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My husband is his mother's sole caregiver with no other family to assist with her needs. I can go into greater detail about our family situation if it will help anyone to answer this question, but the short version is that my father-in-law passed away 4 years ago and she has just never been the same. She immediately started to show some cognitive decline and has gotten steadily worse. Even though her and my husband have never had anything but a wonderful relationship, she has gotten very verbally abusive. Tells him he hasn't been home and visited her for months (he goes there every day) and that she knows he wants her out of his life. She calls us every evening on an average of 8 times and he answers every time even though he knows more then likely she is not going to be very nice. It's bad enough that this is happening so often, but we have recently found out that she is telling all of her friends and family these things as well. He isn't worried that they believe her, but he is heartbroken by her treatment and I just don't know how to help him any more. If anyone knows of any way to help, I would be very greatful.

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Really a diagnosis and staging is important now. Your MIL shows all the signs of severe dementia. So when she is talking and dialing her phone constantly it is the condition speaking, not really the mother any more. It is time for the complete workup. If there is not a POA in place now is the time to do that as she cannot do that after a complete diagnosis. A Lawyer will examine her verbally to be certain she understands what she is doing.
You will need to gently explain to her that you will speak to her twice a day, morning and evening. Do not answer other calls; be certain she understands how to use 911 for emergency. A daily visit may not always be a good thing, as well. If she requires daily care then it is likely that she is now requiring 24/7 care and time to consider ALF for her. She may actually be better with more people around, and with her son handling finances. It was the case for my brother that removal of the burdens of daily living and finances allowed him to actually IMPROVE mentally, due to just the lifting of a lot of anxiety. And anxiety, coupled with the failure in mentation, may be playing together in you MIL case with the loss of her husband.
Educating yourselves on dementia will help her son know that this is not his mom speaking; the sad thing here is that we lose those we love while they remain right there with us.
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ktscarlt Nov 2020
Thank you Alva, especially for the legal information. We obtained an attorney to help FIL and they did Wills and POAs for them. I am relatively sure we are all set there, but it never occurred to me if she had a dementia diagnosis she would be unable to sign off on other things. There are things that should be addressed. Unfortunately, we have addressed the idea of ALF for her. She was all for it and wanted to go visit some. I did days of research and found several I thought would be good. When we picked her up for the first one you could tell she had already decided she was not going to move in to any ALF. We took her anyway hoping maybe she would see how nice it was (and it was nice) and get a little more excited about living there. This didn't work out. We could barely get her to look at a room. My husband at this point refuses to push her into this decision mostly because she is otherwise physically healthy. Also, since she is running around telling people how horrible he is I think he is concerned people with accuse him of putting her in a facility against her will. But I am going to take your advice and call our attorney first to make sure all of that is in order.
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Two things, when did she have a thorough physical including blood work and a urinalysis?

Next, has she ever had a cognitive assessment to rule out dementia?

Whether she has dementia or not, the best way to respond to inappropriate comments is to say something calm like “I’m sorry you feel that way” then quickly change the subject to something she likes to talk about.
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She has dementia, her brain is broken, and her behavior can’t be helped. The caregiving now becomes making sure she is safe and protected from the bad choices she will make. Is she living somewhere safe? Don’t feel like you need to take repeated phone calls of abusive talk.
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Its called paranoia and a sign of Dementia. I agree with Alva and Ann she needs a good physical and mental work up. To tell u the truth, I don't feel she should be alone.

I also will say, your MIL was probably showing signs before FILs death, he was just covering for her. Dementia does not come on immediately, its a gradual thing. His death may have accelerated her symptoms. My Mom became hard to reason with in the early stage. (She would believe a neurologically challenged 18 yr old (mentally younger) over me) She forgot how to take care of her check book. Overwhelmed easily. I had a very simple cell. Worked like her cordless. When it rang u pushed the button. When done the call you pushed the button. She never mastered it, Eventually she couldn't use the phone or a remote.
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ktscarlt Nov 2020
Thank you JoAnn. Your description of the problems you have with your Mom sound so much like issues we are having. At least one of our phone calls a night is how to shut off the TV or use the remote. I was talking to DH and he mentioned to me that his dad was probably covering for her because he had mentioned to him when he was sick that we should "watch out" for her when he was gone. She would need help. We, of course, didn't realize what that meant at the time.
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Kts- You have gotten some good afvice so far, one question- does your husband have a durable power of attorney for financial and medical?
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ktscarlt Nov 2020
Yes he does.
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Thank you everyone. I am going to suggest a physical to my DH again. He is hesitating only because he has taken her to her GP twice and he tells her she has no more cognitive decline then anyone else her age (86) and that it might be amplified by some depression. However, they never did a full work up on her. This is very frustrating when the doctors you trust don't seem to be helping the situation! DH seems to think the doctor won't talk to him without MIL present, but I think he is wrong since he is on her POA. I think my problem here is not only with MIL but also with DH not wanting to go over her head because...I don't know why.
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Ktscarlt- YOU can have a geriatric specialist do a cognitive assessment, and the result is apt to be MUCH more revealing than a cursory exam by her GP.
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AnnReid Nov 2020
IF there is actually cognitive decline along with behavioral aberrations, the psychiatrist or other specialist may be willing to speak to you privately about her situation.
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Your MILs GP has absolutely NO right and NO business telling you that she has no more cognitive decline then anyone else her age (86) and that it might be amplified by some depression, without having done a cognition exam on her FIRST!!! I don't blame you for being frustrated, either. It's time for a new doctor, a neurologist would be best in this situation.

Your MIL is obviously suffering from some type of dementia which is not 'normal aging' at all, but something entirely different. DH should not be 'heartbroken' by her behavior; he needs to understand that her brain is broken and she's not trying to hurt him on purpose or out of spite. Once she gets properly diagnosed, then he will likely see the light and understand what's happening. Not that any of us 'like' what our demented elders have turned into, but at least we can logically understand WHY it's happening, you know?

Your MIL can be given a simple MoCa assessment exam in the doctor's office which will test her cognition skills on the spot. You'll get a baseline score to see where she's at right now, and you can go from there. She'll be asked to draw a clock showing 3 pm (for instance) on a blank sheet of paper, and this is to test her executive brain function. The EB function is like the conductor of the orchestra; if the conductor is impaired, the rest of the band hasn't a clue what to do. That's how it was explained to me, and it makes perfect sense. When my mother was asked to draw a clock back in 2016, she drew some sort of blob-like thing which didn't even come close to looking like a clock. Right then & there I knew she was cognitively impaired and my suspicions were right. Along with dementia comes some pretty drastic behavioral changes which aren't easy to deal with.......and that's putting it mildly. But my mom lives in a Memory Care Assisted Living place where she's well cared for and I don't have to deal with her histrionics 24/7. Thank God.

Wishing you the best of luck getting a REAL diagnosis for your MIL asap!
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