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You don't tell them, and you notify the doctor of your concerns in advance of your visit.
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Beatty Jan 2023
I sent a letter today with 'concerns' ✉️ 😶
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Diane01, welcome to the forum. When was the last time your Mom was tested for an Urinary Tract Infection?

An UTI can mimic dementia and cause other unusual behaviors in older people, especially common in women. The test itself is easy, pee in a cup. If the test comes back positive, antibiotics are prescribed.
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Gently and honestly. I think I would approach her according to what I know of her all of her life, how she deals with uncomfortable situations and fear in general. I believe I would stress that losing some memory and so on is a normal part of aging, and will happen to us all if we live long enough, but that it can be a worry if we are in danger living alone, need more family support and checking, and blah blah, and would she consider going to her doctor; you would be glad to accompany her and support her, and there are simple games/tests you can do at home (there are some tests and questions you yourself can administer; let me know if you need a few).
If there is severe denial you may have your answer that she is already noting failure and in denial, fearful. You may then have to await the incident severe enough that you call EMS and request testing once at the ER.
Is there a POA? Who is closest to this woman? Would family consider intervention to approach together? What are you seeing that could represent DANGER to her? What is in place already or needs to be (POA, Wills, plans and etc).
Other things you can consider is telling her MD what you are seeing and asking for his intervention to ask to see her or to carefully examine for need for neuro eval at next appointment. Calling APS and telling them of your fears for her and asking for welfare check and putting it on them is one more option.
MJ's approach is certainly another option for you, and I agree that if this is a sudden change you need to consider dip sticking the urine at home to check for evidence of bladder infection, or taking a specimen to her doctor for testing.
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She should go see a doctor for a work up, to rule out underlying causes first.

If she does have dementia, you should weigh carefully if this is something helpful for the person to hear, or if it will distress them (as well, they may not remember the information, but may remember the distress caused).

My mother was diagnosed with 'Dementia, probably Alzheimer's' at age 91, when she started being unable to follow her daily routines (meds, showers, food prep).
She had been experiencing some memory loss, that had gradually grown worse, since about age 88.
I took her to her PCP, telling Mom it was for her annual Medicare wellness check. I handed the office staff a note for the doctor when we checked in, detailing the changes I was seeing, and that I was concerned. At that visit we were referred to a neuropsychiatrist for testing.
I gave the neuropsychiatrist a copy of the note too, and noted that my mom would find a diagnosis of dementia scary-she watched it affect a dear friend to the end. The doctor talked about her test results in terms of what areas she tested well in and where she was less strong. She forgot the doctor's discussion by the time we reached the car.
And that was that.
My mother is aware that she has some difficulties retaining information, but it seems kinder to not reiterate that she has Alzheimer's.
This is helpful reading:
https://www.alzconnected.org/uploadedFiles/understanding-the-dementia-experience.pdf
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It's really not necessary to tell her. Having her tested is pretty easy. Talk to her PCP to get the ball rolling. I would tell my mom we were going to talk with a doctor about her memory issues. She knew she had trouble with her memory. But dementia? The doc told her and she didn't believe her. Kind of funny, in a sad way. I would tell her a bit at first but when she was resistant to the idea, I mostly went back to the vaguer "memory issues" instead. I wanted to know what we were dealing with, but to the person with it, there's little value in them knowing.
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CTTN55 Jan 2023
I can't imagine if I had tried to tell my mother that she had dementia. There would have been a yelling tantrum and I would have been chastised, demeaned, etc. As always, she would have insisted that the problem was MINE, not hers.
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