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My aunt had fast onset dementia with a couple of months in rehab. Now she seems better and thinks she's more competent than she really is.

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Dementia almost never comes on quickly. Probably she had mild/early dementia, and then developed delirium while ill. Delirium is a state of worse-than-usual mental function which often comes on when people are sick. It can also be brought on by medications such as Elavil and Xanax.

Doctors are not supposed to stage dementia while people are delirious or have recently been ill, because it can take weeks (or even months) for people to recover to their best mental state after having delirium. Unfortunately, delirium can accelerate cognitive decline and some people with dementia never recover to the way they were before becoming ill.

In terms of your role as POA: usually the POA can act (or override) the older person once that older person is mentally incapacitated. The problem is that most POA documents are not designed to fit with an older person getting mentally worse, and then recovering after delirium.

In principle, now that your aunt has gotten better, her doctors should reassess her mental capacities, and confirm that she is still impaired enough for you to manage her affairs. I seriously doubt she'd still be considered "late-stage dementia"; in late-stage people can't walk, can barely talk, and barely recognize anyone. What you are describing now sounds more in the early-middle stage. But she will be prone to become very confused again when she is ill, and the nature of dementia is that people tend to slowly get worse over the years. So you should certainly be preparing to provide more help and oversight.

As for how to cope with her behavior and the situation...you will need information and support from others with experience and knowledge.

I would recommend posting more questions to the caregivers on this forum. Many people here have been through similar situations and you will get a lot of good advice.

Other resources to consider include Family Caregiver Alliance, the Alzheimer's Association, and your local Area Agency on Aging.

I'm sorry you have to go through this. Although she's not being appreciative, she's lucky to have you. And if you feel you can't do this or if you feel overwhelmed, ask the other family caregivers here for help. Good luck!
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I agree with willardmoxy. Medications can interact and cause the kind of confusion you are seeing. If you can, get her medications checked for interactions for sure and get her onto the bare minimum. Medications themselves can have nasty side effects. Medications have their place, but can do more harm than good in some situations. Try to see that she is eating a whole foods diet; less boxed foods and more fresh foods. Real food will boost her mood along with a minimum of medication. There are foods that are very good for urinary tract health. You might see a turn around in her lookout and attitude with a healthy diet and minimum medications; only those that are absolutely necessary and checked thoroughly for interactions. I have seen many elderly that were so overmedicated they were diagnosed with Alzheimers, but when the medications were minimized they had a complete turnaround. More people need to be aware of this!
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this is just the way I see it, not every one will agree with me. each time your aunt saw a doctor they said she was fine then scheduled her to come back and some or all of them were writing prescriptions. you wrote, "She said she had medication everywhere". in my opinion doctors are over prescribing medications and causing the kinds of problems your aunt is having. google the side effects of some that she is taking. that's why her so called dementia can come on suddenly and clear up suddenly. medical students are being taught to prescribe drugs and invasive tests. that's all. at age seventy five I take no pharmaceuticals. doctors were handing me pills from the first day I started seeing them for extreme fatigue while the real problem was malnutrition, anemia, and heart block from many years of trying to be vegan. even worse than their incompetance was their condescending attitudes. doing my own research I figured out the obvious. I now eat steak and eggs for breakfast along with citrus fruit. I drink smoothies made of fruit and leafy green veggies. within a couple of days of eating healthy and getting outside I felt good again. if I go a single day without eating right I become fatigued again bcs at my age and your aunts age our absorption of nutrients is not as good and we need to replenish nutrients every single day. I think your aunt would get the best care from a naturopathic doctor if you can find one near her. if not then find a doctor who will wean her off medications, especially psychopathic medications, and get her on a natural foods diet. that is my  personal opinion and not medical advice.
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From my experience with my foster dad who slowly developed dementia, what you're describing definitely doesn't sound like dementia but something else going on. I also noticed someone else later on he'll slowly started developing dementia, and I can't tell you for a fact that what you're describing definitely doesn't sound like dementia at all. I would take the patient to a neurologist and get them properly evaluated to see what's really going on
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cccquilter -- I would appreciate it if you could list the foods that are helpful for urinary tract health. It would be helpful information to have. Thank you.
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Cranberries. Juice them with apples for a sweeter taste. Here is a link: http://healthyeating.sfgate.com/foods-promote-healthy-urinary-tract-system-5170.html
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for a UTI load up on these foods water, cranberry Juice, yogurt, garlic. if you don't know how to research on-line have someone teach you. learn how to google stuff. we're all going to get old and have health issues so might as well start learning now how to take of ourselves bcs doctors are being taught to prescribe pills, do invasive tests, and keep us coming back (my opinion)
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Hi AZAUNT0926! Sounds like an overwhelming array of tough, complex issues! I didn't know until it happened to my Mother that Urinary Tract Infections can make elderly go around the bend! Several years ago I thought my Mom had completely lost her mind. She would even reach into the air to touch things not there, couldn't remember and constantly repeated same questions, got really strange ideas, and personality changes. A couple of weeks after the UTI cleared her mind came completely back, and the oddest thing is she didn't remember anything about her mental state during the infection. This happened several times over the years as my Mom is prone to UTIs. Her symptoms aren't always obvious early on and she is either allergic to or doesn't have good responses with a lot of antibiotics. Catheters greatly increase the chances of infection, and they complicate testing. Some bacteria always live in the tubing so doctors wont test or treat until the symptoms become "obvious". Recently my Mother had a stroke and after rehab they sent her home with a Catheter. I strongly suspected she had UTI but couldn't get a response from the doctors and she ended up in the hospital, the infection having gone all the way to her kidneys. Also the Catheter was causing her extreme pain which she couldn't communicate because of the recent stroke. They took the catheter out and relaxed the rule about how many cc's in bladder before they would straight cath. It was three months before she was free of the infection. And yes, good luck on trying to call around and get someone to do appropriate testing and treatment on time with necessary followups. There is also the possibility your Aunt has had small strokes which are affecting her personality and causing her confusion and memory loss. She is probably lonely, tired and scared as you also may be feeling by this time. It's can be very difficult to find one, but she needs a responsible doctor who can/will thoroughly assess her needs, refer to appropriate appropriate specialists and coordinate whatever care she needs. Perhaps her insurance or medical clinic can provide a "Nurse Case Manager" to do this. Can the Asst. Living Owners help you?
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Considering the distance factor, you might do well with a professional geriatric advocate who can coordinate what is needed with your aunt. There are professional associations who do this, their members are bonded and licenses.
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Isabelsdaughter, your mom probably had a different problem than AZAUNTY0926 aunt did/has. it takes endless hours of research and observation to detect individual problems that's why doctors can't do it in a fifteen minute appointment. we're on our own. grateful for the internet ... (my opinion)
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