At what point do you start being seriously concerned about cognitive decline?

[IShouldNotCoco]

My mum is 78 and lately I’ve noticed that she’s very suddenly gone from being a good driver to one who drives in the middle of two lanes and seems unable to realise when it’s her right of way or not. Yesterday, she was waving her fists at another driver even though it was clearly their right of way - the give way line was on her side. She can’t reverse out of spaces now either - I had to take over and do it.

I think if I told her she should stop driving, she’d be aggressive towards me about it. She’s very upset atm because apparently she did an NHS cognition test which revealed she’s in the bottom 30% for her age.

She’s angry a lot of the time, lately as well. How concerned should I be about this? Any advice about how to handle it?

Hugs to you, had been in a similar situation with my Mum. Fortunately the car went in for its MOT & the garage said it wasn’t worth fixing (she’d managed to sideswipe a bus couple of months before!) She fell & broke her arm & in hospital they said the shock of the fall had brought on delirium, she was raving at times, aggressive, fearful, racist, it was awful as Mum just wasn’t like that. She never recovered from that really & declined steadily. The hospital arranged memory test where dementia was confirmed & after a couple more falls she was discharged to a care home. Awful few years for her & our family

You can secretly report her to DvLA and they can require her to take a driving assessment to see if she’s still fit to drive

i had to do this with my mother - she no longer has a licence but it was that or kill someone

she has no idea it was me and she’ll never know. She thinks it was her Doctor reported her

My nan all off a sudden struggled with driving, forgetting how to start the car and struggling with directions among other various episodes of being a little confused. My nan had stage 4 breast cancer when we finally convinced her to get checked over, it may not be the case for you and it is terribly hard to convince a proud person to get checked over x

That must have been so hard for all of you. My DF had similar confusion tgat turned out to be Stage 4 Lymphoma.

I hope you can get her to someone who can check for dementia. I recently had to tell my parent they either agreed to stop driving or I would take their keys away. I couldn't risk them having an accident and hurting someone, it would been so distressing for everyone involved. It's never an easy conversation and I can understand why there are campaigns to make older people take regular driving tests.

You absolutely have a right to be concerned as this does sound like cognitive decline.

I would speak to the GP about being referred to the geriatric mental health team for full dementia assessment. I would also look into getting POA whilst she still has capacity so you are able to deal with her affairs when she isn’t able to.

so sorry you are going through this. We are currently going through similar with my father in law.

I understand how you feel. My mum doesn’t drive, but I’ve noticed that she forgets so much, more than I think is normal for 73, and she just gets really angry when I suggest seeing her GP. I’m sorry I don’t have an answer, just wanted to empathise.

I have reported my mother to the DVLA anonymously. Thank God she has given up driving as a result. She was really dangerous. I also think she’s suffering from early dementia. Her memory is going, she has mood swings, outbursts of anger and depression. I have suggested she needs to go to her GP for an assessment but she won’t.

It is such a tough one, but I think you need to try to have a conversation with her about putting in the necessary things like POA while she’s still got capacity.

Mum is far from needing me to take on her affairs, but because it can take months for the POA to come through, she got it all in place a couple of years ago so that as and when it becomes necessary, it should all be seamless. Because at 77 she is still doing pastoral work, she’s seen too many cases where important decisions got tied up in difficulty because it was all left too late.

So maybe a conversation along the lines of “while I know you’re doing everything you can to prevent cognitive decline, it happens to us all eventually, and I want to make sure that we have the systems in place to ensure you and Dad can access everything you need without it all getting caught up in legal hassles. Can we sort out POA for you and Dad so that if or when it’s needed, your care doesn’t get delayed?”

It sounds like for now they both have sufficient mental capacity to consent, but maybe not for much longer with her. So discussing her wishes and intent while she’s still with it is important for you to be able to make sure that decisions are made with her wishes in mind. It’s not taking over: it’s a practical way of ensuring you can speak for them both if they no longer have capacity to do it for themselves.

And I agree with other posters that a quiet report to DVSA would be sensible.

I can't imagine how much of a difficult situation you are in but please take the right steps to stop her from driving at least. This is a disaster waiting to happen, how will u feel if she killed someone, a family in another car or a child, and you knew she wasn't safe beforehand? It's absolutely not worth the risk. She will be pissed to start off with but she will get over it. Even if you have to make an anonymous call to the DVLA whatever u have to do, do it xxx

It really is worth emailing or writing to her GP with your concerns.

I did read the other day about a link between GA and dementia so it's possible you are correct in linking the changes to the gall bladder operation. You must get her off the road before someone gets seriously hurt. I'd also register your concerns with her GP. It's possibly too late to get a POA in place but worth a try. Plus she can't really change her will if her mental health is in decline, although I guess that it's debatable.

Tell her it's all the medical tests or the DVLA and that you will report her. It's people's lives on the line. Including hers.
She might be angry that her body is failing her.

OP, this is good advice. Don’t phone, write down your concerns. The letter will be responded to by one of the doctors. It will not be ignored.

I asked to pass on my concern to one of the doctors. The receptionist told me to book a zoom call online with one of the doctors and it would be a few weeks before it happened. Useless.

Update;

My mum made plans, yesterday to go and visit her friend, today at 3pm. Today, she had completely forgotten about it, thinking it’s tomorrow (Monday).

Needless to say, I’m more worried than ever. I’ll be contacting the doctors first thing in the morning.

That sounds very much like my mother. I had arranged to pick her up for an appointment at a certain time. When I arrived she was outside frantic, wanting to know why I was so late. I was early.

That’s why I suggest writing. A letter is scanned into patient notes and responded to. Why are people so reluctant to do this ? It also bypasses the receptionist issue.

Please do email or write. It’s the way I’ve found most effective.

I have written to the GP with my concerns - and I’ve used the phrase suggested on this thread about wanting to avoid an accident.

My mum went for her hearing test this morning and her ears are full of wax so it’s been recommended to have them syringed and also a follow up about the tinnitus and the vertigo she’s experiencing.

I mentioned my concerns to a friend of hers who dismissed them all, saying my mum ‘isn’t like the people she knows who have dementia’ and to stop worrying about it because it will only worry my mum. So not helpful 🙄

Also agree with hearing loss and dementia being closely linked.

Isn’t that uncorrected hearing loss? Making people ‘cut off’ from reality?

posted too soon!

Yes, apparently if your hearing is poor as an older person, it puts the brain under more stress and is more likely to trigger dementia which does actually make sense.

I’m in the same situation. We saw the same issues and mum was seen by elderly mental health team. She was diagnosed initially with mild cognitive impairement.
however I spoke to the consultant about driving and he said she can if she still wants !!!! She was a liability on the road, so I removed her license. Luckily my brother is around who can drive her anywhere she needs to go, but I was shocked that they didn’t say she couldn’t drive. Nobody would get in the car with her as she was an accident waiting to happen.
Can you just remove her car keys ?
My mum was not happy and still brings it up 2 years later. Her dementia has progressed and I now lie and say the doctor told her she couldn’t drive. She does acknowledge that, if she causes an accident she would never forgive herself, but then forgets and moans that she was banned from driving.

I would try and speak to the GP as they may be able to persuade her to give up driving easier than you.

Also, from what you’ve written, it does sound like the start of memory problems. It may not be alzeimers though. We think my mum has had some minor strokes. She definitely has some behavioural changes and is quite difficult but it is not really getting worse very quickly. I think she’s only getting worse as she doesn’t do anything any more.

definitely sort out power of attorney asap though. Whilst she’s still able to consent you can do it yourself without a solicitor which is much cheaper.

There are lots of types and causes of dementia so they don’t all look the same.

For example, depression and type 2 diabetes can also cause cognitive problems.

@IShouldNotCocoWe have a friend where hearing loss definitely contributed to dementia but not in brain stress. It’s zoning out because the person cannot hear and taking no action to help the situation. So refusing hearing aids in this case. It’s the start of dementia because they don’t really want to talk to others so the hearing aids aren’t vital in their opinion. They have zoned out and don’t really care. Talking requires using the brain when it’s not functioning as it did. So hearing loss and isolation are the big problems leading to dementia. It’s vital a person is persuaded to do something about it.

There is anger associated with dementia too and definitely not being in tune with other people. The dementia test isn’t fit for purpose. An intelligent person can usually dredge up answers. It’s how they are in relation to tasks and relationship with others that matters. Often irrational obsessions, not participating, not making decisions, and generally losing all sense of humour and spark. If that’s going, then gp immediately if possible. If they won’t go, it’s difficult to force it because they won’t acknowledge what you think.