How do you talk to people who are in denial of their dementia?

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My mom is seeming to be in denial of the fact that she can no longer remember all the important details of her life. Do I just go with it? Do I try to convince her and bring her in to the present moment? It's kind of tiring having conversations again and again, as many of us know. And then there are times she seems to be somewhat aware of what's going on and that things are slipping through her fingers and yet she wants to know about everything but has a hard time accepting it all when I tell her. Confusing.

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So - my opinions, my experience, for what it's worth, here goes...

We went through a lot million-question-marathons of argument/denial at the beginning until I learned how to answer once then postpone the discussion. I chose not to lie (I'm bad at it, don't want to, & he's a human lie detector). I did learn to answer once, then answer with "maybe" to a lot of stuff rather than arguing. The hardest thing for me was not to try to "fix" the dementia by correcting the mistake. I realized this is what I was doing -- I somehow thought if I could just CONVINCE HIM of the truth he would be OK...not rational on my part, but there you are.
The "follow their reality" thing IS hard, and dementia isn't across the board - sometimes they know "our" reality, sometimes not, sometimes they have the sneaking suspicion that something is wrong from reading social cues from others ( like kids ---"Mom's mad...does she know about the vase?"). Especially aggravating is that once a "wrong" idea is in place it is IMPOSSIBLE to dislodge (no matter how unlikely/impossible/etc), while the "right" ideas seem to slip away like they are teflon....for us logic-based personalities it is crazy-making!

So...explain things patiently, and sympathetically. Be consistant, it IS a test. Early dementia patients KNOW something is wrong, and often their memory can be better than they let on. In our best discussion I spent a lot of time explaining (simply) that what his brain was doing was normal (even the denial), and that his brain was trying to protect him (which made sense to him). I found it helped both of us if we talked about his brain in the 3rd person, the same way you might talk about kidney disease or your liver, rather than referring to "him", as it helped make it a bit more clinical and not accusatory. He had studied human thought, philosophy, etc, as a hobby in the past, so that helped. We even discussed that the hallucinations might be his subconscious' way of communicating to him. Am I SURE what's going on in his synapsis? No, but it's as good an explanation as any, made sense to him, comforted him and made him less afraid of them.
OnlyDau64, in addition to the advice given LauraAnne, keep these two thoughts tucked away to take out as needed: 1) Do not take this personally. It is the disease, not your loving mom acting out. 2) IT IS NOT YOUR FAULT. It isn't mom's fault, either, of course, so there isn't any place here for accusations or guilt.

Whatever it takes, STOP HER FROM DRIVING. Backing into a friend's car was bad enough. What if she'd backed into a neighbor's child? Contact DMV to get her license revoked. Remove the car from the premises, take the keys away -- yes, she'll be furious and her anger is likely to last a long time. But it has to be done. No more driving. This means other means of transportation must be arranged. Her not driving is certainly not something you'd do for your own convenience but you must do it for public safety.

Hi LauraAnne, Has your Mom received a diagnosis or are you observing the changes? How old is she? It took me a while, but I now feel it is better to go along with things. Your Mom's reality is what she is expressing to you . . even if it is her life from when she was in her 20s! I visit my Mom 5 days a week. She is in an ALF. She points out her brother (long deceased), tells me I just missed her long time friend (equally long deceased), etc. BUT this is where her mind is, and guess what! They are all (fortunately) good memories for her!!

Your descriptions sounds like early stages to me (though I am far from trained in this area). Use this time to make sure all the proper paperwork is completed. POA, medical authority, someone's name on accounts, etc. My Mom was demonstrating "cognitive impairment" at the beginning of 2011. By June, she would have been considered unable to sign papers. I just made it through with paperwork at the bank that has made things 1,000 times easier.

Make sure there isn't a medical reason (UTI or thyroid issue) or drug interaction before you just accept the behavior.
Go to dept of motor vehicles and ask for a form because of circumstance and take to doctor to say it is no longer safe for ........ to be driving. This is what I did for my dementia husband. Yes he didn't like it and a couple times I left the keys in ignition, like getting gas, that is a BIG NO NO. He got behind the wheel and I refused to get in the car. Luckly via phone our son talked him out. Read all you can to help you both. I think of his brain as a loose light bulb, sometimes on & then off. My husband now sleeps 16 to 19 hrs a day. He showers and asks if he can lay down because he's tired he says. So give extra time to them if you are taking them someplace. He eats slower and walks slower also. He can still play cards but when he begins to ask what to do in cards its time to quit. His dementia has been very slow changing. He asks same questions and I just answer like its first time he asked. If I would sometimes make a corrective remark I'm learning DON'T RESPOND and soon forgotten and no argument which means no frustration on him.
Geewiz has given you some good advice. Reasoning and explaining does not work with someone whose is losing her ability to reason and understand.

If your mother has dementia she will have it the rest of her life, and it will progress. Waiting a few weeks for a formal diagnosis, aggravating as it is, won't change anything. In addition to the paperwork geewiz suggested, you might use some of this time to read up on dementia. Odd behavior is really much easier to deal with when you can put it in context and understand how it fits the disease.

Best wishes to you on this bumpy caregiving road!
my mom is deteriorating rapidly. every pill time its, count, recount, find the med list, drop some of the pills, etc. always someone in the yard on a bicycle, quad or motorcycle. one or both of us are nuts cause i just dont see the people. when ( if )she eventually goes to NH i think ill go to the va stress unit and babble at those poor folks for a week.
Butterfly4, the doctors are right. A person with short term memory loss and dementia cannot safely live alone. Actually, her "safety" cannot be guaranteed anywhere, and she won't be 100% "safe" in your home, either, but it is a matter of degree. Her safety level goes up exponentially if she can be somewhere she will be monitored.

My mother agreed to move into the home of my sister who was just retiring, but then she balked at the last minute. Another sister took Mom aside. "You know, Mom, Sis and BIL are having a harder time paying their mortgage now that they both are retired. They have been thinking about renting out their lower level. You would be doing them a huge favor if you could move in." And she went on to list the benefits, not the least of which is my sister's excellent cooking!

This helped Mom think of the move in a whole new way, and got her through the transition period. She stayed with Sis for 14 months, until her care needs increased. She is now thriving in a nursing home (Age 96, dementia.)

The "they need financial help" message was a total fabrication, by the way. But Mom did pay the same rent she'd been paying for her subsidized apartment. I think all adults should have the dignity of paying their own way. Not necessarily at full market value, but at a reasonable level they can afford.

I guess my point is, if there is some way you make the move more palatable to Mom, do it, even if it means lying through your teeth!
It is possible for people with dementia to have anosognosia. It is a inability to recognize that they have a problem with their minds. My husband, who has dementia has anosognosia. I thought it was denial, until the doctor explained it to me. It's not that he doesn't want to face the facts of his illness, it's that he is incapable of realizing he has cognitive and memory problems. The doctor can look him directly in the eye and say, "You have dementia. It is going to get worse.", and my husband has no more reaction that if the doctor had told him that he has a cold and will be well in a day or two. The part of my husband's brain that recognizes that he has an illness is one of the several parts that are no longer functioning. When he asks me what the various medications he is taking are for, I tell him that they are for his memory, and he almost always replies, "They must be working, because I don't have any memory problems." This man could not tell you what year it is or how old he is or his address if his life depended upon it. He can't remember that he ate lunch five minutes ago. But somehow, he also can't remember that he has dementia. Taking care of someone with dementia is like living in the land of Oz.
Hi, I am in a similar situation as LauraAnne. My mother has not been diagnosed (yet) but is showing all the signs--not paying bills on time, making poor decisions, being very argumentative with me (only child), going behind my back to undo things I've done to help her, lying to her credit-card issuer that her card was lost (or not remembering she had cut it up) to get a new card after she agreed to close an account and cut up a card in my presence...and on and on. She's still driving, though I've been told she's likely to be dropped by her insurer as she's had numerous fender-benders (which she has hidden from me)--she didn't notice that she'd backed into her friends' car in the last incident until, upon returning home, she received a phone call from them informing her of the situation. I am awaiting results from memory testing she was to have had done early this week. She threw a temper tantrum Sunday (Happy Mothers' Day!) and I left the house because she called me a liar and accused me of 'just trying to get control of her money' and 'taking advantage of the POA'. I am glad to find this forum.
There could something besides dementia, such as a UTI or other infection, but if you can't get her to a doctor, there's no way to tell. I would take it seriously though. The problem is that you can't force her to a doctor.

Do you have a list of things that you personally know about her ability to care for herself? If not, I'd take the day to spend with her to make sure you can inspect what is going on inside her home, such as is there spoiled food in the fridge, unpaid bills, dirty linens and clothes, utilities turned off, insurance canceled. That's a biggie. If she is an unsafe driver and her insurance has lapsed, it could be a tragedy. I would confirm her insurance is paid up. I might talk to neighbors too, to see what they have noticed. My cousin was doing odd things in the neighborhood.

Once you get that information, I would continue to try to get her to the doctor, by saying it's required by social security or whatever, but I would take that info with me to an Elder Law attorney to see what is required in that jurisdiction to file for guardianship. At least you'll know if you have enough evidence, based on what you have seen.

You can also report the situation to Adult Protective services and they will investigate.

If you don't think she should be driving, I would contact DMV in her state and see if there is a provision to report an elderly, unsafe driver. Some allow that be done in confidence. They will require her to come in for a test. Maybe that can resolve it.

I'm not sure what else you can do. Perhaps, you'll get more info here. My loved one resisted care at first, but she would see a doctor and the doctor and I convinced her to enter Assisted Living.

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