Mother-in-law with Alzheimer's diagnosis refusing treatment/diagnosis

Welcome. Do you or another family member have durable power of attorney? If not this should be your number one priority. She needs to be kept her safe even if she is mad and angry about it. It’s not easy! Anger is another symptom. If she is living alone, still driving and you’re not sure about bills being paid then it’s time to step in. I would be more concerned with these things than treatment that may possibly slow progression. Even if she was prescribed this medication is she capable of taking it on her own? Safety first! What good is slowing progression if she is in a car accident. Tell her the car needs to go in for repairs and don’t bring it back. Get a little nosy and go through her bills(maybe while she is out to lunch with a sibling), I know it will feel wrong, it’s an invasion of her privacy, but it has to be done for her. If things are a mess do what needs to be done to get things in order. I have read heartbreaking stories here of loved ones loosing or giving away large quantities of money. Act now before it’s too late. Start making plans for her care moving forward. It sounds like it might be time to consider more care. You will probably never get her to agree to any of this and trying to convince her is only going to make things worse for you and her. Anosognosia is very common with dementia and is the inability of a person to recognize their own defects and symptoms. I have found this to be the most difficult symptom we face with my mom. As my moms durable power of attorney and the one that brings her to doctors appointments, I am also on the receiving end of much anger. We have started her an medication that seems to be helping, but again that’s going to be difficult for you. Some people here have created stories to convince their loved one to go to the doctor. Look into therapeutic fibs. I hope there is something here that helps.

Welcome to the forum. Unfortunately what you are describing is very common. This is a good place to learn a lot. If you look to the right of this page under Quick links and Groups, there is one for new members with a lot of useful information and staging tools. If you read a lot here you can learn a lot as well as get emotional support.

It is common to have to do things for our loved one's safety against their will and without their consent. Your mother in law has anosognosia, in which she can't recognize her deficits and thinks she's fine. You should never remind her that she has dementia.

If there is any family member she trusts, that person might be able to convince her to sign papers for durable power of attorney for finances and healthcare. If she won't, you may have to sue for emergency guardianship, which is a more cumbersome process. Talk to a certified elder law attorney (look at nelf.org). These attorneys can also help you assess her finances and get her qualified for Medicaid if she might need it for long-term care.

additionally you need to disable her car. Slash the tires, unhook the battery cable, have it towed, whatever it takes. Other people's lives are at stake.

You mentioned someone has DPOA. Is it effective now or is there a clause saying it’s only in effect after a doctor has declared her incapacitated? The one I have for my mom gave me authirity immediately. I can act on her behalf. She can act on her own behalf too. So technically my mom could reverse any decision I made for her ( but she won’t). If the one your relative has gives them immediate authority, they can start talking to banks etc.

I wouldn’t worry about the lack of medications to slow the progress. They aren’t all that effective for many people and a lot of people can’t take them due to side affects. I think medications for anxiety and depression would be more important for your loved one at this point. It sounds like she is scared to death that all of you want to put her ‘in a home’. Which, truthfully, might come to pass as she progresses. Especially if she continues to behave in a reckless manner.

Welcome to the forums. There is a lot of good information and support to be found in most of the discussions

The attached checklists (presuming Alzheimer’s) might assist you. Stage to the worst behavior, as that’s what you’re going to base your decisions on. People can straddle stages, or occasionally be pushed to exhibit behaviors that are more advanced by stress or acute illness. I know the nurse in you wants to work with her and allow her autonomy, but the disease has progressed so that she’s beyond being able to compare/ contrast and make feasible decisions. She doesn’t have to face her diagnosis- she no longer has the tools to fully comprehend a terrifying and terminal diagnosis, or plot her own course. When information or reminders of tasks become a trigger for agitation, remove the trigger. That may mean you need to let the person she has the most trust in handle her.

In some ways the short term memory loss can work for you if you can get the person in the door for an assessment. That may require a fiblet, like the visit is required by Medicare, or someone’s worried about their own BP and ‘let’s just run into my doctor’s office to see what it is’, if you can get them out and about. Usually if there’s resistance you don’t discuss plans ahead of time. But it will feel counter-intuitive and disrespectful. However, the goal is getting her help, not getting her agreement. She can’t reason anymore.

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

Please familiarize yourself with the characteristic of anosognosia. This is different from denial. If you or professionals believe that she is in denial, this will delay getting anything done. You must prepare yourself to use the work-arounds that the members have learned to use. Your PWD is not aware of her deficits and limitations. Do not discuss these with her, because she will resist vigorously.

Read all of the online reading material for newcomers, they will give you a foundation for understanding what you are dealing with. Be aware that many, if not most professionals are unaware of the realities of caring for a PWD. Many are unaware of anosognosia, which is a major characteristic of the dementias. Read a lot of threads, post a lot, and rely on the knowledgeable members.

Iris