Is it possible to be the only member of my family to "suspect" early dementia?

Both the good news and the bad news is that your mother is in the hospital.

You don't say how old she is, but just being in the hospital causes profound disorientation among most elders. So that might be a factor.

Are you her medical poa, or have a signed HIPAA form so that you can speak with her doctors about your concerns?

Have you spoken to the discharge planners at the hospital? Are you in agreement with her coming directly home, to be cared for by you, or has a rehab center been mentioned to get her back on her feet?

In terms of diagnosing dementia, the only way to determine that is to have her evaluated by a neuropsychologist and neurologist. They will do several hours of cognitive tests, tests of language processing, reasoning, memory, balance, perception and motor skills.

The symptom that you mention, saying that people are hiding things, is something that is frequently heard in dementia patients. No, that is NOT normal aging.

You don't say how old mom is. As one ages, it's not uncommon to become forgetful. And, heck, I had a sister in law who was always accusing her housekeeping service of stealing this piece of jewelry or that...until she found it. And SHE was only 45. Just absent-minded.

You're only mentioning hospital behavior. Could be the temporary effects of whatever put her there...or her medications may have been changed. I've found meds are almost ALWAYS changed when one is hospitalized.

If you are the only one noticing it, maybe you are being unnecessarily hyper-vigilant. Sounds like you live a distance away. Hopefully the other family who DOESNT notice it sees her in person.

Stay alert. Keep mentioning your concerns...document them so you don't forget them. In the end, unless you can convince whoever that she should be evaluated, you may have to not-so-patiently wait for her symptoms to begin to obviously interfere with her everyday life.

Thank you.

Your description sounds familiar to me. I saw things like that, but couldn't make sense of it. I talked to some health care workers about it too. They were coming into her home due to a fracture in her foot. They gave me various explanations and shrugged it off. Her medical doctors didn't notice either. If I had been reading this site then, I would have put two and two together and sought an evaluation. Nonetheless, if it is dementia, it will likely progress and then the behavior becomes quite apparent.

I would keep watch and check on things she reports. Verify her contentions for her own safety. Confirm she follows up with medical care, medication, paying bills and that she isn't eating spoiled food, wanders or gives away her savings.

I would make sure you have her Durable POA, Healthcare POA and Living Will so you can act on her behalf down the road.

I have heard some people talk about VERY apparent dementia behavior in their loved ones and they are in complete denial. I think some people tell themselves anything to put off accepting dementia in their loved one. Sadly, it may take a crisis to get their attention.

Sunnygirl: Thank you so much for your reply. I have a brother who has POA and refuses to share any information with me. My mom is a little afraid of him as he shuts her down when she speaks. He gets annoyed quickly and easily when she repeats things. He does the doctor thing and does not share with me and my other sibling. I keep my distance as he is difficult and controlling. I am carer for my Mom but not in her home. I send in a cleaning woman. I do the cooking and shopping for all needs. I check in daily with her. She is almost 89 years old and is very agitated, frequently angry, and suffering in end stage Congestive Heart Failure. I have many concerns. Twice now she has been hospitalized for either failing to take or taking too much of a drug. It's is not just the conversations. She does not think people are hiding things; she thinks they are misplacing them when they go in to clean. I have tried to get home care in on a regular basis and she is not having it. In hospital, they at first decided she needed in home care now. Then they thought a nursing home for a time. They believe that she cannot be alone. Then (and I know this is an insurance/money issue), they have decided to send her home in a few days. She has fallen many times, been to hell and back with surrgieres, a stroke, a heart attack, etc. I pray for an easy end and pray for her to live at the same time. I truly hope that IF it is dementia that it moves VERY slowly. There are too many things to list, but all I can say is that: she is closest to me and pours her heart out to me; she has to hide it with the others as they, both of my siblings told her they don't want to hear it. I listen, but then she will misunderstand me or something and I try to explain myself and to her I am either "lying" or "not caring" or something. All confusing. This is a 180degree turn around from who she was all her life ... a loving, wonderful and caring Mom and my best friend. Now, we are more often on the "outs" than not. This hurts because I need her to know that I love her. I don't want to put her in a nursing home. When I suggest in home care, she yells at me "would you like to have people come into your home?". I do understand this, too. I am sorry if my original post was not clear. She passes those quick tests that ask: who are you, where are you, etc. But , I have read that in the early stages, they do pass these tests. I am concerned now becaue in the past few weeks it is progressing more than before. She does not realize that she is ill with CHF. Family kept this information from her. Then hospital told her her heart is very bad and her heart rate and A-Fib is off the charts. So its a minute to minute thing here. I don't want her to suffer and I don't want her to die. Make any sense? She is just so angry ... and now this anger is expressed at other people besides me, but mostly me. I try very hard and apologize all the time (wrong or not) to keep the peace. Yesterday, I called the hospital and said "Hello, I love you". She said "Why are you calling". I said "to talk". She yelled "she wants to talk! *(&(&. This is NOT her. She is agitated badly and I know it. No one is listening. They wont give her an anxiolytic to calm her down because they say she will fall. She falls anyway and I wonder if the falls are not just from the extreme weakness that comes from congestive heart failure. Sorry for the rant and thank you for listening. I am going to try to visit her in home and do some breathing exercises with her to relax and some meditatioins. I try to reassure her .. I try to help her talk about the past .. the good old days but then she compares them to now and she is so very upset.
Thanks to all.

Family dynamics can be quite challenging. You know how much you and other family members can stand and what will cause you to take action. Apparently, numerous crisis have not made much of a difference.

If your mom has been taken to the ER twice due to improper medication administration, then I would be very concerned. It's not even a close call when it's that severe, IMO.

Frequent falls can be related to mobility issues, but they also often accompany Vascular Dementia. My loved one had many falls and fractures and that's one of the major things that indicated she was in trouble. The reason is that VD causes severe balance issues. They can tip over for no apparent reason. AND the judgment leaves and they think they don't need a walker or that they are able to go up and down steps alone. Their judgment leaves them and they take unnecessary risks.

Since your brother is POA and he is being secretive and not advocating for her care, I might question why. Is there some financial bias? Would she be a self pay person at an Assisted Living or nursing home facility? I would consider his motivation of non-action. Do other family members agree with you? It bothers me that your mom is afraid of him. That is concerning.

I would consult with an attorney who regularly handles Incompetency/Guardianship cases in your county. I would find out about the process, the proof needed, etc. That way you know what you would have to prove to file and get guardianship. That would trump over the POA and the guardian would then make the decisions if mom is deemed incompetent. If you nor anyone else in the family wants to do it, the court can appoint a third party who has been pre-approved by the courts to be the guardian. They would decide where mom lives and the care she gets.

It could cause a lot of hard feelings and discord in the family, but it is one option to attempt to protect your mom when no one else will. I wish you the best. Please post how things go.

Thank you again. No, no money at all. He loves her but I do believe he is burnt out and in denial. She will not go to doctors with anyone else. I have offered. In any case, they would be unable to tell me anything. This happened a number of times when I went to ER and to surgeries with her. Dysfunctional families are really bad news. Another factor is that she "pretends" with them, and then tells me how she really is. She told me this. I once called him when she complained how poorly she was feeling (chest pain) and he said "well I spoke to her and she says she is just fine". I have read that UNTIL a person is incompetent you cannot take any action and, of course, I would not want to. It's a tough place to be. Thanks again.

For whatever reason, the one you care for and whom you suspect has some dementia will be on their best behavior and put on a "show" for doctors and the family members that do not see them on a daily basis. In my opinion, this is very common and it takes an "out there" episode with the others before they will believe what you are experiencing. Start keeping a journal and try to stay sane.

If she is indeed incompetent, she's not likely to tell you that she is and ask that you step in and make some hard decisions. Most of the time they are uncooperative, disagreeable, stubborn and insistent. The patient exhibits their inability to make good decisions by their actions. That's when the adult children realize that they know better than the parent. It's sad, but it's the truth. I think some adult children just can't make that call. They keep relying on the parent's word, even when it's obviously not prudent.

I would consult with an attorney who regularly goes to court in these types of cases. They know what the courts look at and what proof you need.

I see.

thanks again for all your answers and for taking the time to advise me on this. I cannot do POA as I am quite ill myself. I will have to find some way of handling this. The sad thing is that none of the doctors see it and I read where sunnygirl posted "it often sadly takes a crisis".

Um, Trying, I'm go back to reading your post more carefully but end stage CHF and vascular dementia go hand in glove. And the only thing you can say with certainty about its progression is that it is random and unpredictable. I am sorry to say. What was the event that put your mother in hospital this time, exactly? And what is anybody saying about discharge plans?

What in the blazes was the thinking behind not telling your mother about her heart condition? Whatever happened to informed consent? However. There it is.

Your not wanting your mother to suffer and not wanting her to die makes perfect sense to me. Exactly so. I wanted my mother to get better. I wanted her to have a chance to recover. I knew very well that these ideas were unicorns, but that's what I *wanted.* Knowing that something is impossible, having wants that are even mutually exclusive, may not be rational but then we're talking about your emotions. Rational don't come into it.

You must feel very frustrated with your family's approach, I should think. I don't know if this will help, but however haphazard and shambolic their way of going about things is, you could keep in mind that even if everyone was all-knowing and efficient and lovely, they still wouldn't have the perfect answers. So the difference it makes is less than it feels. I don't know what's the matter with me this morning, I'm all over the place, but I hope you know what I'm getting at: your mother isn't missing out on a perfect answer that would solve all her problems, because there isn't one. The surrounding muddle is hard enough to cope with but at least you don't need to fear that it could be making a material difference to the outcome, which I hope is some comfort.

But meanwhile what you're going through is a horrible experience. Typically, in late stage CHF, micro strokes caused by compromised blood supply to the brain create the piecemeal disintegration that you seem to be looking at. Depression, anger, loss of inhibition could all be part of that picture; so could loss of balance; the not being able to make the simple calculation about the gloves, again, that fits. Finding the right combination of therapies is incredibly difficult, and especially so if there isn't a family and medical team consensus on what the key priorities are. At this point, given what you've said about the wider family's feelings, I wouldn't be very optimistic about arriving at one, either. For your own sake, it might be better to step back from that and let them do things in their own way, rather than try to take charge. Suggest practical ideas by all means, help where you can, but your mother put your brother in charge, that's not your fault, and I doubt if challenging it now is worth the battle. It's a great pity that there wasn't more preparation and teamwork established earlier on; but then it's wholly understandable. We only get one shot at handling this situation, where we're supporting our parents towards the end of their lives: how can we possibly be expected to get it all right?

Towards the end of her life, in the last months, my medically qualified daughter shifted her approach to her adored granny. She stopped contributing nudges and suggestions to the medical team (she'd made two highly effective interventions earlier on), and instead kept to two main themes: commiseration with anything that was bothering my mother, and exuberant love and approval. Maybe the best thing you can do for yourself and your mother is keep giving back the love she always gave you in bucketfuls, just as you are doing, in spite of the times when she rebuffs you or acts out. She isn't herself, but you can be yourself. Hugs to you, please keep posting.

Countrymouse:
Read your post and it made me cry. May God bless you for your kindness. Yes, "bucketfulls" and to Keep loving her no matter what. Yes. I will and I will listen to her no matter what. I am imperfect and I have been angry and frustrated at times. I will try harder. As to not telling her, she does not want to know. She always said so. And, often, she would ask me "what is wrong with me", and when I would start by saying "your heart", she would stop me. She is again in the hospital and someone there told her her heart is "very bad". She went into such agitation and her heart rate was uncontrollable. that no Ativan at any dose could stop it. I know they love her. My brother is 50, healthy and his perspective is that my mother needs to be "cheered up" by us and that we need to "change the subject" when she tells us that she is hurting, in pain, whatever. He sent an email to EVERYONE in the family about this .. her personal issue with depression and how she talks about all she has been through. I feel that YES, of course, she is. She is grieving so many losses and she is suffering. I wanted to email him privately and tell him that he should not email everyone about her personal issues or call her a liar because she is NOT lying. She is possibly in early dementia. I am not a doctor. I had suspected the vascular thing, but did not know that it goes hand in hand with CHF.. Can you point me to a resource regarding the relationship between the two? Perhaps THEN, he might see. Thank you for validating my feelings as no one else is seeing what I see, but then, they do not talk to her daily like I do and she told me, in confidence, that I am the only one she can talk to. Yesterday, she was "back" and said "I love you dearly with all my heart". I'm sorry if this post is not upbeat.

One last thing: my mother was the kindest, sweetest person in the world. And good to all of us and so many friends. I want so badly to "give back" but illness is so bad with me, that I am limited. I do talk to her, I do cook, send food, get husband to do shopping, and send depends and ensure and whatever she wants. It just hurts. I am not supposed to feel this. After all she is 88 years old. I have had her for a long time, but my heart has not caught up with my mind. Thanks again and blessings to all.

Countrymouse, you said "don't know if this will help, but however haphazard and shambolic their way of going about things is, you could keep in mind that even if everyone was all-knowing and efficient and lovely, they still wouldn't have the perfect answers. So the difference it makes is less than it feels"
YES. I do get this. My posts must sound scattered. I know I am already grieving.
Thanks again.

My turn to cry. I wish I had understood much, much earlier on how all of the baffling little things that happened were to do with brain symptoms: I would have been so much kinder... or so I tell myself.

Anyway. This is a link to a learned article but one with good, practical recommendations once you get past the Doctor-ese language: hindawi/journals/crp/2012/595821/ It explains how improving your mother's lifestyle and support at home will improve her health, her heart function (possibly) and therefore her mental state, for example - aiming for a virtuous circle. Please, please don't go looking for miracles; I'm just hoping it will point your brother in the right direction. The better your mother's heart failure is controlled, and the better the support she has in daily life, the easier it will be for her to manage mentally too.

The Alzheimers Society supports people living with all kinds of dementia, not just Alzheimer's Disease; so that might be a good place to look.

The American Heart Association at www.heart.org has articles about cognitive impairment and vascular dementia. One point that comes up immediately is that mobility and exercise are important to brain function. I expect that's why your mother's hospital team are leaning towards protecting your mother's sense of balance by not giving her anxiolytics - that is, because they are trying to keep her mobile as far as possible. Everything's a trade off, they're not ignoring her mental state, they're just prioritising her physical one.

You're not supposed to feel hurt? That your lovely mother is ill and suffering? Er - yes you are! Of course you do. Being strong doesn't mean not being upset. Be kind to yourself, too.

And so it begins. You are NOT going crazy, you are recognizing the first symptoms of dementia and your mother needs to be tested. To hell with the other family members, you can tell them you told them so when it becomes fully blown.

Yes, it IS possible to be the only person in your family to suspect Dementia, I too was in that position. My "family", sister & her adult children, were horribly abusive towards me, as I pursued getting my 94 year old Mother to her Dr. for testing for Dementia. Her Dr. did the usual testing to rule out any vitamin deficiencies, or other reasons for her behavior. He then sent us to a Neurologist for further testing. She was diagnosed in Stage 1 of Dementia/ALZ. At the time she was diagnosed, my sister & her kids didn't accept it, and as I tried to move my Mom into Assisted Living, they put her & I through hell trying to do it! My Mom had made me her POA many years ago, which infuriated them all, but with that in place, and with the support of my hubby & kids, I moved her. Before I got her moved, her behavior was pretty bad. She was hoarding spoiled food, verbally abusive towards me, refusing to take meds, accusing people around her of stealing items she misplaced in her apt. Fast forward 1 year later. She did well in Assisted Living for about 6 months, and then it became apparent her needs couldn't be met there. So, I searched for a Memory Care facility, and didn't inform ANY of my family of this decision, until I found a place & signed the lease. I then informed them via certified mail. My Mom has been in a beautiful, loving, memory care facility for 2 weeks and I have seen a DRASTIC improvement in her! She's pleasant now, very little agitation, she eats well, she laughs again, and mostly, she's healthier then she's been the past few years! My point, go with your gut and push aside any person that gets in your way! You know your loved one best and you are their only true advocate ! I thought I was helping my Mom for years, but in hindsight, what she needed I didn't get her until recently. For years I ran around like a crazy person trying to do everything I could for her, but I finally realized, I wasn't the one who could really help her, her needs we're much greater. Please, please, don't go through the hell we both did! Seek out a great Nuerologist & have her tested. The worst thing will be that your wrong, but if your right, you will be doing the best for your loved one by accepting it, and moving forward.

Totally stinks about family dynamics. If she is telling you the truth about her situation more so than the person with the POA, why not ask her if she prefers to change her POA...those are changeable. Could be to you, a friend or whomever....also, document the instances of behavior. Date, time, circumstances, was she calm, aggitated, not feeling well, like that. Iver time there will be a pattern and this can help later on. Also what the solutions seem to be. Good luck

It is quite possible for the "actress" in your mother to come out in front of your siblings and her doc. A friend of my late mother's said "from all perspectives, your mom looks very well." However, only I knew she was demanding to live alone, was 94, legally blind, had CHF and A-Fib and a BP of 60/40.

A lot of good answers and experienced viewpoints, but I think Ferris said it in a nutshell. From what you've said (unless she began behaving this way right after starting a new medication), the dear lady has early symptoms of dementia. By acting now, there are measures that can be taken to help slow down or minimize your mother's dementia. At the very least you will have a better idea of where you stand and she can be cared for in a way that deals with her condition more effectively. Please do what you can ASAP to get her evaluated by a certified professional and have him or her write a statement in plain English for your siblings.

When my mother began acting loopy, but very gradually, my brothers & I could see it coming but we were all stymied as to how to handle the situation. She wasn't far enough gone for us to have her declared incompetent, but she managed to blow her finances to hell. We had no authority to intervene. As Sunnygirl stated in different words, it is very difficult for grown children to swap roles with their parents and become the ones making the judgment calls. It just ain't natural!

Llamalover47, excellent point about the "actress" in one's Mom. I never realized that my Mom was experiencing dementia as she was always putting on a good front any time I saw her, when talking on the phone, or visiting the doctors.... I figured she was doing great at 97, same with my Dad at 94.

When my Mom returned from a short hospital stay due to a fall I hired caregivers to help give her a break from all the daily chores... after 3 days she wasn't having any more of that, and she asked the caregivers to leave.... [sigh]. I said ok because I thought she was still of clean mind.

Another fall happened, this time very serious, and I finally felt comfortable enough to snoop around my parents house. I was surprised to find past-due bills, and other strange things that indicated my Mom wasn't thinking clearly. Boy, she had me fooled.

My mother is acting loopy and I actually think siblings don't WANT to know because it might mean more work for them. She has always been illogical and a drama queen, so it is hard for the rest of the family to tell - and we are constantly in fights over her check book because she wants to control it ( $72 overdraft charge this month, alone) and I tell her that she cannot manage it.
The person who is around them the most will notice the weird stuff. I plan to go on a trip and let siblings take over for a while - they will be singing a new tune then.

Thank you, freqflyer! It does happen. Yes, they can trick you into thinking everything's "all peaches and cream."

Thank you again freqflyer. I am so sorry that your mother put up a false front. My mother was a perfect "sugar coater." I wanted to hear the truth...no such luck! Even to the doctor, she said "everything's fine." It wasn't by a long shot!

I went thru the same thing with my mom - I did not think she be driving anymore but I put my foot down and sold the car. she never mentioned it again. I've checked into homes buy the only option is to all my money or she could give her assets to to pay for clothing and personal likes. in FL you can only $2000 in the bank and then she will be put on Medicaid. I would find a nice assisted living home where they seem to be compassionate and other residents seem happy. you can probably get her on a waiting -- that would be better than some of the state homes. my friend did that to get her mom into mayo nursing home. it was sad but at least she was around other women her age and they usually have been trained in alziemers care. medicare provides me with a visiting nurse and doctor . they are not very good but they do look at vitals and even arranged for a portable sonogram which showed a lot of stones. you might want to visit a reputable psychiatrist which I had.to do after a severe trauma. the med helped with the rage and agitation. he could also help you. many of them just will accept what you or your ins. I was afraid to see a psychiatrist at first but glad I did. see if you can find one who offers councilling - the are a great resource for bouncing off ideas. lisa (gibbons?) has a foundation you can talk to I I think its called "a home for mom. go online and i'm they must have info and diagnostic info. you need to get in your brothers face and give what have found himself burned out so you can thank him for his
caretaking service but have done your research and would like to take some of
the stress off of him. the patient will always fight you no matter what but you both need to do the best by mom. they're caretaking agencies and group therapies youn both should consider. you'll meet others in the same situation and they can provide info but most importantly support. take care, sorry this is so long kathy