Dementia

[daepp]

My mother's was certainly exacerbated by the illness and death of my father.

That said, she definitely has dementia. Not only was it diagnosed, the unbelievable shallow short term memory is no grief - she simply does not remember what happened a few seconds ago.

[tabs]

"Not only was it diagnosed," That set it in concrete....


Here is another possibility..the ordeal of going through the traumatic events of losing a long term life partner might cause so much strain in a person of advanced age that phyisical deteroiation does occur....that is kinda what I was leading to when I said you cave in....

However anyway U wana cut it....U should be thoughfull and sensitive in your evaluation and not jump to a conclusion before you give some time to sort out the facts.

[daepp]

Tabs - are you aware of the actual testing process?

Over several visits over 6 to 8 months, memory etc tests are given repeatedly. It leaves little to subjectivity.

And the arisept (sp?) if anything just stabilized her - no reversal.

[dd74]

Originally Posted by flatbutt

Arisept...

That never worked for us. But each case is different.

[HarryD]

Originally Posted by tabs

At 90+ what the fk do ya expect...there is going to at least be some physical deterioation. Most people are lucky to be still drawing a breath at 90

Agreed. they had a good run. Lived independently until 5 years ago. Still, the declineis painful for both me and my parents.

[widgeon13]

I have gone through it w/ my mother and now the early stages w/ my MIL, it's never easy or pretty. You have to determine if she is in any danger of injuring herself in this situation. If she is living alone, perhaps she can continue for a while with some assistance. My mother was having memory problems, not eating properly but she always denied it. She would go out looking for my father who has been dead for 19 years and had a serious problem with falls in the house. She finally broke her hip and had to go in the hospital, then rehab and from there to assisted living (skilled nursing) dementia unit.

It was very stressful for my older sister who was the major caregiver as she lived close by. It's very difficult to deal with and let me say I had numerous discussions / arguments with my mother before we made the decision to get her in skilled nursing. As much as it was against her will, it was the best thing for her health and care. She is now 97 YO, is doing much better as she is also on a medication that helps to mellow her personality.

It was and is a very stressful situation but she is better in the place she is presently and we are not constantly concerned for her wellbeing. Each situation is unique. I would recommend if there is someone who can come into the house to give an evaluation.

We also went through the process of taking her car away a number of years ago, actually we didn't take the car, just the keys so she couldn't drive. She was very offended that we thought we knew was was best for her.

I would be happy to try and address any specific questions that you might have based on my personal experience.

It is the most difficult situations that I have had to deal with and I will leave it at that, far from being a laughing matter.

[RPKESQ]

Dottore,

I feel for you. My mother went through Alzheimer's. It started slow but increased it's tempo after only a short while. What was most painful to me was occasionally seeing the stark fear in her eyes when she could realize something was wrong but could not figure out what it was.

She went from a feisty, highly motivated super woman to a totally dead to the world, unable to do anything (speak, stand, sit, respond in any way, etc) bit of still living flesh that she remains today. Why and how she still lives is a mystery.
The last 10 years have been hard on us all, especially my Father.

Remember that this is a very scary time for her, but she needs you more than ever. You need to be the one to make the best choices for her. She cannot.

Good luck and let me know if I can help.

[tabs]

Originally Posted by DAEpperson

Tabs - are you aware of the actual testing process?

Over several visits over 6 to 8 months, memory etc tests are given repeatedly. It leaves little to subjectivity.

And the arisept (sp?) if anything just stabilized her - no reversal.

In your mom's case I would say the evaluation was right, but that does not always make it so...What I am saying is give it some thoughfull evaluation before coming to a conclusion...there are other possibiliites..especially if this just reared its head in a short order.

I had an Aunt that lived in Worcester MA who was in her late 80's. she would call me up at 3 Am her time and tell me about her lost cat (she didn't even have a cat at that time), and her special peeve was that her DIL and Son were stealing from her..I knew form the get go that her mind was going...the reason for her failing mental abilities was that her heart had slowed down to 30 beats a minute before they put a Pace Maker in..that lack of oxygen caused her brain deterioration which only really started to show up several years later...she finally passed away when she was just about 91...

One interesting thing was that her mental state of mind at the end was an exacerbation of her earlier peculiarities. So one might say she fell into her own paticular madness.

[Jim727]

Dottore -

Very sorry to hear that you are facing this. My mother used to say "getting old is not for sissies" - sadly, 'tis true.

We have been through this as well with my MIL - alzheimer's. Good advice has been given here, hopefully I can add a bit.

First, for your own mental well-being you need to steel yourself to the reality that what you have now is as good as it's going to get. She might become the nicest or the meanest person in your world, but whatever you get you can't take it personally. It's harder for you than for her.

Second, no car. You didn't say if she drives, but there is nothing good for her on the road. Lose the keys. Disable the car. Whatever it takes.

Third, now is the time to find assisted living for her. Do not wait until you need it - good facilities have waiting lists and you don't want to get near the bad ones. When evaluating assisted living, cost is not an indicator of quality - the first evaluator is your nose. If it doesn't smell good, run away immediately. The second indicator is how the staff relates to the residents. Some treat residents like objects, some like valuable people; guess which you want. Ask to be introduced to a resident - if they don't know patient names that's a warning flag. Ask how they treat incontinent residents and how often they are bathed. Incontinence is not out of the picture with dementia, and how the facility treats the incontinent person speaks volumes about their care methods. Also, look at dining facilities in the unit. Some look like they are meant to be hosed down and others look like a Marriott. The really good ones will invite you to a meal in the dining facility. Ask about no-notice visitations. If they want you to make an appointment, that's not good. Look at their activity lists, haircut and bathing schedules, etc.

We also went with a facility that had skilled nursing in the same building. When the time comes that skilled nursing is required, you don't want to have to start the research/wait cycle all over again. We used Heritage Club in Colorado for my MIL - they were half the cost of a dreadful place and the care was outstanding.

If your mother is living alone she will deteriorate faster than if she has an active social life. That's one of the reasons why assisted living can be so valuable. Television is a lousy companion and definitely mentally passive (and deteriorating). Good assisted living will prolong her quality of life significantly. In our case, the assisted living gave my MIL a much better standard of living than she had at home with part-time caregivers and at only a marginally higher monthly cost.

My MIL was an inherently unpleasant person and also would not take advice from anyone. She would, however, respect her doctor's opinions as an authority. We managed to consult with her doctor and start the process of nudging her in the direction she needed to go. Kicking and fighting, as it may have been, at least we were able to gain a slow step-by-step progress toward the concept of living somewhere else. She never bought in, but I think it helped a great deal.

The move was "interesting". She was adamant that she would not go - even though there really was no option to let her stay alone at home. We stopped trying to talk her into the move and just did it. To ease the transition, my wife took her to lunch while I moved her most familiar furniture into her new room. That way she had some familiar items as comfort items. Once in the facility she rebelled for about a month, but then forgot that it wasn't "home" and actually ended up enjoying her new friends. That part, at least, was rewarding.

Last, I encourage you to review finances and legal options. Unfortunately, we had to go the full court-appointed conservator route as her parents did no planning whatsoever. Not fun - I recommend getting a trustworthy attorney familiarized with the situation early. If you don't need much help you have bought peace of mind; if you do need help you are ahead of the game.

I much prefer your fantasy of life in old age. Let's hope we get to do it that way.

Wish you the best.
Jim

[dd74]

Originally Posted by RPKESQ

Dottore,

I feel for you. My mother went through Alzheimer's. It started slow but increased it's tempo after only a short while. What was most painful to me was occasionally seeing the stark fear in her eyes when she could realize something was wrong but could not figure out what it was.

She went from a feisty, highly motivated super woman to a totally dead to the world, unable to do anything (speak, stand, sit, respond in any way, etc) bit of still living flesh that she remains today. Why and how she still lives is a mystery.
The last 10 years have been hard on us all, especially my Father.

Remember that this is a very scary time for her, but she needs you more than ever. You need to be the one to make the best choices for her. She cannot.

Good luck and let me know if I can help.

Is she in France with you? I wonder how the French medical system accommodates Alzheimer's patients.

[pwd72s]

Originally Posted by DAEpperson

My mother's was certainly exacerbated by the illness and death of my father.

That said, she definitely has dementia. Not only was it diagnosed, the unbelievable shallow short term memory is no grief - she simply does not remember what happened a few seconds ago.

My mother in law was so far gone that the death of her husband of more than 60 years meant nothing.

A few days after he died, she asked: "What happened to the nice man who was here?" When told he'd died, all she said was: "That's too bad...he was a nice man." This said in a tone as if discussing a rainy day...

[tabs]

I also had a friend who at 56 was diagnosed with having an early onset of Alzheimer's...in the end what it turned out to be was a nervous breakdown that mimiced Alzheimers.

[blk911]

Dottore,

I feel for you, going through this with my dad right now. Mom died three years ago but before she went she kept telling me "you better keep an eye on your father, he's losing it". We thought she was just old cranky whatever, fact is, he functioned pretty well while she was alive because she kept him busy and because she required his full time care, he had a purpose and she was giving him direction. Right after she passed, we could see something not right with Dad. Dementia causes inability to follow directions, short term memory loss, impaired judgement, and a number of things. There are actually several forms of dementia and sometimes Alzheimers is present as well. No cure, no reversal, but they can slow it down and perhaps control unwanted behaviors somewhat if that is an issue. Tests are simple, I was there when they administered them, basically asking questions in a conversational fashion. Best bet is to get her to a Board Certifiied Geriatric Psychiatrist that specializes in memory related diseases.

Is she the surviving spouse of a war time veteran? If so, check with the Veterans Adminstration about benefits under a program called Aid & Attendance. Assisted living is not cheap, but cheaper than your sanity. Very difficult to deal with a loved one, they are no longer who they used to be. Be happy to answer more questions or whatever, just PM me.

Blessings,

Mike

[RPKESQ]

Originally Posted by dd74

Is she in France with you? I wonder how the French medical system accommodates Alzheimer's patients.

No she is not in France with me. My Father cannot bear to be very far (15 min. away) from her. And my Father doesn't have a passport and hates to travel anywhere outside the county he lives in.

I travel to see my Mom about 3-4 times a year. Of course she doesn't even know anybody is there.

In France her care would be 1/4/ the price with equal level of quality. And that is with private insurance as she is not a citizen.

[JavaBrewer]

Keeping this thread on track...

Dottore, I can only offer sympathy. Have not experienced this personally but with my aging parents (77 and 74) feel something like this is just round the bend.

Best,
David

[turn9]

Originally Posted by Dottore

So with my father recently deceased, my mother is slipping into an increasingly deep fog.

Her short term memory is deteriorating rapidly. She asks the same question 20 times. Tries telephoning her girlfriends on the TV remote control. Is incapable of looking after her finances. Constantly misplaces things and blames others.

She is seriously batty in other words, but categorically refuses to accept this.

We want to drag her to the doctor for a dementia test —but will have to do so kicking and screaming.

Anybody been here before? How comprehensive and involved are dementia tests? Are there any meaningful treatment options? How do you actually get someone to the doctor who is in complete denial?

What a drag it is growing old....

Dottore,

First of all, my sympathies for your loss and ongoing problems with your mother.

Her symptoms could all be secondary to severe depression, almost unavoidable after the passing of a spouse. She needs evaluation and therapy ASAP.

If she had another underlying condition, an acute depressive event will make that condition worse until the depression is treated.

Good luck to you and family,

T9

[Dottore]

Jim727: Thanks for that thoughtful post. And thanks to everyone else as well.

Have done a ton of reading on all of this over the past couple of days, and all the issues are coming into focus.

I realize now how long we have been in denial about my mothers very serious health issues —always wanting to believe that her behavior was simply a manifestation of the eccentricity of age.

Time to roll up the sleeves and make a few changes.

Cheers

[widgeon13]

Good luck, it will be one of the most important challenges of your adult life, it was for me.

[peppy]

Dottore, I have been lucky as I have 2 older sisters that have done great with my mother ( she has Alzheimer's).

Getting our mother to go and start having the tests was a bit of a struggle, it was a long process.

As far as drugs mom has had good luck with Aricept and Namenda. From what I have read these two drugs are used for dementia as well as Alzheimer's. (they just slow down the disease, they do not reverse or cure)

Dottore, we were all guilty of denial with my mom.

[Milu]

I'm another one in the club.

There are drugs that slow down the symptoms a little but they only help a little.

My mother was reasonably ok until about a year ago. Six months ago it started to be a concern and I hid car keys and her handguns (don't ask!). I placed her in the same carehome as her sister for a month before Xmas to see how she got on there (for the future) and for physio therapy for an orthopaedic problem. The place is excellent but She hated it. On her doctor's advice I organised a part-time nurse for her, she subsequently declined again and I'm now organising full time live in help and reorganising her home.

Progress is being made in understanding and medication but it sure ain't easy.