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My Mom can still dress, bathe, use the bathroom on her own, and perform some household duties without too much issue. She can manage some crosswords, but only briefly. She can’t manage money, can’t understand a lot of documents or tv shows, can’t keep track of what she eats, forgetting people, loses hours at a time, she forgets descriptive words, and has had delusions of dating her son. She is in strong denial of any issues. I have no clue where she is with her memory. She has refused going to a doc. We finally got her to go, but the doc is taking baby steps since she is not agreeable. Sometimes it seems really bad and other times not. It seems like she gets worse at night.

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Dementia behaviors change day to day; what your mom does one day, she may forget the next. She can be fine today and act totally unhinged tomorrow; that's the nature of the beast. I don't think 'baby steps' is a smart plan, frankly, because a diagnosis is needed so you can know where mom falls on the dementia scale (from 1-30) and see what type of care she needs, whether it's in house or in a Memory Care ALF. It's not safe to leave her alone, in any event, so know that now. Things getting worse in the evenings/night is known as Sundowner's and you can Google it for tips about what to do. The only thing that helped my mother with her Sundowning was Ativan, honestly. Sundowning doesn't usually happen until dementia/ALZ gets to the moderate stage.

I suggest you read this 33 page booklet (which is a free download) which has THE best information ever about managing dementia/Alzheimers and what to expect with an elder who's been diagnosed with it.


Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580


Here is a list of useful tips for you to use when dealing with your mom nowadays:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The "Do's"
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

A good book to read is Living in the Labyrinth: A Personal Journey Through the Maze of Alzheimer's, by Diana Friel McGowin. Learn all you can about AD/dementia b/c knowledge is power!

Wishing you the best of luck with all that's going on.
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You have to understand that dementia doesn't not affect memory only. There are other symptoms and signs as well. Delusion's or false beliefs, anosognosia (unawareness of having the disease), poor calculation (can't manage money), confusion, mainly at night. Symptoms fluctuate from day to day. Just the fact that she has delusions about dating her son, puts her on a middle to advanced stage of dementia.
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The more pressing question is; does your mom have someone assigned as a PoA? This is the person who should now be reading the document to see when their authority kicks in to allow them to begin managing things regardless of whether mom "agrees" with it or not. If this is you, please review your document. I'm sure it requires at least 1 medical diagnosis of incapacity (or cognitive/memory impairment).

If she does not yet have a PoA this may still be able to be created by her. Please call to discuss with a certified elder law attorney. It is worth the cost of the consult (and the first one is often free) and any further such fees should be paid out of your mom's money.

Here's what I did with my MIL who showed signs of memory impairment: I made an appointment for her with her regular M.D. telling her a "therapeutic fib", that an annual physical was required by Medicare (or Social Security, whatever story you think she'll accept). At the appointment go with a pre-written note telling who you are in relation to your mom, and give them all the concerning reasons why she needs a cognitive/memory exam. Give the check-in person the note discretely when you check mom in. Then ask the receptionish for the Medical Representative HIPAA form and have your mom put your name as ther MR. Now the doc can legally discuss your mom's private medical information with you without your mom being present or giving any further permission. At this exam, also request a test for UTI, dehydration, vitamin deficiency and thyroid problems -- as these can all create dementia-like symptoms but are treatable. Good luck!
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