My mother (85), a very intelligent woman though almost certainly with NPD, moved to AL near us three years ago and basically devolved responsibility for her life to my husband and me (without asking us!). Never sociable or outgoing, like many older people she has suffered mentally from the lockdown and is getting more and more confused and mentally lazy. She won't read a book, says she can't understand official letters any more and at times forgets who her great-granddaughters are.

There is vascular dementia in her family but we have no idea whether these symptoms amount to the onset of that or just the effects of lockdown on an already negative personality. It would be very hard to get a doctor to assess her and we don't have POA yet.

Any advice?!

Thank you.

I think it is really hard to tell the difference between them: dementia, depression, decline, also delerium (with UTI/chest infection).

Even the experts can't always pick it - especially when people can *show-time* & present well to Doctors. That's where a screening test & then other more detailed cognitive testing will be used & highlight the difficulties. BUT. As you mention, there are many barriers to this: inc getting a face to face appointment & any willingness to participate from your Mother.

So. What to do until those barriers can be removed?

I'm afraid I really don't know! I faced similar when my Mother was in rehab. I asked questions - but got no answers. Same show-time & refusals.

My approach has been, if it looks like a duck & quacks like a duck, it is probably a duck. (My best guess is Vascular Dementia).

I watched many Teepa Snow YouTube's - check out the *Diamond* dementia stage (if you haven't already). I basically try to keep what she can do & outsource the rest plus keep solid steel boundaries!
Helpful Answer (3)
Reply to Beatty

We have signed a form allowing us to be party to some of Mum's medical information but I'm not sure how far it goes. She doesn't have a regular doctor and hates going to see anyone - and our surgery is discouraging visits anyway owing to the virus and Mum has no technology by which to speak to them. Only one visitor is allowed into her AL at present so we can't ask for a home visit either. I wrote to them before the lockdown expressing my concern about her mental/emotional state then, and all they did was test her blood pressure. She is quite good at pretending all is well when with a medic despite moaning all the time to her family.
Helpful Answer (0)
Reply to helenb63

The fact that you don't have POA doesn't mean that you can't communicate with her doctor, just that the doctor can't communicate with you.

Does she have an Internist or geriatrician whom she sees regularly? Would you be comfortable writing that person and expressing concern about her recent cognitive issues?
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Reply to BarbBrooklyn

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