Undiagnosed parent who is in denial

JC510

So here is my issue and if anyone has any thoughts it is greatly appreciated!

My mother in law has alz/dementia, however, this is only my opinion as she is undiagnosed. She is 77, lives alone and prefers to be alone which I know is a problem, and her symptoms are as follows:

Repeats stories constantly, doesn't remember emails she sent or calls she made, has accused her last 3 maids of stealing from her (a spoon, a roll of toilet paper, soap, nothing of value), she tells my husband and I about certain neighbors who are now very mean to her or act strangely to her (these stories are so outlandish they cannot be happening), she has fallen twice now while walking her dogs and the last fall she was injured. 

There are more, but you get the picture. We recall these things beginning to happen  about 3 years ago, but since they have gotten worse and her 2 falls were both within the last month we know we need to do something. 

One thing I did do was start going to her manicurist about 6 months ago, she sees him once a week and has for the last 15 years. When I came in he said he has been wanting to meet me for quite some time because he has noticed all the same things I have and he is worried about her.

Regarding the denial part, she believes that since she exercises regularly and eats vegetables daily there is nothing wrong with her. She gets very defensive at the hint of any cognitive decline. She keeps up her physical health, sees doctors for that  but the mental is a whole different ballgame.

Ok, so today she is dehydrated, this happens every few months or so, and she is going to get fluids at a hospital. Here is my ultimate question:

Is it wrong of me or my husband to privately tell the doctors/medical staff my suspicions in the hopes they will mention something to her?  Maybe give her advice and suggest she get tested? We really want to talk to her ourselves but she avoids the topic and we don't want to push and allienate her further. Her second fall was yesterday and she hit her head pretty badly, but the paramedics said there was no concussion. We know this will happen again and we don't want her to get hurt.

Sorry for the long post, but any thoughts are appreciated. Thanks!

NizhoniGrrl

What kind of planning is already in place? Who is her healthcare proxy and POA? Whomever this person is needs to get more involved in her life generally to get a better handle on what is really going on. Convincing people with cognitive decline is often a losing battle. At some point there will need to be an intervention, but softly getting involved now is a start.

JC510

Oh yes, I forgot to mention that we have discussed POA and other directives with her re health etc., of course we discuss it implying it is about physical health, and we get no response, or at least no response that's helpful  She believes we are trying to control her life when we ask about it. We are so gentle and try not to push, but she responds with things like it's not necessary and it's not an issue. So yes, I completely agree with you that this needs to happen, it has just been a losing battle.  I even had my dad discuss it with her, explaining that these are the things that he did to ensure that I could take care of him in the future should he need it. It fell on deaf ears. She lives right around the corner so that's good  and we see her often,, but we know we need these things done and we were thinking that getting a diagnosis would be a good first step.

jfkoc

So glad yyou are here...it's a good place for support and info.

I think a key to all of this, perhaps to everything, is the approach.

Directness no matter how "kind" is often met with failure.

Yes, absolutely get information to   your mother's Dr. because the whole process begins with ruling out the causes for the behavior you are seeing. Especially important because some of the possible causes are treatable. Do google so that you can be certain that the proper protocol is followed.

Now regarding legal maters. I firmly believe everyone needs to have their legal lives in order. One possible way to help your mother with this is to get your ducks in a row and have her go with you as you do this. You can even list her as agent and then remove her.

Space within

So glad you are here.  There is so much information and great advice given from this meeting. Although it may have been stated already having to do with the "denial" part. I believe it's hard for all humans to accept that they are 'not okay", or something is "wrong" with them. Yeah who wants to hear that? ha ha .  With dementia the person may truly be unaware of it, or the scary sad part to it, is a person feeling deeply sad, afraid and confused- trying to play it off.   Yes, it's all in the approach.  

Are you able to check in and see her everyday? Or some family member around to take turns until you her in for tests?  With her falling recently and being dehydrated, she may have hidden symptoms going on . 

Wish you the best in getting her the care.

I'm glad you found us. 

Jude4037

I think having your POA done is a good idea and medical POA often can be done at you local hospital. Saying is case the next fall has her unable to talk let’s tell them your thought on it so you don’t have to make decisions for her. It’s up to her. It makes it easier on you also.

Iris L.

JC510 wrote:

Regarding the denial part, she believes that since she exercises regularly and eats vegetables daily there is nothing wrong with her. She gets very defensive at the hint of any cognitive decline. She keeps up her physical health, sees doctors for that  but the mental is a whole different ballgame.

Please read about anosognosia.  This is a characteristic of dementia that causes the PWD (person with dementia) to truly believe she is fine.  She sees no need for doctors, medications or changes in her usual routine.  If you confront her to see reality, she will resist and become upset, as you have noticed.  You will have to use work-arounds to get things done.  Learn from the members. 

Ok, so today she is dehydrated, this happens every few months or so, and she is going to get fluids at a hospital. Here is my ultimate question:

Older adults, not only those with dementia, gradually have a diminished sense of thirst.  Dehydration is common and also very dangerous.  Read about hydration in older adults.  You will have to become pro-active in monitoring her fluid intake, do not rely on her because she will not be able to.  Also, check her kidney function with the doctors.

 

Is it wrong of me or my husband to privately tell the doctors/medical staff my suspicions in the hopes they will mention something to her?  Maybe give her advice and suggest she get tested? We really want to talk to her ourselves but she avoids the topic and we don't want to push and allienate her further. 

Again, you will have to become pro-active.  The members will have good ideas on how to go about this.  Someone should accompany her.  PWDs don't remember what happened at their doctor visits.  Read about HIPPA.

Her second fall was yesterday and she hit her head pretty badly, but the paramedics said there was no concussion. We know this will happen again and we don't want her to get hurt.

Read about fall prevention in older adults.  Falls are common and repeated falls can be a predictor of mortality.

Sorry for the long post, but any thoughts are appreciated. Thanks!

There is a lot to learn.  Keep reading and keep posting!

Iris L.

towhee

If her doctors are talking to each other, that is if they all know that she has had two falls and is repeatedly getting dehydrated, they already know something is wrong and would probably appreciate information from the family. Most people on the board write information down and give it to the doctor before their family member is seen by the doctor. I think doing this would be fine, ethically speaking. Legally, considering Hipaa regulations, you can tell the doctor about your MIL behavior and your concerns and he can ask you questions, he just can not give you information about her unless he has permission from her in some way. Usually, whenever someone has a doctor appointment there is a place on the paperwork where you can list who the doctor can talk to. If you can get her to fill that out then that doctor can talk to you. Or, if she will let you sit in on an appointment, then that is often "permission" that the doctor can talk to you, at least at that particular time. The doctor might be able to help you get her to sign a Hipaa release, it only gives him the right to talk to you, it does not give you the right to make decisions.

She is not going to understand that she has cognitive problems. Use the falls and the dehydration as reasons for testing.

The paramedic decided she did not have a concussion? Must be a very experienced paramedic.

JC510

Thank you to everyone for these replies! I did think about using the dehydration and falls to encourage her to get tested, staying away from the alz/dementia language but just that there could be a neurological issue causing these things. These message boards have been so helpful and I am more aware than ever about how proactive my husband an I need to be, without upsetting her of course. Thanks so much!