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Today I filled out the neurologist's intake questionnaire which I have to complete and send in before an appointment will be scheduled. My husband (67) was referred to neuro after I told his primary care physician what I had been noticing in him the past year or two (short term memory loss, inability to focus, nastiness, depression, combatativeness, forgetfulness, etc.). My husband failed several of the cognitive tests the doctor gave him in the office at his recent appointment. I filled out the questionnaire and consulted with my husband on much of it, which sent him into a minor fury as he says he will tell the neuro that he disagrees with what I have been noticing in him. I gave him examples and he denied them all. He said the "issues" I see in him are present because he just doesn't want to bother with things he just does not care about or are not important to him (even if those things are important to me or other people). He claims he ignores and "forgets" anything he is not interested in. He ended the conversation by saying that he is much smarter than he lets others know he is. Is this sort of denial common when dealing with patients in the early stages of cognitive issues? Because, if it turns out that he has just been "playing dumb" from disinterest or apathy these past few years....then we have a whole other problem to deal with. Lastly, this may or may not be significant but one of his doctors noted to another of his doctors in a letter, 7 years ago, that he felt my husband was at risk for vascular disease. We did not even find this out until last fall when we took his records to an endocrinologist that his PCP referred him to for depression, ED, fatigue, mood swings, etc. The endo did not find any problems in blood work done at that time.

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Do you not see the irony in expecting a person with suspected dementia to have an accurate understanding of his dementia and an accurate recollection of telltale events?

If it's not too late, I'd duplicate that questionnaire, let him do his version, and submit it alongside your version. The discrepancies themselves will be revealing.
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Reply to Countrymouse
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I think denial is very common, especially regarding any illness related to aging such as dementia. Ur husband sounds like my dad actually. Nobody wants to be perceived as old and there is also the driving issue. Most ppl don't want to lose their license either so they make excuses and find any and everything to blame whatever on so it won't seem like they shouldn't be driving.
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Reply to Stephanie4181
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I would think that defensive excuse making is common in all of us. None of us want to be held up for examination of our mental capacity. Just the idea that we may have some horrible disease that is going to rob us of our identity is usually enough to set off all the defensive alarms. Add to that the idea that a loved one who is supposed to defend you is seemingly working against you and you have the perfect recipe for depression, anger and defensiveness. See?
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Reply to faeriefiles
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Monica19815 May 17, 2019
Yes.....I see. Thanks for your response.
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I write from the patients perspective. I began noticing I was losing my ability to memorize things back in 2011. I brought it up with the doctors, continually for just shy of 5 yrs. I was told, I was under too much stress, sleep apnea, which I'd been diagnosed with 15yrs before then, etc. I was having trouble learning new airline reservation systems (travel agent 38yrs.) I had soaked that information up easily for most of my career. Then, in 2016, I was fired from my job, for failure to meet goals. Then the doctors took note. MRI, neuropsych exam. Bingo at just shy of 57, early onset ALZ. I never denied my troubles. Finally I had an answer and that was three years ago.
My point is that if you have family, pointing out their own difficulties, and you are told, not to worry, push for more testing. Now, just before my 60th birthday, I'm looking at being 8yrs down the road already, and I keep bringing up differences I notice. I know I'm declining, and people around me keep saying, quit being a pessimist. Denial can come from the other side of the coin. I saw this happen to an uncle and my stepfather. I knew something was wrong. I still know what is going on now. Family be bold and advocate for your family member that believes they may have a problem.
Fortunately for us, my DW and I were doing retirement planning when I was diagnosed and all of the legal issues have been taken care of. I am grateful, for the three years I've had really enjoying life and the relief that has come from having a diagnosis. Yes, memory problems can develop at a very young mid life time of age. Don't put off the things you want to do until retirement. One may not be in a position where they can enjoy it. I am never bored, but there are a lot of things I can not or shouldn't do and I accept it. I pray, that the coin doesn't flip on me, and that I begin a stage of denial. Perhaps this is not an appropriate response to the question, but it had me wanting to bring forth these thoughts.
The sky is blue, the sun is bright, and we woke up breathing. Be kind to the pensioners, if your lucky one day you may be one.
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Reply to jfbctc
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Look up anosognosia and confabulation. This takes some pretty wild turns at times.
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Reply to Segoline
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My significant other has vascular dementia. Denies he has any problems. Common statements from him are: "I'm retired, so I don't have to know the day/month/year," "I don't care about that (something that is really important to him), so why would I remember?" This has been going on daily for 12 years. With each memory failure he acts as if it is a one time only problem. Doesn't remember that it just happened an hour ago. Is surprised when the same thing happens an hour later.
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faeriefiles May 21, 2019
I would probably be the same way except I'd point out that I have never been able to remember today's date, people names etc. I was born air headed when it comes to details.
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My husband was relieved to have the diagnosis of Alzheimer's. He said it gave a name to what was going on in his head.
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jfbctc May 21, 2019
Hi MaryKathleen,
I too was relieved when I got my diagnosis. I thought finally, I know I'm not making things up, I know I'm not crazy. Thank you for sharing your husbands thoughts with me.
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Sometimes it's so hard to trust modern medicine. My dad didn't want to tell the Dr anything either.
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Reply to Tiger55
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I believe denial is on everyones plate. As noted in another response, no one wants to have age issues or think they are old. My brother was in denial for many years. We did discuss his dementia with him. He was a little snippy in the early stages, but now he accepts it and kind of understands it. The other day someone asked him how he was and his reply, "I am doing great, but they tell me I have dementia. I think I might because I always forget things". He is in advanced stages now - no violent behavior unless he gets backed into a corner by the aids or nurses. Then he just yells - he has not struck out yet. Some times he just doesn't want to go with the program of the day...
I think you have to weigh out the persons personality and stage of dementia in order to discuss it without creating fear. They know something is wrong, but can't figure it out. I found with a lot of love and interaction my brother accepts his fate... There is a class on dementia that gives you a reality box you strap on your head. It creates everything a dementia patient goes through. I think this should be a mandatory class for all caregivers and family. It was an eye opener to actual live this disease for an hour or how ever long you can take it.
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Daughter2951 May 21, 2019
Explain the reality box, please.
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Monica, before I read these responses, I was going to say I don't know if it's common, but it certainly is valid. My mother did the same exact thing. And the same thing as paulat585 above this response.

She says she's fine - doesn't matter she doesn't know what she had for breakfast. It's denial based in fear. But as another poster suggested, look up anosognosia. The behavior is likely a common reaction and indicator that something is wrong.

I wish you luck. I wish us all luck.
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