Anosognosia - Mom refuses help

Lou107

I am the only living child and live on the other side of the country. Mom (89) has lived on her own for about 5 years since my dad passed away. During that time i have been paying her bills and doing as much as i can from across the country. I first noticed my mom starting to experience memory lapses about 20 months ago. It has become increasingly worse in the last 6 months. It has gotten to a place where she can no longer be on her own without help to keep her medications straight and simply just letting her know day, time, and basics like grocery shopping and hygiene. So 3 months ago I came to stay with her in hopes of getting her help, via a live-in or possibly AL. However because she has Anosognosia associated with her Dementia she refuses all help. She imagines that she is doing all these different activiites on her own like golf, travel, and planning parties but in reality, she does none of these things. She has been spammed numerous times and even bought an extended car warranty for a vehicle she doesnt even own. When I try to tell her what is true, she calls me a liar, says that I just want to put her in a home, and tells me to get the hell out. She has a wonderful doctor but he can only do so much. Other mental health services are incredibly hard to find and the wait times are typically 4-6 months before you can even get an evaluation. I have visited several AL living facilities and my wife and sister in law have looked at facilities in California and Texas. All offer an appealing active community but Mom won't budge. Due to her denial, l started looking at MC facilities but just not convinced she is ready for that. Anytime I or anyone attempts to tell her she needs help, she turns on them. She has become so verbally abusive to me and goes into a full blown screaming rage almost to the the point of physical contact. I am starti g to be concerned for my own health. A person can only take so such and the things she is saying are very hurtful and scarring, just to hard to forget and move on. I know it is the disease but still, a mother should never say those things. I feel that my options are limited with her unwillingness to accept the help she needs. I am trying to do what is right for my mom, even though she doesn't see it that way. I am lost on what I can do going forward without committing her to MC against her will. Hoping for advice from anyone who has experienced this with a aging parent.

Emily 123

Hi Lou,

As hard as it may be to do it, you're going to want to move her closer to whoever the primary caregiver is. If possible, somewhere within an easy drive. You may have to make the move by telling her she's coming for a visit. The MC may become an apartment she stays at while her home undergoes repair.

You can see that her executive ability, the ability to make a plan and follow through, has left her. Because the disease has removed her ability to retain information, she still thinks that she's participating in events because she always has—she can't recall NOT participating, so assumes that her life is proceding as usual, and this is where the resistance comes in. That being the case, what she can remember is very real to her, and she will become resistant when you try to drag her into the here and now decision-making process or explain the losses you see. You will not make sense to her, and she'll become upset. While she may not recall the exact conversations with you, she will hang on to that heightened emotion each time, becoming more and more resistant.

As wrong as it feels to fib to your parent, you'll have to meet her in her reality in order to de-escalate the situation. Stop discussing her care with her around, or talk about any plans to move her, and remove her from the decision making process. Work around her. It won't feel right, and you'll really want her to sign off on the decisions you're making, but that's not going to happen because the disease has made it impossible for her. She is beyond the point of being able to use logic and reasoning because you have to have a working memory to do that. She can no longer determine what's best for herself. The goal needs to pivot to making decisions to keep her safe and, given the anosognosia, her happiness or contentment will be a bonus, but not always something that can be achieved.

It sucks.

Your mom's doctor may want to prescribe something for her as well to help her with her anger and upset.

I would say there are several types of MC. There's the type of AL facility that will only use their MC to house the most debilitated of their final stage dementia patients (You'll hear 'oh, they're not ready for MC yet''), but there are others that will provide support for a variety of stages—some people clearly need the support of MC but are physically in great shape. The first AL type may not be staffed to provide the support that an MC will—as your parent's needs increase they will be too understaffed to adapt to the additional time requirements of their care and your parent will struggle to keep up. The facility may suggest that you hire a private aide to fill the care gaps.

Too, don't forget that a good care home might be an option as well.

Others will give very good advice here. Best wishes.

I found these things helpful:

https://www.smashwords.com/books/view/210580

https://tala.org/wp-content/uploads/2019/04/Tam-Cummings-LLC-Handouts.pdf

https://www.youtube.com/watch?v=awBm4S9NwJ0

https://www.youtube.com/watch?v=coiZbpyvTNg

Moderate dementia:

https://www.youtube.com/watch?v=6cZTgG6kDjs

Careblazers-How To Convince Someone With Dementia They Need Help:

https://www.youtube.com/watch?v=ncKhXQtnyfI

https://www.youtube.com/watch?v=rO50pVUOlbE

mabelgirl

My mom is the same as yours. It is a very tough row ahead for you. Do you have DPOA with medical? If so great, you can make the arrangements for her and then move her to a safe place to live. If not you’ll need to seek guardianship and will unfortunately need an elder law attorney.
It’s very hard to take control over one’s parent. We just have lived too long with them being in control of their self. I found doing this assessment helped me come to terms with what I am dealing with. When I find myself questioning my actions this assessment reminds me I am really not dealing an adult but a child stuck in an aged body. Found at

https://www.tamcummings.com/tools

Although I am one of seven siblings, since I am the caregiver I get the brunt of my mother’s anger and verbal abuse. Medications have helped some and the Dr has recommended more but I’m hesitant to give it to her. It’s weird but at least the agitation is a sign of life, versus the sleeping all day. She still will call my siblings liars if they side with me when she calls to complain but it’s different when you’re in your own home being greeted in the morning with abuse. I’ve gotten better at protecting my mental state but it does stick with you. For this reason I am looking into moving her into ALF. It’s what is best for both of us, because both of us matter.

I pray for your strength for you and peace of mind you’re doing what’s best for everyone involved.

Dingie10

https://alzconnected.org/discussion/69865/anosognosia-mom-refuses-help

I know this is very stressful for you. My mom, who has dementia, was also verbally mean to me, but her doctor put her on risperidone to help with the anger issue. You can check with her doctor to see if this medication would be helpful.

I know it’s hard, but hang in there.

psg712

I'm so sorry that you are hearing hurtful words from your mom. It's unfair, especially when you are rearranging your life to help ensure her safety. But dementia is unfair to everyone , especially the one who has it and cannot perceive her own need for help.

I agree with all that Emily recommends. Would strongly advise that you seek a facility in your home area and move her. Even in a good facility, she will need close family involvement, and it's impossible to see all that is going on if you are a long distance away. If you think she might try to run away from the new place, you'll need to get her in a locked MC. If the idea of MC has already occurred to you, it's probably time.

My mom was unhappy about the move too, but being home alone was no longer safe, even with caring friends looking in on her frequently. I felt terrible about uprooting her from her community, but the reality was that her dementia had already eroded relationships and made it very difficult for her to participate in activities she formerly loved to do. She lasted about a year and a half in AL, then made the transition to MC when she could no longer manage personal hygiene or find her way to the dining room. AL can be scary when you can't understand the instructions for activities or remember to ask for help for a bathroom accident. Mom took to just sitting in her room all day because she had no idea what else to do or where to go. Did not bathe or change clothes and resisted my help to do so. MC has been much better for her.

While she was still in her own home, we went through the extended home and car warranty purchases along with other payments to unscrupulous organizations that prey on the elderly. It sounds like it's time to take the checkbook and credit cards and to disable internet access if your mom uses it. I forwarded my mom's mail to my house even before she moved. She was furious when a clueless mail carrier spilled the beans, but she could not figure out that she could cancel the forwarding order with a quick trip.to the post office. You just have to do what she needs done to keep her safe and let her be angry about it. If the anger is ongoing or escalating, and of course if she attempts to get physical with anyone, reach out to the doctor for some medication.

Nothing about this is easy. But you are doing the right things for your mom. Stay strong and know that we are all here for you.