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My 94 year old mother lives in her long time home with daily help and a college student who lives in the home in exchange for checking on her morning and evening. She also has a dog. Until about a year ago, she was fairly social. She has been screened for dementia, and it has not been diagnosed, Her vision is excellent since cataract surgery, and her hearing aids seem to work when she uses them. She is rather frail looking, but she walks, uses the bathroom, etc. She also had an emergency alert device.

She is less and less prone to engage with anyone, although everyone who comes into the household does try to spark conversation. She won't answer the phone unless she knows that my daughter is calling. When I try to talk to her, she pretty much tries to shut down the conversation with stock phrases, however if I really insist that she pay attention and have an exchange, she is quite well oriented and gives appropriate responses. I am really confused as to whether I should let her follow her inclinations and just zone out!

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First: Have there been any medical issues that have arisen? Any doctors she's seen in the past month or a little longer that might have given her cause to become a bit more withdrawn? Anything else to which you can attribute the change?

What does the college student have to say about the situation? Has she seen the change in socialization, or in any other aspect?

Second, other than home visitors, has she had the chance to be social outside of the home, such as at Senior Centers, book club meetings, church, etc.?

Third, who are the people who come into the household? Are they friends, medical people? This could make a difference as she just may not feel inclined to make small talk with people. I often feel that myself.

Fourth, if there's nothing physically or mentally to explain the change, perhaps it's just slowing down and no longer feeling the need to be socially obligated. Perhaps she's tired of making small talk. Perhaps she's just tired, period. In the 90's the energy often isn't available just to be social.

I remember thinking that when I turned 50 I was going to stop engaging in conversation with people at work other than just the normal pleasantries. I got tired of the whining, obsession with surgeries and physical issues that were very private, and just plain gossiping and backstabbing and complaints about the firm.

When I turned 60 I decided I didn't have to listen to people who didn't interest me. Sounds snobbish, right? My feeling was that if someone didn't bother to educate him or herself, why should I waste time listening to their boring conversation. Someone intelligent always attracted my attention though.

At 70, I reaffirmed that commitment. Boring, whining, self-absorbed people get a polite hello and "Sorry I can't talk; I'm in a rush" response. I don't get paid to be a listener. I especially avoid people in doctor's offices who see any other person in the waiting room as someone on whom they can immediately begin to discuss their problems, especially medical problems. If I do listen to someone who seems upset and make a suggestion which is ignored, I immediately smile then go right back to my reading.

That's one of the few good things about electronic devices in medical facilities - some people are so busy texting or engaging in some online activity that they don't even make an effort to be courteous.

Your mother may just be getting tired as I did of making conversation with people in whom she's not interested.

I might mention it to her just to confirm that there isn't anything else going on, then let it drop. She's definitely at an age during which reflection on life is appropriate, and that may be overriding any desire to engage in casual social activity.
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The people who come into the household are mainly her housekeeper, who is available to take her where she wants to go, a second college student(paid) who comes in some mornings to watch dvds and have general conversations with her, me when I'm in town, occasionally an old friend or neighbor, her bookkeeper, etc. She sees her internist around once every month to six weeks. Most of the people she socialized with a few years ago have died or moved to assisted living.

I am definitely of the school of thought that people should be able to follow their preferences and not nagged or hounded. My main concern is that she may be accelerating her decline into total disability by being so disconnected. When I ask her what she's doing, she says "thinking," which is a valid activity in my book. Sometimes I do think I should be pushing her to do more, but it WOULD be pushing, not suggesting or facilitating, because she pushes back. She is quite adamant about not wanting to move.
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The people who come into the household are mainly her housekeeper, who is available to take her where she wants to go, a second college student(paid) who comes in some mornings to watch dvds and have general conversations with her, me when I'm in town, occasionally an old friend or neighbor, her bookkeeper, etc. She sees her internist around once every month to six weeks. Most of the people she socialized with a few years ago have died or moved to assisted living.

I am definitely of the school of thought that people should be able to follow their preferences and not nagged or hounded. My main concern is that she may be accelerating her decline into total disability by being so disconnected. When I ask her what she's doing, she says "thinking," which is a valid activity in my book. Sometimes I do think I should be pushing her to do more, but it WOULD be pushing, not suggesting or facilitating, because she pushes back. She is quite adamant about not wanting to move.
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Thinking is a very healthy activity and it can be quite stimulating. You could ask her what she's thinking about. I have a feeling this young lady really knows what she's doing and has her wits about her.

It can also be that she's still connected to those she feels are important in her life.
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