the undertaker to mind his own business, she'll get in the coffin by herself ___ it.

The way to tell if there are physical reasons behind any behavior changes is to have a neuro-psych eval with bloodwork. If those words seem too scary to mom, then don't use them, but DO make the appointment! This is when it helps to know your elder and what will or won't be acceptable to them. Make sure you tell the doctor's office that your mom/dad is afraid to come and if they have always been against seeing any kind of "head doctor". It's a generational thing where there was a stigma about it.

Maybe this will help:

==Mom, it's time to go to the doctor. Let's go. (Vague. no mention whatsoever of why or which doctor).

==We're seeing this doctor today because Dr. So&So said he needed this guy's opinion. (Play dumb, and that you're just following doc's orders.)

==This doctor's exam is part of what you have to do for benefits. (I dunno, I'm just doing what the insurance said to do....)

I found with my mom, I have to play stupid because I am always going to be the dumb child. Nothing can be my idea or of my arrangement because she has always been paranoid that everyone is out to get her. I have to make sure I play my role. If I get out of my role, things never go well.

If you start getting too many questions, you can try the old redirect -
==Hey! Let's go for ice cream after! How about a treat?
==Wait, before I forget.....Did you say you needed new deodorant? No? I wonder who said that to me. I can't remember. Maybe it was John. That's just going to bother me all day long. Maybe it was Sue. Gosh.
==I think I'm running out of toothpaste, we might need to pick some up on the way home. Do you need toothpaste?
==I'm trying to remember the words to this song - do you remember it? It goes like this...duh duh duh duh....
==Hey - when I was little, did we have a clothes line in the yard? Was that a neighbor instead? Who had the little dog down the street? Do you remember Mr. So&SO and how often he cut his grass? My goodness it was like he was out there all the time and the noise!
==Do you remember if grandma put mustard in the potato salad or not? I was trying to remember how she made it and I think I got it wrong.

Etc. Just change the subject any way you can to something not remotely related to neurology or doctors, not difficult/taxing to talk about, and maybe from the past they can still remember.

Good luck out there!
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seerli, it is amazing how our parents deny they are getting older and don't want help at home. My parents are that way. My Mom will give her geriatric primary doctor an icy stare if the doctor tell her *it is age related*. On the other hand, my Dad accepts that he has age related issues. But if I suggest to my parents that they might want to visit a really great retirement village and I shown them the brochure, Dad will say that is great, maybe in a couple of years.... couples of years? They are 92 and 96. I probably will be moving into that community BEFORE they do :0
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Go to both doctors, but I vote for the neurologist first, if you can. The GP may be easier to get her to go, since she probably already acknowledges those ailments.
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Thank you all for taking the time to help. I appreciate your responses.

Sandwich... yes, I agree... follow your gut is usually the best course

Vegas... I have read the stats for dementia in the elderly and I know my grandmother had dementia when she was my mother's age which is why am wondering now if this is where we are headed mother has not had any upsets lately but has declined physically quite a bit.....I have been reading up on dementia for the last year or so. I want to be ready if it happens her ct scan was lower back. Shes having a lot of back pain lately so trying to find the source. You are right, she cannot live alone (although she doesn't believe that). She currently lives with my husband and I .

freq....normally, i would not be concerned about the glasses.... but she was driving her car at the time!! Luckily she was only going half a block in a straight line or I would have had to chase her down...LOL

bradp..i probably should discuss with her gp

I have seen this decline coming over the past year or so but this now seems to be snowballing into something that seems more serious. I know that if I approach her she will take her usual stance of deny, deny, deny. She refuses to admit there is anything wrong. We have been trying to get her to agree to someone coming in once a week to help her but she just doesn't think she needs it. Perhaps i should make an appointment with her doctor and discuss. Would it be best to use her gp or her neurologist? She won't go to a geriatric specialist.... she refuses... I've tried... she is very frail and has a wide variety of medical conditions (arthritis, fibromyalgia, lupus, hypothyroidism, myasthenia gravis,mitral valve prolapse and more)
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Dementia is not always obvious, and diagnosing it is also difficult, and sometime it’s difficult to say how this illness will progress, why don’t you consult a GP for an answer or specialist?
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Have your Mom have a complete blood work up to see if she is low in something.... could be something as simple as low B12.

Or maybe she was stressed out about the CT scan. Stress can make you forgetful at times.

I wouldn't over worry about forgetting glasses... my Dad's been doing that for years [he's 92 now] and he's worn glasses since his college days. And Dad has a long list of meds he takes and he's always calling prescriptions that he already had filled... just too many pills for anyone his age to try to keep track of. Getting his eyeglasses changed did help somewhat, as he was reading 3's as 8 or 5, vise versa.
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The CT scan was of her head, I hope. And I hope she has a really good Neurologist. Your gut feeling is right on target, and mom can't live alone anymore and be safe. Time to call the family together and make some decisions.
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Those sound like the symptoms I had after my husband's death. I was told that was "normal grief" for some people and not to worry about dementia. They were right. Has Mom had any big emotional upset in recent months?

Having her checked for a UTI is not a bad idea, although 7 months with the symptoms makes that sound less likely to me.

And, of course, these could be early warning signs for dementia. Sandwich has good advice about keeping a journal of things that don't seem quite right. It is maybe a little early for medical evaluation, but keep the journal and plan on sharing it with her doctor if this persists or gets worse.

Meanwhile, start reading up on dementia and how to deal with persons who have it. Knowing what to expect is hugely helpful.

There are many posts here about dealing with dementia. Let me warn you, though. No person gets ALL the possible dementia symptoms. No two cases of dementia are exactly the same. The same medication work great for some and are awful for others. It can be really overwhelming to hear stories of late-stage dementia while you are not even sure you are at the beginning. Know what to possibly expect is good, but too much information too early can be very hard to deal with.

Take one day at a time. Observe Mom carefully. Make notes. Be prepared to explore this with her doctor. You and your sister will manage this just fine!
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Fifty percent of those 85 and older have dementia. At age 83 the chances are quite good that some additional decline is occurring. Also, get her checked for a UTI. Symptoms vary.
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ALWAYS listen to your gut instincts. ALWAYS. Be it babies, grannies, or life in general. Cognitive decline doesn't happen all at once usually, and it is the little things that tell us what's going on. Keep a journal of what you observe and be persistent until you find a doctor who will be considerate of what you say and willing to help you.

DO NOT let anybody blow you off or tell you it's in your imagination. Worst case, you can find out more information to help plan for your mom's immediate care. Best case, it's nothing major and you still have lots of time to plan ahead. More information is NOT a bad thing here. Please check back and tell us what's going on!
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