Diagnosed as 'fine' - why am I still concerned?

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(This is actually an update to a previous question where I was advised to have him diagnosed)
Hi. I recently posted about a friend, let's call him Mike (70), I am convinced has dementia. His doctor yesterday told us he was 'fine'. But I have been in this situation for about 7 years now and I disagree. Just a few points: A.) the doctor did a 3-question mini-mental and Mike answered correctly (except the day) but with hesitation. B.) Mike lied about taking his BP tablets; he has taken 3 weeks' worth over the past 3 months (I checked before we left). C.) He lied about 'coping', saying he does all his own ironing, etc. In fact, he eats ONLY takeouts, does no washing and baths once every two months (he showered before going to the doctor, the first time in two months). D.) The fact is he has had to sell his house to pay debts relating to non-payment of utility bills. E.) Asked what he 'does', he replied reads, goes for walks, watches TV and keeps busy. In fact, he reads newspaper (not books), does no housework or cooking, walks 20 minutes a day, goes to pub every night, stares into space. His TV has been broken for the past two or three months. His laptop lies on the floor with a broken screen, so he uses the TV screen to get onto the internet where he accesses various webcam sites and porn.

I did an online test as a friend for dementia. He scored 15 (1 to 5 being 'normal').

So, am I wrong? Is this just laziness/ depression (there is a good possibility of this). Or is just still at a stage where he manages to hide it? Or is the doctor an idiot?

Regarding the doctor, to be fair, it may well be that Mike is actually functional and the doc thinks it's not at a point where anything needs to be done. Plus, the doctor must have noticed how dishevelled he looks.

My decision right now is to walk away. To take the odd meal and be a friend, e.g. invite him for a barbecue, ask if he needs stuff. But NOT to go and fetch his medication, only remind him when it needs renewing, not chase him up on it every few days. I have done what I can and now it is up to his family. (Sons who live up the road visit about every 3 months or so. Sisters pop in and rant at filthy house but think he is just lazy. I am the one to take him to doctor, for X-rays, to the shops, etc. NO MORE. He told the doctor he has no problem going to the mall. In fact, he hasn't been for a couple of months. Eats takeouts and buys coffee locally. Has no need for cleaning materials. Even admits his underpants are so old they fall down around his waist.).

I have spoken to pub friends and neighbours: 'Hell. Mike's been wearing the same shirt and jeans with a hole in the crotch for two weeks now.' 'I asked Mike what he and James had been talking about last night but he couldn't rememember he'd spoken to James.' 'His house smells awful.'

Thanks in advance. I guess I want confirmation that it's OK for someone else to pick up the reins now. We were an item for a while but are just friends now. I work from home and, just starting a new business, don't have time to be a carer. I also have an 81 year old mother who takes a bit of my time (she is GREAT and fit and fine but needs help, for e.g. taking car to mechanic, and I like to spend fun and quality time with her going out and having meals. Who knows how long she has.)

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Every answer here has offered something of value. Personally - and I know that this is hard - but I think you may have to step back and just act as a friend. Then, let the adult children know that Adult Protective Services will be notified if they don't step up.

This man has done what many do - he's fooled the doctor or found a doctor who doesn't want to be put on the spot. Likely a combination of both. However, from everything you say, he has either major depression or dementia. Which one it is doesn't matter right now. He needs help. If his kids don't step in within a week after notification, call APS. Give them a list like you gave us and tell them of your concern. Then you've done what you can.

You're a wonderful person to be so concerned. Even if this was a relative of yours or a parent you'd be having trouble getting him help he doesn't think he wants. That's what APS is for.

Take care,
TimeOut, I remembered when you raised a similar question before and were wrestling with the choice between remaining involved vs. letting (hoping, really that) the family would step in and become involved.

For someone not familiar with the background, this post will help:


It seems this is still an issue. I sense that you feel a strong moral and personal commitment to this man, which is understandable. It's also understandable that it's not easy to just walk away. It seems that you're still running errands for this man as well.

I'm assuming that the family still hasn't involved itself? It really IS their responsibility, whether it's to assume care or arrange for it.

I think there are a few issues that would affect your involvement.

1. Do you legally have any authority to assume any kind of care for your friend? If not, you must know that you're limited in what you can do.

2. This isn't meant to put you on the spot but is something to consider. Do you feel that continued involvement in attempting to provide care for this man takes priority over (a) care for your own life and (b) care for your 81 year old mother?

Another option to get help for this man is to contact APS, especially if the family hasn't stepped in to become involved. From your previous post and this one, I think this might be the better course of action as from the description of his physical condition and lack of cleanliness, it seems he could benefit from being someplace other than where he is now.

I wish every Demenia test were more thorough, involved logical problem solving and given at 4:00 in the afternoon. My mom lied on her questionare too. Only someone observing the person in their home will give the rest of the true story. Docs just don't want to give a Demenia diagnosis. They are too worried about themselves.
TimeOut, you care because (1) you were an item and (2) you are a nice person and don't want to see someone in trouble that you *can* help. You have done everything you can reasonably do unless you want to take this person's care over completely. You have told family, you have told doctor. You will need to let it go and unfortunately it will take a huge crisis for someone to step in. Make sure that it is not you. His family is willing to let you manage it all free. Please don't.
Step back. Others will step up. If they don't, call Adult Protective Services. The occasional visit for a few hours to help with something specific -- his meds perhaps -- and to see how your friend is doing -- should be enough to get others involved if you have to.
Your comments have made me think of a few things. When Mike first had his 'hiccup', as he calls it, I DID do some research and the University of Cape Town DOES have a clinic. Free as they use the data for research and study. I think that Mike might be amenable to this. It's less 'threatening' than a doctor. It's kind of focusing on why he has this 'fuzzy' feeling and can't always remember things (which he admits) rather than doing a test at the doctor to see if he may have's. This way, it could still be (he thinks this is his problem) a lack of vitamins and the fact he played with a broken thermometer when he was young (mecury poisoning). Who knows, he could have a point there. When I have time, this is an avenue to explore.

A good test is important, that is clear from the comments above, because it's the unknown that is scary. I told him last night: 'I don't really care about your lifestyle choice, whether you do dishes, but I don't know what's wrong and I'm frustrated.' That's what it boils down to.
I agree with the others as far as doctors go. Where I live there are hardly any Geriatricians. We were sent to a Neurologist when my wife's symptoms first started but he looked mostly for "stroke" related problems and said it was just aging. Even I knew it was not just aging. Two years later the symptoms were far worse and her GP again sent us to the same neurologist but I started looking in other cities and found a University Hospital that had a memory care clinic. They did a battery of test's (stopped in the middle actually because she could not complete any) and quickly diagnosed her with dementia. It might be a good idea to stop in at a nursing home or assisted living where they do memory care and ask for doctor they would recommenced.
Hi and thank you to everyone. Without exception, ALL the answers were helpful and I feel quite relieved actually. Perhaps more accurately, I feel I can let it go now. And I am not going to feel guilty about not popping in every other day. Sometimes I so resented this 'wasted' time when I should be working. Some very interesting points, for instance, regarding Geriatricians in Ireland (I am in South Africa). I'd go so far as to say the answers to the post cover all the issues I had remaining. So, I'm on my bicycle, so to speak. I'll pop over some curry mince and veg this evening but giving him the odd nutritious meal now and then is the limit of my involvement, I am resolved. Thank you all again.

I think like with most things, one needs to change one's habits and while it's difficult at first, eventually it becomes routine.
I think you answered the question many of us have asked:

"Yes, my resolution to step back will happen over time. Last night he mentioned he has no petrol till pension gets paid so I have to lend him money"

You HAVE to lend him money? No, you don't. You're not family.

This is a choice, one which I expect you'll continue to make regarding involvement in other aspects of his life.

Honestly, don't you think it's better to admit that you WANT to be involved and avoid the dilemma of debating whether (not when) to withdraw? Just be honest with yourself; there's nothing wrong with that.

But a lot of people have invested some time to help you out. If you don't want to change, remember that the next time you decide to post and request advice.

I think it's more important to be honest with yourself than attempt something that isn't going to happen. Just make peace with what he is and do what you can and be content with that.
Here in Ireland it is not the GP Who diagnoses the Patient with dementia or Alzheimer's. The GP makes an appointment for the Patient to be examined by a Geriatrition, Who' specialises in the brain.
TimeOut I'd advise You to pull back and allow Mike's Family to look after Their Dad, before You get in too deep. If You were to engage in Mikes care You would neglect Your Mom and this is not an option.
You are a wonderful Person, and the World would be a better Place if there was more People like You.

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