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Old 12-27-2012, 09:10 AM   #1
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Advice please

Hello, I am having some concerns about my MIL and i dont know too much about alzheimers disease and i would like opinions on if you think i need to have her checked out or not. She is 71 yrs old. She has always been somewhat forgetful and temperamental but to me she seems to be getting worse. I have discussed this with my husband but he does not seem concerned about it. She repeats herself all the time and when we try to explain something to her it takes forever to get her to understand and most times i dont think she really understands it. Example.. she bought a television and it is supposed to be delivered. She has forgotten that she ordered it and it was only a couple of days ago she asked 3 times the other night if she ordered it or not. if her computer is not working the way she thinks it should she throws a fit like a 3 yr old and i mean literally she screams pounds tables and stomps around. she gets mad and upset very easily. she doesnt drive anymore because her car broke down and it has been a yr since she has driven but when she did drive she got lost in her own neighborhood twice and she has lived her over 30 yrs. sometimes she seems fine other times not. she does play games on the computer, puzzle games that require thinking and figuring things out and i think she does ok with them. I know there is no way we will get her to the dr to be examined and she would be very mad if we told her we thought she might have this so i dont know what to do. any advice anyone can give me is very much appreciated. Im not sure if this is just old age setting in or if it is something more.

 
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Old 12-27-2012, 08:58 PM   #2
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Re: Advice please

If you think there is a problem, then there probably is a problem. Growing older does not include cognitive impairment. I will repeat... old age does not include cognitive impairment. Repeating oneself, forgetting recent events (such as the TV), and having trouble with electronics are all symptoms that there is something going on. Behavioral changes such as the temper tantrums are also symptomatic. Getting lost and withdrawal from things she used to do are also symptomatic. My bet is that she has difficulties with math, recipes, and multi step instructions. I also bet she has difficulties handling her money and paying her bills. Just the fact that you are here says there is something beyond normal aging going on with your MIL.

As for hubby not being concerned... this is a typical response. Even the idea that a loved one has some type of dementia is scary and in the early stages it is easier just to ignore it. The fact that this disease, in the beginning stages appears worse at times and better at other is deceptive. It lets you explain away the bad times and focus on the good times. You need to pick the worst of times and go from there. You didn't say if your MIL lives alone?

As for a diagnosis, it is imperative that you find out what is going on. The symptoms you are seeing could be caused by something that is fixable. Many times prescription medication side effect can cause cognitive problems. It could also be from B12 deficiencies or other medical problems that can be resolved. You would not want to let those types of things go unchecked if you can fix them. Or it could be because of brain tumors (benign or malignant that also can be fixed). If there is some type of dementia present then plans need to be made and early intervention can make the situation better.. If she is living along the she will eventually need 24/7/365 care. You will need to make sure her legal papers are completely including a durable POA, medical POA, living will, will, and other necessary paperwork so somebody can handle her financial, legal, and medical decisions. Ignore this will only lead to difficulties down the road. Not knowing is not bliss but a recipe for disaster. Knowing is the first step in knowing what to do next. Ignore it will not make it go away.

You can get her to a doctor!! It might not be easy but it can be done. You don't have to tell her that she might have dementia and you need to have her tested. She needs to go for a general physical, blood work, and other necessary test regardless of any potential dementia. Before she goes you need to ask the doctor to include a Mini Mental Status Exam in his list of test. That 30 question test will give you an indication of what you are dealing with and you can go for follow up diagnosis if necessary. You need to rule out all the other potential causes of the cognitive decline before you label it dementia.

If you though she had cancer you would not just say... we can't get her to the doctor. If you though she had a broken hip you would make sure she went to the doctor. If you think she has a cognitive problem you must do the same. Make her an appointment and tell her she is going for a check up... end of story If she get angry, so be it. She will get over that anger and you will know what you are dealing with

My Mom didn't go to the doctor willingly. Her Mini Mental score was 24/30 so I knew there was a problem. We were able to rule out other medical and drug side effect causes. She fought me tooth and toenail when I suggested further cognitive testing. I made the appointment anyway. I insisted that she go. She was angry and I got an ear full for the 45 minute ride to the clinic. I had "lost my mind". By the end of the day, she was no longer angry, just tired, and I had my diagnosis. Mom is now in the final stages of Alzheimer's. I have been handling all of her medical, financial, and legal decisions for over 6 years. I am eternally grateful that the necessary legal papers were accomplished so I could do this. She was at home for almost a year after diagnosis with a care giver, in AL for 18 months, and in a locked dementia unit now for almost 4 years. At no point in this process did she recognize that she had a problem and ask me to do any of this. It is just what has to be done... and can be done

Hope this has helped....

Love, deb

 
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Old 12-27-2012, 09:07 PM   #3
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Re: Advice please

Hi Worried,

Welcome to the board. There are so many knowledgable and supportive people here, hang around and you will learn so much.

My mom is 72 years old and I recognize the symptoms you are talking about like they were yesterday. Unfortunately, they were about 4 or 5 years ago and she is now in Assisted Living. Most people, including myself at one time, will tell you she should be evaluated for all sorts of treatable conditions that mimic dementia. That would be a prudent thing to do for sure.

Your MIL just sounds so similar to my mom though, that I am worried. Dementia is not a typical part of "old age setting in." It is a disease process that is much more common as we get older, but there is still so much unknown about it. Your MIL may not have Alzheimer's, but a different type of dementia, of which there are many. My mom has a dementia similar to Lewy Body even though she doesn't neatly fit into any diagnosis.

So what you are describing sounds so much like early dementia, and it is expected that she will sometimes be concerned but also be very much in denial. What is most important right now is making sure she is safe and not driving. You will probably be advised to start getting certain affairs in order like durable power of attorneys for finances and healthcare.

It's a complicated road ahead, unfortunately. So many people want to stay in denial, but that has never served me well. I am SO thankful I trusted my instincts and took action when I did to take over my Mom's finances, bet her off the road, and into a safe living environment. I shudder to think what would have happened if I didn't act exactly when I did (a few weeks after having a baby, no less!).

Good luck, and hang on for all the other excellent advice you'll get. This group is SO helpful.
Annie

 
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Old 12-27-2012, 09:17 PM   #4
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Re: Advice please

Long story tried to make short-sorry but I failed!! I had a similar situation with Mom, for about 2 yrs there were just these little things about her that were just off a bit. Not just forgetfulness but the inability to learn new things like working her e-reader that she bought herself or her new cell phone that she just had to have but then was so afraid to touch it because she was afraid to hit a wrong button and never be able to get back to home screen. Also tax time last year, she had alot of anxiety about it and every phone conversation was the same--"What are you up to Mom" "oh just getting all my papers together for taxes" her appointment was 1 month away and she doesn't have squat to claim! I would just roll my eyes like --yeah-whatever. But when my aunt visited her, she had financial papers spread all over the table and living room floor--this was not normal for Mom. Many other little things were also happening, just not enough to put 2 and 2 together for her. She is a very physically healthy lady who turned 69 last March so how do I get her to the docs? I couldn't. She started having hallucinations, which I found out that had been going on for long time, but she didn't want us to think she was nuts. Still couldn't convince her, she was still capable of living her life and take care of herself. She started having severe IBS--aHah! A way to get her to her doctors! Nope! It would clear up so who needs a doctor? Life as we knew it changed in Sept when her IBS-which she was trying to hide from me so I wouldn't nag her to go to her dr's--ended up putting her in the hospital with severe dehydration, this sent her mind over the edge with delusions hallucinations very wild and vivid for her, and major confusion. Finally I got a geriatrician to check her out and he gave her the mini test (MME-I think) and she failed big time. Test were run after she was out of hospital, brain spect scan, CT scans, blood test. With the spect scan, results show mostly vascular dementia with some frontal lobe dementia possible too. No MRI was completed because she freaked out-with a sedative. Doctor explained to me that when she is under stress or anxiety, her brain basically stops working, so every time she'd go in for this test or that test, it was causing her brain to shut down more and more, to the point that now she only has few memories of the past 10 years and most of her memories she has is beyond that. She is incontinent already. A month ago I had to moved her into an AL, medications are kicking in and I am happy to get a few precious moments of a normal conversation with her but then its gone and the delusions are back. Would anything be different if I could have got her to go to the doctors sooner? Maybe, but I will never know so I can't dwell on it. Moments of guilt?? yes but in my case I could not have forced her to go to the doctors up until the time that she had something 'physically' wrong with her, she was stubborn like that.
They want to be independent for as long as they can, afraid someone will try to take that away from them. Let your MIL-with your guidance, be independant, but also maybe find ways to bring up an 'article' on new drugs that are out that help with memory, putting a positive spin on it just might get her to be curious enough to talk to her doctor about it. Hopefully you will get some other ideas from the wonderful people of these boards on how to approach this with her, and to even get your husband on board too but guaranteed he will be in denial because when its your own parent, its very hard to face the truth.

 
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Old 12-28-2012, 09:59 AM   #5
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Re: Advice please

Thank you every one for your help. She doesnt live alone she lives with us and i am a stay at home mom so I am with her day in and day out. Hubby works so he doesnt see her as much as I do and is unaware of what is going on with her most of the time. You mentioned the B12 deficiencies, she did have this problem several yrs ago but it was different she was totally out of it the most bizarre thing i have ever witnessed. She was thinking I was an alien and all sorts of thing, but she didnt live with us then and we didnt see her as much so I dont know how it started out, i just remember the full blown effect of it. She now takes B vitamins but i suspect she doesnt take them every day. she says she does but i dont think so. she does not eat right at all i make dinner and lunch every day but she will not eat what i cook. She eats lunch meat sandwiches almost every single day, or she will eat some frozen junk that goes in the microwave, i have witnessed her eating ice cream or cookies at in the morning and at different times in the middle of the night. she has very strange sleeping patterns. As far as her managing her money, i dont know if this is a problem or not. she gets pretty good tabs on her money she calls the bank to get the balance daily and freaks out if there is a charge she doesnt remember paying. If she gets down below 1000 dollar balance she has a fit. she has been doing that sort of thing for awhile until last week. she bought a new tv which she thought she needed and in the same week she bought a new computer she orders this stuff online. hubby told her she didnt need a new tv but she bought it anyway which took her balance in her checking account down to 200 dollars she never lets it get that low and when i told her what it was she seemed surprised so i dont know if she is still calling every day or what. anyway i am going to talk to her dr and make her an appointment to come in so he can see what is going on any additional advice would be great thanks again

 
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Old 12-28-2012, 11:00 AM   #6
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Re: Advice please

Oh man honey, I can SO identify. I don't know much about the B-12, but wow, your mom acts so much like mine did 5 years ago.

My mom didn't live with us, but 2 blocks away in the same subdivision, so I saw her multiple times a week. From being a very good sicilian cook with a gourmet kitchen, tons of cookbooks, she went to eating nothing but WW Smartones frozen dinners, canned soup, bagged salad, and occasionally a turkey sandwich. She would hang around my house all the time raiding for cookies, which I discouraged since I have young children that I try to keep on a healthy snack schedule. By dinnertime I tried to get her to stay so she could at least have a decent meal, and when she'd eat with us she acted like she hadn't had a hot meal in years. I just couldn't understand it.

My mom got EXTREMELY impulsive AND compulsive with her shopping. She'd see something on tv and bam, she'd buy it. Yes, she would repeat purchases. Sometimes buying something online, forgetting, and then going to the mall and buying the same thing again. I'm a stay-at-home mom too, and it started with her going on shopping trips to Target and Meijer every day, and raiding the clearance rack at the high end dept. stores for baby clothes every day. We chalked it up to new grandma giddiness. She's always been a shopper, and I never really cared, until it all started cluttering up my house, and if I told her to stop she got ANGRY.

She was always very competent with her finances (or so I thought) and was well-off, so I tried not to worry too much. I figured she'd know what she could and couldn't afford. My guess was I'd have to take over her finances at 70 based on things she said here and there that worried me, but we didn't make it that long. I had to take over when she was 68. And it was in the nick of time... I went over the last 2 years of CC bills and found late payments, things like $1000 spent at a mall kiosk, donations to bizarre charities, etc. I still let her keep a couple of credit cards and I monitored them closely. I then spent 2 years doing nothing but stress about all her QVC purchases that were a few thousand a month. Totally impulsive, with less than 1 minute thought on each one (I know that because I've seen her in action). After I realized she truly had no ability to reason or control herself, and I was tired of hauling brand new expensive stuff out of her apartment, I pulled the plug and took everything away except a small amount of cash.

The fact that your MIL checks her balance on the phone every day alarms me. First of all, it's a little obsessive compulsive, but I sort of check mine every day too. But I keep track of it myself. The fact that she has to keep calling her bank signifies to me a feeling of losing control and confidence in herself. It's like when you constantly check the oven or iron, wondering if you left it on. If she needs to know her balance, and she is appropriately competent (by my standards, at least) she should be able to keep a bankbook or Quicken and track her balance herself. I didn't think my mom would have late bills in a million years because she always seemed to be doing nothing but PAYING bills when I'd come over. But then I realized she was always embroiled with bills and bank statements because she never could get a handle of what was going on. Basically, she needed help.

I'm glad you're getting her to the doctor for at least a mini-mental. If possible, see if he can do a MOCA (another type of doctor's office dementia check), it's a little more accurate in the early stages.

Glad you found us, and listen to everything deb says, she's an unfortunate expert in dealing with demented loved ones.

Annie

 
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Old 12-28-2012, 11:05 AM   #7
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Re: Advice please

By the way, out of curiosity, when you say she repeats herself, is it like she asks the same question over and over like every 5 minutes? That's typical of Alzheimer's, but my mom never does or did that. She has what is called perseverative speech which is she just keeps repeating any given sentence or answer to a question as if I didn't hear it. It's like she gets "stuck" and we have to try to cue her to move on. When she's not perseverating and is having a normal conversation, I know she's having a "good" day (or hour), and when the perseveration is bad I know she's in a negative state. Just wondering what kind of repeating your MIL has, because I haven't really talked to anyone who has the type my mom has (give me a shout if you're out there!).

Annie

 
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Old 12-28-2012, 12:21 PM   #8
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Re: Advice please

My dad (diagnosed with Vascular Dementia) tends to repeat himself or repeat questions a couple or few times in a conversation. Not constantly, but when something is on his mind, he wants to keep talking about it, probably unaware that he mentioned it before. He gets stuck on these (usually misguided) ideas and comes back to them again and again.

 
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Old 12-28-2012, 12:41 PM   #9
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Re: Advice please

an example of her repeating herself is when she bought this tv my husband was trying to explain to her that she didnt really need it, and she did not remember if she ordered it or not she asked 3 different times during this conversation if she had ordered it or not. she may tell you a story and then come back in 30 minutes later and tell you the same story like she had never told it before. it is very difficult to explain things to her because she just doesnt seem to understand and repeats the same questions over and over again. if she has some sort of appointment we have to remind her the night before and then again a few hours before and then an hour before to make sure she remembers and gets ready.i made the appointment with her dr i spoke with the dr by phone and explained my concerns, she has to go in for labs on monday and then to the dr on wednesday they are going to check for the B12 and they are going to do some sort of memory test so i will know a little bit more then. thank you all for your advice and support

 
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Old 12-28-2012, 02:16 PM   #10
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Re: Advice please

Yeah Worried, that sounds like the Alzheimer's type short-term memory loss . That's what my grandma did who had Alzheimer's, and parents of friends. I'm no expert of course, so it's imperative you have her see her physician, and then if need be, a good neurologist specializing in cognitive disorders.

 
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