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The roof does need to be replaced, I own the house with my sister and we're trying to figure it all out. I've got a few bids, I need to check references, insurance, etc. It isn't leaking, so there aren't any immediate issues. My mother is insisting that it be done right now, when I try and talk to her about it, she bangs her fists on the table like she's an army general giving out orders. She actually got so worked up about it last week that she gave herself a nosebleed, which landed her in the ER. She's on Coumadin, so it was difficult to get the bleeding to stop. She's never been an easy person to deal with, but I'm wondering if this could be the early onset of some kind of dementia. She went to her doctor and they didn't seem to think anything was especially wrong. She's had urinary tract infections in the past that made her very impossible to deal with. Thanks for any feedback.

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At 92 the dementia wouldn't be "early onset" -- that term means the dementia symptoms showed up before age 65. I think you are asking if this might be the beginning of some kind of dementia.

You say she has never been an easy person to live with. Is this pounding-on-the-table behavior and demanding immediate action new behavior for her, or just more of same?

Her doctor didn't seem to think anything was especially wrong. Did she go alone? Did the doctor hear the story of her obsession and demands about the roof? What kind of doctor was this -- geriatrician? GP? Internist? What information the doctor was given and the doctor's specialty can make a big difference in how doctors respond to very old people.

Whatever the cause of her obsession and outbursts, I think I'd try to keep her calm, reassure her, and not say anything that sounds argumentative. "Yes, Mother, I am so glad you understand that the roof needs to be replaced. It is a big help that you know that and can be patient. We want it to be done right and I'm afraid I'm getting a little slower in my old age. Would you like to see what I've learned so far -- or would that be boring for you?"
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Couple of things to consider-
- when she went to her MD did they do a "mini mental" exam on her. These are usually the clock drawing & 3 word recall & most gerontogy oriented practices do this. If not & mom is seeing a family medicine doc or general practice internal medicine guy, you may need to find a gerontogy group to see her. At 92, there will be age related cognitive decline but testing can give you all an idea of what type of dementia mom has & what approach and meds to take. Whatever issues she has are only going to get more intense & challenging. You really want to get some data on her status ASAP before she gets into the more muddled middle stages of the different dementias as different types benefit from different medications. My mom was Lewy Body dementia and for her Exelon worked while Aricept didn't, but Aricept works better for Alzheimer's dementia.

- now about getting repairs done. If roof doesNOT need work, please please don't do it! Or get mom completly away away for days if roofing gets done. Mom will come unglued with workers. The guys will show up early, all sorts of noise, scraping, smells, dust, derbris, music, likely foreign languages being spoken. Mom could well get all paranoid about workers.

thousands of $$ for roofing might better be spent on moms rent at an IL or AL.
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Igloo gave very good advice. If the roof doesn't need replacing, then don't do it. We want to validate concerns, but not when they lead to spending thousands of dollars unnecessarily. Replace the roof only if it needs it.

Your mother sounds a little like mine. My mother has vascular dementia with mobility problems. She has this idea that something is wrong with the floor, and it is what is making her walking difficult. She thinks the floor is on stilts and it is creating cracks between the boards so that wind can blow in. She doesn't understand the concept of subfloors or enclosed crawl space. She wants someone to come out and fix the floors. We had extra floor supports put in four years ago, which is when the trouble began. She called the workers so many times that I finally had to "lose" their business card.

When she talks about it now, I assure her the floor is fine. My brothers and her friends have also told her the floor feels fine. She'll accept it for a little while, but soon it starts in again. She has blankets on top of the thick rug in her room to keep the air from coming in between the cracks.

Yes, it is crazy making. But no, I'm not going to call floor and foundation people out and incur that type of expense. I don't usually mind going along with her delusions, but this one would be expensive and destructive. This battle has been going on for 4 years. She forgets most things in her life, but not the floor.

Ruggles, with your mother's health history, I wonder if there is some vascular dementia going on. What you describe sounds a lot like other cases I've heard. My mother has no problem passing those little mini-cogs, though she is late stage VaD. The longer (15 min) test picked up on her deficits better. She hasn't had the hours-long test. I wouldn't put her through that, since it is exhausting.
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I laughed when you wrote about her fist pounding on the table. Sounded just like my 4ft.7in. MIL. It is about control. You mom has little control over much of her life compared to what it was in years past. The pounding fist and her voice are all that is left. After the roof it will be something else in the house, or meals, or neighbors. She wants what she wants when she wants it. The advice to get her involved might be good IF she is able to understand clearly and reason out decisions. My MIL, had we gotten her involved in something like that, would have dissolved into hysteria within a few minutes saying that she didnt' understand business and claiming that we were just trying to show her how stupid she was. It can be a tightrope for sure. You can try giving her a ride about the neighborhood to look at new roofs and decide on colors. Then talk about it takes time to select and order the supplies and schedule the roof. Stall as much as you can without creating more chaos. And I do agree to getting mom out of the locked house when the workers are there. My MIL, if she stayed home, would have claimed that the men were on the roof trying to look into her room or planning on attacking her or stealing things.

Once, when we my hubby and I had taken my MIL out to eat at a small local sports bar she came up with all types of ideas claiming that we had taken her to a saloon where the men took the gals into the back for sex. When we had been served she didn't like it that she had a regular lunch and we had soup and cornbread because my husband worked and "a working man needs his sustenance". In a few minutes we needed to pack up the food and leave because she was making such a fuss that the guys at the bar watching a football game had all turned to see what was going on. The young waitress was most cooperative and told me that her grandmother lived with the family and on occasion had this sort of meltdown. The waitress told us that her mother was always very calm and told the children, "when you are old all you have left is your voice".
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I'm going to repeat what Torie said. It is about control. Whether or not the roof needs repairs may be in her mind, but WHEN to do it is about control. My 96 year-old aunt does the same thing when she isn't getting her way. She pounds her fist on whatever is close or, if she is standing, she picks her walker up and pounds in down on the floor in frustration. I recently had my roof replaced (my Aunt lives with me in MY house) and it was unnerving to her but she was OK once she knew what was going on. They were here a week. I made sure I was here all day every day while the repairs were happening just to give her a sense of safety so it wasn't a big problem for us at all. My Aunt doesn't have Alzheimers but definitely has age-related dementia
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And, just FYI. My Aunt came to live with me 14 months ago. In this short time, her cognitive thinking is now completely non-existent. I took her for a check-up right after she came. She knew date, day of week, president, social security, etc. She doesn't know any of that now. That's how fast the decline can be.
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Your mother should watch her temper - the Coumadin is an anti clotting drug, and that nosebleed must have been pretty difficult to control. My mother was on Coumadin; she had a funky blood disorder called polycythemia vera. I sometimes get nosebleeds due to dry air.
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I agree with do not fix the roof while she's there, for a couple different reasons. My Dad was home with his dementia, when they had a cracked toilet and a flood. The two weeks of fans going, workers in there, painting, new carpets going down etc, totally flipped him over the edge with his dementia. He became incontinent because he would not walk in the bathroom when he needed to because the tall fan outside the door drying the walls and floor, were a 'guard' to him, who was going to attack him if he walked down the hall. And all of a sudden, he lived in a boarding house and my Mom owned it, because all these people were coming in and talking to her....not him. And the MEN...were trying to get too friendly with Mom and he was going to punch them out!! On and on. Within a month, he had become so agitated we had to have him placed as he was attacking Mom!

Now, the other reason....I see does not apply because you own the house...so never mind about that! IF you must repair, can Mom spend some time with another relative, or can one of you take her on a mini vacation until the worse of the work is done? My Mom, who has Alzheimer's, gets this way about certain things. One reason I believe, has to do with 'new things that must happen, are very stressful for someone whose mind doesn't work right, to keep thinking about. They get anxious and then agitated. Also, my Mom wants it all to happen right now....and I can see that it's because she is never sure she will remember to do it, if it doesn't get taken care of right now....she won't admit to any issues with her memory, but she will let it slip that app'ts need to be made 'NOW' because they might not get done....and then when something is scheduled, she frets and frets about it til it's happened. So sometimes, we just don't tell her what is on tap, until the day before or the morning of.....and, also, at 92, she may spend time thinking that she doesn't have much time left to get things to happen too! But it does sound like dementia of some kind is related to all this fist pounding! As others said, I strongly recommend a geriatrician or geriatric psychiatrist etc....because they are going to be much more focused on seniors and dementias and testing/watching for cognitive abilities and they much more thoroughly understand the meds that work to keep these elderly people calm but not sedated.
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Ruggles: Yes, Jeanne is correct-early onset dementia is that which starts at 65. Elders' minds do not work correctly and they're going to be agitated easily. I suggest you take her to a psychiatrist, who may be able to prescribe a low dose anti-anxiety med.
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And I agree with Jeanne - an elder needs and SHOULD HAVE a patient advocate that accompanies them to the doctor appointment. Else, the doctor is, quite likely, going to send the elder away with nothing accomplished. My late mother would go to the doctor by herself because she refused to live with me. The doctor would ask what her ailment was and my mother would respond "oh, nothing."
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I read the original post again. Doh. How did I miss that the roof does need to be replaced? We're having to have some work done on the house now. I called some companies to get estimates. My mother started pushing at me even before the estimators showed up. And she pushed me to call to get numbers. When are they going to start? Why don't you call them? I hadn't even gotten all the estimates in yet. I'll be glad when it's all over. I'm not worried about my mother. I'm worried about upsetting the rabbit, with all the workers outside her room and on the roof. She is going to be so scared.

Good luck getting the estimates and work done without so much angst, Ruggles. I know you'll be glad to have it all behind you. I hope you have a stretch of sunny weather to get it done quickly.
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Thanks for all the helpful replies. The roof definitely needs to be replaced.

I used to go to all of her doctor appointments but I got so burned out that I now pick and choose the ones that seem most important, her cardiologist and her rheumatologist are the ones I make sure to always be present at.

Her primary care physician is just awful, a few years ago I was able to switch her to a really wonderful geriatrician, unfortunately, my mother decided she didn't like her and fought with her at every visit. It got to the point where she would call their receptionist and would threaten her that she was going to have the doctor "reported to the authorities". At the last visit, it was recommended that my mother go see a therapist due to what the doctor described as "psychotic thought patterns". Her irrational behavior is nothing new, she has always been paranoid and belligerent, and drama addicted. She ended up going back to her PC physician.

Every time she ends up in the hospital (on average 2 times a year) they will give her the simple cognitive test, my mother always comments that "they're trying to see is she's crazy" - so on some level, she's actually acutely aware of what's going on around her.

The concept of the "voice" being the last bit of power in their possession really is intriguing. It puts a lot of her behavior in perspective.

The one silver lining that's come out of the nose bleed ordeal is I was able to get her cardiologist on the blood thinner Savaysa. She complained bitterly about getting blood tests she had every couple of weeks due to the Coumadin )who could blame her?) and I think she was having a difficult time adjusting the dose correctly. Going up tomorrow to get the prescription filled.
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Just be careful with the Savaysa. My cousin, who is a nurse, warned me about the newer anti-clotting meds. My mom is on Warfarin too and also gets her INR regularly checked and her dose adjusted. My sister-in-law with cancer just went on Xarelto. As my cousin told me, the problem with the newer meds is they don't have a reversal agent like Warfarin does. So if your mom was to take too much, there's not a med that can be used to counteract it like there is with warfarin.

If your mom takes her own meds, I'd be careful...if you administer them and she has no way to get to them, then you're probably OK.
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Get her off Coumadin ASAP. There are other drugs that are much less dangerous. Sounds like your mother is a control freak & has a nasty temper - that's not dementia if she has always behaved thus. I gave Mother Pycnogenol and Ginko to regulate blood clotting. I know that's herbal and I'll catch hell from some members of the group about it, but it worked. She died in her sleep at 104.
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My mother went eight years ago due to metastatic lung cancer at the age of 79
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My MIL, who has no dementia, but is just super, super anxious, cannot handle having ANYTHING done at her house, yet she keeps calling repairmen to deal with things, then she calls my poor hubby to come "supervise". I know it drives these repair people crazy to have her standing over them wringing her hands at the thought of needing a new garbage disposal or having the pilot light re-lit on the furnace.

Hubby and I have done a lot of small jobs for her and she will inevitably end up sitting in her recliner with a cold compress on her head due to the "stress" of us just "BEING THERE".

I had to turn on her sprinkler system one year and it was a messy, muddy job. Hubby was out of town so he was guiding me through the steps via cell phone. MIL about had heart failure. She went in the house and LOCKED THE DOOR on me. I finished, got the sprinklers adjusted and went to tell her that I was leaving, and she would not answer the door. So I called her on my cell, left a message and went home. She was just so stressed out by the mess (which I completely cleaned up) she was in bed for 2 days.

Since then, when any major repairs are done, she is hustled off to a long lunch with one of her kids.

Get the roof done and take her away while it's going on. If she is anything like my poor MIL, the stress of people making one heck of a lot of noise--it will kill her.

I feel sorry for her. The perceived stress of anything out of the ordinary just puts her in a terrified state, and we can't talk her down.
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Midkid, I feel so sorry for her. It must be terrible to have that type of anxiety. It is hard for people around her, but it must be torture for her.
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JessieBelle-
Not to hijack the OP, but I guess to add to it...anxiety over EVERYTHING is just debilitating. MIL has this with some people (me, my other SIL, some neighbors) she is just fine around her own daughter.

Life is just too much for her. She will not medicate for this crippling disease. She literally cannot be around our family--b/c she hasn't ever chosen to be a part of us, she now is overwhelmed by more than one or two of the great grands at a time. My kids are very understanding and don't bother her when they come to town, sometimes they will pop in for 10 minutes, but 15 would be out of the question.

She dislikes me intensely, always has, and one of the ramifications of the illness is that she doesn't want to have to deal with me in any way, shape or form. She doesn't acknowledge my presence anymore, doesn't even send a b-day card. I am not allowed inside her home any longer--(long, kind of hilarious backstory on that)..so I keep away from her. My hubby thinks this is all my fault and says he cannot go visit his mother because I am not allowed there. (Actually, I can go, but I have to stay on the back porch and am not allowed to use the bathroom.)

Writing this down, makes her seem really unbelievably mentally ill. I think she is, but she's not my mother and I'm not making that call.

I just mostly feel bad for her, her world of comfort is so small. And she is one of those people who is going to live forever and ever.
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