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Mom is 92 and broke both her hips so now living with my family. She has dementia of some kind for a few years now and just got worse after being in the rehabs. And she got covid in the first one 2 years ago!! The doctor in the 3rd rehab prescribed "sprinkles" for her mood disorder (thank God!!). She wouldn't take any meds and kicked and spit at the nurses!! I would love to know what kind of dementia she has, but she refuses to get diagnosed. The rehab says she has Alzheimer's, but they didn't say which kind? Doesn't she need a brain scan to diagnose? She doesn't remember my sons even though she sees them every day!! She won't sign anything to give me power of attorney over her health!! She won't give up control!! She has to ask me where her room is or even if she slept here last night!! Help!!

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The question to ask yourself is: why do you now need a more exacting diagnosis?

By your description your mom seems fairly far down the dementia path. Maybe what needs to be diagnosed is whether she has a UTI, which can make her dementia symptoms much worse. If she had anesthesia after her injury, this may have sped up her dementia symptoms as well.

She doesn't sound like she'd be able to assign anyone as PoA at this point. You may decide to pursue guardianship or the county may have to acquire it, so that someone is legally able to manage her affairs and act in her best interests. I'm so sorry for this distressing situation. Even if you can't afford to pursue guardianship, the remaining solution is for the county to have it. So, there is a solution no matter what, even if it isn't what you had hoped for.
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What's the difference what 'kind' of dementia your mother has? And if there's more than one 'kind' of Alzheimer's, I'm unaware of it myself! Also, what are 'sprinkles' other than the sweet dashes one puts on top of ice cream? If that's what the doctor prescribed for her mood disorder, why are you 'thanking God' for having no real medication to address such a thing? Brain scans don't always 'diagnose' AD either; unless plaques are found in the brain. Oftentimes, dementia can be due to multiple types; not just one; vascular dementia combined with AD, for instance, is common.

How you engage with your mother & handle her behaviors is even MORE important than a diagnosis, really, and knowledge on the subject is crucial.

Dementia behavior is extremely difficult & frustrating to deal with, that's for CERTAIN! I suggest you read this 33 page booklet (which is a free download) which has THE best information ever about managing dementia and what to expect with an elder suffering with it, as your mom clearly is:

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

Another good book is Living in the Labyrinth: A Personal Journey Through the Maze of Alzheimer's, by Diana Friel McGowin. Learn all you can about AD/dementia so you'll understand how life in your mom's mind works.

Wishing you the best of luck with all you have on your plate.
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Just2crazy71011 Mar 2022
Thank you, lealonnie1 for all of the information. You asked me about the "Sprinkles" I had mentioned. Seriously why would I give my Mom sugary ice cream toppings for her mood??? The medication is nicknamed "Sprinkles", because you can sprinkle it on the food. The real name is Depakote. It is a mood stabilizer. My Mom was prescribed it in the second and third Rehabs she was in. If it wasn't for Depakote my mother would have been sent anywhere, but my house long ago!!! Thank God for her sprinkles!!! She fell 2 years ago and got Covid, which I believe made her memory/paranoia worse. She was very confused and fell 2 weeks later and went to another rehabl This time they prescribed the Depakote, but I never filled the prescription. After many, many family arguments with her, she fell in a bucket in her room and couldn't go to my Uncle's funeral!! We called an ambulance and they convinced her to go to the hospital and so 3rd rehab. In this one they couldn't get her to take any of her medications, really just pain pills or Advil, and she would kick and spit at the nurses!! They prescribed Depakote and antidepressants and this time I filled the Depakote prescrition!! I don't give her the antidepressants. And I would really like have definitive diagnosis. My mother-in-law had 2 kinds including Lewy Body and another I can't remember.

Mom living at my house was supposed to be temporary. Never expected her to fall again!! My husband and I built a house in SC 3 years ago and we've driven down there with Mom 2 times. Now she doesn't want to go and I can't go and my husband has gone twice now without us. My husband's family don't live long. He's 60 and wants us to enjoy his last few years, and I hate to say he's at the end of his rope.
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Most dementias are only diagnosible upon death and autopsy. It is usually diagnosed by symtpoms, some types with scans if they are vascular, due to small strokes and etc.
There is no reason to know the exact cause, because for the most part there is no treatment for any dementia, only for the symptoms. So report her symptoms to the doctor when you need help. What you are describing is common to most dementias.
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There are over 400 different kinds of dementia including Alzheimer's, so at this point it seems a bit useless to wonder exactly what kind she has,(plus they're sometimes hard to diagnose properly)as it won't change anything anyway.
It's obvious she has some kind of dementia, and with her age, she probably doesn't have more than 8 years yet to live, even without dementia, if she's lucky.
While it's true that some dementias are more aggressive than others,(i.e. vascular and Lewy body)I wouldn't be overly concerned but instead just enjoy whatever time you have left with her.
And you can forget about getting any of the POA's for her as she is too far gone in her dementia to be able to legally sign them. Your only option will now be to get guardianship over her.
It sounds like it may be time for you to be looking into finding the appropriate memory care facility to place her in.
Best wishes.
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Hello, Geaton, and thank you for answering my questions. My mother-in-law had Alzheimer's and recently died from it. Her's was inherited from her mother. They both died about the same age of 77. Dementia runs in my mother's family as well. Her father had Alzheimer's for at least 8 years, her brother and his son also. My uncle died after he refused food and drink and they said he died from dehydration!! My mother is at a point where she will only drink half of her coffee and a slice of toast with jelly until dinner. She barely drinks 8 oz of water a day and her dinner is what you would feed a 2 year old!! My cousin is living with his dementia for 25 years and doesn't remember his mother!!!! When Mom fell last year, the EMT's had to convince her to go and she didn't want to, but thank God they were able to get her approval!! I have POA of her money, but I don't for her health care. I would like a diagnosis so I can Guardianship eventually. As far as the UTI, I had a doctor come to the house, because she was in bed for 24 hours and yelling that she was dying!!! She tested negative for covid so they left something for to pee in and she won't do it!! That was 2 weeks ago. Like I said, she is so difficult!!! As it was the second time in a month sleeping all day, I too wanted to find out if she had a UTI!! But we'll never know. She didn't have anesthesia, by the way. They gave her something to block the pain so she was half awake for her surgeries. Thanks again for responding!!
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Regardless of her diagnosis, she is mentally incompetent and her signature is worthless. If she refuses to see a doctor and take medicines, there is no law that allows anyone to push medicines on her against her will. The is only one way out: Involuntary Commitment. A doctor, a psychologist or a mental health social worker can fill out special documents stating that she needs to be admitted involuntarily to a psychiatric facility for a psychiatric evaluation. On the grounds that her life is at stake, because she is unaware she is ill and her behavior is reckless and dangerous to herself. Once evaluated, she can be taken before the Judge, who will commit her to a psychiatric facility where she will be medicated. Once, she is properly medicated, she can go to an appropriate facility for follow up.
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