Mom in Denial of Memory, Physical Mobility and Aging Issues

Dave Cahail

My 84 year old mother who is in AL MC due to VD is driving me insane. Not only is she in denial of her memory issues, she doesn't recognize that her morbid obesity and lack of exercise of many years has contributed to her mobility issues, odd walking gait, deformed (very narrow) feet, and leg discomfort. She has also been breaking and losing teeth - all part of aging as I am told. 

I have tried multiple times to find shoes to fit her odd feet in order to provide more stability and support when she does walk. But nothing is going to resolve her feet form or walking. Now she is complaining of right leg discomfort due to having carried my sister in a cast 62 years ago. She has had two hip surgeries (partial replacements) as well as a knee replacement in her right leg. No way will it ever be normal. I try to explain this but she expects that everything will go back to being normal if she goes to another orthopedic doctor. I am hoping that orthopedic doctor will just tell her that there is nothing that can be done and that it just part of aging. 

She lost one of her crowns today during lunch. Not the first time this has happened. Mom has had multiple broken teeth, bridges, etc. and the dentist has tried to empathize but explain it is part of aging. 

Mom just doesn't like to hear it let alone acknowledge she is aging and she isn't going to be able to do what she used to do. She still thinks she is going to try to go home as she can take care of herself but every time something comes up she calls me for help. She doesn't like the doctor at the AL MC facility as she won't tell Mom what she wants to hear. My siblings and I always tell Mom that she has to talk to that doctor as she is the one person who can discharge her. 

She recently lost all her bras and so I spent the whole day with her shopping for bras. She was so determined she was a particular size and shape - not understanding that was years ago and she has gained a considerable amount of weight since as well as aged. It took several sales clerks and myself numerous times of having her try on bras that were too small for her before she finally admitted she needed something bigger. She also doesn't understand given her size, there are limited clothing options.

I tell her I am doing the best I can to try to help her but she doesn't acknowledge that let alone my time and efforts. I can't be constantly searching for clothes for her or taking her to appointments for things that can't be fixed to a state in her mind that doesn't really exist for the rest of us. 

I have to draw boundaries on how much I can do for her, especially knowing she isn't going to get younger and her mental and physical issues are not going to improve. 

Any suggestions on how my siblings and I might get Mom to understand (especially given her vascular dementia) that life is going to get harder the older she gets and that she needs to do the best she can with what we can do for her? She acknowledges she is lonely too but she was lonely at home before all the hip surgeries and dementia diagnosis. Lonliness is another element that we can only help minimize but her happiness is up to her. My siblings and I can't make her happy. We frequently discuss that she will become more bitter and angry as she progresses. It will become her reality and we just need to set boundaries on how much we can and are willing to be part of that reality. 

Again, any suggestions are appreciated. Thanks.

MN Chickadee

Hi Dave,

You aren't going to "get her to understand," reason with her, convince her, or persuade with logic or evidence. That just doesn't work once a person reaches a certain point in dementia. Many, many people here can attest to that. The brain becomes too compromised to recognize its deficits, and the reality they live in is literally all they are capable of, you have to meet her there. There is even a medical term for it. look up anosognosia. It is completely par for the course with dementia and not her fault. She is never going to recognize your efforts. Her brain does not have the insight for that anymore. In her mind she is fine and you are the one with a problem. You cannot change her mind and the sooner you accept that the sooner you will be able to find what actually works. Workarounds and therapeutic fibs. Secretly replacing clothing in her closet with forgiving ones that will come close to fitting, such as pants in the right ballpark with elastic waist. Perhaps have the bra clerk measure her and set aside some bras of that size, go back later to purchase on the down low and replace what is in her drawer with the right ones when she is out of the room. The dental thing is rough; it often becomes a losing battle and we end up modifying the diet, cutting things smaller etc. if the person can no longer tolerate dental work. She has a terminal brain disease, and as loved ones we have to decide what to treat that will improve quality of life and what to let go and just make her as comfortable as possible. 

Dave Cahail

Thanks MN Chickadee. You remind me that we are on this journey with our LO too - just different perspectives.

Emily 123

Hi Dave,

She may only be able to access memories from quite a while ago at this point.  So her leg hurts and the memory she's pulling up is your sister in her cast.  Her mind does this:  Pain + accessible memory = source of pain.  She may have lost enough of her memory that she thinks she's younger, or can't reason that she's older, and so the bra size she wants is from the age she thinks she is.  Sounds like it would just be easier if you make purchases for her by yourselves and show up with the new items instead of taking her shopping  and getting into situations where reality and her dementia are going to clash.  Her denial and inability to recognize her own aging is not on purpose, but certainly is exhausting for all of you. You're definitely not going to be able to reason with her.  That, and her ability to empathize or feel grateful for what you're doing for her is probably pretty much gone.  It really stinks.

Maybe read this and see what you think: http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf

Cynbar

This is a tough road that many of us have been on.  I think you summed it up when you said "I have to draw boundaries on how much I can do for her." You have set yourself up with an impossible task --- making your mother happy, reasoning with her like a normal person, trying to get her to acknowledge your efforts and her own limitations. It is never going to happen --- her brain is not working right, she can't process anymore and it's like you are speaking two different languages. Let go of the expectations, stop trying to explain. Arguing with her only gets you both more frustrated and angry. You can't make her happy, no matter how hard you try. Set those boundaries now. Limit phone calls and visits, she has staff to take care of her. When she complains, don't engage, listen for awhile with occasional non-committal replies. Buy her the appropriate clothes and shoes, then put them in her room.Sadly, happiness isn't a realistic goal for many people with dementia. Your job is to make sure she is safe and well cared for --- you have done that.  This is a problem that can't be fixed, just managed.

eaglemom

As others have said, you can't 'fix' this for her. No matter how hard you want to, you can't make her understand. Its the disease I'm sorry to say. So going forward keep in your boundaries you've set, making certain she is safe and cared for.

Have you spoken with the orthopedic doctor without your mom? You might try to do that, but with HIPPA the office might be hesitant. You and I can reasonably understand a surgery won't "fix" this, but sadly she can't. If you try to redirect her with something else, what does she do? That is your best bet for now.

eagle

King Boo

A shield, a little bit of a deaf ear, and having a store of deflective validations goes a long way.

Also, loosing the expectation that Mom is capable of in depth reasoning or learning.

"Your hip hurts?  Yes, you were a great Mom to carry sister when she was in a cast.  Does it feel like that?  I heard this doctor is a great doctor, so and so said so, you deserve the best!  She/he's it."

Learning to go with whatever the situation is at hand, no matter how you feel you fell down a rabbit hole, will lessen your stress considerably.

The best answer is the one that brings the most comfort.  To her.  Not you .

Carol Ann K

My DH has become angry with our grandson (29 years old) whom we adopted as our son when he was 3.  DH asked son to move back in our home to help us 5 years ago.  Son is a barber and is very busy.  DH believes son doesn't help around house which is wrong.  When son goes the extra mile DH thanks him then next day says son is lazy and doesn't deserve to get our home upon our death.  We also have a 52 year old son who had a stroke 6 years ago and his wife divorced him after the stroke.  This son has a studio apartment next to our home.  He cannot speak and only has the use of one hand.  Our 29 year old son also helps me with this 52 year old son.  All this being said, I want to know how to react when my DH gets angry with 29 year old son and threatens to kick him out of our home.  His reactions and belief are all wrong.  Today he refuses to talk or acknowledge 29 year old son.  This is very hurtful to son and also to me.  DH and 29 year old son were always very close, until this last 6 months.

JenDod

This string of posts has been a very helpful reminder for me - so, thank you. 

I moved my dad into AL in January. The initial transition was rough, as I expected, but I applied all of the advice I've received. We eventually got through it, and he became more content. There would be the occasional bad day, but they were less frequent. 

A few weeks ago, he became frustrated - and often angry. His mood doesn't alternate between content and angry anymore. I'm assuming his dementia has progressed enough that he has moved into denial of any memory issues. He calls and texts multiple times a day, asking me to come talk with him about moving back home. As many other people have reported, his words can be very hurtful. It's really hard to hold back from trying to even kindly correct him on some of the things he says I've done. However, I know that trying to clarify things or smooth them over would likely just anger him even more, and would absolutely be forgotten the next day - having served no purpose.

Until this recent change, I could still visit my dad a couple of times a week. If his mood turned bad, I could listen & acknowledge his frustrations - and then gradually wrap up my visit. Lately, I can't answer the phone or go visit, because he only wants to talk about why I moved him and when I'm moving him back. He isn't clear enough to know how long it's been since we've talked, but he does sometimes ask why I'm ignoring him and avoiding his calls (only then to use that as a bounce-off to saying "if you would move me home, you wouldn't have to deal with these annoying phone calls" - which is clever, and makes me smile, but isn't enough to wash away the guilt from his other attacking messages).

I communicate regularly with the medical staff at his apartment, and have a video call with his doctor coming up. The nurse at his apartment will join us in the call. I I think he needs a medication change.

I hope that my post will help encourage and remind others - as all of yours have helped me. I needed to be reminded that I'm doing the best I can by ensuring that my dad is safe, in a nice apartment with caring staff, and that he doesn't mean the terrible things he says to me. The person he is now largely isn't my dad anymore. When this all started, he knew I was doing everything in my power to help him, and he told me regularly how much he loved and appreciated me for that. I just have to hang on to that and try not to let his angry calls and voice mails make me feel misplaced guilt.

Suzzin

Carol, you and your grandson are wonderful people. That's a lot to ask from anyone (including your son). I'm hoping your can find time with him to tell him that he's a great kid, that it's just the illness talking. Maybe you can give him space to leave your house, leave his dad's house, and go out and do things that he enjoys. Can you talk to your husband's doctors and see if there is medication to help with agitation and anxiety? I sort of feel like it's triage, that if medication helps calm the one person who is causing damage to the other three then it's worth considering the trade off.