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My mom is fairly young, she's 70 and I think she may be in the beginning stages of dementia. There is a history of it in her family. Two years ago she fell down her back stairs and hit her head. She was taken to the hospital and tests were conducted and it was determined that she was fine. Within the past year and half, she has become increasingly paranoid, forgetful and argumentative. She often doesn't make sense when she speaks. She is still seeing the neurologist that she was connected with after her fall. She has made mention of the doctor running more tests and when I ask why, she tells me that he is trying to rack up her bill, clearly that's not the reason. I've tried contacting her doctor and I know he can't tell me anything, but I at least want to express my concern for her health and well being to him. She lives alone and I worry about her and don't know what to do or where to start. I'veI've tried talking to her and she's not willing to cooperate with me, she wants to argue with me. Any advice or suggestions would be greatly appreciated.

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I sure hope that she'll go back to the neurologist for those tests! And ideally, that she'll let you come with her. (Tell her you want to observe so you can check out the charges and make sure she is not being overbilled.)

That really is the best first step ... have her examined and tested by an expert.
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Falling and hitting her head could have caused a concussion. This can lead to the same kind of brain damage that looks like early dementia. It might resolve itself in a couple of years, especially since your mom is not very old.
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The first thing I would do is get a second opinion. The second thing I would do is have your Mom agree that you can be on the HIPPA form. That way you will be IN on her medical issues. Thirdly, before it gets to the point your Ma cannot make reliable decisions obtain POA and DPOA. You may also may want to consider Advanced Directive. Good Luck
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Good for you for giving the MD information, likely your mom isn't giving good information. Yes, see if you can give your mom a reason to go with her that she will like. Jeanne's suggestion is a good one. It does sound like the MD is trying and your mom isn't cooperating. You've tried reasoning with your mom, if you haven't tried this, try focusing on your love and concern for her and stop there. She might be able to hear that when reasoning with her may not be possible at this point. Is there anyone (primary care doctor, pastor, friend, etc) that she is willing to listen to and follow their guidance? If so, enlist their help. And yes, Smschaff34's suggestion about POA is good, if she will cooperate.
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You might try faxing-emailing-writing the doctor in regards to what you have observed (frequency/how often, recency/how recent, severity/how bad, and duration/how long) her symptoms last and cause-effect if noticed when they come and go (e.g., time of day, better/ worse before/after a nap, after an outing) and genersl info (incontinence, head-aches, dizziness, sensitive to sensory like touch, light, temp, eating changes). You're right MD can't reveal info (you/she needs to get a POA and DPOA in place quickly for the future though if you don't have one). Many MDs don't feel comfortable calling back family even if they have the time w/o consent on file. But a well-written letter puts it all right there and documents the concerns, which might give MD insight and/or nudge. Other people's answers are great too (observe MD/tests). I'd want to look at the scans and review meds Rx. Even if you can't read them yourself, asking the MD take you through them means he has to look at them again. Surprising what they sometimes see that they or initial reading had missed. A second look is good. Looking for changes over time and/or trauma. Careful/watch out in general are hematomas especially if she's on blood thinners and UTIs are totally different/dementia- like as we age vs. symptomatic pain. Surely he's done a work up incl those...hope helps some. Good for you to be there abs care.
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You need to get a POA from her that includes health issues so you can ask the questions you need answered. I would think she is still suffering from the fall. Not all concussions occur right at the moment of impact. If you don't get the answers you want from her doctor, ask your mother to see another doctor to "make sure the extra costs are true". 70 is fairly young in this day and time and she should not be suffering from these issues. It seems something is not quite right but you will definitely need the paperwork in order before you start asking questions. Ask the doctor or a hospital for the correct paperwork to allow you to see everything on her health and make decisions for her in case she isn't capable of doing so. I hope everything turns out ok for her and this is something that will get better over time. Keep in mind, you may need to move her in with you in the next 5-10 years if she doesn't get the help she needs now.
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Try writing the doctor a letter detailing her behavior. It sounds as if you do not have a Durable Power Of Attorney for medical issues. Does anyone in your family have that document for your mother? If so, have that person contact the doctor. If not, you are going to have issues getting the information

Either way, the doctor clearly sees problems and would likely welcome your input. What he or she can do about it without help from the family is hard to tell. Try this step anyway and see what happens.

I agree that the head injury could have contributed to this - maybe sped up the development that had already begun.

Good luck,
Carol
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Just a thought… Is your mom on a low-fat diet? If she is, you might try convincing her to add butter, olive oil, coconut oil, full-fat dairy, and even meat fats to her diet. The low-fat diet has created an epidemic of brain disorders, including dementia. Look up the Low-Fat, High-Carb diet (LFHC). You’ll find excellent information by Medical Doctors Stephen Phinney, Jeff Volek, Dominic D’Agostino, and Eric Westman. Much of their information is available on YouTube. Also, if your mom is on statins, be sure she is taking CoQ-10, which is an enzyme statins destroy. It would be great if you could get her to a good naturopathic practitioner who understands nutrition.

Yes, the fall may have caused damage. But her brain might have a fighting chance to recover with proper nutrition.
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I'm sorry. I meant the Low-Carb, High-Fat diet (LCHF). Remember, High Fat. Low Carb.
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First, the idea of Durable Power of Attorney may scare your paranoid mom. It may be easier to ask her to add you to a simple Healthcare Proxy first (available online and at most doc offices, and you keep a copy). This will allow the doc to share info with you. You could tell her you're worried about her care if she were to fall and be unconscious, unable to speak for herself. All true. Once you're in a position to talk to the doc, you can ask for a memory test: the doc asks some 12-20 questions and gauges her memory ability. Since she fell, I would hope the neurologist had brain scans done. If not, you may want another opinion/doc. She may seem young for dementia, but it's not out of the question. And if diagnosed early, some meds are said to slow its progress. And more med trials may yield results by 2020!
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Melanie241,
You indicate that your mom is not only forgetting things, but often what she says doesn't make sense. And that she had a head injury two years ago. What made her fall? It's good she's been having regular tests with a neurologist. Her symptoms could be related, but they might not be. Maybe, she's had a stroke or has some other kind of condition. Perhaps her doctor has information about that, but he can't provide it to you.

Of course, you can give information to him. I've done that. I hand delivered a letter to my cousin's doctor in person. I detailed what I was seeing with my loved one, so when she examined my loved one, she had much more information. The doctor conducted the mental exam and then saw how severely effected my loved one was and she was able to diagnose dementia.

Since your mom is not cooperating, she may refuse to sign a Durable Power of Attorney and Health Care POA. Do you think she would, if you could explain to her that you want to look into all the tests she is having and see if they truly are necessary. Explain you need POA to do it. The approach that you don't think anything is wrong, might get you more leverage with her than her thinking you are anxious to get more tests. Your input to the doctor can be kept confidential.

Another suggestion BEFORE you write to her doctor is to spend a couple of days with her in her home. Take note of how she is able to function. I would also see if you can watch her write something. I found that my loved one had written some checks that looked very odd and had didn't even look like English.

I'd try to determine if she Is she actually cooking, doing laundry, bathing, paying bills, taking meds, dressing herself appropriately, steady on her feet, etc. I might even go for a walk and chat with the neighbors. They often have had encounters with people who have dementia in their neighborhood and have stories to tell. My loved one would go to her neighbors and tell them she needed food and cat food. The truth was that she had plenty of food and cat food, but she was imaging that she didn't. I would also talk to her friends, church family, hair dresser, etc. I'd try to see the changes that all of them have noticed. That would also help when you send the letter to her doctor.
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I agree with what others say talking TO the Doc about your concerns is not GETTING information only filing him in on what her routine is and how is varies. I began a journal on my MIL when I first began being her care giver and her Dr. who is being changed soon couldn't care less about her changing conditions. But for sure keep a record of what's going on review it now and again just for your self and if all else fails find a Dr. who DOES want family input !!
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Melanie241, last year my Mom also had a serious fall where she had hit her head. Prior to the fall my Mom was fairly sharp for someone who was in her late 90's and still living at home, with my Dad. ER ran a battery of tests and found a brain bleed caused by the fall, and a previous brain bleed from a fall that I never knew happened. My parents were good at hiding those facts from me.

The last fall spiraled Mom's memory into late stage dementia. Doctors tried rehab but that didn't work, thus Mom was placed in long-term-care, and 3 months later she passed.

Head trauma can be serious stuff, and one needs the right kind of doctors to map this all out. Melanie, if your Mom is starting with dementia, I believe there are meds that will help slow down the process, but I am not familiar with the meds.

Hope everything works out for the both of you.
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You or family should start going to all the doctor appointments with her. I've had many frank discussions with the doctors in the hallways. All the medical jargon sounds like jibber-jabber to a lot the elderly with memory problems and it's hard for them to ask the right questions about medications and treatments for everything, not just memory issues. I always step out of the room, so they can have private time, but always there for the important discussions.
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At the beginning stage of dementia, think long term, e.g. MPOA and DPOA.
Also, think safety, e.g. safe driving skills, potential kichen fires, etc.
Also, think financial fraud. Trust me, once the diagnosis is known, she will be the subject of daily telephone solicitation and sales calls. Email is ridiculous as to how many foreign lotteries she will win, ex.
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When my parents came back from doc appts ( way prior to moms dementia diagnosis) and said everything was good, he said we are both doing good. Ok dad what was your blood pressure, I don't know. How was your blood sugar test? Gee, I don't remember but I did tell him that joke i told you last week and he thought it was really funny. He said his daughter getting married next month. After receiving these types of answers my sister and I decided that it was time that one of us went to everyone of their doctor appts. My mom hated going to the neurogist and after many conversations she finally said to me that the doc makes her feel dumb because she goesnt know the answers to all of her questions. I told her if she didnt know it was ok to say, I don't know. I then explained to mom that after the doc asked the questions that I would talk to him about everything else I noticed. My mom still hated going to the neurologist but allowing me to do most of the talking made her feel a lot better. I typed out a short note to the doc and asked the nurse to please make sure he read it before coming in the room. While in the office with the nurse for every doctor my mom and dad went to i would say, mom, is it ok that i talk to the doctor on your behalf, mom said yes and I ask the nurse to please get the form for mom to sign so we would have it on file. Sorry for rambling, hope some of this is helpful
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Someone mentioned statin drugs--if she's on them, this is not a good thing--I had to get off of them some years ago because of brain fog, and have seen other situations where there are memory issues. Some doctors understand this, and some don't.
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All these answers are good! Especially note that it might be much easier (and quicker and certainly cheaper) to get your mother to sign the HIPPA form at the doctor's office indicating that that doctor can share info with you. It's a start. It's not what you will need SOONER RATHER THAN LATER if, in fact, she is beginning a journey with dementia but it's a foot in the door, so to speak. I especially like the comments above that amount to the best advice I ever got for dealing with dementia: enter in to their reality! Tell her you are concerned she may be right about the doctor and so that's why you want to go with her to an appointment (make it for her if you have to) and that's when you can try for her to sign the release for that medical practice. This is also called the "therapeutic lie". When people have altered mental states due to dementia it's a waste of time to try to change their minds and it just makes them angry and more frightened and frustrated. Calm reassurance works so much better and is the only way that I found to gain some measure of control over whatever was upsetting Mom. Not wanting the tests or to see the doctor may also be denial by your Mom (conscious or unconscious -- but my Mom DEFINITELY DID NOT WANT TO KNOW) so you have to find a way to make it about the doctor not her. Don't bad mouth him, of course, but tell her you want to check him out and because you love her you want to make sure she's NOT being taken advantage of. I hope this works and do let us all know!
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I have a very dear friend who is in the beginning states of Alzhemiers. She is 89. At the drop of a pin, she will get angry with me. She is not my mother and she is my friend. I can choose to ignore her illness. This is basically what I have done so far. When she is having a bad day, I just let her talk. She calls me numerous times a day. She is still driving so I offer to take her where she needs to be. But, she always replies No. If she has an accident, I can only pray it is not serious and they take her license away. I am 74 and I really don't want this in my life. I wisher her children would take a better interest. I have never seen her daughter come to visit, and her son is presently living in his truck. He can afford anything he wants but chooses the trust as his apartment. I spoke with him and told him I have concerns for your mother. That is about as far as I wish to go. It is so sad to watch her. And the phone calls are sometimes to yell at me for something she THINKS I have done. This is a terrible illness
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Run for the hills. As a caregiver for 10+ years...that is the best I can say.
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I went through this with my mother, she has been in denial that there is a problem for the past 5 years. 3 years ago she came to live with me (under the idea that I needed her to be here to help me after a divorce), and I managed to convince her that it would be wise to have all the medical and financial POA's filled out for safety (she has an older sister in NH with end stage dementia and no family with POA authority) and so I would not go to jail on those occasions where I had to speak to the bank or insurance company for her. I also filled mine out at the same time, to give her peace of mind.

Then she took a fall that required stitches, and I used that as the reason to see a neurologist (I needed forms filled out for LTC insurance to approve home health care assistance claims - and her GP would not fill them out).

I was going to just tell her that it was recommended for all people of her age to get memory tests done, even just as a baseline. But the fall gave me a better reason to get it done.

Needless to say, she scored 24 out of 30 in the MMSE, which is not bad, but her short term memory is shot, and she has trouble with simple tasks like paying bills or balancing her accounts.

I do agree with the other posters here, that getting those POA forms (and others like a will, and pre-need guardianship as well as a living will/advanced directives) is extremely important before the impairment goes to far.

Good luck.
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Mom was given a test by her neurologist when she hit her head. It told if she had a concussion. He did two six months apart. I feel the signs your Mom is showing is not early stage of Dementia. Its further along.
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from my experience CALL her primary care doctor and set up an office visit for the 2 of you asap . it was a painful discussion for me and i wish someone would have told me that i could do it instead of waiting for my gf to do it
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Without a medical power of attorney, until she either is a danger to herself or others (like driving), she has a right to argue with you, etc. I would send a letter to her doctor describing her recent behaviors so you have documentation and proof you tried to give him/her the information. If the doctor is still running tests, then there has to be a reason per Medicare coding, otherwise, the doctor can be charged with Medicare fraud. Given her family history there is cause for concern and sometimes the more you push, your mother will push back against you. At some times during the day, my husband will tell me I'm the one with the memory problems, and then when someone asks him how he is doing, he will say, "My memory is not so good". Keep observing her, try to get her on tape so you can prove her sentence structure is incorrect. The brain has to go through about five steps before it can process a word, then speaking it (you must know what the word means). My husband's sentences are not making much sense these days, but it only shows me that his brain damage is progressing which is typical of dementia. Do the best you can and learn as much as you can about dementia because if you are a biological daughter, then you have the genetic predisposition to dementia as well. Best wishes!
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Melanie, you need to get her tested immediately. There are medications that slow down or help dementia/Alzheimer's if you get them soon enough. The doctor can tell you what the future holds for you in the way of assisted living arrangements. If the doctor tells you that she does have dementia, you will need to update yourself on the disease by researching the internet or library or other means to find out what all is in store for her and you. You will need a POA to make her decisions if and when she will no longer be able to make them herself. You will need to watch her a little more carefully because she can change rapidly and you need to be alert as to when she needs to be in an AL. Good luck in finding out all you need to know.
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But honestly, there are no medications that are VERY helpful. Really the main reason to get someone tested is to rule out conditions that are treatable, like B12 deficiency. The neurologist we see is nice, but I wonder about the medical value of our visits.

Alzheimer's sucks, and then you die!
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ALSO, be aware that NO medicine slows the PROGRESSION of the disease -- AT BEST they MAY, in some individuals, improve SYMPTOMS. For a while. As caregivers we certainly deal closely with symptoms, so I'm certainly not discounting the usefulness of the few drugs available that may work in that regard! But you should also know that many people have side effects associated with the drug(s); my Mom couldn't take Namenda at all. And, I've been told, that the drug or drugs work -- if at all -- only in the early stages. However each patient is as individual in his or her reaction to the drugs as each is unique in symptoms. So ask lots of questions of the neurologist -- don't hesitate to take notes! God Bless.
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I think it's time to easily persuade her to stay with you. It's tough because she seems to be in an uncooperative state already but she definitely should not stay alone.
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i already have a dpoa over my mom,but I never had her sign a medical poa.Can and does my dpoa status make way for me to deal in her medical issues within this parameter,or can i only do that after she signs a medical poa to me?
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Normally, you'll need a Medical POA for medical issues. If she is still competent, I'd get it signed ASAP.
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