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My wife has dementia and won't follow orders from the doctor, the nurse, or the physical therapist. Would it help if I told her that she is fading away and should follow their advice to prolong her life, or is that being cruel?

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Dementia: If you told her she would forget that you told her. Show her your medications and you both take them at the same time. Have her work with you on filling the 7 day med tray together !!! If she needs to exercise, have her watch you exercise, and ask her to join you. Show her that You Want TO Live !. and live.
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