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My mother who is 88 lives with me and has not been diagnosed with Dementia or Alzheimers. However, I have noticed that lately she is very sleepy during the day and when awake is very confused about what time of day it is. This thinking persists even when I remind her of what the time is. Most of her memory and living skills seem to be fairly intact, although she loses things frequently. She has an annual in June, where I would like her to bring it up, but when I mentioned this she gets real defensive. How does a caregiver bring something to physician attention without the patient consent?

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The way to inform her doctor of these things that concern you is privately, not in her presence. Keep the note concise and quick to read.
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Definitely contact your mother’s doctor, preferably in the form of a letter. I did this recently as my Mom was not acting herself, she was making poor choices, sometimes incoherent, etc. Of course, after I dropped that letter spilling my guts out off to the doctor, I felt that I had thrown Mom under the bus and felt so bad. However, a day later I went to pick her up to take to a doctor’s appt and found her on the floor, nonresponsive, she had apparently gotten confused and taken an extra dose of her Oxycodone - BTW, this was my BIG concern in the letter. Things are definitely better but it is time for us to look into AL. Good luck to you.
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Who has POA? Maybe it is time for you to get POA. Don't wait until it is too late.
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Thanks all. I will try to communicate ahead of time. Mom started with her confusion after naps but now it's 75% of the time. Medicine has been the same forever but I can ask. I do not have power of attorney but maybe in the future. I have heard that UTIs or other illnesses can cause confusion as well so we will have to get everything checked out
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I found my mom would be confused about the time if she had been sleeping deeply and woke up suddenly. She'd think it was 6 AM instead of 6 PM and when I'd call her for my nightly check-in, she'd tell me she was making breakfast or if I woke her, she'd say she needed to get up to make her breakfast. So I think that's fairly common. Before I'd get off the phone, I'd remind her again that it was evening, not morning. I think seniors can take a while to orient themselves once they wake up. So you might say it's PM not AM but it may take 3-5 minutes for that to sink in.

My mom was never diagnosed with dementia, but she had no short-term memory and lost a lot of her reasoning power and initiative. But she was able to live in independent living (with a lot of help from me) until she was almost 98.

When she went to the doctor, she'd always downplay any issues, partly from memory loss and partly because that's what a lot of old timers do (show timing). I always went in with her and would chime in and say, "Now mom, remember when you didn't feel good..." or whatever. I also would give the receptionist a note for the doctor to read prior to her appointment about things to cover with mom. It worked well. Good luck and keep us posted.
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It could be any number of things that are causing her symptoms and like others say above, the doctor can run tests to see what's causing it or at least rule some things out. I'd make a list of your observations and send them, in writing to the doctor. I dropped mine off in person a day ahead of the appointment. It's not a violation for you to give him something. When you arrive for the appointment, I'd make sure the doctor got it and read it before the consult. I did that and it really helped provide the primary the heads up. She was able to do do physical exam, order blood and urine tests and do a mini office eval. We were able to get our questions answered and a diagnosis, that was later confirmed by a neurologist.

It's nice that you are so considerate about your mom getting defensive, but, it seems to me that seniors are often defensive and maybe somewhat difficult.  I wonder if that is just the way it is.  I have found that I don't tiptoe as much as I used to, but, just try to be reasonable about things. To me, sometimes people just have to accept things, even if they are our parents.  I learned that them getting annoyed over me doing something to help them, will just have to be okay.  They have gotten over it and later all was well.  lol 
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Amy, is the confusion about the time of day happen after your Mom had taken a nap? Sometimes that will happen to me. And I know it has happened to my Dad on numerous occasions.


Have your Mom's primary doctor check what medicine your Mom is taking. So many meds can cause on to be very sleepy, thus napping on and off during the day. For me it was my blood pressure pills, boy those really had zoned me out until the doctor found a dosage that was good to use.


If you are the Medical Power of Attorney, you can give permission to the caregiver to bring up this issue with the doctor. I allowed my Dad's regular caregiver to speak on my behalf and if she, herself, had noticed anything out of sorts.
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Send a letter to the doctor ahead of time. Perhaps to arrive a week before the appointment. In the meantime keep a diary of the changes you are noticing, but also everything else going on in her life. Diet, sleep patterns, toilet patterns if she lets you know, any other changes you notice. Record the times of day you are seeing these things occur.

That way when she goes to the doctor the Doc will know what is going on.

I did this with my mil. Her behaviour was getting erratic. We share the same doctor, so when I was in getting my annual, I told him about my concerns. He followed up with her on her next visit, without giving me away as it were.
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