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Or should I just try to get her doctor to know my suspicions before her next appointment. She's real mean. I'd like to avoid a fight (we already fight once per day over the most obvious safety issues).

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Here's what I did with my MIL:

I pretended I took a call from her doctor and that they wanted her to come in for a follow-up check (she had a prior back injury) then offered to make the appointment for her. I took her to the appointment and as I helped her check in, I discretely handed the nurse a pre-written note asking them to do a cognitive and memory exam, and told them my concerns. At this point I was not her PoA and not even her HIPAA Medical Representative, but they did it anyway. I even asked MIL if she minde if I sat in on the exam. I sat behind MIL so that when the doc asked her a question about doing her ADLs I could indicate yes or no for the actual answer if she didn't answer correctly. She totally failed the cognitive exam but the goal was to see how bad it was and to have it in her medical records.

If you're not her MPoA or Medical Representative I don't think her doctor is legally allowed to take or act upon any information you try to call them with. BUT I would try the note method. At check-in ask for the HIPAA MR form and encourage your Mom to put your name. If she resists, you can ask the receptionist why it is important to have a MR. Then at least you'll be able to discuss your Mom's personal medical information with her doctor without your Mom having to be present.

If no one is your Mom's PoA I encourage you to figure out how to get her to create this legal protection. One strategy is to download the forms for her state from Legalzoom or Rocketlawyer. This may be easier than getting her to a lawyer and it is better than no PoA. This is what we did for both my own Mom and my MIL. We have had no problems.

Fighting with your Mom over things indicates that you need more information about dementia and how to better engage with people who have it. Dementia robs people of their reason, logic and empathy so YOU are the one that needs to adjust the relationship if you wish interactions to be productive and more peaceful.

Watch some Teepa Snow videos on YouTube, they are super helpful and not boring. Others can recommend books. Here is a list that I keep at my home to remind myself when dealing with my 93-yr old Mother:

Rules for engaging our loved ones with dementia:

1) Agree, do not argue

2) Divert, do not attempt to reason

3) Distract, do not shame

4) Reassure, do not lecture

5) Reminisce, do not ask “Do you remember…?”

6) Repeat, do not say “I told you”

7) Do what they can do, don’t say “you can’t”

8) Ask, do not demand

9) Encourage, do not condescend

10) Reinforce, never force


The overall goals should be to:

1) keep them as calm and peaceful as possible 
     (because they are less and less able to bring themselves to this state on their own)

2) keep them physically protected in their environment and from predatory people

3) keep them nourished with healthy foods that they will accept without fighting or forcing

4) keep them in as good a health condition as is possible, that their financial resources will allow and within their desires as expressed in a Living Will (aka Advance Healthcare Directive) 

5) keep them pain-free as possible and within their desires as expressed in a Living Will (aka Advance Healthcare Directive)

The caregiving arrangement needs to work for both the receiver and the giver. If it is onerous to the caregiver, then the arrangement is NOT working. Alternative types of care must be considered to avoid caregiver burnout.
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I'd email her doctor in advance about your concerns and ask him to do some cognitive testing. Tell him/her everything your mom is doing that gives you concerns, including how she acts, and add any other relevant information. Tell him she gets really angry with you, too.

I see no value in talking to her apout it at this point if all you two is get into fights. Having the doctor's opinion to back you up would be far more useful.
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Would you feel dishonest NOT telling Mom?

If so, what about pre-warning of a 'general checkup' appointment rather than mentioning the specific concern beforehand?

Or are you worried about her reaction in the Doctor's office?

I imagine Mom's reaction will be a combination of the Doctor's skill in asking in a non-threatening way + Mom's personality + Mom's mood on the day.

Any backlash from Mom later can get the truth:
"I had concerns so felt it was right to speak up, rather than ignore. Because I care".

Edit: Just saw your other post re Mom & caregiver burnout...

This could be an excellent way to intro..

Hello Doctor, I am concerned about Mom as she has a large burden caring for Dad. I was hoping she would be able to talk to you & find out how to improve the situation for both of them. Thank you.
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peanuttyxx, if your Mother is acting real mean it may not be dementia but an Urinary Tract Infection. Have your Mother's primary doctor run a test. An UTI in an older person can mimic dementia, and cause a lot of other issues, like fighting. At least you can rule it out if the test is negative.
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