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Sometimes there is medication that can help, if the doctor is clueless maybe find a geriatric doctor that is more versed in senior issues.
You don't say what the diagnosis is.
These illnesses are all different in every different patient.
For example, a patient with epilepsy might not remember, especially what they said.
A narcissist may remember an outburst, but will not admit it, feel remorse,
or apologize.
A kind person may remember (or be reminded) and be apologetic.
Patient's not remembering much of anything (Alzheimer's, Dementia) won't remember, but may have a moment of clarity and recall for a short time. Instead, they might remember they dislike you in particular, for no real cause.
All sorts of differences.
Focus on safety for yourself, and the patient.
biggest issue is that you can tie yourself in knots trying to find rhyme and reason where none exists. Do they know it at the time? do they know it an hour later? Next morning? Next evening?
There just aren't any factual answers.
Rather than to to make yourself nuts with unanswerable questions, I suggest sticking to the practical... how do I handle it? Do I let myself become entwined in the craziness, I do I function normally in the midst of this,?
Look to to take care for yourself, and protect your mental stability. Treat it as just another fact..deal with it...and expect no reasoning to come of it.