How should I deal with Mom's memory issues?

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My 83 year old mother has had increasing short term memory problems for 5 years and was diagnosed with MCI last year (she scored 26 on the test, 27-30 is normal). Other than memory problems she doesn't have other issues - at least so far. Her house, clothes and person are clean and kept to her normal high standards. She still makes her grocery list but sometimes needs help finding stuff in the store. She still cooks, not as much as before but still eats well - just switching to stuff like cottage cheese or sandwiches that don't require cooking. I talk to my mom on the phone a couple of times a day and spend 4-6 hours with her at a stretch a couple of times a week. My dad has heart disease and more advanced dementia and is quiet aggressive and verbally abusive to Mom. I try to get Mom out of the house more, but she won't leave my dad. When Dad has upset her, she has more problems. The doctor says the stress is making Mom's problems worse. Until recently her memory issues were sometimes a nuisance, but didn't cause any real problems. I'm not sure if the "problems" now are mine or hers.


Her brother (W) died last week on Friday. When I called Mom around 7:30a the Saturday morning to tell her about it, she told me she knew he had died and someone had called her the night before. When I spoke to her again in early afternoon, she told me her younger brother had called and told her brother W was dead. When I spoke to her again in early evening, she didn't remember her brother was dead or that anyone had spoken to her. Sunday morning she got into a big argument with Dad because he said her brother was dead and she told him he was out of his mind. She spent 6 hours at my house the Sunday during our weekly extended family dinner and brother W's death was discussed several times. When I called her later that night, she "W is dead?".


When we tell Mom she has forgotten something she will say that "her memory isn't that bad" although she did agree to stop driving last year when I asked and then pushed me to sell her car since she didn't need it anymore.


So my question is - when she tells me her memory isn't that bad, should I try to convince her it is and give her some examples? When she doesn't remember something and wants to know why someone didn't tell her sooner do I say we did and she just forgot (which usually leads to "my memory isn't that bad")? I feel like I'm almost being verbally abusive to make her face her memory loss, but when I need her to adopt some workarounds (like writing stuff down) or give up something (like driving) I also feel the need to honestly discuss it with her. Mom is still "here", her personality and reasoning seemingly intact - just sometimes lacking the information she has forgotten.


During our call this morning, I asked her to write down that her brother died Friday and the arrangements that had been made and tape it to the fridge. Once she had heard something enough times it seems to "stick" so I'm hoping that seeing the information in her own handwriting will help her retain it.

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Under the stress, her memory could be worse temporarily too. Or there could be an emotional component or inability to accept such devastating news. Even if not, I would not try to convince her how bad it is, I would try to convince her how normal and common it is instead (though of course it is not really "normal") and encourage the habits of compensating for it that she is willing to do.
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I am in the home at least a couple of times weekly and I look for problems when I am there. I open and check the status of food in both the fridge and freezer, walk through the house, check a closet out, etc. I usually bring food when I visit, but Mom usually makes tea or coffee, adds something from her leftovers, pulls condiments out of the fridge, etc. She also does some tasks when she is at my house (like making biscuits). I _know_ Mom is still keeping the house going. I'm concerned that could change quickly if my Dad's status changes physically or mentally. Eventually Mom will not be able to keep things going by herself but right now she's doing great at the day to day stuff.

I had a monitored security system with smoke detectors and panic buttons installed a few years back.

The brother and myself who are primary/secondary POA for Mom agree to support our parents in the home as long as that it still working, then put Dad in AL/NH, move Mom in with me, and sale the real estate. Dad has paranoid personality disorder (predating his dementia from multiple TIAs and Parkinson's) and would never consider signing one. We are hoping that when/if we need to move Dad to AL/NH, the hospital social worker can talk him into it or help challenge his competence. There's not a lot of real estate, but a nice home they have lived in for 50+ years and some rental property. I relocated a couple of years back to a single level home on property adjoining and near other family so when that 24/7 time comes with Mom, I will have someone who can monitor and/or stay with her for a couple of hours at a time while I take care of myself, shop or go to my appointments.

The brother who opposes AL/NH refused to acknowledge that Dad had _any_ problems (even with official "dementia" statements from his doctors going back more than a decade) until Dad was hospitalized last year with a heart attack and could not cooperate with hospital staff during the coronary stent procedures.

The neurologist "thinks" Mom "might" be in the early stages of Alzheimer's but isn't sure because so far she only has memory problems. He also states that the slow progression of her memory problems and still only impacting short term and recent memory is not the usual progression. I'm planning like we're on the Alzheimer path and hoping that maybe we're not.
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I'm not sure what type of dementia your parents have, but it can progress quickly. It sounds like that may have happened with your mom. I would be very hesitant for her to be progressing, yet in charge of another person with dementia. I would be wary of her contentions. Dementia patients can seem to make sense and promise many things, but they cannot deliver, due to their brain not allowing them too. I would be concerned over a crisis. I would spend one on one time, verifying that she can do what she says. Even then, her abilities can change daily. I'd approach it with caution.

My cousin went from running her own household one month, to not being able to do much of anything the next month. She couldn't pay bills, prepare food or work a remote control. She seemed very credible when she said she just needed me to pick her up some groceries, but she did not know how to open a can of soup. I have to remove all things of danger from her home like knives, scissors, toaster. At anytime she can forget to turn something off.

Also, have you stayed in the house with mom to confirm she's doing what she says she's doing. Often dementia patients claim they are cooking, bathing, paying bills, clearing house, but they are not. They don't realize that they aren't. I'd determine exactly what she is doing. The test from last year may not longer be applicable.

How much real estate is there? Why not consult with an Elder Law attorney who focuses on Medicaid, so you can find out what options there are and if there are any that might satisfy your brother. However, the most important thing is making sure the parents are well cared for. I'm not sure your brother may understand the progression of dementia. It often involves total dependence on the caregiver for 24/7 care, including feeding, toileting, bathing, dressing, etc. Paying for this for both parents in the home would be quite expensive. I'd get the cost for the options and discuss it.

Who is the Durable Power of Attorney? What do they think?
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No permanent help in their home - both parents are resistant. Limited home nurse visits and PT following Dad's heart attack and hip replacement. My brothers and I are in the house every 1-2 days and speak with one parent or the other daily. Mom is keeping both house and flower beds going with limited help. There is a long standing argument where Dad wants Mom to stay out of the master bedroom and she tells him she will continue to clean her house. Mom sleeps in a room across the hall but still has most of her stuff in the master bedroom. Dad probably needs or is close to needing AL or NH but one brother doesn't want that since it would require selling real estate to fund long term. Mom is planning on living with me once Dad is gone - at least until she needs nursing care. I have them on the waiting list for meals on wheels, but that's a 6-18 month wait. Recently Mom agreed to begin going to a senior center a couple of days a week where meals on wheels delivers - she can take a meal home for Dad even if he won't go to the center.
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How much care do you have going into their home?
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You are not going to win the memory battles. It's just frustrating both of you and causing more stress. Let her be in her reality, dont quiz, correct and give her memory tasks. She can't reason very well and it will get worse. Read about dementia on this site. Great info here on how to deal with the memory issues.
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