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Mom is 91, post stroke, chf and repaired broken hip. She was dxed with Vascular dementia after the stroke and mild cognitive decline a year before that. She also has aphasia from the stroke, so often it's hard for her to tell me things. She mentioned today that in the last two days, she's had an "episode" of "not knowing what to do next". She wasn't able to elaborate, but I asked if it was like when you're driving around a corner and suddenly nothing looks familiar for a second. She said yes, it was like that, so we gave it the name "brain freeze". Is this a symptom of something? Mom has a DNR and DNI and we're pretty much done with tests and procedures.

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Ha! - [holding my hand up and waving excitedly] - I know this one! - "initiation" or "motivation" centres, I've heard them variously called. I'm afraid it's just another chunk of the sponge filling up or falling off or however you visualise the vascular dementia (though personally I think of it as whac-a-mole because you never know where it's going to pop up next).

I was grousing to Dr daughter about her granny's sulking over food: I'd put the plate in front of her, she said "that looks nice", and then nothing happened. No movement at all towards eating it. When I asked mother why, she literally did not answer, not a word - I now understand that this further complication happened because she couldn't understand the question because she wasn't registering that there was a problem (this all gets very complicated, sorry), but at the time I was nothing like so sanguine about it. Comically infuriated and tearing my hair out, more like, I should think.

Anyhooooooo, far from being a wind-up merchant who was intentionally annoying her poor long suffering daughter (me), daughter explained that mother was having a problem with "initiation." The brain sees the sandwich, the person fully intends to eat it, but the critical message from brain to hand to get its arse into gear and pick up the food fails to get sent. I had accidentally discovered that if I picked mother's hand up and placed it on the plate (I'd thought maybe she couldn't see to do that) she could then complete the movement; but she couldn't start it off, was the point.

If your mother is the sort who finds it reassuring in itself to know what the heck is going on, I hope that will help - it's a tiny bit of brain that isn't working. I suppose - I haven't found one yet, but I'm working on it - if you can find prompts and cues that start her off with whatever she's wanting to do at a given moment it might be a way round?
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Babalou, this sounds like a TIA to me, which would fit with her diagnosis I think?
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You know, as I typed a family email last night about this, I said to myself, "someone on AC will know the answer to this", and wasn't I right!

Cwillie, yes another TIA, I'm sure. I was about to muse to mom, "oh maybe you've had another little stroke", but I remembered just in time that the last time I said that, mom's face filled with terror and grief and she said " I've had a STROKE?". Reassurance seemed to help.

CM, my gosh woman, we're so alike with being pleased at knowing the answer! Consider yourself the gold star pupil for your lovely and detailed explanation. Mom is in a nursing home where they take good care of her. I'm going to speak to the APRN tomorrow about this so that they can keep an eye on prompting her to eat if needs be. THANK YOU BOTH!
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