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My mother who is 82 has been declining for several years, it started with repeating herself and now has progressed into having what I call timeline issues. For example things she showered yesterday when it really has been two weeks. Do I confront her with the reality? I tried to talk about it and she denies anything is wrong. She refuses any medical tests including basic memory tests from the doctor so we cannot get an accurate diagnosis.

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Today actually went pretty well. I used the "eyebrow twitch" to let Rn know something was up when mom said something,, so we could ease into it. So when Dr came in he asked her about "anything else besides the pain bothering you?" She told him I was worried about her memory, used the "I am 88 " excuse,, but he was very sweet in explaining that there is forgetfulness, and then there is memory loss that can affect your independent living.( as in taking care of herself some, he knows she lives with us) . Like your pills, your rollator and exercizes ,, etc. He told her there are some tests they can run,, she asked if HE could do them, and he said yes. So we're thinking about it.. not an outright rejection. We don't mention ALZ, just memory decline. I actually don't care what an official diagnosis is,, the end result is basically the same for most dementias. I just want us all on the same page
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Has she asked directly?
If she has you can honestly say since you will not go to the doctor for tests we don't know for sure.
But will she remember that? Probably not
If you tell her she has dementia will she remember that? Probably not.
She wants to know she is safe.
Her world is shrinking. She will be happier with smaller groups, with familiar places. Less noise and confusion.
Confronting her with reality...her reality is now totally different than your reality. As difficult as it is try to "go with the flow" and pick your battles. Dig your heels in when it is truly important. And you will find that there really isn't a lot that is TRULY important.

You can get aids that are great in getting someone to shower if it is difficult for you. The CNA that helped with my Husband while he was on Hospice seems to have the "magic touch" when it comes to getting people to shower or bathe from the stories she told me. (I asked because this comes up in the support groups I go to and I asked if she had any words of wisdom)
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Do you have a signed Durable POA and Healthcare POA? I'd try to make sure those are in my possession as you move forward. The reason being that it's more difficult to work on her behalf and promote her medical care, if you don't. But, if you have that, I might focus on getting her a regular check up with her primary.

You can give her doctor the heads up before hand. I typed up a list of my observations to the doctor, so she would know what to look for when she sees the patient. The right doctor can conduct an office eval in a very calm and nonthreatening way. The doctor can also check for infections, medication issues, nutrition issues, hormone problems, etc. The doctor may be able to rule out other causes for the cognitive decline. And, if appropriate, he can refer her to specialist or place on medication if she would benefit from it. Some types of dementia don't respond to medication. She might resist, but, it just takes trying different things to get them to accept. Things coming from her doctor might be easier for her.

That's what I focused on with my LO. Her doctor wanted her medications administered correctly, proper nutrition, physical therapy, proper rest, etc. I reinforced that all of this would help promote better health and memory. So, even though, her doctor told her that she had dementia, she didn't really understand what it meant. And, I didn't keep mentioning it either, because, she would have forgotten it. Even when the neurologist told her that she had dementia, she just said that she didn't want to lose memories of her parents, but, she seemed to forget about it a little while later that day. She never mentioned it again.

So, even if you tell her, there's no guarantee that she will accept it, believe it or even remember it. So, to me, it just depends on what works for your situation at the time. Getting through each day with the LO being protected and cared for, is really all you can really hope to achieve. Getting a PWD to bathe, is often an ordeal and is addressed with different strategies. Having them understand, process, accept and work with you on things......I suppose it happens, but, I don't see it that often.
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Angec, I would not suggest your tell your Mom that she has dementia, that would only terrify her if she understands what is dementia.

Any time my Dad would call me saying he can't remember something, I would tell him I have that same problem, too. Told him that as we age that the file drawers of information in our brain are full, and sometimes the drawers get stuck :) Got Dad laughing so that made him feel a bit better.
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I’m in the same place. After losing my dad to ALZ, my 85 yr old mom is now showing more concerning signs of dementia. She absolutely denies any issues and can also be “normal” for the short doctor office visits. She has agreed to see a neurologist and completed an MRI and will be taking cognitive tests In a couple of weeks, if only to prove me wrong. She doesn’t like me going to doctor visits because she only wants the doctor to know what she wants him to know. I’m still going to every visit and also sending notes to her doctors about behaviors and events. At this point, the diagnosis will be more for myself than her. I need to know where she is and what to expect so I can plan her future. She never remembers what the doctor tells her anyway. She doesn’t have to accept the diagnosis, but it will give me the needed authority to execute my durable POA and medical POA and start planning her care for the years ahead.
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Evelyn48 May 2019
I like your response. I'd like to know if when you send notes to your mom's doctor does he respond to you himself? I've send notes to my 92 year old mom's doctor over the last 4 years as she has undiagnosed dementia because she refused to see another doctor he was referring. I never receive a direct response, he has an assistant call me. For example with his changing a prescription due to information in my note, I receive no information on how the medication work's, side effects, etc. I have become more frustrated with him as my mom's condition has progressed over the last few years.
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This is the typical. You can't talk with her about it. Just agree with her. And in sone states POA's can't be issued as the person authorizing the POA (your mom) has to be of right mind. I petitioned the court & was ordered guardianship.
What you can do is tell her the doctor appointment she set a month ago is tomorrow or in a couple of days. That she wanted to make sure that she made her appointment because medicare wants to be certain she gets her annual exam, etc.
Redirect as much as you can.
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It amazes me how my mom would seem totally 'normal' when drs or other people would speak to her for a short time. I had my mom accessed in her own home, I told her it was my friend coming for a visit. My mom denied any memory issues, I just say we all forget things sometimes when she's anxious about her memory.
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Overthehill May 2019
I recently went to a 2 hour workshop on Alzheimer’s and this very thing was discussed. For some reason these “patients” can act perfectly normal when going to a Dr. or when visitors stop by. The social worker actually denied care for my friend’s mother for this very reason! Yet it takes 2 people to care for her 24/7 because she can’t be left alone. Eventually it got straightened out. The workshop was by the author of the book “The 36 Hour Day”...a must read for anyone who is a caregiver of someone with dementia.
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I wouldn't try and confront her with anything, even the sound of it sounds like an argument waiting to happen. If you were able to arrange a home visit from someone who could do an assessment they would be able to do the tests without her even realising they were taking place, alternatively perhaps she could "accompany you" to the Dr and he/she could talk to her without her realising it was actually her appointment. I don't know what you would hope to achieve by confronting her, it isn't something she can do anything about, and will simply sound as though you are criticising her for something she may know but not want to accept. Good luck in finding a way to get her an assessment, but it isn't going to change a lot for you regarding having to deal with her situation.
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I/We do the opposite actually and find it very helpful. When loved ones/clients realize that something is wrong and that they're no longer the same person, I just assure them that I/everybody forgets too and that is normal. Whenever I visit our clients, I always share with them how I keep forgetting where I put my eyeglasses and what I did yesterday. They'll smile and I find it very sweet that they just start reassuring me that it's ok as long as I don't forget to visit them. A little white lie isn't bad if it will make them feel better. Giving them stress or something to worry about will not help.
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Jannner May 2019
I totally disagree with you on this. I have a number of chronic illnesses and I can tell you someone knows when their body is not behaving normally. If anything, they may be too polite or kind to tell you, but if anything you are creating more stress. They know it’s not normal and you are lying to them which is more stressful. You don’t have to use the words dementia or Alzheimer’s but don’t say it’s normal, it’s not.
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My husband’s diagnosis is”mild to moderate cognitive decline“ of the sort that frequently develops into Alzheimer’s. When asked about it, he says he feels great and there is nothing wrong with him. But he also frequently mentions that he used to be good at something and now can’t remember how to do it. I usually respond with something like, “Yes I know! That’s so frustrating, isn’t it?” Then I tell him, “That’s why we’re working with your healthcare team. The part of your brain that knows how to do that is broken and we’re all trying our best to find ways to fix it. Meanwhile, I love you very much and I’m here to help.” Also, I try to lavish appreciation for the things he does to try to help — even though, after he empties the dishwasher for me, I have to wait until he’s not in the room, and find where he put things so I can find them quickly when cooking. So many little things during the day that can be irritations if I invite them to be. I try to remember to instead remind myself that it truly is caused by a broken brain that is losing brain cells at a rapid rate, and not by his “not paying attention” or “being self-centered” or “not listening to me” or “not caring about anyone but himself” or any of the other judgments that are so easy to fall into. My mantra: “Whatever I focus on is what I’m going to get more of.” So it only makes sense to focus on keeping things pleasant and non-combative rather than on all the ways this makes us feel cheated. I came up with this reminder “poem”which may or may not have relevance to anyone else. Related to my choices: (1) To resist or to face this disease head-on and stride down the path courageously and (2) To whine and entertain self-pity or to invest in self-care and acknowledge and protect my inner strength and power to make it through this, as I have made it through many other tough things in life. It’s a simple two-liner:

“I’m a strider, not a limper; I’m a shout and not a whimper.”

Seems to invite my inner Wonder Woman to take over while my inner Eeyore takes a long and restful nap.
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vicky64 May 2019
Love your Mantra "Whatever I focus on, I will get more of"!! And so very true!! When I was upbeat with my mom, she reflected that back to me, sort of!! When my attitude was one of discouragement, so was hers!!  Which, of course, becomes a cycle!!
Thank You!!
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