How to get a diagnosis when person won't go to a specialist and is it imperitive?

Jenmcmur

Hi, this is my first time on this site and posting.   My mom has been experiencing memory issues for more than a year and recently has starting having delusions about her neighbor and calls me nightly to ask where the kids are.   She often thinks she is watching someone's kids or she thinks her adult sons are young and are missing.  She is in complete denial of most of it.  She does acknowledge when I tell her no one is visiting for her to watch because of covid, that she is mistaken, but that is all.

I have to take her to all dr appts now because she gets lost otherwise and have brought my concerns to them.  They have given referrals to neurologists, but she absolutely refuses to go to one.  They have told her that her memory issues that I have told them about are not just age related, but she just hand waves that away. 

My biggest concern right now is that she thinks her neighbor is trying to drive her crazy.   She says he yells all the time and keeps her up at night.  This is especially maddening to me because her hearing is terrible and she wont wear her hearing aids, but this she hears.  (I know this is my problem, not hers.)  I have never witnessed this when I am there and occasionally she will tell me she is hearing it when there is no noise, then we go look for what it may be.  Today she started parking her car in the street between their houses instead of her garage because "he is taking over everything".   She tells me she yells at him and I'm worried that at some point she will either call the police or they will call the police on her.   I've tried to get her to move in with me (I live 5 mins away), but she refuses.  

She also is a big scam target.  She has called me over several times in agony on the phone with some scammer that has said she has a warrant out for her arrest or her grandson has been arrested, etc.   She once even put money in an envelop and dropped at the post office to pay for the taxes for a windfall.  I luckily was able to intercept at the post office before it was mailed.  

Its clear to me she has dementia, but is it that important to get her diagnosed if she is adamant against it?   I have a POA for her but only if she becomes incapacitated.  I'm not quite sure what constitutes that, but I know she will super mad if I try and take over her finances and such.  I talked to the bank and they will allow the POA to take effect if I get an affidavit from her Dr.    

Any and all advice appreciated.

Jen

terei

You could try just taking her to an appointment without telling her prior.   Make sure the Dr has an email in advance describing her behaviors.   

Others may have suggestions about getting her to a dr.

If you cannot get her in to see someone, you may have to be ready to do something at the point she has a crisis.   That might be that she calls the police + gets out of control so you can have her taken to an ER + then to a geriatric psych ward for assessment.    The crisis may be a medical one where she ends up in the hospital where you can arrange to have her seen by someone.    It might also be an accident...auto, a fall, getting lost somewhere, etc.

What ever the crisis is, make sure you have a plan in advance of what you are going to do to have her assessed.  Know where the nearest ER is.  Where the closest Geri psych ward is, etc + be prepared to grit your teeth + instead of going to the hospital to pick her up, insist that she be placed for assessment.

sandwichone123

For most retired people, a diagnosis isn't imperative. In your case, though, it's apparent that your mom needs help she's not getting. Someone needs to be able to prescribe medications or other care because she can't keep accusing the neighbors, having financial problems, driving with poor judgement, etc.

A skill that's often used to help people with poor judgement is obfuscation, or lying. She needs care, so you may need to take her to an appointment without her knowledge, telling her something else entirely (oh look, I need to stop by this office for a minute before we get ice cream).

A diagnosis isn't that important, but better care is at this point.

jfkoc

On the other hand I do think a diagnosis is essential. Dementia can be the result of thinks that are treatable for example Vitamin B deficiency.

Dementia caused by Alzheimer's, Parkinson's etc is determined only by ruling out all other causes. In other words, there is no "test" for Alzheimers.

There are sites online the discuss diagnosis. This is one;

https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048075

Once the likely cause of the dementia is identified it becomes important to know what drugs are either indicated or contraindicated.

Find the best specialist you can to be on your team....it may take time.

If she is against it or you prefer not to discuss the problem with her you can make up a reason to go ie it is for Medicare  or and insurance policy.

Quilting brings calm

I think you already have enough of a diagnosis from her regular doctor.  It was my mother-in-laws family doctor that prepared the statement declaring her incompetent so that my brother in law could invoke the POA that he had.  My spouse also went to that appointment.

[Deleted User]

The user and all related content has been deleted.

star26

The POA may specify exactly what is needed to enact it. Usually it's at least one letter of incapacity from an MD. Put together your documentation to present to the MD. With my Dad, I had to mail it to the doctor from out of state. Some MDs do not like writing such a letter even when the need is obvious to all. I had this issue and there are ways to work with it. If you have the misfortune of needing the letter from a doctor like this, don't accept this as defeat. It's essential you get the letter and start acting on it as Victoria described, regardless of your Mom being super mad. Otherwise, you will probably find yourself in a world of regret later on.  I feel for you - this stage and the scenario you are in is VERY difficult.

Jenmcmur

Many thanks for all the words of advice and support.  I am definitely overwhelmed and at a point where I know I need to do something, but not totally sure how far to take it and know its going to be really HARD.   Great advice by all.  I guess getting the dr letter now is probably smart and starting to take action as well.   My BIG fear is that my mom will get so mad and shut down and shut me out.  That would make things so much worse.   I'm fearful of this next step.   

I'm thankful to have found this forum to learn from all of you.   And I'm lucky that I have siblings that are on the same page with me, just none are close enough to help with other than moral support.   So I do feel like its a big weight on mostly my shoulders.   It hard on my whole family as well, my husband is very supportive and will go along with whatever needs done.  Its also hard on my kids, they see grandma doing weird stuff and they don't really understand why.  I feel like I may need some counselling as well just to get thru this.

Anyway, I'm sure I will be posting more and asking more questions as I wade into this and hope to be able to help others behind me.   Your support is greatly appreciated.

smbren

I had trouble getting my mom to her first appointment.  I chose the doctor carefully.  And due to personal issues with the doctor, I had to restart my search and went with the second choice. 

But then it was very important that I communicated to the doctor what was going on.  In the beginning, this was a fax to the office prior to visits detailing as much as I could.  Now, we have email correspondence.  

But that initial visit, was just called a 'geriatric visit'.  As people over 65 it is recommended they have a geriatric visit.  From there, the doctor helped drive the diagnosis (which we already had) and drive the conversation and direction that should be taken.  It hasn't been an easy path, and is still tough (on me) when we have her follow up appointments (later this week), but it was what I did to get her there.  

I'm not a lawyer, but if you try to enact the POA, think about what your mother will be thinking and feeling at that point.  I can say this as these are things I struggled with.  You need to find ways to convince her to go, or do the white lies to get her to go.  

I don't know what state you are in, but for me, even after the geri pschy appointments, it was a challenge to get her to take the meds.  So things continued to escalate.  I learned from various resources (including an elder law attorney and ALZ resources) what I may have available when things got out of control.  I won't go through that as I believe many resources are state specific.  But I will say, if things get out of control at a given point, you should call 911.  I was very close many times before we brought my mom to the hospital (probably the hardest night of my life).  If you feel she is a danger to herself or a danger to others, that is a definite reason to call 911.  But as for finances, if she is missing a payment here and there, you may be able to use the POA to help, but she will fight you by the sounds of it and like my mom, she is probably socially passable with competency tests.  I chose not to push this as I know how the competency works in my state and I did not want to push that button unless I was sure the court would agree with me.  The state does not want to give up someone's rights, for obvious reasons.  

Your mother sounds similar to what my mother went through.  And you can't really reason with her, and argueing will get you nowhere, but you will need to schedule that appointment and need to make a reason for her going.  Then once there, the doctor will be prepared with the info you sent ahead of time.