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No diagnosis. Beginning to question my sanity here. In telephone conversations she shifts from topic to topic and I get confused. yes me! I can't follow it. She can, in the same converstion, say two opposite things.
Example: I am going home from hospital tomorrow. (she really is in the hospital now) and then two seconds later, says I am going home today.
Does misplace things and thinks that the woman who comes in is putting them in different places. Who knows?
She bought 10 disposable gloves. I explained she would get five uses out of them. She had trouble comprehending this. Then got it
Says I am lying or that I am accusing her of lying. This is not so. Cannot convince her of this.
I hate even putting this out there. Family doesn't see it. They say it is just her nerves. Is it? Or they say: well, she is old and it is normal in old age.
Thank you.

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Um, Trying, I'm go back to reading your post more carefully but end stage CHF and vascular dementia go hand in glove. And the only thing you can say with certainty about its progression is that it is random and unpredictable. I am sorry to say. What was the event that put your mother in hospital this time, exactly? And what is anybody saying about discharge plans?

What in the blazes was the thinking behind not telling your mother about her heart condition? Whatever happened to informed consent? However. There it is.

Your not wanting your mother to suffer and not wanting her to die makes perfect sense to me. Exactly so. I wanted my mother to get better. I wanted her to have a chance to recover. I knew very well that these ideas were unicorns, but that's what I *wanted.* Knowing that something is impossible, having wants that are even mutually exclusive, may not be rational but then we're talking about your emotions. Rational don't come into it.

You must feel very frustrated with your family's approach, I should think. I don't know if this will help, but however haphazard and shambolic their way of going about things is, you could keep in mind that even if everyone was all-knowing and efficient and lovely, they still wouldn't have the perfect answers. So the difference it makes is less than it feels. I don't know what's the matter with me this morning, I'm all over the place, but I hope you know what I'm getting at: your mother isn't missing out on a perfect answer that would solve all her problems, because there isn't one. The surrounding muddle is hard enough to cope with but at least you don't need to fear that it could be making a material difference to the outcome, which I hope is some comfort.

But meanwhile what you're going through is a horrible experience. Typically, in late stage CHF, micro strokes caused by compromised blood supply to the brain create the piecemeal disintegration that you seem to be looking at. Depression, anger, loss of inhibition could all be part of that picture; so could loss of balance; the not being able to make the simple calculation about the gloves, again, that fits. Finding the right combination of therapies is incredibly difficult, and especially so if there isn't a family and medical team consensus on what the key priorities are. At this point, given what you've said about the wider family's feelings, I wouldn't be very optimistic about arriving at one, either. For your own sake, it might be better to step back from that and let them do things in their own way, rather than try to take charge. Suggest practical ideas by all means, help where you can, but your mother put your brother in charge, that's not your fault, and I doubt if challenging it now is worth the battle. It's a great pity that there wasn't more preparation and teamwork established earlier on; but then it's wholly understandable. We only get one shot at handling this situation, where we're supporting our parents towards the end of their lives: how can we possibly be expected to get it all right?

Towards the end of her life, in the last months, my medically qualified daughter shifted her approach to her adored granny. She stopped contributing nudges and suggestions to the medical team (she'd made two highly effective interventions earlier on), and instead kept to two main themes: commiseration with anything that was bothering my mother, and exuberant love and approval. Maybe the best thing you can do for yourself and your mother is keep giving back the love she always gave you in bucketfuls, just as you are doing, in spite of the times when she rebuffs you or acts out. She isn't herself, but you can be yourself. Hugs to you, please keep posting.
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My turn to cry. I wish I had understood much, much earlier on how all of the baffling little things that happened were to do with brain symptoms: I would have been so much kinder... or so I tell myself.

Anyway. This is a link to a learned article but one with good, practical recommendations once you get past the Doctor-ese language: hindawi/journals/crp/2012/595821/ It explains how improving your mother's lifestyle and support at home will improve her health, her heart function (possibly) and therefore her mental state, for example - aiming for a virtuous circle. Please, please don't go looking for miracles; I'm just hoping it will point your brother in the right direction. The better your mother's heart failure is controlled, and the better the support she has in daily life, the easier it will be for her to manage mentally too.

The Alzheimers Society supports people living with all kinds of dementia, not just Alzheimer's Disease; so that might be a good place to look.

The American Heart Association at www.heart.org has articles about cognitive impairment and vascular dementia. One point that comes up immediately is that mobility and exercise are important to brain function. I expect that's why your mother's hospital team are leaning towards protecting your mother's sense of balance by not giving her anxiolytics - that is, because they are trying to keep her mobile as far as possible. Everything's a trade off, they're not ignoring her mental state, they're just prioritising her physical one.

You're not supposed to feel hurt? That your lovely mother is ill and suffering? Er - yes you are! Of course you do. Being strong doesn't mean not being upset. Be kind to yourself, too.
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Your description sounds familiar to me. I saw things like that, but couldn't make sense of it. I talked to some health care workers about it too. They were coming into her home due to a fracture in her foot. They gave me various explanations and shrugged it off. Her medical doctors didn't notice either. If I had been reading this site then, I would have put two and two together and sought an evaluation. Nonetheless, if it is dementia, it will likely progress and then the behavior becomes quite apparent.

I would keep watch and check on things she reports. Verify her contentions for her own safety. Confirm she follows up with medical care, medication, paying bills and that she isn't eating spoiled food, wanders or gives away her savings.

I would make sure you have her Durable POA, Healthcare POA and Living Will so you can act on her behalf down the road.

I have heard some people talk about VERY apparent dementia behavior in their loved ones and they are in complete denial. I think some people tell themselves anything to put off accepting dementia in their loved one. Sadly, it may take a crisis to get their attention.
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And so it begins. You are NOT going crazy, you are recognizing the first symptoms of dementia and your mother needs to be tested. To hell with the other family members, you can tell them you told them so when it becomes fully blown.
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For whatever reason, the one you care for and whom you suspect has some dementia will be on their best behavior and put on a "show" for doctors and the family members that do not see them on a daily basis. In my opinion, this is very common and it takes an "out there" episode with the others before they will believe what you are experiencing. Start keeping a journal and try to stay sane.
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Yes, it IS possible to be the only person in your family to suspect Dementia, I too was in that position. My "family", sister & her adult children, were horribly abusive towards me, as I pursued getting my 94 year old Mother to her Dr. for testing for Dementia. Her Dr. did the usual testing to rule out any vitamin deficiencies, or other reasons for her behavior. He then sent us to a Neurologist for further testing. She was diagnosed in Stage 1 of Dementia/ALZ. At the time she was diagnosed, my sister & her kids didn't accept it, and as I tried to move my Mom into Assisted Living, they put her & I through hell trying to do it! My Mom had made me her POA many years ago, which infuriated them all, but with that in place, and with the support of my hubby & kids, I moved her. Before I got her moved, her behavior was pretty bad. She was hoarding spoiled food, verbally abusive towards me, refusing to take meds, accusing people around her of stealing items she misplaced in her apt. Fast forward 1 year later. She did well in Assisted Living for about 6 months, and then it became apparent her needs couldn't be met there. So, I searched for a Memory Care facility, and didn't inform ANY of my family of this decision, until I found a place & signed the lease. I then informed them via certified mail. My Mom has been in a beautiful, loving, memory care facility for 2 weeks and I have seen a DRASTIC improvement in her! She's pleasant now, very little agitation, she eats well, she laughs again, and mostly, she's healthier then she's been the past few years! My point, go with your gut and push aside any person that gets in your way! You know your loved one best and you are their only true advocate ! I thought I was helping my Mom for years, but in hindsight, what she needed I didn't get her until recently. For years I ran around like a crazy person trying to do everything I could for her, but I finally realized, I wasn't the one who could really help her, her needs we're much greater. Please, please, don't go through the hell we both did! Seek out a great Nuerologist & have her tested. The worst thing will be that your wrong, but if your right, you will be doing the best for your loved one by accepting it, and moving forward.
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Totally stinks about family dynamics. If she is telling you the truth about her situation more so than the person with the POA, why not ask her if she prefers to change her POA...those are changeable. Could be to you, a friend or whomever....also, document the instances of behavior. Date, time, circumstances, was she calm, aggitated, not feeling well, like that. Iver time there will be a pattern and this can help later on. Also what the solutions seem to be. Good luck
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It is quite possible for the "actress" in your mother to come out in front of your siblings and her doc. A friend of my late mother's said "from all perspectives, your mom looks very well." However, only I knew she was demanding to live alone, was 94, legally blind, had CHF and A-Fib and a BP of 60/40.
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Llamalover47, excellent point about the "actress" in one's Mom. I never realized that my Mom was experiencing dementia as she was always putting on a good front any time I saw her, when talking on the phone, or visiting the doctors.... I figured she was doing great at 97, same with my Dad at 94.

When my Mom returned from a short hospital stay due to a fall I hired caregivers to help give her a break from all the daily chores... after 3 days she wasn't having any more of that, and she asked the caregivers to leave.... [sigh]. I said ok because I thought she was still of clean mind.

Another fall happened, this time very serious, and I finally felt comfortable enough to snoop around my parents house. I was surprised to find past-due bills, and other strange things that indicated my Mom wasn't thinking clearly. Boy, she had me fooled.
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You don't say how old mom is. As one ages, it's not uncommon to become forgetful. And, heck, I had a sister in law who was always accusing her housekeeping service of stealing this piece of jewelry or that...until she found it. And SHE was only 45. Just absent-minded.

You're only mentioning hospital behavior. Could be the temporary effects of whatever put her there...or her medications may have been changed. I've found meds are almost ALWAYS changed when one is hospitalized.

If you are the only one noticing it, maybe you are being unnecessarily hyper-vigilant. Sounds like you live a distance away. Hopefully the other family who DOESNT notice it sees her in person.

Stay alert. Keep mentioning your concerns...document them so you don't forget them. In the end, unless you can convince whoever that she should be evaluated, you may have to not-so-patiently wait for her symptoms to begin to obviously interfere with her everyday life.
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