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Mom will occasionally ask me why she has such huge lapses of memory, why is she confused about who certain people are, etc when she has moments of clarity. I don't know what to say. Do I tell her she has dementia? What have you all told your dementia people if they ask?

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My husband knew from the very beginning that he had dementia. This made it relatively easy to talk to him about his symptoms. He was an engineer, and interest in cause-and-effect was part of his personality. He had Lewy Body Dementia, which we both referred to as Lewy. I could say things like, "Don't worry if you don't remember that. It is Lewy messing with your memory. Maybe it will come to you tomorrow. Until then I'll remember it for you so we can take care of it."

My mother, on the other hand, used denial as a primary coping mechanism. We did not use the word "dementia" with her, but we occasionally had to refer to her "memory problem." If she was was worried when I was getting ready to end a visit to her nursing home that she didn't remember how to get back to her room I'd say, "It's OK if you don't always remember that. All of the helpers here know where your room is and will gladly push your wheelchair back. At your age you are entitled to let other people help you with your memory."

This is not a one-answer-suits-all question. Based on her personality, how she has coped with other problems in her life, and perhaps how severe her dementia is, do your best to figure out what approach will be less stressful for your Mom.
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For my Dad, I started to notice sundowning dementia, to which he would telephone me and be confused... when he wondered why he couldn't remember a certain thing, I would tell him "oh that's part of old age, I have my own moments where I can't remember something" and that made him feel better.

Then I used the reference that the file cabinets in our brain are filled, so it takes longer to find the right file. Then that became a joke with my Dad when he couldn't remember something. "Darn file drawer is full".

I never brought up dementia because my Mom had passed from a serious fall that created late stage dementia, so I didn't want Dad to think of that. I would use the term sundowning if talking to an Aide or doctor, as Dad didn't know what that term meant, and he never asked.
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when she could live on her own my mom would say "I can't remember a thing! I must be crazy" and I would laugh and nod my head and say "me too! I cant remember Anything!"
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Some people are able to understand they are having cognitive decline and are able to participate in plans for their progression, such as where they will live, AL, MC, sign POA, etc. But, if that has already been done and they don't remember doing it, then, I wouldn't stress the memory issue.

If mom asked about it, I might just provide whatever explanation that works in the moment. Whatever makes her feel safe. Something that she won't have to worry about.

When I first took my cousin to the doctor with her memory problem. I was pretty clueless. I knew hardly anything about dementia. So, when she started repeating things over and over, I would ask her if she remembered asking me the same question 3 minutes ago. She would say no. I knew then it was pretty serious. So, I stopped doing that. Instead, I would comfort her and say that we all have memories issues at some time or the other and that hers would improve with a better diet, medications, better diabetes control, therapy, better nutrition, etc. I kept encouraging her to enter AL, where she would get all of those things and get better. It worked too. She seemed fine with that explanation. Later, of course, she forgot all about it. She no longer knows what memory is or that she has lost almost all of hers.
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Mthr discovered she had a new scar on her belly as she recovered from cancer surgery. When ever she has a question about her memory from then til now, we tell her that's related to her surgery, that the anesthesia took away those memories. It satisfies her 100%.
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You know your mother best, and I agree with Jeanne that the 'correct' thing to do is to tell her what you think she is best able to cope with. I'm sorry that that's such an open-ended answer; but at least there's some comfort to knowing that because there is no absolutely right thing to do, and all you can do is your best, you can't either get this 'wrong.'

On a practical level, with both vascular dementia and her heart condition, I found that sketching diagrams for my mother was a good way of explaining roughly what was going on. I think my mother found this helpful partly because she always was someone with a lively curiosity about sciency things, and partly because it showed the *reason* for her ills - that there was nothing culpable, for example, in memory lapses that had a physiological cause and weren't just a failure on her part to concentrate or pay attention.

If you don't feel confident about producing a sketch there is lots of good material online. And if you're anxious about mentioning the D word, talking about brain function and physiology could be quite a useful way round that.
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Once the Neurologist used the D word with my cousin and I in the room. He said she had it, but he wasn't sure why yet. He went on to name different types of ailments like Alzheimers, Lewy Body, etc. When we left she seemed to understand only a portion of what he said. She said that she just never wanted to forget her parents, because they were such good people. I assured her that she never would, although, I had no idea if that was true. But, you know what? She still remembers them and she's now stage 6 and some 7. I think that maybe I was right. At least, I hope so.
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