Two Elderly Parents with Different Cognitive Issues?

vwtyler · January 15

Hello, all. I found this group months ago, but only finished the registration process last week. All of what I have read so far has been so supportive and helpful, and I've already received my copy of The 36-Hour Day. Thank you all so much!

The family (except my mom) started noticing more cognitive decline with my dad (89yo) about seven years ago, and at that time, with both parents' consent and the help of their attorney, took all actions to get the correct documents in place. I have DPOA, am on their credit cards, etc., and now handle almost all of their financial and administrative matters (my brother handles a couple of things too, informally). My mom (87yo) has never been involved in those things, and refused to step up (I understand, she's a different generation).

They moved into a retirement community (independent living) at the end of the summer in 2025. My mother was VERY reluctant to leave their home, but seemed to understand that we needed to have them be at a retirement community, to protect both of them in the future. Since then, I have seen noticeable decline in my mother's cognition and mental health (her internist, after talking to her, put her on an anti-depressant about 3 weeks ago). Her ability to understand most things is at this point, better than my dad's, and for example, she isn't forgetting words or concepts (my dad has lost many words and concepts).

My dad is doing pretty well, while of course still going downhill. He's happy and settling in. My mom is not, and continually talks about wanting to be at home (their old house). She appears to be in denial about my dad's cognitive decline, or can't tell. She really wants to go to Florida for three months in the winter, as they used to, and within the last several weeks it's a daily + call to me about why I'm not letting them do that (they can't drive there, don't know how to get food, etc.). I am taking them there for two weeks in February. My mom is bullying and stressing my dad (and me) about all of this. I tell him that he can leave the room, or leave their unit and walk around the (inside of) the community if it gets too much, but he's got his own issues and doesn't really understand.

For my mom, I have tried reasoning and arguing, before realizing that I need to be dealing with her like I do with my dad, and avoid either of those. I sympathize that she's unhappy and frustrated; I remind her that change is increasingly difficult for my dad; he tells her that he doesn't want to go to Florida, but he's doing it because he loves her; I try to change the topic with her to "let's plan what we'll do when we are in Florida."

Bottom line, my mom is focused on herself and what she wants, and doesn't seem to be supporting my dad. And my dad is living with her, being increasingly worried and puzzled about her, while trying to operate in a world that he's slipping away from.

Any suggestions for how to manage my mom's behavior and feelings, and support and help my dad at the same time?

H1235 · January 15

Welcome. Dementia can look very different depending on the person. Has your mom seen a doctor. Things like lack of empathy, lack of good judgment, depression, trouble with logic and reasoning, problems with executive functioning are all dementia symptoms. Another common symptom is anosognosia. This is the inability to recognize their own symptoms or limitations. Many people mistake this with denial. This can be very dangerous p, since they may put themselves in a situation they can’t handle, trying to do things that may cause them harm. From the description of your mom, Im seeing a lot of these things. I will attach a staging tool just in case you haven’t seen it. I took way too long to recognize theses symptoms in my mom. My mil with dementia presented much differently. I would send her doctor a note about the things you are noticing and try to get her evaluated. If she is also struggling with dementia, she is not going to be able to care for your dad and keep him safe. I wonder if an Al facility (maybe with two rooms next to each other) would work better for them. I’m glad you found us.

DBAT.pdf

Anosognosia and Dementia - AgingCare.com.pdf

Quilting brings calm · January 15

My mom had the classic symptoms of dementia. My step-dad did not. He just started acting even more stubborn and did things out of character. It didn’t help that he had only an 8th grade education and a 3rd grade reading level. Mom was diagnosed through observation, scans and a ten minute MMSE test. I finally got my step-dad referred to a neuropsychologist who did the 2.5 hour testing.

Both your parents probably have cognitive issues/ but have different types of dementia. It’s hard to deal with two of them at the same time. You’ve done the right thing in getting them into a safe environment- but you may need to start looking for a higher level of care before long. Assisted living.

The best way to handle your mom is what keeps your sanity - change the subject or just flat out end your visit for the day with whatever excuse you come up with. You can’t make her happy and you can’t make her understand why living on her own isn’t a safe option. You so don’t have to answer the phone every time she calls.

vwtyler · January 16

Thanks for your helpful comments.

Yes, my mother has seen a doctor, her internist (he's the one who recently prescribed the anti-depressant). She has so far refused any memory / cognitive testing, though he has repeatedly asked her to go through simple initial testing. To a certain extent, it doesn't matter; we know that she's declining (except that she's always been a bit self-centered).

Yes, I could decide to not take her calls, but sometimes my dad calls using her phone, and I don't want to not answer him. I have ended calls with my mom when she's gone on too long saying the same thing. It's self-care for me. And I'm ok with being the target for her anger or blaming if she focuses on me instead of my dad. I'm a target because I'm more involved in the decision-making than my brother (I'm a corporate attorney and oldest child, so the obvious choice to be, as I tell them, their "administrative assistant").

Yes, AL or MC are future possibilities. My hope, in addition to those, was that they could stay in the independent living unit for as long as safely possible, with as much help as they need coming in on a daily basis. Those are decisions for the future, based on their deterioration.

Thanks for providing the attachments. I had already downloaded the DBAT (my brother and I are each going to fill it out for each parent, then compare), and the other pdf was a helpful read.

SDianeL · January 16

https://alzconnected.org/discussion/comment/263631#Comment_263631

sorry about your parents. You have received excellent advice already. One thing that I would worry about is your Dad being able to leave the apartment on his own. There have been several elderly people with dementia living in AL who wandered off recently. One they haven’t found yet. One they found deceased from exposure. An AL isn’t a locked facility and the care isn’t 24/7.while MC is. In my opinion the caregivers in MC are better trained to care for dementia patients. I think your Mom also has dementia. If so, she is unable to care for your Dad.see if her doctor say the test is required by her insurance as part of her wellness check. I would worry about you taking them on a trip. Change of routine and unfamiliar places cause anxiety in PWD. The last trip I took with my DH was not good between his anxiety and my stress. If you are doing this to try to make your Mom happy you may be causing your Dad unnecessary anxiety because he already said he doesn’t want to go. Could you hire someone to stay with your Dad while you take your Mom? Something to consider. Please keep us posted.

Two Elderly Parents with Different Cognitive Issues?

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