How to get medical staff to understand my mother is lying?

You are medical POA now for someone with vascular dementia; it would be so much better now if you would just attend all MD appointments with Mom if you are in the same city, so that you can gently correct crucial information like fall history. Explain the need for this by letter with all MD and Nurse Practioner etc. Because yes, esp with the Narcissistic mixed in, confabulation can lead to medical folks honestly believing a good story.

I sympathise.

Q: Do you have any health problems?
A: No, I'm fine.

Apart from the congestive heart failure, chronic kidney disease, hip replacement, gastric ulcer....

Mother later explained that she "didn't count" anything that was controlled by medication. The appointment when a nurse practitioner cancelled her pacemaker implant based on mother's claim that she could walk up to a mile "but I get a bit tired" was the last mother ever went to alone. It was supposed to be a chat about living with heart failure. No examination, no investigations, no corroboration; and interestingly no cancellation letter, either - I found out by luck. I quite enjoyed following that one up.

We have to go through this grey area, only not so much grey as Kafkaesque, while our demented elders are not yet officially away with the fairies, or whatever technical term your jurisdiction uses.

I take it your mother's medical teams are actually *acting* - prescribing, treating, etc. - based on their clinical observations and your contributions, rather than your mother's claims? Assuming that is so, and you and they both have the obvious risks covered, then there are at least three things to be said for solemnly writing down the patient's own account.

1. As you already said, respecting the person's dignity and autonomy, as far as it remains possible;

2. The discrepancies between the patient's own understanding versus the results of scans, blood tests, clinical examinations and reliable witness accounts are in themselves helpful to understanding the patient's mental state;

3. The practitioner needs to develop a relationship with the patient. Upsetting, provoking, challenging or contradicting the patient is not going to help that. Gentle questions and explanations will work better but first you have to establish trust.

So I wouldn't be fooled. The fact that the doctor is keeping a straight face and handing over the notes doesn't for a second mean that the doctor actually believes that your mother is CEO of a tech company (though she may be! How would I know?). But I think you already know that perfectly well - is there a nice soft surface you can go and bang your head against?

Janner, ah yes, the "I am fine" when one's parents are at a doctor's appointment.

My parents had a great geriatric physician, any time she would ask my parent(s) a question, she would glance at me to see if I shaking my head yes or no. If "no" then she would quiz my parent(s) until she got a good answer. I was always sitting behind my parents in the exam room so my parents didn't know what I was doing :P

My Dad was pretty good at being upfront with his doctors, but not my Mom. My Mom was always in denial that she was aging [in her 90's].

Who deamed Mom as having Dementia? I hope a neurogist and not a PCP. Whoever diagnosed her, that paperwork needs to be in all her doctors files. If u haven't been going to appts with her, u need to. Right in the room. I always wrote a list of things I had seen. Changes. I would give this to the receptionist for the doctor. Then his questions could be based on what I had written. Your POA should be on file too.

My Mom's Dementia was noticeable. I had asked that no one talk to her about her care. If I wasn't there, I was to be called. I showed up one day to two nurses (think they were students) explaining what was going to happen to my Mom. I told them she lost them after the first word. Her ability to process was really bad. My DH has lost hearing in his left ear and has maybe 20% in his right with an aid. Deaf without it. Domu think I can get doctors and nurses to understand this? No. I called one doctors office and asked the Nurse to put a pc of paper with the words DEAF where it was the first thing the doctor saw in the folder. My DH could not get this man to look at him when he talked.

You brought it up —let your Mom maintain dignity - even if you harbor resentment. Her doctors are trained professionals, perfectly equipped with the ability to examine and analyze her condition. The only thing you must correct are relevant facts of medical necessity. (Do so out of your Mom’s earshot to avoid embarrassing or humiliating her).

Most Doctors offices now have "Patient Portals" that you could set up.
The advantage is you can send messages to the doctors offices.
Prior to the visit send a message "reminding" the doctor and the staff that mom has dementia and that she had surgery for a broken hip on...since the last visit she has fallen ..X number of times..and any other information you want them to know.
Also instruct them to also give you a copy of the "after visit" notes.
I might add that if you are in the room with her during the visit and the doctor does go over any follow up information he or she may be talking to your mom but the information is also being imparted to you and this may be a way of keeping you informed but also respecting your mom as an adult that still might be able to make some decisions on her care.

Schedule a consultation with her medical team and inform them of your mother's tendency to lie. Hand them your medical POA and make them look at it. Also, while my mother never outright lied, she often didn't understand or follow a question and would answer with something completely off the wall. I went to every appointment with her and if that happened then, I would just shake my head to let them know of her error. I was fortunate that her doctor was also my doctor so he was very accommodating with that understanding.

It sounds unrealistic for you to attend all of her doctors' visits because of your own health issues. Her doctors do need to be informed *by you* **in writing** that you are her medical POA and scheduling visits and reporting results must be done with you and only you. Whichever doctor diagnosed her vascular dementia wrote a report that was sent to her PCP, if he was the one who referred her for neurologic testing. Get and copy that report and attach it to a copy of your medical POA documentation and send it certified mail return receipt requested to the new cardiologist. Once you get the signed card, call the office and confirm that the report has been added to your mother's medical record, and request a call back from the cardiologist acknowledging same.

If she has dementia, think of her answers as "wishful thinking" rather than lying. Be a little more understanding that her mind is not functioning logically. Try not to correct her in a way that makes her feel denegrated. You need to talk to the doctors when she is not there, and you should be providing her medical history. The suggestion to inform her doctors in writing is a good one.

My step fathers wife does the same thing, she has Dementia/ALZ, maybe stage 5, the doctors are useless in figuring out whether she has Alzheimer's or Dementia. Anyway, when we were cleaning out their house we saw a receipt from when she was in the hospital for broken ribs last July (un beknownst to us) we and the doctor asked her about it, she said she wasn't. She wasn't lying, she just didn't remember. Many other scenarios, my brother talks right to the doctors now, not her, so we know what is going on.

In my case, it’s my sister in laws who tell me that MIL is “really with it “. They don’t like it when I take notes and email a summary of my visit. Of course, if they visited more than once a month, it might be different. I drive 45 minutes and they are much closer. One even lives .5 miles from ALF.

Mom’s history, diagnosis and even the narcissism is a carbon-copy of your situation and my sister, just last week, had a particularly ugly scene in an appointment with a new neurologist where Mom started yelling that she was being blackmailed (wrong word, but implied sabotage), because my sister wanted the doctor to know about the diagnosis of vascular dementia and some of the episodes of confusion and paranoia. My sister has pretty much sacrificed her life to the PoA role, is so patient and sweet, and it is so hard on her when these outbursts happen. The Patient Portal suggestion might be helpful.

Just skimming some of the posts below it looks like your mom's medical team t least for the most part is using My Chart and your mom is participating. This has been a godsend for us because I can communicate with all (accept one) of Mom's doctors this way. As you have MPOA and access to her account (I never had to prove POA just my access to her account seemed to do it) you should be able to just send a note to providers either before an appointment and or after to make sure they are up to speed. But her cognitive issues and tendency to see her own truth should all be part of her medical history, the fall, her current residence are all part of the record that follows her and is part of the provider portion of the system that included My Chart, at least it is for my mom. Now a lazy doctor who doesn't take the time to know these things or have staff making sure they know ahead of an appointment is one I'm not sure I would stick with but that's up to you. Your mom's primary should be managing this as well, I assume her PC was the one who referred her to this cardiologist? I ask because typically the referring doctor sends a note to the new specialist filling them in on the pertinent info but again I guess the specialist needs to read that... I would let her PC and whoever it was that referred her to this cardiologist (if they aren't the same) know about the experience and your concern, they might refer you to someone else or get in touch with the new cardiologist and get them straightened out on things but it is important they know because they are deciding who to refer which patients to and it might sway that for others in the future.

Also while my mom as well will answer questions opposite of the way we might for her it isn't because she is actually lying. She will knowingly stretch the truth to look better sometimes but more often she remembers things with rose colored glasses and because she has been deaf in one ear most of her life it comes naturally to her to agree her way through conversations even when she has no idea what was asked or said she convinces you she does. If your mom is telling people she lives on her own and still works it may not be a lie at all it may simply be what she believes or remembers at the time. So I might not tell doctors she lies but rather her reality is sometimes from the past rather than today's reality and while you want her to feel in control and keep her dignity it's important they look for silent ques from you on important questions and or communicate with you through the My Chart system or in person with any questions or information of importance. Again her PC should be able to put that note prominently in her electronic chart.

I've noticed when I take Mom to doctor appt. They talk to her directly and ask her questions. Sometimes she can answer but it becomes very apparent very quickly that her responses aren't all there. Many times she will try to answer and then looks to me to confirm what she is saying. If what she says is really far off but seems to be accepted as fact by the Dr. I'll just give him a wide eyed look and a subtle shake of my head. Later I'll leave him an e-note for her record. Many people don't like the computer for communicating with the Dr. But I find it makes life so much easier. She is able to maintain her autonomy and I am able to keep the Dr corrected on the important stuff. Like the 15 falls and 6 ER visits since Jan. When she claims no falls and walking without difficulty. She uses a walker and drags her left foot.

So many people do not know the unique problems those with vascular dementia have so getting care providers to realize what is really happening takes great persistence. I can empathize with you because people are always my husband to be like those with Alzheimer's dementia and he just is not.
Do you have medical power of attorney for her? Or are you her contact person? If so, contact them on your own and set the record straight because down the road the reality of her situation may be impacted by this information.

Persons with vascular dementia go through a stage of "confabulation" where they make up information (1) to fill in memory gaps and (2) to save face.

It's clear that your mother is seeing herself "as she used to be" in her prime. Perhaps she was 5'7" as a young woman; after all, everyone shrinks in height with age. Perhaps she was employed full-time and lived alone at some point in her past. It may not be intentional lying on her part; she may actually see herself as a moderately tall, young, vibrant, independent woman.

My father had vascular dementia - and I saw the same behaviors in him.

The medical staff may not be taking correct notes for her condition. The most correct way is to write something like, "Patient stated that she works full-time as a secretary and lives alone in an apartment" - or whatever applies. That way, it is a simple report of "what the patient stated" rather than fact.

The first thing that needs to be done is getting POA over her health. If she is still in control of medical decisions the staff will always go to her first. Express this to the social worker on call at her facility. If the doctors are ignoring you then the social worker will step in on your behalf.

Oh I get that & it’s so frustrating! Our Dr thinks my mother is the next best thing to chocolate when she’s in his office, acting all sweet. The Dr does look at me after he asks a question but I don’t really think he cares what I think or say. Maybe they think we have dementia too???? I think a consultation type appt would be good to schedule to discuss mom. Schedule first thing in am before he starts his busy day & isn’t exhausted. Maybe they’ll listen.

Since it was a new Dr, it was likely he had no medical proof to make him doubt her. (Could you request medical notes from the person who diagnosed her dimentia?) Also bring copy of hospital notes on broken hip, to show to any new Drs. That kind of stuff would be objective proof. Otherwise, just stay in the waiting room next time she visits the Dr. so you don't have to listen to her lying. In the end, it's not worth letting her drive you crazy. That's what I ended up doing after my mother got mad at me for telling her Dr the truth. Good luck.

It makes me think of how us kids think our mom had an agreement with her physician that she didn't want care to prolong her life. She was ready to go. She knew us kids would protest and intervene. Doctor/Patient confidentiality.

I ask the exact same question every single time we're at the hospital or a rehab facility or wherever, and my mother with DEMENTIA is being questioned in earnest by the doctor. He's recording her answers as if they bore ANY semblance of truth to them, without batting an eye. Um, do you realize the woman has DEMENTIA? Oh no, she says, all innocence and light, I've never fallen. Really? How about the 3 DOZEN times I know about, the countless times I don't know about, the broken ribs and sternum bones she managed to hide but showed up on the CT scans in various stages of healing, and on and on. I am her medical POA and I'm sitting right there, yet SHE is asked the questions, regardless of her mental disability. It's ludicrous, really, and just another example of the sheer incompetence we're faced with when dealing with care for the geriatric crowd. It's kind of like the pediatrician asking the 4 year old for her health history, isn't It? That would never happen, yet our mother's are taken at their word no matter WHAT condition their mind is In! Our medical community needs to come into this forum and read up about what it's REALLY all about to care for the elderly. They'd learn an awful lot!

Yes so frustrating. Maybe try to let the 5"7 wash over you but ensure the vital stuff is correct (about heart, falls etc)

Like others, I've resorted to the subtle head shake, the wide eyed look & written letter dropped off for the Doctor - either before or after. Especially if getting out is hard for you, write letters or use tech methods.

My sister has mental illness, funny how I never considered vascular dementia as well (even thought Mum is on that road) - who knows? She has 'wishful thinking' & has memorably said to a new Specialist "I NEVER fall. Well not anymore. Not for ages". I looked over to big bandage on thumb (from latest fall). Doctor questions. Answer: "But then I went & fell TWICE last week". LOL! This silliness was new to me but Health Professionals must see this ALL the time.

Also, "Yes I do my own shopping". Some questions. Answers included "My Dad writes a shopping list. My Dad buys it online. My Dad pays for it. My Carer picks it up. My Carer puts it away in the cupboards".

It helps me if I can have a laugh (later) but also to remember these symptoms are caused by her brain. The lights are on but a lot of fuses have blown.

Good luck for your journey with this.

I know what you mean. It’s infuriating. I found that I have to be like a school teacher controlling the attention span of a child. Their answers are standard and they love to cut you off. I check everything and ask questions it’s what you have to do every time

It is uncomfortable to speak for a parent. I always feel like I am overstepping but sometimes my mom will not say things that she should say or she will say things that she shouldn’t.

For instance, with home health the lady who bathes mom is at least 400 lbs. I am not making fun of her but she does seem to have mobility issues and doesn’t do the greatest job.

When the nurse asked if she was satisfied with her aide mom said to the nurse, “Well, she can barely fit in our small bathroom!” It isn’t a small bathroom. But mom didn’t want to insult her. I had to explain what was happening.

I gave the aide specific instructions on mom. She doesn’t follow the instructions. I am polite with her but she tells me, “Oh, let your mom do everything that she can by herself.” I get that but mom can’t reach because of a rotator cuff issue.

It ended up being a total waste of time explaining our experience because the nurse proceeded to tell me that I was speaking for my mom. Grrrrrrr! So, I just didn’t say anything else. Kind of annoying because why ask a question if she didn’t want an honest answer?

A few years back, my mother forbade me from going into the MD examining room with her (because she was sensing that the dr. was talking to me and not her; what was happening was that my mother wasn't hearing the dr.).

So the dr. didn't realize the showtiming that was going on from that point on. "Did you tell the dr. that you are only showering once a week because you have such difficulty getting into and out of the tub?" "I'm not going to tell her THAT!" was the response. I find it hard to believe that the dr. didn't suspect some dementia, but I think that as long as my mother wasn't still driving (she wasn't, as I was the Dummy Daughter Driver), that the rest of my mother's life didn't matter to the dr. (she knew there was a local daughter -- me). But once she became hospitalized/then rehab/then permanent placement in SNF, the staff included me in everything and didn't seem to take my mother's input unless it was whether or not she was in pain. My mother's dementia (long hidden, but I knew and sometime felt that people didn't believe me) had become full-blown by that time.

I always had access to her MyChart, so kept track of her health that way, even though I didn't go in to the dr. appointments that last two years or so (unless it was an ER visit; I always went in for those).