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You have gotten some great advice here, the only thing I would add, especially in the beginning before you are able to see a doctor, is to document those moments/situations that she does seem confused. It will help when talking to the doctor also. We did this with my father and it was of great help.
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Thanks everyone for your responses and insights. This has helped me enormously. I really appreciate it.
To answer some of your questions:
1. She is not on any medications except food supplements like Fish oil
2. She never drinks alcohol
3. She has never smoked
4. I talk to her daily about an hour. She tells me her daily routine. Pretty much everything that she does during the day. So I kind of know what she is eating from a diet perspective.
5. It's probably worth mentioning the fact that when she had lost her way to her old home, she was stressed out. Perhaps in depression. She sounded like she has no purpose in life and wants to embrace death. Now though she sounds happy.

I am now able to clearly understand that I must not ignore or neglect as these could be clues to bigger problems ahead. Unfortunately I do not have a heavy support from people who live closer to her.

As a first step I am considering either getting her here or planning a trip to see her and get her diagnosed on the pretext of annual physical check.
Based on the outcome of the results I can better make the judgmental call instead of jumping on to conclusions.

Again thanks for your time. I will post updates, if any.
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First, you have to rule out any physical issues. A B-12 deficiency acts like dementia. Being a woman she is more likely than a man to have hypothyroidism which also can present with confusion, forgetfulness, etc. You did not say how you know she eats a balanced diet since you live abroad. When on lives alone one can eat anything. Suggest she go in for her annual checkup which today includes a memory test. It is not that extensive, but it will give her doctor maybe some clues. Whenever someone objects to being forgetful that in itself is a clue. People with dementia do not know they were forgetful so cannot tell you there is a problem. Sounds like she has a social connection and if you know any other the other ladies maybe ask them how they think she is doing. Best wishes trying to diagnose from abroad.
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THE DREADED UTI !! I should have mentioned this when I posted recently above, as did Grace1234. I learned the hard way that urinary tract infections are very common in the elderly and they make dementia MUCH WORSE for some reason. You stated you live out of town, but if you can possibly arrange to get her into the doctor's for a urine test, please do it! There are often no symptoms, which makes it even harder. As my mom continued to get more and more batty I started taking her temp after each "batty" episode, and if it was elevated even a little I ran her in to the doc, and several times it was a UTI. A course of antibiotics for the UTI magically clears up or at least slows down the dementia--almost like magic. Hard to believe until you actually see it happen. A couple of months ago I took her to the ER suspecting a UTI and I was right; they hospitalized her for a week to give her intravenous antibiotics. The result was good news/bad news; they cured the UTI but all that time in bed made her too weak to walk. She was transferred to a skilled nursing facility for physical rehab and did fairly well. Cranberry juice supposedly helps ward off UTIs, and that facility served a glass of cranberry juice with every single meal, morning-noon-night! So they were definitely onto the UTI problem! Cranberry juice and stay hydrated. Very difficult to monitor when you are not in the same town. Again, blessings, blessings, blessings. Hate to say it, but this seemingly minor confusion stuff may be the start of a long haul. And if you try to talk to them about being confused, they get irate, as you may already have learned. God bless.
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Please have your Mom diagnosed by a physician specialist such as geriatrician, neurologist or psychiatrist to remove all doubts.
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I agree with most. The important thing is to have it diagnosed. When my mother was diagnosed the Doctor said she would be in a home and not be able to take care of herself in 2-3 years. It is now 9 years later and she is living with me and doing fine.
She is on aricept and namenda. The earlier they catch it the better.
We also "play" memory games that helps her work her mind.
There is no cure but I am convinced that there are ways to push out time.

Good luck, it must be hard to be so far away.
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Redhead, do you have legal papers for Power of Attorney, or can you apply for guardianship, so that you can sign him up for Medicare, and legally act on his behalf for proper care?
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my father stopped getting dressed, sat or lay in bed all day. he lost his keys, had to sit on stairs all day until I came home from work in Connecticut.
when I asked him where he went and how he lost his keys, he just gave me a small child-like smile. One day he went out and could barely climb the stairs we live in a fourth floor walkup, he collapsed on the bed, swetting and glaring at me with such an angry look - I yelled at him and grabbed his throat in aggrivation. I was convinced he was acting, trying to get me to pity him. One day I came home from a 3 week vacation with my friends and I noticed he had urinated on an linoleum floor - it left a big dried stain and he had a hard bowel movement in the kitchen sink. I said nothing but cleaned it up. I thought he was losing it. He refused to sign up for medicare - did not trust doctors at all. He refused to get any kind of medical treatment. He is 86 and demands I give up my job, sit at home, no TV, no radio, no music. Any advice?
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As you do not live anywhere near your mom, is there anyone else you can trust to take her to a doctor for evaluation? If you are truly worried, then maybe it's time to find a way to keep her safe and get her meds that can help if it is dementia in any form. The fact that you are so worried should be telling you it's worth looking into further.
This can be very difficult to deal with long distance. If there is any way you could get back to the states and spend a week or 2 with her, it would give you the chance to watch her closely and see how things really are. Good luck!
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I think this may well be early signs of dementia. Igloo572 describes "getting lost" as a kind of hallucination, and I totally agree. As I learned, far too slowly, hallucinations are a big part of this disease, and they start out small and odd. My mom started with some off and on odd behavior several years ago and it was only in retrospect that we could look back and realize that this was actually the dementia starting. Among other things she was experiencing small visual distortions. She said that all the girls at the nail salon had gotten their lips enlarged over the weekend--they must have all gone together.
(!) She thought her TV was "getting too big." A favorite shirt got "too pink," so she stopped wearing it. And the usher at church "switched" her walker for somebody else's old walker. These incidents occurred several months apart at first and then got more frequent. Then suddenly she got paranoid and the cleaning lady was stealing everything, including the sink strainer; that's when it finally dawned on us, and the hallucinations got more and more bizarre, including people breaking in and leaving things, then breaking in and stealing them back. Looking back it took a really long time for us to recognize what was actually happening. Having her evaluated by a gerontologist is excellent advice. I spoke to a neurologist who advised against evaluating her (!) because he said it was obvious she had dementia, the evaluation itself would just upset her, and the available medications were not that helpful. Good grief. Be sure to find a doctor who is actually willing to help you! And God bless. This is no fun for sure.
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It's amazing how medication or lack of can effect an older person so that needs to be checked right away. Also, my mom had a urinary tract infection with no symptoms other than acting like she had dementia so that could be a problem. She got better after being treated but unfortunately at 98 now she really does have it which is no big surprise.
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When talking to my mother about my concern with awareness issues I focused on, if there is a problem there is medication to help slow this down and the sooner we start the longer we may have. She is on medication now but is very reluctant to take any of the memory testing and from what I have read that is normal, they dont want people to know or even confirm for themselves. Good Luck and God Bless.
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Oh my, this is classic. My mom is now 96 but about 4 or so years ago she had an episode that was clearly a sure fire sign that something was wrong. Long story but she had come to live with us for issues with her eyesight and hearing but was able to be alone when we went to work and such. One evening my daughter and I went to a town nearby to shop and my husband and son were out of town. When we returned we were followed into our driveway by a sheriff's car. I didn't know what to think. As we went into the house, mom said that the little girl would not talk to her and that she had called 911. When I met the deputy on the doorstep he said she had said something about seeing ghosts.......another episode didn't happen for a long time. At first I chalked it up to just her not remembering that we were shopping but as time went on things started happening more frequently and now it never known what kind of day we will have. It is a very cruel disease. I hate not having my "mother" much anymore. To me it doesn't really matter which kind it is....it is just very cruel and we deal with whatever comes our way. It is stressful as I am her caregiver. Just make sure your mom remains safe and routine is imperative! Her doctor also said that some medications have side effects that are not much better than the disease so do research. Blessing to you. And find support for you too. It not easy and you will need a support system. This site has been awesome for me so far and I just found it by accident a couple of months ago....keeps me sane....if you can call it that. lol Oh and remember to laugh! Sometimes their antics and conversations are so bazaar that if you don't laugh you would cry but laughter helps and remember, you are not laughing at your loved one you are just laughing at the situation.
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Several have mentioned shuffling. Shuffling and congnition issues are two of the signs of something called NPH. It involves excess fluid in the brain cavity placing pressure on parts of the brain. the third symptom is incontinence. It is treatable. Youtube (extreme) NPH walk.
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Everyone has given such insightful answers. But, in the end--if there is no cure of dementia, then you have to "treat" or "deal" with it as a family. My Dad forgot his way to the train station and got lost for hours in his car. Scary! So now, he lives with me and 95% of the time he is self-directing--even if it's to go look out to see what the weather is, that's what he wants to do. He shuffles when he walks and needs help for some very personal care, but Dad watches the news and can tell you the facts and retell the story. Whatever medication he takes--will it make him better? What about the side effects from the meds? I have been using coconut oil and having him drink coconut milk and sometimes he is so alert that it makes us nuts--but Dad was never easy anyway! Make sure your loved one is safe--with daily living assistance, shopping assistance, no driving etc--and enjoy them! When they do those ridiculous things, or say something out of the ordinary, don't let it alarm you. If it is harmless and they can be redirected--great. If not, be patient and keep smiling. It is a hard road--especially when your loved one was always self-sufficient and in-charge of themselves. It is the rest of the family that, at times, can be the most harmful when they don't accept the situation or want to become involved so they will get what's in the bank!
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Run...do not walk to a geriatric neurologist!!! If it is dementia and it is identified early, medications do exist to arrest its development. Wish we had done this much, much sooner with my mom. I wish you all the best!!!
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Don't rule out a UTI. Before dementia came into the picture mom was suffering with urinary tract infections that caused her to be confused. Now when Moms dementia gets worse it's aggravated by a urinary infection.
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The earlier you can get this diagnosed, the better, as medication may delay its progression. Good luck to you.
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All good answers, I lived abroad and noticed things odd with my mother. Has there been any unsettling things happening in your mom's life, death, loss of pets, etc? Does she drink? I found that my mother was drinking more than she ever had after my dad died. Has she suffered any injuries that require pain meds? Self-medicating for pain is common. Sometimes because I talked so often to my mother she would feel so close to me that I was with her and this was before any dementia onset and before any issues. So, I would keep an eye and ear out and keep track.
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I think time will tell, as I think now it is too early to know what is causing her memory problems. Sometimes even a bad night's sleep can cause forgetfullness even in younger people, so I would not be concerned yet.
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jlakhani Your concerns for your Mom's behavior and questions like yours are where it began for most of us. We are here on this site and going through it or have been through it all and still learning, in one way or another.
Awareness of a mental or behavioral change in an elder is a good reason for concern and should not be neglected.
Dementia is a broad term used to describe a mental impairment.
Some causes of dementia may be stopped or reversed if they are found soon enough, including:
Brain injury
Brain tumors
Chronic alcohol abuse
Changes in blood sugar, sodium, and calcium levels (see: Dementia due to metabolic causes)
Low vitamin B12 levels
Normal pressure hydrocephalus
Use of certain medications, including cimetadine and some cholesterol-lowering medications
Dementia usually occurs in older age. It is rare in people under age 60. The risk for dementia increases as a person gets older.
Alexander disease
Canavan disease
Cerebrotendinous xanthomatosis
Dentatorubral-pallidoluysian atrophy
Fatal familial insomnia
Fragile X-associated tremor/ataxia syndrome
Glutaric aciduria type 1
Krabbe's disease
Maple syrup urine disease
Niemann Pick disease type C
Neuronal ceroid lipofuscinosis
Neuroacanthocytosis
Organic acidemias
Pelizaeus-Merzbacher disease
Urea cycle disorders
Sanfilippo syndrome type B
Spinocerebellar ataxia type 2
It is possible for a patient to exhibit two or more dementing processes at the same time, as none of the known types of dementia protects against the others. Indeed, about ten per cent of people with dementia have what is known as mixed dementia, which may be a combination of Alzheimer's disease and multi-infarct dementia.
Therefore a proper diagnosis is the place to start.
You should educate yourself about... healthcare, legal, financial, and care giving, issues involved.
Always remember these things....no matter how you are treated by the person who has any type of Dementia, that you are not at fault, don't feel guilty if you are doing all you can do.Put out one fire at a time. Music is the best medicine of all.
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Sounds like it could be dementia. It's those surprising, double-take comments that are the first indication for most family & friends of dementia patients that clue them that something isn't right. With my experience, it was when my mother saw a photo of the Grand Canyon and mentioned that we had been there on a family vacation. We hadn't and she had not. If that wasn't bad enough, when I shook my head and said we didn't vacation there, the look on her face was very telling and sad. She was trying to weigh the situation...and figure out what had just happened. ("Am I losing it?") I think it was a scarey, rude awakening for her and you could still see it on her face an hour later . That was my moment of realizing something was wrong. My father and siblings each had their moments of realization too. However, early on, weeks or months would go by before seeing another indication of memory loss. Though my dad, with her everyday, saw signs more frequently. Living abroad, I would assume you don't see your mother much. So, keep in mind that there might be more going on, and more frequently, than you are aware of.

Normally I would say that perhaps she had had a stressful day and wasn't thinking clearly when she lost her way to her old home, but later recalled it. I think we've all had days or moments like that...temporarily having memory or logic fog. However, you experienced another unusual memory issue with her, so now a pattern is being created and frequency of these moments has increased. Is there a friend or relative who sees her often whom you could ask if they have noticed unusual comments or activities with her? Have any of her medications been changed lately? Medications or a change in dosage can cause forgetfulness or unclear thinking. Has she been ill? What we would consider minor, temporary illnesses or maladies, such as a UTI, can have a bigger impact on the mind and body as we age. I think they a friend or someone who sees her frequently could give you a clearer picture as to what's going on with your mother, if your concerns are warranted, and whether you need to intervene.
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Jeannegibbs...I love your answer. Yes..I do believe she is experiencing the early signs of dementia. She is probably okay right now..but I would check on her often. Talk and listen to her stories, if you can get her in to be evaluated. But don't brush it off...its dementia but this can go on for quite some time. I agree with Jeannegibbs fool her into a appointment, take her in for a flu shot or something. When my mom was showing the signs I took her in for a Vitamin B12 shot and it did help for awhile but the progression with get worst some day. So keep a close watch. If things really start to sound off...check on her. Like Jeannegibbs said...its all in the flavor. And believe me it will go south one day. Good-luck and God Bless.
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jlakhani, Ice cream is ice cream. Most ice cream is vanilla, but lots of other ice cream is chocolate, and there are a few not-very-common kinds of ice cream, such as licorice.

Dementia is dementia. Most dementia is Alzheimer's, but lots of other dementia cases are Lewy Body Dementia, and there are some not-as-common kinds of dementia such as Frontotemporal dementia.

Does that help clear up the dementia scene, or just add confusion?

Whatever kind of dementia a person has, it is that kind from the beginning. (Chocolate doesn't become vanilla.) It is often very difficult to even guess what type the dementia is in very early stages, so it is often just called dementia. Later it may be called Alzheimer's or Lewy Body or Vascular (or one of about 50 other names). It was always that -- we just didn't know what to call it. It isn't that dementia "ends up" into Alzheimer's -- if that is the kind of dementia it is, that is what it was from the very beginning. As it goes through its progression it just becomes more apparent that it is Alzheimer's (or Vascular, etc.)

Dementia is progressive. Overall it gets worse. But sometimes addressing the symptoms improves the quality of life so much that the dementia seems to be halted or getting better. That is a wonderful outcome when it happens -- enjoy it while it lasts -- but ultimately the disease gets worse. As far as I know, there is no way to stop the progression, but there are many ways to improve quality of life. Some people think there are ways to prolong the early, mild stage, but eventually mild becomes moderate and that becomes severe.

I think that it is perfectly OK to "fool" your mother into an evaluation. Make the appointment but tell her it is time for her flu shot or her booster tetanus shot or a routine physical, etc. and let the doctor know about it ahead of time, so she can have the shot/exam/whatever first and then without making a big deal of it also have some testing done.

What I found extremely useful in caring for my husband was learning as much as I could about dementia in general and about the particular flavor of dementia he was diagnosed with.
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You might be interested in the Alzheimer's web site (alz.org) it has lot's of good info. So far there is no cure and only some 'possibility ' of slowing the progression. Merck was just highlighted in local paper for their research into this area. There have also been some articles on the use of coconut oil! I believe there may be something on this site about it. Routine - Routine ROUTINE helps the person experiencing this. A private talk with your Mom's doctor may give him a head's up on your observations. The doc can then give ideas on how to handle. Good luck
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Thanks for your answers.
@3pinkroses - could you give more details about your MIL? Has she gone through some medications? My sister lives close to my mother's house however as I said my mother gets offended when we talk about having her tested. So I'm still figuring on how to deal with it.
@igloo572 - From what I have read thus far dementia is a progressive disease. However from your experience do you think it's possible to stop the progression? Can loneliness worsen dementia? Does dementia necessarily end up into Alzheimer?

Thanks again for all your inputs. It greatly helps to take the next steps.
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It does sound like the beginnings of dementia. My MIL started out like this as well. She was always an independent woman and quite healthy. We noticed she was forgetting directions as well. She would forget where her doctor's office was or some other familiar destination. Hopefully, you can have your mother tested, as above suggested.

You mentioned you live abroad - are there any siblings, family members that can check on her? We had a lot of help with neighbors, etc. as we lived 2 hours away and couldn't see her all the time. Take care.
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JL - my guess is that she has dementia but not Alzheimer's. Most of the media and articles in the US are all about Alzheimer's.

My mom - who is now mid 90's - was extremely high functioning till about 3 years ago. Doing just like your mom but there started to be gaps but still overall very cognitive and competent. For her, the first things were visual - like seeing animals
or other visual hallucinations like getting lost (not because she couldn't remember where the house was but rather couldn't make out the streets or houses). She started to have this inablility to walk normally- now she is ambulatory but she walks with a shuffle (can't do a heel-toe-lift walking) with her feet on the floor. She probably has Lewy Body Dementia (probably because you can't say definitely till an autopsy is done). What was great for us, was having my mom become part of gerontology practice in which testing was done to be able to narrow down the type of dementia and where she was within the LBD spectrum. The med's for the dementia's are different so what works for LBD might not be best for Alz. Also for LBD there are some med's that absolutely are wrong. See if you can get her evaluated by a gerontology practice, if you can.
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