Mum becoming increasingly difficult/demanding

[RoséProsecco]

My mum is 81 & widowed. We lost dad 3 years ago from dementia & she cared for him almost till the very end. It must have been incredibly hard (during covid).

I'm wondering if she now has depression or if there's something else going on.

She seems to have great difficulty retaining information, particularly around plans/arrangements. Cannot get anywhere on time. Wax in ears but won't book a hearing test or pay to get them cleaned. Lots of point-scoring comments, not being able to follow conversations.

And is having increasing difficulty doing the most basic of things eg bank transfers, phoning the bloke to clean the gutters.

She almost seems a little irrational in hee thought processes - just not logical at all.

Her driving has deteriorated & she recently had an accident, writing the car off. We helped her buy a new one, which she's struggling to consistently drive it (same model but newer) & is taking it to the garage tomorrow as she thinks the car is at fault - when it's clearly her.

She prepares a list of jobs for my younger sister who lives nearby & visits weekly - but is becoming increasingly overwhelmed with the amount mum is asking of her. She has expectations that daughters help mothers, and is very reluctant to try & do things for herself.

I'm not sure if she's just declining cognitively, or depressed or if this is just normal ageing?

Any words of wisdom appreciated- thanks

I think it is probably a combination of a number of factors causing this decline, and the thing that jumps out at me the most is that she is still driving. That worries me.

Why is she refusing to get her hearing checked?

Firstly, should she be driving at all. Frankly she sounds dangerous.

Whatever the underlying issues are, the hearing will be exacerbating almost all of those things so if there's any way to persuade her to sort that you'd have a much better chance of establishing a baseline.

Would she be more open to one of the opticians that also do hearing checks rather than an overtly medical setting?

The hearing issue certainly leaps out at me. It seems pointless to try to encourage cognitive or memory testing or anything like that until her hearing is as good as it can be, because without a doubt it will be affecting her more generally.

It seems unusual though that she won't consider an appointment for this - like a PP i wonder why?

She must have very complex grief and perhaps trauma, and I would really encourage her to think about therapy - again it sounds incredibly unlikely that she would do that, and it would be better if she could hear the therapist!

Maybe express some gentle frustration to her - ask her to let you help - at least to book an audiology/microsuction appointment.

The driving.... she still lives in the family home - been there over 50 years & it's not in walking distance to shops (her mobility is poor). She can't cope with downsizing/moving so it's her independence. Won't get taxis.

The hearing.... doesn't want to pay for it. Can absolutely afford it. My sister arranged a hearing test & for the wax removal to be done - but mum isn't sure what they exactly told her about whether she needs a hearing aid or not.

The driving..... I hear you but she must stop driving if she is unsafe. Otherwise she could kill herself or others

Thanks for the replies so far.

I think there's a huge amount of denial about things eg hearing. Or just refusing to accept things she doesn't like.

And she can be so difficult/resistant about things- for example dad was not safe at home & she was putting up barriers to him going to a care home which was needed. She was just "down a hole" with that one.

OP, Maybe there’s a clue in your last sentence?
’She was just ‘down a hole’ with that one’
Presumably your DM was under great stress when DF was unwell, however, it’s possible that the behaviour that she displayed then is just continuing on but worse.
The barriers are because she’s shit scared and realises she’s losing her control.
I think you should try to get POA if you don’t have already and sabotage the car. If she’s on the ball she will arrange for the car to be repaired but if she can’t organise that, then it gives you a valid reason to say if she unable to work out how to get car back on road she shouldn’t be driving …

Hearing test
Memory clinic
Additional support - PA, cleaner, gardener, etc.

Start the ball rolling on all of this so that she has a network of support in place. It won't get any easier. Daughters cannot do it all so don't kill yourself trying.

Sorry, the fact that she is struggling to organise/remember sounds like cognitive decline to me rather than trauma or grief.

Complex situation: in a specialist nurse in older people's medicine and we see this frequently, here's my offering if I were to see her in clinic (very generalized as obviously it's more complex than a mumsnet post for you all!)

1.General health check incl examination/weight bloods etc to check no physical cause for symptoms common culprits: aneamias/vitamin deficiencies/thyroid issues amongst others

1. Medication review - some medications even if been on for years may need altering/stopping/monitoring

1. Initial cognitive screen such as 6cit

1. Hearing - this is sooooo vital to sort and rule out as a cause! If she won't pay to have them sorted we often find that people are happy to put olive oil drops in - it may take up to 6weeks ish but it will soften and come out eventually without intervention. You can also buy an 'ear bulb' for a couple of pounds from the chemist or Amazon and rinse the ears out yourself after 2-4 weeks of oil (as long as no pain or discharge etc from ears).

1. Sight check eg is she up to date with opticians?

1. Screen for mood disorders, often present differently in the older person. Can become cranky, frustrated or withdrawn, fiercely protect independence etc. is she lonely? Isolated? Anxious? Bored?

That's a very quick whistle stop presuming no need for a physio or occupational therapist input!

Psychologically it's a big thing to go through the process of accepting your loss of independence however small chunks that may be in. She's probably aware of her current issues and scared what it all means.

You can get round these things by treading carefully such as suggesting she goes for her yearly review at the doctor's but perhaps having a telephone appointment with a GP prior to this for abit of background so they know what to focus on. If she can afford it pay for help - she gets to feel in control of this type of help as she's paying to a service such as gardening, cleaning etc rather than having to ask her children.

You can ask for a carers assessment for your sister from social services and/or the GP surgery and this will also open up other avenues of support for her/you.

Unfortunately these type of circumstances often build up to crisis point along the way no matter what anyone does to help if the person maintains capacity. We're all entitled to make unwise choices if we so wish (at the horror of families often!)

I do agree with other posters though, the fact she's still driving from what you describe is actually quite worrisome. This may be some leverage to get checked over aswell.

You can tell her Dr your concerns and the DVLA.
You could do with lasting power of attorney sorting now - I think a major push from you all is needed to set her up for this next stage of life.
I agree with paying for support but ensure she’s claiming all she’s entitled to claim etc. I don’t know how you insist when she’s so stubborn but your sister will need to push back on her demands.

It’s almost certainly cognitive decline at 81, unless she otherwise is writing novels in multiple languages, playing chess etc regularly. She is 81!

She is also probably scared of what she knows is happening. Get a POA in place if you haven’t already.
And she MUST STOP driving! Enforce this any way you can. It is dangerous and unfair on society to have very elderly people behind the wheels of cars.
It sounds like you also are yet to come to terms with her age.

It really doesn’t sound like she should be driving. I’d get that clarified asap before she hurts herself and / or someone else.

My mum was similar although thankfully she gave up driving. My brother was talking about buying her a new car and I said don’t you dare!

Getting her health sorted out (she had an underlying health condition she was ignoring) and getting hearing aids has been a game changer. She was presenting like someone with dementia but it was just deafness. But if she ignores her hearing loss it will have an impact on her cognition over time. What worked for us was getting Mum’s very bossy SIL to book the hearing appointment and go with her. She just wouldn’t take no for an answer - two grumpy old ladies together haha!

Mum has also become obsessed with not spending money as she’s got older. I can’t help with that one sorry, drives me mad.

These replies are so helpful - thanks.

I've done a bit of googling & yes cognitive decline sounds very familiar, especially the bits about following instructions, making decisions & poor judgement- that's exactly where we are.

She already has a cleaner & gardener, I have suggested to my sister that she perhaps employs someone a few hours a week for "admin" - a PA type person. She will be very resistant to this but can absolutely afford it.

We already have POA & are spending a fair amount of time trying to sort out the Trust since dad died, which is why the extra demands are difficult. I would rather be spending quality time with her rather than doing her to-do-list.

She is at the GP a reasonable amount (asking for free ear cleaning when was told last summer it was no longer done for free!!!) and has regular check ups for her heart condition. Sometimes has anaemia (I'm sure it's dietary) but gets prescribed Iron.

The car was replaced quite quickly - I hadn't been aware of her driving at the time as I usually drive her everywhere. That's going to be a huge one to tackle.

I live an hour away & am a full-time NHS worker plus single parent so am pretty overwhelmed at the best of times.

I think a sisters meeting is required & I'll visit mum over 1/2 term and have some gentle discussions to start the ball rolling.

It’s almost certainly cognitive decline at 81, unless she otherwise is writing novels in multiple languages, playing chess etc regularly. She is 81! If by cognitive decline you mean early dementia, it’s not an inevitable part of being 81. To assume that, because she’s 81, “It’s almost certainly cognitive decline” risks missing all the other possibilities in @SlB09’s post

It is dangerous and unfair on society to have very elderly people behind the wheels of cars. It is dangerous and unfair on society to have people without the capability to drive behind the wheels of cars. It’s dangerous (because our society is built on people having access to a car) and unfair to older people to generalise that all elderly people are unfit to drive.

There’s a huge range of fitness levels amongst older people. One 70 year old can easily be less fit and less mentally able than another 80 year old. Medical and other decisions should be taken on an individual basis, and not on the basis of their physical age.

It's so hard to differentiate between these things - my dad had dementia & it was the classic signs (loss of short term memory) but mum seems different.

I know she's on anti depressants & that these "cries for help" and general avoidance of responsibility can be a sign of that.

But I've had some good pointers on here to start tackling things.

No advice really my mum is a similar age 83 with some similar issues to your mum OP. She also lost my dad to dementia during lockdown and as they did everything together although they never did very much she is lost without him as she has no friends. She has a local community centre on her doorstep literally a flat 50 yard walk away but she refuses to try out anything going on there. She also doesn’t speak to either of her next door neighbours. Thankfully she never learned to drive so at least I don’t have that worry.

But she hasn’t had her ears tested in years so can’t hear, gets the wrong end of the stick and can’t follow conversations often. She also says she hasn’t had her eyes tested for 5 years. She often moans about her health but outright refuses to visit the Dr’s and would be even less likely to go to the hospital.

My mum sits in her ivory tower aka her house expects us all to visit often and seems to be trying to play us all off against each other (my sis, my DB, me and my niece). Commenting about who visited when, how long they stayed and what they have done for her this week or today. My husband is also ill so I don’t feel the need to take part in competitive visiting. Her father did the same playing his children iff against each other which she hated so thought she might have done better but she is very like him and his behaviour.

She seems to idolise my sis and her daughter my niece so they have access to her credit card and can do no wrong. Whereas I am cast aside and made to feel like the black sheep of the family. If I offer to do anything for her, take her anywhere now etc. I am knocked its as though she is trying to punish me.

My mum plays on having social anxiety when it suits but funnily enough she is always ok when she goes out with my niece and her boyfriends extended family or out with my sister.

You can only offer to do what you can do OP. Take care.

Well, I'm sure your mother's independence is more important than killing someone

Ffs

An elderly driver killed a child round here in the most traumatic imaginable circumstances, our community will never forget and the parents will never know happiness again.

Please, please stop your mother from driving.

I've had to stage a driving intervention before with my dad, it was much more difficult than anticipated due to DVLA regulations (basically they rely on people stopping driving themselves). But it was necessary.

I don't think I've seen enough of mum's driving to make a decision on that one. I have only been in the car with her once for 10-15 mins in recent years.

Her accident was clipping a central island type kerb at night driving in rain so hard to make a decision on that.

Thing is, with the driving, you need to stop BEFORE it gets bad. So once you get the first signs of driving skills deteriorating due to age, you need to stop then, not wait until its really unsafe. And as for driving giving elderly people independence, so what, their independence is irrelevant compared to the safety of other road users and pedestrians.

I think elderly drivers is going to become a massive road safety issue before too long. I'm aware of this myself. I'm in my 50s and live in the countryside. I'm just going to have to move to a town.

Yes they are often not lit us as they should be so it can happen

Yes, safety of other road users is paramount, but it isn't just a matter of "independence" for elderly non-drivers, they are excluded from a full involvement in a social life, and lack of social interaction is one of the big drivers of dementia. Access to medical and other services becomes a real problem. Public transport is poorer than it has been any time in the last century, and taxis are only really viable for short (<20 miles) trips. The general public is quite happy with this state of affairs, and not willing to channel more funds to public transport. Ultimately, hopefully self-driving cars will come to the rescue, but for those of us likely to give up driving in the next 10 years the future looks bleak.

The accident that really preys on my mind was the young man who was showing off to his girlfriend and crashed at 80mph in a 30mph limit just outside my house.