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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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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:

https://www.agingcare.com/questions/told-family-has-dementia-what-is-minimal-responsibilty-184110.htm

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.
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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.
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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.
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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.
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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,
Carol
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I agree on the dr point. My mom saw her primary physician who did nothing, 3 neurologists, 2 psychiatrists, and a neuro psychologist before finally being diagnosed (although loosely - since there is no test that can tell for certain) with frontal dementia. It's time for the family to step up. APS (at least in my area) is bombarded with calls about seniors needing assistance. They are sometime slow to respond. Best of luck to you. It's time you took care of your own and his family steps up
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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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A quick test does not diagnose dementia! My father had the testing for it done in the summer of 2013, and he went 8 hours a day for like 3 days! They gave him LOTS of tests. They'd tell him stories, and then have him try to recount them hours later (he didn't have a clue on those). They tested his math (he was still good at it back then), and who knows what since I wasn't there. They tested response time, and the list goes on.
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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.
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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.
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First, decide how much more you want to provide for your friend. Secondly, if you want and can get him to a neurologist do so. He is not "fine", and three questions does not make a thorough mental examination! Alert his children your observations, and then let them care for him or not. It is sad when adult children do not step up to the plate.
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You probably are caring for him out of guilt. Don't worry, it seems to be a common thing here. We cannot watch people go downhill and not try to intervene. That is in the makeup of a caregiver. Even though you say you will let go, you probably won't. Maybe cut the time you give him little by little. I would call adult services immediately but first call his kids. What is going on with kids today? I don't recall this happening with the elderly when I was young. I always saw the grandma or grandpa living with the kids. It was part of our life. I was faced with the same thing with my Partner's kids. Even his niece. My partner cared for his niece's father for years while he was in a care facility, but when my partner became ill, the niece as well as his kids disappeared. In fact, his son told me he would put him in a nursing home if I was not in the picture. So I carried the whole load. Not complaining as I loved him dearly and would do it all over again. These kids today are in for a sorry surprise when they are old and their kids are nowhere to be found. This is what they are teaching their children by their actions. God Bless you.
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I agree with Carol et al. It is time to hand it over.

I share your frustration. My husband is beginning to suffer memory loss and confusion. So, since I know that the earlier one begins memory meds, the better, I naturally wanted him to have the meds NOW. I made an appointment with our family doctor, and he gave this silly test for memory, which my husband passed with flying colors. NO meds, says the doctor.

But this test in no way reflects what I am living with. My husband and I have conversations and make decisions that he does remember two days later. I don't know whether to be angry or sympathetic or both. I am frustrated and worried. and, for what it's worth, I can't hand it over. Tag, I am it.
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Sorry, that was he does NOT remember two days later.
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Hi timeout! thank goodness you get it...no one is making you suffer but yourself...he has a family, and this situation will get worse, he's only 70??? Yikes It sounds like he's just a slob...and doesn't care either.
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Please don't throw words out like "slob" and "lazy" when you in fact have no idea what the person is experiencing. It is a symptom, nothing more, nothing less.
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I went through that testing with my mom several times. Brought it up to the doctor and they gave her a three- or five-question test. I called the police for wellness checks. Both thought she was fine. I finally called adult protective services and they say mom needs a guardian.
Since you're not family, you may need to step back a bit and just keep an eye out. If you think there's a real danger, call adult protective services or social services or whatever agency.
It sounds like he's still active in some ways -- the daily walk, a visit to the pub, etc., -- so that's good. It beats total isolation.
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Salisbury: Have your husband looked at by a geriatric specialist; the first thing you may want to look at is what meds he is already on and find out if any of them have side effects involving memory or brain function(statin drugs do); also check for infections. Some people have reported good effects from adding coconut oil to their diet.
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I think I would most definitely get a second opinion for your friend.
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A 70 year old man acting this way? Not taking a shower for months? Step back, BUT HIS FAMILY NEEDS TO GET HIM TO A PSYCHOLOGIST LIKE NOW! Something's wrong with this man BIG TIME! Honestly, I don't know how you have been able to deal with his stench! Give it up! Someone else can step up.
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If he's stopped bathing recently, as in the last few years, I'd say it's cause for concern, but if he's always been one to skip baths, he just may be that way. I used to work with someone who rarely bathed. Perfectly fine in every other way, but we had to go to the boss and campaign to order him to bathe because he stunk so bad. Some folks, sadly, are just slobs.
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dear ferris1....that is my opinion...you have yours and I have mine! he could very well be a lazy slob...I think his friend knows his past and his present state. Was he a sloppy guy before????
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If your friend has a substance abuse problem, it could match all these symptoms. Is that a possibility? You should think about reading the book CO-DEPENDENT NO MORE by Melody Beaty. It was an eyeopener for me about saving people.
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my previous response was deleted, so i'm going to reword it...was he a slob before...you've known him for years. if he was...then nothing has changed. let his family take care of him...it's going to get worse...sounds like you're already burned out!
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Hi
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.
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In answer to another comment, yes, his symptoms could be alcohol-related. Not quite sure how to explain it, he doesn't show any signs of drinking too much but he drinks every day and probably has for the past 40 years.
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In response to two other comments, he became a slob when he retired, 10 years ago.His daughter-in-law mentioned it to me once. I don't care if he stinks, BUT we all know how a good bath makes us feel - refreshed and invigorated. :-) It's not just about being offensive to others seeing as he lives alone.
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Salisbury, my sympathies as I don't live with Mike. I understand your frustration with your husband tho', as you mine. What has really helped me besides this forum (I'm wordless for how grateful I am), I think a sense of humour helps. I tell my mom 'the latest' and we cackle away madly ... 'He did what ...? LOL!'

Perhaps making lots of notes after a conversation? With dates on them. Maybe stuck on a board or something. Then he can remind himself and you won't feel like a nag.
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I agree with both LifeExperiences and Ferris about the laziness. While it is not a good term to bandy about, it should not be ruled outright.

And, in response to another comment. 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. LOL!
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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.
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