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She's "normal" on the outside but having serious cognitive problems/in denial. A little background: we are dealing with my mother-in-law. She's 74, lived in WA for many years and now lives in a house on our property in TX. She's always been a little quirky and odd and as she has now been diagnosed with mixed dementia (AD and vascular), she is manifesting quite a few symptoms. Her short term memory is a problem (the only problem she'll admit to) and her balance is starting to go - not uncommon with vascular dementia. I guess she'll also admit to balance issues but is convinced that has something to do with vertigo (she doesn't have vertigo) or other imagined issues - anything but dementia. She's narcissistic (as I note a number of similar parents on this board are). Since she's not driving any more (a recent potentially serious accident triggered a loss of drivers license as well as the appointments with neurologists). We have POA now (completed last week) and obviously can maneuver the paperwork however we want, but still want to involve her in the process as we are firmly persuaded that being with people would be very good for her (as opposed to the relative isolation of our rural property). As we are only 25 minutes from the center of a large city, there are options, although we do have financial constraints. Our frustration is just dealing with her on a daily basis. She's demanding, argumentative and (generally) unappreciative - even though she would vigorously disagree with that statement. Her daughter has a very demanding profession and even though she is often working from a home office, is unavailable to her mother until dinner time - a concept that's difficult to understand for my mother-in-law (she's here so why won't she see me?). I work on our property and resent the fact that as soon as I'm visible through the windows of her house, my mother-in-law is in the midst of what I'm doing, even when I have to run her off because I'm operating dangerous machinery. Her cognitive impairment coupled with her narcissism means that when she wants to talk with someone, she gets very sulky when they are unavailable. it's gotten to the point where I neglect outside chores and activities just to avoid her. While we are looking for an AL facility, the choices are somewhat limiting because of finances. She makes just enough to not qualify for medicaid but not enough to pay for something decent. Home care in this rural area is impossible - we've tried and tried and even when we get someone, they don't last more than once or twice because of their own disorganized personal situation.


I'm guess I'm just reaching out to get conversation going in the hopes that one of you will see something and comment on something that was helpful in your situation - and that your idea or thought will be useful in ours. Thanks for "listening".

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I would also keep check on other things in her house, like is she eating spoiled food, In the early stages, my LO insisted on eating spoiled food and was in denial of the danger. And giving out her ss# and date of birth to strangers at the door or telling people in the grocery store how much money she had in her bank account! And ordering large quantities of random items. (50 air freshners.) They may seem fairly okay, but have huge issues that are placing them at risks.
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Hi, jrc. I understand what you're going through. I think it is totally okay not to press the issue of dementia. It is a frightening concept to many who have it and so is pushed out of their mind. The logic is that their mind appears to be working fine enough to them, though they are probably very aware of some problems. My mother is this way. For her comfort I never use words like dementia or Alzheimer's. They upset her. These are things that happen to other people in her mind.

I have the feeling that your MIL is bored. I don't know what she likes to do, but I wondered if she would enjoy being around other seniors at a senior center. The senior center close to me has a lot of things to do -- games, exercise, yoga, tae chi (or however it's spelled), dancing, choir, road trips, lunches. Some seniors go to the center every day and make friends with the people around them. I wonder if you, your husband, and SIL could arrange to take her to one a few times a week so she can get out and stretch her social legs. We have one man who comes each day to the local senior center while his wife works. He had a debilitating stroke a few years back, but it still able to do many things. The center is perfect for him, since there are people to respond if anything happens.

It is hard for young people and old people to live together. Younger people still need to do things that leave the older people out. Boredom and loneliness can start to be a problem. If you don't mind doing some chauffeur work, look around to see if there are free opportunities in your area. If your MIL is doing fine except for the boredom, it may be an answer.
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Get her into a senior daycare facility. Hopefully they have one close by. Maybe two or three days a week, whatever you can afford. She is probably lonely and reaching out the only way she knows how. Nothing can cure lonely except people.

Barring that, see if you can find someone in the neighborhood who could spend even two hours a day with her late morning into early afternoon. In addition to keeping her company, maybe she could do laundry or dishes or light cleaning. Vacuum one day...laundry next time. Whatever.

Even if mom qualified, I don't know whether or not Medicaid would pay for AL. It's sure something for you to investigate, though, if you haven't already. She can't be DQd because she makes too much money. They'll just take all her money and make up the difference. I think. If you haven't checked into this seriously, now is the time...if not for now? For two years from now.
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It's good you are reaching out for advice and information. I wish I knew more abut the financial question. There are some around here who may have suggestions. I know there are spend downs to qualify for Medicaid, but I think they involves assets and not income. I hope you'll get some good info here on that.

I will say that it's sweet to get MIL's input, but it's not likely she will ever cooperate or be compliant voluntarily. You are not likely to convince her of a diagnosis if she is not inclined. I say whatever works is the best route to go. Tell her what you need to in order to protect her.

You don't know how fast she will progress, but my LO progressed quickly with AD mixed with Vascular and was not able to live alone. You're smart to plan now. Eventually, she will need constant supervision.

I think what would concern me immediately is the balance problem. My loved one had that too and it caused multiple falls and multiple fractures. I would keep watch on that. Sadly, even if you encourage the use of a walker, they often resist and ignore you. Constant supervision and reminding is almost the only option and even then falls are a risk. Please let us know how you manage this.
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