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I've provided a lot of details in my other posts here about her behaviors, so I'lll keep that part brief.FWIW I generally like her doc. But I have raised concerns with him before, privately, and was surprised to see hat his office basically said evertyhing was fine because her labs were good. She did say they gave her a basic "are you having thought s of jumping off a cliff" depression screening, which she passed. They set her a follow up for 6 months out. (She's 76).

Today was the appointment and quite honestly, I dragged my feet calling the doc because I didn't know what to say. So the appt came and went, with(thankfully) her labs being fine, and a followup appt 6 mos out.

Here's the thing. I see issues. I see confusion quite often, trouble understanding things. Some daily tasks are too much for her (the remote control for instance). She relies a lot on notes. She sometimes shakes. She is often irrational when presented with something and shuts it down, although that may be from lack of understanding combined with overwhelm. She is childlike, dependent, clingy, some of the things she says are, I'm sorry, but just embarrassingly dumb. She is also heavily anxious to the point of dangerously raising her blood pressure when scared, all the time and loops on things.

That said, she can also be demanding, stubborn, and refuse to do or try even small things if they are new. So it's possible she refused anything other than a blood test since she prefers to "heal herself."

i have raised all of these issues with him and she comes back with a clean report. I'm not sure what to say to him because she's not doing the typical Alzheimer's things, like forgetting (except when she;'s stressed - when she's baseline, (these days her memory is better than mine). She's not forgetting what the car keys are for. She's not making appointments and then insisting she didn't do it. She recognizes people. She is having trouble doing simple things on bad days, but generally can manage her finances (well maybe not completely, because she wasn't provided for before my dad passedI but she can manage her acct, etc.

All this makes me think that maybe she's not got dementia although something, now as in the past, is definitely not right.

I've already raised these things with the doctor. What is the best way to appraoch it again? Should he have done something different? What should I be looking for? What should I say?

She would likely resist any meddling of mine in her health affairs (so it has to be on the down low) and resist any test her would ask her to take. He may have also decided it's best not to stress her, since any test would make her anxiety loop for months. When I take her to the doctor, she is so stressed that day and before and after that she can barely function.

What should I be watching for/asking about? And shouldn't se have more frequent checkups at her age?
Thx in advance

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Thank you all for your perspectives. I just told her I had to go away for a couple of days in a few weeks to see a friend, and it's important. She was anxious about it and started looking for the date on the calendar to see the days, etc. I could feel the anger rising and finally went out and talked to her. Told her that I could not be here all the time and that she needed to be okay with sometimes being alone - that I wasn't abandoning her , and would help as much as possible, but that all this anxiety when I leave has to be handled. She is maybe not that aware of it. I told her I am glad to help but that there' snot a need in this situation for me to be a 24 hour caregiver. She laughed it off and said of course she doesn't need that. But she is highly anxious and dependent even though she sees herself as otherwise.

I told her that i might at some will be moving out, that the situation was working alrgitht for us right now but was not long-term, and that might mean relocating close-by (in-state) for work. I don't anticipate doing that(relocating) though. but you never know.
I told her that if she is uncomfortable being alone we can get her a medical alert button. She laughed at that too but I think the point was made.

If there were genuine medical issues going on it would be a different situation- broken hip, stroke, etc, so that's a grounded fear. But at this point it's mostly anxiety and dependence along with a basic level of care such as household tasks/business, driving etc. Be a babysitter to her anxiety disorder? Over it.

It was helpful to just confront this head-on and it helped to dissipate some of the anger so that I can sleep tonight. This board has been very helpful.
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I asked the first question because my mother would have told anyone who cared to listen 3 years ago that she "couldn't possibly" live someplace other than her home of 50 years. Well guess what? That wasn't working out for us, the two of her three kids who were responding to her emergencies. "Sorry Mom, we can't do this anymore" (" this" being three straight days of missed work due to her hysteria, anxiety and imagined need for rescue). I have a job and myself and a household to support. I'll work with you if you'll work with me. But no one should be the guilt ridden indentured servant of an elderly parent.
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Trapped, your Mom is only a few years older than I, and I know the sense of fear about living alone, in case one gets sick. All it takes is one serious medical incident to start that ball rolling. I use to be very independent and lived on my own after my divorce for over 20 years, had my career, had my large house.... then wham, I got sick and my whole world spun out of control. Now if my sig other goes away for a couple weeks for work, my confidence level nose dives. I want my old confident me back, but that isn't happening.

I think if I was on my own now, I would seriously move into a retirement community, have my own nice condo, and make some new friends who would be just be down the hallway from me. A very short walk to the on-site doctors if I was having any issues.
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trapped, what you are doing is fine. It sounds like both she and you are getting some benefits from living together. If you know she would be unhappy in a facility and it is making it easier on you financially, then it sounds like you are doing the best thing for the moment. It is very frustrating, though.

My mother was resistant to any testing for dementia for a couple of years after I got here. In her case, I don't know if diagnosing cognitive impairment would have been useful. Her problem is more with reasoning than memory, so I don't know if any of the dementia drugs would have helped. As my mother became more impaired she opened the gate for me to help more. This may happen with your mother, too.

It would be great to live on our own again. I've been feeling like I'm getting lost. There's nothing to stop us from rebuilding a life from where we are. It is what I am aiming for. I hope you're able to get a good job close by and set up help for your mother when needed. That would help things fall in place for you. I get the feeling you are doing a good job with a difficult situation.
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Is she happy now? Are you?
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Thank you... yes, and menopause isn't helping. That's probably exacerbating the anger.
It's hard because she's here. My original plan was to live a few hours away but she insists she wants me in town in case she "gets sick." At first i was angry at what i viewed as pure manipulation, but now that she is having some real issues cognitively II'm not so sure that's all of it. It would be heaven to live two hours away (a thousand miles away) but I think she needs more help. II don't think I could send her to a home because it would be awful for her. She would be so unhappy. I can't wait to move out of here and get back to some kind of independent life though. Even if close by. But being able to make a living will be an important factor.
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Trapped; your name says it all. Your mom has trapped you with Fear Obligation and Guilt (FOG). Can you get some psychotherapy or counseling? The only way out of this is for you to change your viewpoint (because you're not going to change Mom). As you've mentioned, she's been dependent her whole life and now YOU'RE the one that she's dependent upon as her retirement plan. I should ask, what's YOU'RE retirement plan? This is not going to work out for you. Unless things get set up so that you can get back to career building, there is no retirement plan for you. the only way you can really "take care" of your mom is to take care of yourself. I would start by getting YOU some career counseling. Then I would talk to her doctor about the fact that you are going to have to move to the big city to get a job and will not be able to live with mom; does he think that she's able to live independently? Ask the doc to set up an evaluation of her ability to plan, get around, etc on her own. Since she's low income, there are resources out there to help her.

You can, of course, just continue as you are. But even then, to maintain your sanity, you should seek counseling and perhaps meds to get you through this.
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She's open to vitamin supplements - maybe I could talk her into taking St. John's Wort to lift the mood. Oh wait, not likely...
=)
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And if she bucks at this and says "old age is not a disease" you ask if she believes in pediatricians for babies. The elder body reacts very differently to medication than does the typical adult one.
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I think a lot of primary care docs are not well versed in aging and dementia. A geriatrician - not necessarily even a neurologist or psychiatrist - might have a better handle. Some geriatric places have catchy names like "Longevity Center" and you could act real upbeat and tell here there is this great new thing to help her live longer and better...they might even have non-medical visit programming that would help you get her foot in the door.
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I am living with her for the time being. Financial issues play a part for me as well as, I am helping her financially. I do plan to move as soon as possible but it may be awhile. Believe me, if I was able to move today, I would.
Originally the idea was to coach her on things to try to make her more independent, but she's so resistant to anything new and unable to handle some tasks such as shopping I no longer think that's realistic, especially after seeing her struggle with sequencing some tasks. Sometimes she seems ok (for her, not really 'normal' per se) but when pressed with stress she becomes confused and usually needs to be rescued - by the sales person, by someone who notices, etc. I think it's genuine at this point and not pure manipulation. So I think the goal of her being fully independent is unrealistic, although partially independent is doable. When she is under less stress she is much better. I would like to see her get a cat scan though or something objective to evaluate her. ALthough her memory seems to be decent at this point other than an excessive reliance upon notes, which might be excused due to her age and confusion.
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Oh! I should also add that all of her meds should be checked for side effects. You can Google them. You may see some cause confusion, etc. Suspect and change those to see if it makes any difference.
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trapped, I do get exactly what you are saying. My mother is as stubborn as a mule, but as dependent as a baby. It makes for a very frustrating combination. She is unable to manage the simplest things now. Really, she has always depended on others to take care of her when it came to business matters. This is certainly not one of the ideas that I had for spending my retirement years.
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Unless she's got a UTI, it's highly unlikely there's any cure for what ails her. Every six months for a check-up is pretty standard.
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Trapped, are you living with her? Enabling her? What would happen if you step back and let nature rule?
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I wish I could just make the appoiintment and take her. She would never agree to such a thing. She goes out to the grocery store or doctor and her blood pressure climbs to very high levels. Temporarily. I suggested seeing if there was some kind of spot med that would bring it down on such occasions but she refused. She lets everyone within earshot know how upset/blood-pressure-raised/dizzy/anxious she is but when I suggest a solution she shuts it down and says, "i'm just fine." The problem with her is that you cannot tell her anything and suggestions make her angry. Short of drugging her and dumping her in a cab I could probably not get her to agree to go to another doc. I think her doc is a decent guy but I agree, this is not his specialty. He is, however, aware of her eccentricities and her anxiety attacks and does seem to handle her with skill and calm her.
If it was just anxiety it would be one thing, but combined with a certain amount of confusion that the anxiety makes worse, there are secondary issues.
I will keep a log and talk to the doc. It's frustrating for me because I end up being a babysitter (literally, "taking" her to the store because she "can't handle it"), but it does appear to be the case that she "can't handle it.' I guess what I am saying is that i resent being a babysitter, but there are so many cognitive and physical issues that kick in for her I would be afraid to just turn her loose to, say, the grocery store for fear she would become confused or so anxious she could not function on her own.
Man how I hate this. I really, really hate this. Sorry but that's the truth. I'm trying though to deal with it and to get better but I spent about 80% of my time outwardly helpful and internally angry.
If she had been willing to do something about her anxiety years ago it would not be this bad. And she won't do anything about it now, which leaves me with the lifelong role of babysitter. It's infuriating. But I don't think she's capable of helping herself or being turned loose. She finds tasks such as the gas pump and the credit card swipe very overwhelming.
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She needs to be seen by a geriatric psychiatrist or a neurologist/neuropsychologist who specializes in dementia evaluations. Her doctor is only looking at her organs. Someone needs to see the person. Just make the appointment and take her. Don't tell her beforehand.
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I think she may be picking up on YOUR anxiety. Anxiety is supremely contagious. Maybe you could avoid coffee that morning and do some deep breathing exercises and consciously relax. If doc is only seeing her every six months, she's doing well. My MIL is CHF, A-fib and a few other maladies so the MD sees her once a month.
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My mother has had two different family doctors in the past five years and one doc sent her to a psychiatrist to be screened for dementia, so you could mention this to her doctor. I told my mother ' look, this is the doctor's idea opinion to rule any serious problems out.' She wasn't happy about it, but she went.
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Memory loss is not the first or the primary symptom in every kind of dementia.

Disorders other than dementia can cause irrational behavior.

If she isn't being followed for a chronic condition (COPD, CHF, diabetes, etc.) the 6 month schedule sounds OK to me. But I'm wondering if she is seeing the right kind of doctor. As Jessie mentions, a Geriatrician would be a good bet. Or a geriatric psychiatrist. Or a behavioral neurologist. But how would you convince her to accept such an appointment? If she happens to acknowledge that she has a lot of anxiety, you could say, casually, "Did you know there are doctors who specialize it treating anxiety?"

I suggest keeping a notebook of the irrational or out-of-character things she does -- the things that concern you. Before the next 6-month appointment summarize the notebook. Send it to the doctor ahead of the appointment. Ask for a referral to a specialist (if you haven't gotten Mom in to a specialist before that.)

It sounds like her behaviors are annoying and concerning, but not at this time urgent or dangerous. Get her into a specialist if you can. Document your concerns for the next regular appointment if you can't.
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And don't be surprised when your mother says, "I don't need a psychiatrist. I'm not crazy!" That is the standard response, I believe. You may want to think of a way to convince her the geri psych could make her feel better.
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This sounds a lot like my mother. She lost her reasoning ability before she began to have serious memory loss. My mother has had generalized anxiety disorder (GAD) all of her life. She has taken some form of benzodiazepine for about 50 years. She is also diabetic. I personally feel her GAD and diabetes have much to do with the progression of her dementia.

Doctors many times do ignore signs of dementia. I can understand, since there is usually no cure and diagnosing it can cause distress. So they let it go. If you do want your mother to be evaluated to see if there is something that can help, schedule her an appointment with a geriatric specialist. They know what to look for and are not afraid of the word dementia. The doctor may also be able to refer you to a geriatric psychiatrist who can work with the psychotropic medications to make your mother less anxious and more comfortable.
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I am also wondering what other types of things besides Alzheimers could be going on and what can be done about them.
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