Worried mum had early dementia but she refuses to accept. Help!

[Heidi3333]

Worried mum may have early dementia but she refuses to accept it

Hi there can anyone please advise?
My mum is 75 and over the past few years I’ve noticed that her cognition is declining and it seems to be getting worse. Examples of this include:

⁃	often repeating herself in conversations 
⁃	asking the same questions over and over again 
⁃	Has difficulty following instructions and conversations
⁃	Forgetting events and recent information 
⁃	Frequently losing things over and over in the house eg - glasses, teeth, handbag etc 

I’m worried she may be developing early signs of dementia. I have mentioned her poor memory to her before and she always gets very angry and defensive. She is the same if my Dad mentions anything. I expressed my concerns to her again last night and she shouted at me to “shut up” more than once. She said these symptoms were a normal part of aging. I’m a nurse and have training on dementia but she still wont accept what I’m saying, instead she accuses me of interfering/being critical etc.

Ideally I’d like for her to have a chat with her GP about this but this is going to prove impossible. She’s a bit of a hypochondriac and usually loves talking about her ailments but refuses to discuss any of this at all.

How do I deal with this?
Thanks

If she is due to go to the GP for something else then you can leave a note there for them to look out for signs or perform an assessment during the appointment?

Have you thought seriously about how she would react to the diagnosis if it is dementia? After all, there is no cure and very little that can be done for it. I'm 70, my mum and maternal gran both had dementia in their 80s, and so I absolutely dread getting it myself. If it was diagnosed and I was still having lucid periods, I am afraid I would be using them to plan a quicker way out, rather than spend years being cared for.

Hi there

Thanks for the replies.

I did consider mentioning it to her GP but if it was bought up in future consultations I'm sure she would be furious with me for going behind her back.

And yes I have considered how she must feel about a possible diagnosis. I'm sure she's very frightened and that explains her anger. However, this makes it difficult to get her any help.

I'd much rather she went to her Gp off her own back but I don't think this is likely to happen!

While there is no cure I believe there are drugs which are meant to slow down the dementia. I think it depends which type the patient has.

It is also sensible for the individual to let their family know there wishes regarding future care whilst they are able to. It is best to have an advanced care directive.

So there can be a reason for getting a diagnosis.

Advise the GP of your concerns and ask them to invite her for a memory assessment under the guise of a well woman check.
Have you got POA for your parents? Always wise anyway.

@Heidi3333 I think you're right, this sounds like classic early-stage dementia and is exactly how my relative started showing symptoms, right down to the defensiveness.

In my experience be very careful about how you proceed with this as people with dementia can become very suspicious and paranoid and can see the person trying to get them help as the enemy. They just go into denial and do not want to believe they have dementia as they are frightened. This means they can start to distance themselves from you or, in more extreme cases, believe you are trying to harm them. In my case, my relative began to believe I was trying to steal all their money and put them in a care home, they wrote me out of their will and wrote some acquaintances who suddenly 'befriended' them in even though we couldn't have been closer and I was only trying to get them help and support. I was later granted Deputyship by the Court of Protection who were completely satisfied that I had done nothing wrong and only had my relative's best interests at heart but it really was hell in the years before that.

Unfortunately, if people are considered to have capacity they can resist help as much as they want even if it means their quality of life is very negatively affected as a result. I really had no idea of the horrors of dementia before all this, it was a total eye-opener.

Hi thank you for the replies.

I want my mum to get an early diagnosis (if she indeed has dementia) so she can start on medication which will help slow down It's progression; I have explained things to her but she just gets furious and won't entertain it. I have a feeling things are just going to continue going down hill from here on in ☹️.

I don't have POA for either of my parents.

WarmSandwixhes - sorry to hear about your experience, that sounds really tough. It's not easy is it?

I think I will just have to leave things as they are just now but if they start to get any worse then I'll probably have no option but to inform her gp against her wishes.

See if you can get POA for both your parents asap - your mum might be more willing to do it if your father does it at the same time. I hope they have wills sorted out? Write or email the dr as suggested as people often take more notice of their dr and they can disguise the appt as something else.

i hope your mother isnt driving as that could be dangerous - we took my fathers car away once he was diagnosed and luckily he forgot about it after a few weeks.

unfortunately it is one of the difficult things about dementia - the person not being aware of their own decline.

Dementia is so awful, could your mum be frightened and if it's not spoken about, it's not happening?
Getting poa and finding out what her wishes are for future care are good ideas but difficult if she won't talk about it.
My mum refuses to go to the GP about anything at all now (late 80's) because she 'doesn't want to know' .

Hi everyone

She gave up driving about a year ago. Now has dad has to ferry about everywhere. She said she gave up due to her 'nerves'. At first it used to irritate me and I felt sorry for my Dad (she always drove fine before) but now I think it's for the best!

I apologised for upsetting her last night and things are fine again. I'm not going to bring it up again for a while but I'm going to do what some of you suggested and keep. A diary for 'evidence'.

Thank you x

You can advise the GP of your concerns and your DM need never know. You'd be acting in her best interests after all.
Would she attend for a 'well woman check?' /covert memory assessment? You could sell it as something everyone has after a certain age. The GP is God to many older people.
I think that's the only way to go.

We are in the same position OP, apart from DM is single. We really don't know where to turn as she hasn't seen her GP for years- she's super healthy just forgetting loads.

Does anyone know if there are other avenues to pursue, other than the GP?

Thank you@Heidi3333, it's very tough. Just be very careful. I got my relative's GP out under the guise of doing a 'general assessment' now that she was getting older. It was really a dementia check but I explained to the doctor how paranoid she was. Despite the doctor pretending like this my relative still guessed it was me that had asked for it to be done and it further damaged our relationship. The doctor also missed that she was in the early stages of Alzheimer's as my relative was very good at disguising it, they don't look too closely, especially if people are resistant to the idea that they are having problems. They also tend to focus very much on memory issues whereas behavioural issues can be very bad before memory issues cause too many problems.

Getting your dad and mum to do a POA rather than just your mum is a very good idea. I would explain to your dad that if your mum loses capacity without a POA being in place it will cost thousands to get a Deputyship - and it takes ages, it took about four months about five years ago and it's much worse now due to all the backlogs.

You're very fortunate your dad is still around and living with your mum. When they're living on their own it's a total nightmare. Good luck with everything. Remember, you can only do your best, you can't control dementia.

Even if your mum does have dementia, if she is at the early stages, she probably knows and is frightened. As others have said, there's no cure, so what's the point of a diagnosis, other than to make her feel worse?
I would try for power of attorney, to be prepared for the future.

After all, there is no cure and very little that can be done for it.

Not entirely true. A relative is starting on medication to help slow the decline. Access to psychological help and a treatment group (not a support group, actual things to help with memory issues) is also being provided. All NHS.

More support can potentially be put in place both financial and practical, things become available from diagnosis that weren't before (even taking account of the fact that our system is on its knees).

Yes, this is true. On a practical level it is much easier if someone is diagnosed. There are also drugs that do help help slow down Alzheimer's for some people such as donepezil (also known as aricept), rivastigmine (exelon) and galantamine (reminyl).

What about other things that might be affecting her, eg vitamin b, thyroid, would she get them checked? At least it would rule them out

As others have suggested we got mum to see the GP ny tell8ng them our concerns and they invited her for a general health check. She agreed to a memory test to "prove you all wrong". Now we have confirmation of the problem and she is on donepezil but she has completely forgotten the medical appointments and brain scan so is still convinced she is fine. TBH she probably still has enough understanding for the knowledge to ve terrifying so maybe that's a good thing but shectries to do her own admin and then we have to sort out the mess.

Hi did you find out what is wrong? My father is presenting similar symptoms

Hi mum of two

No I'm no further forward. Her symptoms have stabilised and haven't got any worse so I've just left things for now as I'm pregnant and do t need any agro! If she gets worse then I'll have to think of a plan B x

I find a lot of the advice good although i believe its not that easy in reality. My mum has deteriorated rapidly over the past 12 months, she has just reluctantly gone into a care home for a trial - much to the family relief as her behaviour was becoming dangerous to herself and others.
We took her to a family wedding at the weekend, and she became very disorientated. Firstly she kept refusing to do anything (we understand she has a right to make decisions) however she was contradicting what she wanted to do - example, she wanted to get to the wedding on time, but refused to get dressed. She wanted to eat at the reception, but refused to go to the table. During the trip home she decided to cut her catheter bag tube, because she said it wasnt connected properly, she attacked my partner who is a nurse when they tried to reconnect another catheter after she gave her permission to do it.
We have contacted her GP with our concerns who has told us she has to give permission for an assessment. We thought she may have a UTI which may be the reason for the confusion, but she doesn't.
As a family we are all extremely stressed as we don't know which way to go forward. A recently spell in hospital, a doctor told us he believed she had dementia, and they cared for mum as if she did, even placing a forget me knot above her bed, yet we still have no formal diagnosis.
she has told us she tired to commit suicide, by not taking her medication, then calling us and telling us she has been unsuccessful - all of which we have told her GP but they are reluctant to get involved.
It is so painful seeing such an independent lady turning into something none of us recognise. My partner and Neice who is also a doctor believe she has vascular dementia and is probably the reason for such a rapid deterioration. We are just hoping now she is in full time care they can actually assess her.

Well if your father is currently ok talk t0 him about setting up POA and get him to talk to the dr. Better if it comes from him anyway