My mother is having tremendous difficulty with managing her activities. If she needs to be somewhere at 9:30 she may go at 7:30. She doesn't seem to understand how long it takes to get to something. Or how long she has between thing. She knows what time it is. She knows what time she has to be there. But she can't seem to figure out how much time she has between now and then.

I'm sorry that you're frustrated with your mom. It sounds like she is cognitively declining. Schedule an app't with her PCP for a complete checkup including a cognitive test. Prior to app't express your concerns with the doctor or nurse. If she doesn't have a PCP, seek out a geriatric PCP. Hopefully she will let you take her so you can make sure that she is honest with the doctor. After results are checked by MD he will be able to refer her to the necessary specialist or tests. It may be time to give up license & decide future living arrangements. Definitely speak with your mom prior to seeing the doctor about necessary paperwork that she needs to get in place for an easy transition should decisions need to be made. Pay an unexpected visit to see her & try to notice how her kitchen looks-dirty dishes, food in frig, meds in bottle showing whether or not she's taking them, whether she can fix her meal, dirty linens or towels in hamper. You should be able to get a feel if she's having any trouble with other aspects of being unable to continue living alone. May need to speak with her about need to increase her level of living to AL or Memory Care after app't. Using an oven may also be a safety risk.
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Reply to ToniFromRVA

Imho, perhaps the first course of action is to take her to her physician for an evaluation. Prayers sent.
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Reply to Llamalover47

Time and the understanding/comprehension of it is one of the biggest problems with dementia/Alzheimer's related issues. My mother has dementia and lives in Memory Care Assisted Living b/c there is NO WAY she could possibly manage time, never mind understand what day it is, even with the Alzheimer's clock I bought her. That clock (which you can get on Amazon) tells you the day of the week, the time of day, the date, the year and whether it's day time or night time, all in big bold neon letters and numbers. It sits right in front of my mother and still she asks me 'is today Sunday?' when it's Wednesday. Now, mind you............she is otherwise quite functional and would likely fool you (and others) into thinking 'what is SHE doing in Memory Care?' Dementia tends to present itself in odd and different ways to each individual, but time is a biggie.

See if you can do this: give your mom a sheet of blank paper and a pencil. Ask her to draw you the face of a clock showing 3 o'clock. See what she does. This is part of the MoCa cognitive exam and shows executive brain function. EB function is like the conductor of the orchestra; if the conductor is not there or compromised, the rest of the orchestra hasn't a clue about what to do. When my mom was asked to draw a clock back in 2016, she drew a blob of something nowhere NEAR a clock. That's when I knew what was happening with her, regardless of the 'showtiming' act she was able to successfully put on with everyone. She was diagnosed with progressive dementia shortly thereafter. She's at the moderate stage now, and would definitely not be able to function independently b/c her biggest issues (besides being in a wheelchair) are working gadgets like remotes for the TV, the thermostat, telephone......etc. Pay close attention to your mom to see what other activities of daily life (ADLs) she's having trouble navigating.

It's time for her to have a full medical exam, as the others have said. In the meantime, for your own head, see if you can get her to draw a clock so you'll have an inkling about what's probably going on.

Wishing you the best of luck!
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Reply to lealonnie1
Beekee Nov 16, 2020
My mother can't draw a clock and can't say what country we are, but she can still carry on a polite conversation, make witty remarks and puns, quote Shakespeare, toss in a few phrases in French, and talk about the latest national news. She can't add and subtract anymore, but she managed to cover that up for two years. Chatting ability and covering-up skills are preserved much longer than telling time!
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If she is living alone, this time thing could effect other things. Such as putting something in the oven to cook - did it cook for 5 minutes and underdone or did it cook indefinitely and could be a safety issue.

If she is not being supervised or attends functions alone, maybe she needs someone to go with her. To avoid getting lost and to be on time.

If going somewhere is the only issue she has right now (and I would highly doubt it), then make a calendar of her events, what time to get ready and what time to leave the house.

You might want to have her checked out by geriatric doctor about dementia issue
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Reply to my2cents

Best plan of action is to get a thorough checkup, including blood work, urine test, etc. The doctor's office can try the mini-mental exam, but it can't always determine much, especially in the earlier stages of dementia. Getting this test doesn't mean we or they think she has dementia, it is just another tool to rule out other conditions. I would start here rather than taking her for long tests with neurologists and machines. IF these checks/tests reveal cognitive decline, then you can decide to go for more extensive tests. We never did. Most likely my mother's dementia is vascular, as she fits into most of the symptoms and progression (also has been on BP meds for as long as I can remember, so it is possible she had some minor strokes we aren't aware of. She did have one last month, but is 97, and has been in MC almost 4 years now.)

Mom's first "test" was actually done by a nurse in her own place and it was much more extensive than the test our doctor used. The agency we were considering sent her to do an assessment. It was covered by Medicare. She told me that if mom had agreed to some personal care, some of the time aides were there would also be covered by Medicare, but she refused. Perhaps the doctor's office can have someone sent to perform this test (two of us were also present during the "test".)

I had already realized she was having issues - not with time really, but repetition of statements and questions, within minutes, not over a long time. That's when I started learning about dementia. Hindsight revealed other issues, such as no longer cooking and putting supplies I brought away, then asking for more as she'd forget to check the place she put them! I was in the process of hiring aides to check on mom and have them confirm she took her meds from a timed/locked dispenser the nurse suggested. She didn't need a lot of assistance at that point, it was more a sanity check for me. The plan was to increase the hours as needed, so she could remain in her own place longer. It didn't last 2 months (5 days/week, 1 hour/day only) - she refused to let them in. On to plan B - MC.

If they rule out any other condition (there are several that can mimic dementia, esp UTIs, dehydration, overhydration, imbalance in diet, etc.) and the tests do show she's in cognitive decline, it's time to start planning for her care. More intensive testing can be done if they need to determine what type of dementia, such as LBD, but it isn't always necessary. If they plan on medication (no cure!), it would be best to have this testing done. If not, why put her through that?
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Reply to disgustedtoo

Absolutely get her screened for a mental/cognitive disorder. I had much of this problem as a result of my ADHD in my 20-30s. it was causing me to have horrific time management and executive functioning disorder. The only thing that helped was to get on the proper medication regiment.
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Reply to KHolzmann

The mini mental cognitive assessment at the general practitioner's is not super useful. Bring her to a neurologist for a brain MRI and an in-depth cognitive assessment, mostly pen-and-paper activities, some verbal--takes over an hour. Can't be faked by a nice smile and polite demeanor. These tests have been used for a long time and the neurologist will give you a written report on each aspect of cognitive function they tested. They'll give you recommendations. Mom will be much more likely to believe an authority, rather than you. The tests give a sense of the tip of the iceberg. Just by itself, it's not too terrible if she can't do a simple child's dot-to-dot activity, especially if she's still shopping, cooking, reading the newspaper. But her inability to remember steps and instructions from one moment to the next--that's the problem.

My mother asked me what time it was, as she sat right in front of a clock that said 9:30. I said, "Look at the clock." She said, "But I can't tell if it's am or pm." She was next to a big window. It was broad daylight. She did not have the logic to put it together. It was one of those moments I got a sense of just how bad off she was. She doesn't have a continuous sense of time anymore. It's like her brain "updates" every 15 minutes, wiping away the previous events to make room for the next input.
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Reply to Beekee

My mom had time issues, too. Unlike your mom, my mom couldn’t tell time (when she was diagnosed with Alzheimer’s), but like you mom, she was having the same (poor) judgment regarding time. I’m not a doctor, so I’m not diagnosing your mom, I’m just sharing our story. My mom would get confused about a.m. and p.m.
 I even wrote a book about my husband and I taking care of her, called, “My Mother Has Alzheimer’s and My Dog Has Tapeworms: A Caregiver’s Tale.” I have a chapter entitled, “I “a.m.” Confused, because she was getting confused all the time, about time. We got her a clock that said, “a.m.” and “p.m” and I reinforced with her what that meant.
 When she lived independently, before I realized that there was a problem, she offered to pick me up for a dentist appointment, and she showed up 3 hours early, with the excuse that she didn’t want to fight morning rush hour traffic, but she showed up right in the height of morning rush hour.
When I picked her up for a doctor’s appointment, I told her I’d call her at 8 in the morning, telling her I was getting ready to leave, but she called me the previous night at 8 p.m., asking me if I was getting ready to leave. A CAT scan had showed that she had had a previous, mild, undiagnosed stroke, and that might have contributed to her issues; I don’t know. I found out several years later that a stroke is sometimes misdiagnosed as vertigo, and she indeed had 2 episodes of that. Whether or not either of those incidents were really strokes, remains a mystery. Shortly after her time issues, she moved in with us, and I learned that I couldn’t say, “Mom, we’re going to meet a friend for coffee in an hour;” I just had to help her get ready an hour before, (getting dressed, having breakfast, etc.) She’d sometimes put on her socks, then take them off, then put them on again. I think she might have been confused as to whether she was getting up in the morning, or getting ready for bed at night, but that’s just a guess on my part. I agree with others: you might want to get your mom a good medical work-up/evaluation. Best of luck.
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Reply to rlynn123

Since your mom has visual problems, visual clues will not work for her "time keeping." She may have some Alzheimer's type dementia that is messing with her ability to process this executive function in her brain. t may be time to have somebody help her with getting ready and getting to appointments and other activities. Whoever helps her, may have more success tying time to activities: we need to leave after this song/movie is over for your appointment, we need to get you ready for bed after dinner, please take your medications now so you can have your breakfast as soon as it gets here...

Please have a doctor evaluate her for dementia. In early stages, medications can help. In later stages, medications are not effective.
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Reply to Taarna

It seems your Mother is having short term memory problems.

I would arrange a medical review. I would want to rule out other causes (ie vitamin deficiencies etc). The Doctor may want to do a cognitive assessment (Mini Mental) & re-do in 6 months to compare.

Reason found or not, adapting to this change will be the challenge now.

Calenders, reminder txts, alarms, notes are used by some people with varying success but are of zero use to others.

Reading a note 'get ready at 7:30, leave home at 8:30' over & over won't work without comprehension. Or being able to connect the time on the note to the time on the clock. It's actually quite a complicated brain process to plan back from appointment time, travel time, getting ready time etc.

My Mother lost a little of this 'time feeling/planning' after a TIA.
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Reply to Beatty

Your Mom should not be responsible for getting to appointments. It sounds like she needs more structure.
It also sounds like she should not be in Independent Living.
It might be time to get an evaluation done should she be in Assisted Living or possibly Memory Care.
Is it possible that she could leave her apartment at 10:30 at night for an appointment that she has to get to at 11:30 in the morning?
IF this truly is the ONLY problem she is having then a board with the time she has to leave for the appointment not just the appointment time written down. But I suspect that this is not the only trouble your mom is having.
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Reply to Grandma1954
InFamilyService Nov 16, 2020
This works for my mom about telling her the time she has to be ready. I tell her a time 30 minutes before she has to leave the house. Never do I tell her an appointment time. It's too much and she gets confused. She has a large calendar and I write get ready time beside my name so she knows whether my sister or me are taking her. For some odd reason she numbers the ends of her pill sorters even though every week has the same pills! She only has one out on the table at a time. I put the next week's sorter out when I check in. Who knows why but its important to her and keeps her calm.
Your profile says your mom is 88 years old, living in independent living with age-related decline, anxiety, and vision problems.

At her age (and since you didn't mention it) she most likely is now in cognitive decline. She not only can't maintain her "usual" functions but is actively losing her abilities and this includes any new learning. Please take her to her doctor for a thorough physical and cognitive (including for a UTI) so that you know what you are dealing with and not exhausting yourself trying to prop up the illusion of independence. Do not let her go by herself and tell you the outcome of this visit. My family didn't realize my MIL wasn't remembering to eat because she'd tell us she ate, give details of what she ate, yet there was no evidence she was eating when we checked her fridge full of rotting food and no dirty dishes or food containers in her garbage. She would tell us she took her meds but that also wasn't accurate.

I'm hoping you (or someone) is her durable PoA. If not, this needs to be put in place before any diagnosis of cognitive decline, so that the legal authority cannot be contested. If she still drives this too must be reconsidered. Countless on this forum have been in your position. It's not easy to be at this juncture of realization of her mental decline. I wish you all the best as you help her.
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Reply to Geaton777

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