I've posted before about in-law care-giving. Aged mother in law, lives in same town.
We are at the tail end of a visit from sister in law from several states away. Sister in law has been here for 3 weeks caring for her mother. A much welcome respite.
It had been discussed, prior to her arrival here on the scene, she would be talking it over with her mother, to try and get her mom to come up to her home, for a stay of maybe a few months.
This, in my opinion, is absolutely essential, as I am expecting twin grand-children, due in about 1 month (if they don't come sooner, as is the case a lot of times with multiples pregnancies). The expectant mother also lives locally here, and has a 4 year old daughter. I will be on that front, helping .. as much as is needed. And not on the front with mother in law and care-giving, and have made that as obvious and apparent as I know how to make it. It would be great if mother in law would agree to go to her daughter's home (several states away) for a period of a few months .. and allow me the latitude to put my energies where I want them to be, on my daughter who will have had a c-section .. and my grand-daughter (4 years old) and new twin babies.
Nothing doing. Mother in law has dug in her heels, and will not hear of it, going to stay with her daughter for any period of time.
What are her reasons?
In mother in law's defense ... her daughter ... I don't even know how to describe it. I will say that when her daughter comes here to visit, she all but breathes for her mother and if she could find a way to do that, she'd do that too. She is the most nervous nelly, never sit down - ever ... worry wart, do everything, all the time .. person that I've ever encountered.
A great example, as I was taking her to the airport yesterday for her departure, . I reached into the fridge to grab myself a bottled water and shut the fridge and turned to walk away, as I've done for all of my 50 plus years living on this earth .. and she said to me, "Oh make sure that fridge shut". WTH???? Like I don't know how to shut a fridge? That's just a small, very small slice of what she is ... how she is.
She is so very hyper-vigilant, seeing to every minute details down to it's finest most minuscule point, fine tooth comb, questioning every point along the way, "should we do thus and so, but maybe if we do thus and so, then such and such will happen, maybe we should do it thus and so .. but then so and so might happen, maybe we shouldn't do thus and so, but do "x" "y" and "z" instead, but if we don't do it that way then ..........", on and on and on and on it goes. And usually in hyper warp speed, as to every single friggin thing.
If her mother moans .. "what's wrong mother?, why did you moan, are you alright?".
Mother: "Yes, I'm fine, I was just sighing out loud".
Sister: "Why did you sigh? Are you hurting, are you sure you're alright, why are you sighing what's the matter?"
Mother: "For God's sake __________________, I was just sighing, .. calm down, I'm fine".
Sister: "Are you sure, .. because if something is wrong you need to tell me".
Mother: "Everything is fine, I'm fine".
Sister: "Are you sure, we did a lot yesterday, did we do too much, maybe we shouldn't of gone to two doctors in one day .. was that too much for you, are you too tired now, maybe we need to move those other doctor appointments so we won't have two in one day, is that too much for you, for one day .. is that why you were sighing .. what's wrong, are you sure you're alright".
Hopefully that kinda gives a little bit of a snapshot of what goes on when sister is in the ring directing things.
So in mother in law's defense.. I do get it, why she wouldn't be chomping at the bit to go to her daughter's home.
BUT ....
The only experience she has with her daughter, in the last years as mother in law has aged and been unable to go anywhere much, has been the daughter coming here, periodically, for periods of about 3 weeks at a stretch. When her daughter comes here, she moves heaven and earth for her mother and then some, and doesn't sit down, doesn't stop .. the WHOLE ENTIRE TIME.
Is there a possibility maybe (as I said to mother in law, when she expressed that isn't happening - talking to me - her going to her daughters .. ever) .. could it be possible that maybe if you would go to where she lives .. she'd be more busy managing her own life in that setting than your's and she would get out of your backside .. and not be as hyper-drive-vigilant as you experience in her, when she's here, could that be possible.
The daughter is retired, lives several states away. Does come here, generally, every few months .. and stays for a period of about 3 weeks at a stretch. I wish I could make a list of everything the daughter did when here this last time, but it would take up the whole character allotment:
I don't see it that way. I think she wants to comply . in fact, today when they did get her out of bed . she didn't feel well .. upright now .. which is rare . they don't seem to be able to get her upright much without she feels faint, nauseous . light headed . but today they got her up .. and she reports not feeling well . .but she was so determined . she'd tell you . to push past it . that she wants to get on with the business of getting stronger .. thought she'd push on past it .. let them haul her to the PT room where she then fell over .. puked .. almost passed out.
I think .. just from the time I spend around her, . she wants to comply .. as she does have some understanding that she needs to do these things . to get stronger ..
But there is a disconnect there .. that her brain doesn't then compute .. oh hey . there's that water they keep telling me about . let me take another sip and another and another and another ..
It just doesn't compute.
Her brain .. here she is being brought up out of bed and not feeling well .. your brain should tell you .. "hey folks this . .this isn't feeling right . I don't feel right" . and say so .. but her brain .. doesn't seem to compute that. And so she says she wants to 'Push on past it' . and then the result . not good.
I don't think in her case it's willful.
He does in fact see . she can never live alone again . ever.
But .. he just is too mired in the sorrow of what her life has become to see much else.
We can’t really depend on that recollection.
Dang it!
It seems like you and SIL have really cleared the air between the two of you, Dorker. She seems to agree with most of what you say, yes? I hope this time of united purpose has served to heal some of the rift that occurred between you two when you refused to be the stepper and fetcher for MIL any longer.
I wanted to say that my mother also has such vivid dreams now that she thinks they are reality. That is some of why she gets delusional. The problem is, she doesn't quite believe she was dreaming. She gets very angry if someone doesn't agree with her.
I think we can all understand why MIL doesn't want to drink water. More water in = more water out, and that is an issue for her. I really do think SIL is going to end up at POSH cajoling her mother to drink (just like she did when MIL was living with her). Didn't MIL always have to be cajoled like this? Why would it be any different now?
Is H still going by to see his mother? I know he must go by on the weekends, but is he going to go by this week?
So she gets out of bed to wash up before the SW was due to arrive and breaks her hip. She's agreeing to go to therapy even when she feels lightheaded so she can walk again.
I wonder if telling her that FP is off the table due to funding issues might be a kindness in this situation.
My mother had that attitude, also. Even now, she tries to engage the staff much more than her fellow residents. I don't think she will ever accept that she is among her peers in terms of functioning.
And she still hisses to us about some of the fat workers. Sigh...And she still obsesses about money, even though we have told her that it is all taken care of. She was so upset the other day that one of the CNAs made out a receipt for her that her NH bill was paid in full.
For the most part, her struggles present day are her forefront .. not so much what is out in front of her .. further up the road.
In fact, all of this has so knocked her back that there really hasn't been much coming from her corner, as was previously the case, about the whole "Now don't ya'll put me somewhere with people who don't know chit from chitola". Heard that one before hip break . along with other protests having to do with the fact she would N-E-V-E-R consider herself to be among that *lowly* population.
Haven't heard anything more of it .. since the hip break .. other than .. like yesterday as she talked of struggling to come to terms with .. that here life has become this .. this will be her day to day from here forward. She didn't peg any of it though, .. "don't put me with people that don't know chit .....".
The fact of the matter .. and SIL and I both firmly entrenched there, .. (DH not as much) ... she will never be happy. In fact, we'd been talking about her brother in law (MIL's brother in law) in TN .. he'd been moved from FL .. up to TN .. to live with his daughter a year or two ago .. and .. that in the end, didn't work out so well .. and has since been moved into an AL there in TN.
He laments . .apparently to his daughter, quite a lot .. that he wants to go back to FL .. to an AL in FL ..
He has no one in FL any longer, .. he would tell you he has friends there .. (his friends are either now deceased or too old to be of any help to him at all). His daughter tells him this .. "you can't go back to FL dad .. there's nothing there for you anymore, you need to be near family and so you'll need to stay here in TN .. where I live". This goes on all the time .. this dialogue between she and her dad.
SIL telling me that she and this daughter . up in TN .. they'd been talking about their respective parents . .and that both of them, SIL and her cousin .. they both say .. "they will never be happy again . .what they want .. is so far gone .. they want to be back in their home .. viable .. and able to do .. on their own .. and nobody can give them that .. that's what will make them happy and it's not attainable".
SIL and myself firmly entrenched in the realization she will never be happy. I don't care if we had the means to put her in a palace .. with hand maidens at her every whim . .she'd still not be happy. She has a broken body .. and a broken brain . at this point . and nothing can fix that . but the cloud . and the cloud comes when it wants . .not when you want it to.
Yes, I guess .. I hadn't maybe stopped to realize that for the most part, . .what a turn-around .. SIL and myself, in agreement on most things. I'm no longer fighting an uphill battle, one I departed entirely .. in trying to get her to realize the brevity of all this. She's there, .. firmly sees it.
And on the dreams thing .. yes .. her dreams are so real to her . that it's hard for her to distinguish between . that was a dream, this is real.
In fact, yesterday when we were there, and talking of the night before when she'd called SIL that she was stuck in her home . in IL . needing SIL to come to her, help her get out .. talked of all that, and MIL talking of how real it was. Her then saying the following: "these dreams .. they're so vivid, they're so real . I have a hard time telling what is real and what isn't .. in fact, you two here right now .. I might just as easily call one of you later and ask you .. did I brush my teeth . was that real, or did I dream it".
(We'd just helped her to get her teeth brushed).
Ya know, .. so many problems that are rooted in the dehydration . that can be one of them also . .delirium .. and disorientation . along with the getting impacted, along with the weakness and too low of BP.
2. Tell the doctors/ DON about the vivid dreams. They can be a side effect of some antidepressants.
Cited to Jessica her having gotten impacted .. and her daughter having found her with feces on her hands, .. and in some pretty severe pain . from being impacted.
Having vivid dreams she's unable to distinguish that are dreams and not real ..
A lot of this can be hung on the fact, she's dehydrated ..
That the doc had now rx'd . .something to raise her too low of BP . and that he started an IV yesterday afternoon for her. But .. how much of this is unreal expectations on our part . and how much of this is just a simple matter that she needs a higher level of care than this setting.
Jessica; "Well are you planning to be at the Action Plan Meeting on Thursday".
Me: "Yes, .. I'm going to be there".
Jessica: "Well . what I would suggest, that is where you get some of this addressed .. and so document your concerns . and bring those up . and I will be there also .. but to expect that she will see to her hydration needs when she is repeatedly being given IV fluids for that very failure . is not realistic. The staff there need to be aware and come up with a workable plan to make sure she stays better hydrated and so you look for that improvement when there is a document for need there, and if they can't address it . that's when you begin to look at a different setting.
Seems like from SIL's morning phone convo with her mom this morning, more lucidity and maybe even more energy level . it was MIL that called SIL this morning . and told her "I just wanted to call you and let you know that I'm doing fine this morning".
Well of course she is, she's several hours at this point into IV fluids .. (HYDRATION).
I did tell SIL that she should talk with the doc about the anti depressant and if she's still on it, . and if it's been pulled why .. and if she's still on it, is it one that is known to cause vivid dreams.
On the point about her too low of BP ,, and yet hauled off to PT . .and there having fallen over, and puked, etc ..
Jessica's advice, bring that up at the Action Plan Meeting, . yes they should be documenting her BP .. it's known she has too low of BP . and you said a doc is now rx'ing something to bring up her BP . so that may be what addresses it in the end .. but bring that up .. as you document some of these things . that they should be checking her BP .. before and during PT . and if so . what is their threshold . as to .. too low for participation in PT . and what level/goals are they working on . factoring in the too low of BP.
I learned through hard experience to check my moms med list very carefully each time she entered and departed a hospital. There were always errors.
The hydration issue---arrgghhhh--my mother has a permanent catheter in place, and she STILL has incontinence issues, so she also has to wear depends and a couple of pads. Somehow, despite the fact she also withholds liquids from herself, can fill that cath bag and overflow everything. So she drinks even less. I have noticed some days she is definitely struggling to make sense, and she doesn't have dementia. She's dehydrated. I can always cajole her into having a Coke, and while that's actually a little bit dehydrating--well, you gotta pick your poison, I guess. Once mom is hydrated, she is also much more able to connect the dots of a conversation.
We don't think about it, but the BRAIN needs fluid. A young brain is very "wet" and an older one is "dry". Almost exactly like a sponge. And a dry brain doesn't work too well.
Not saying that hydrating MIL will be magical, it won't, but if it helps her in her cognitive skills, then great. And realistically--she cannot bear an IV 4 times a week just for hydration. She simply HAS to drink. Is she "stuck" with ice water? I personally love that, but I have several different kinds of drinks in a day. can't she have a coke or sprite? Something that has some bite to it.
You honestly cannot hope for too much, at this point. If she can get out of bed on her own, take care of her own toileting needs and feed herself--without daily aid, that may be the best you're ever going to get.
Sadly, you and she have to accept that she is never going to go home and she's never going to be 'happy' again, but she wasn't EVER happy before, that I can recall.
Are you hanging back on saying "yes she has dementia" because you don't have that POA signed yet? No judgment on that, because you have to get that ASAP....but you can't say "yes she has dementia" out of one corner of your mouth and then say 'MIL, please sign this binding document' out of the other.
Hope you can get that POA signed. Then other stuff will continue to crop up--once she is legally declared incompetent (and you guys need to accept that it's OK for her to have that label. It's accurate and gives her CG's a baseline of what they can expect of her!) you can find the placement that is best for her.
Sorry DH is having a pity party, but sheesh, he's in his 60's right? Did he think mommy was going to be here forever? He MUST have given her aging a passing thought over the years! Ah well--I cannot talk, my own DH, while not the least attached to his mother said just the other day "I fully expect my mom will outlive me" and I couldn't argue, she probably will, She's definitely in better health than he is.
So much for not stepping back in, right? I'm proud of you, though, You have stood your ground and not let anybody use you. You're actively helping and supporting your DH and his sister MOVE FORWARD.
The attending MD . over-rode a decision yesterday as to a rx for increasing BP . for now. His feeling . we need to get her hydrated to see if that improves the too low BP .. and we won't know if we start giving her meds to increase the BP . whether that has improved it . or better hydration. The doc says he has put in the orders that the staff are to push fluids ..
MIL reports they are in . the staff . routinely taking her BP at present (she is on IV fluids at present though) and standing her up and taking BP . at standing . taking her BP at sitting . and they are all pushing her to drink . and so I guess the doc having put that in the orders, is working somewhat .. the staff pushing for same, each one that enters.
In fact, I mentioned to SW Jessica this morning that her brain hasn't been right .. and I would've deemed her to have some dementia even before all this happened and this, all this trauma . has certainly made things much worse.
Jessica's take on all that: "Well we won't know . for certain . whether some of what you're seeing is anesthesia related .. that can take a while . but at some point it may become more obvious that this is her new baseline as to her functionality if it doesn't return. Some of that will get a closer look when she goes to SNF as part of her purgatory and so it will get looked at, at some point, but to even try to address it at this point . with her post op and having so many problems . wouldn't be prudent right now"
Me: "yes and on that point . how long . how long does one assume . oh it's the general anesthesia .. at what point do we determine . that her brain is further damaged .. and she is not gonna return to what was her normal before .. ".
Jessica; "Oh I don't know . most doctors would advise a couple of weeks a month . if you get a month into this post op and aren't seeing improvement .. but again . how much of it is also attributable to dehydration . that too remains to be seen . but if you get a month into post op and aren't seeing improvement there, you may just determine at that point that's her new normal".
I'm not afraid of saying the word Dementia and haven't been for a long time. Don't forget how SIL and I almost went to blows . MIL having been hospitalized for a UTI .. about the time the twins were born, me on that front . even though I'd clearly said I wouldn't be available to the MIL scene . and yet there I was .. front and damn center. A neurologist brought onto the case there on site . in hospital . and some cognitive deficits they'd found in screening there. Me shouting HOORAY ............. HALLELUJAH ............ it's being seen .. not just me . it's being SEEN! The neurologist wanting that looked into further at discharge.
SIL then flying in to take over her mom's care and me on that page .. "SIL they want her seen for a nuero eval . as to cognitive impairment .. they found some deficits in a screening there".
H377 I Had been on that confounded page and been harping at that .. I had thought (mistakenly) that the fact it was now seen and picked up on by med staff would mean it would get addressed finally. Wrong.
What did SIL do with that directive?
She and I almost went to blows over this one, a couple of years almost .. back in all this.
She didn't think it was necessary .. why would they even test someone in a hospital setting .. screen them, they don't feel good, they've been upended into an unfamiliar setting . and they want to count those screenings as valid . that's just preposterous . they should never even screen anyone in that setting.
I almost blew a damn gasket .. at SIL. Where the h377 else do you think these things get picked up and what's the harm . have her tested for Crying out loud I've been saying her brain isn't working .. have it looked at.
So what did she do .. off she goes to the normal neuro doc that MIL had been seen by for her neuropathy . only she found in setting that appt .. the neuro doc herself . off for vacation .. only one available the PA there . a PA that had never met MIL. Sets the appt w/the PA at said office, and off they go.
The story behind that appt became as follows (still makes my blood boil)
SIL: I took her in and the PA felt like I do . they should never screen for that in a hospital setting and count the results as valid .. the person's world has been turned upside down .. they don't feel well .. he didn't think it was necessary to test her any further".
It's not me that has been afraid to say it .. By a long shot!
But if you ask her . the answer you'd get: "How much of this can be attributed to the dehydration, the trauma of all she's endured recently .. the too low of BP .. the general anesthesia working it's way thru her system . how much of it is all that".
If you ask me, the answer you'd get: "You might be right SIL .. I guess we won't know . til we get further down the road post op .. but .. I can tell you that her short term memory even before all this .. wasn't good . she could never remember her meds .. .she couldn't remember what they were for .. she oculdn't remember appropriate dietary restrictions . as to chitapalooza .. and hydration, etc .. ".
SIL: "Yea you're right .. I was seeing all that when I had her in my care, and constant reminders as to her meds and her questioning me as to what this pill is and that pill . and then having to stay after her dietary issues and so forth . yea I saw that".
So .. where the crossroads meet at this point .. what is temporary . what is permanent . I guess we have no choice but to wait and see .. as to what level of .. yes the dreaded word .. Dementia is at work here.
I don't mind saying it .. not one iota . been saying it.
But .. I do stop short of labeling her that, absent any formal dx . in dialogue with any medical professional .. as they'd then want to know how was it dx'd . "well it wasn't". And then a slew of other questions that I can't answer, absent any formal dx.
Now give yourself permission to prioritize your energies as you need. If MIL needs help, let her hire assistance, because you will be unavailable.
Ref her probable (virtually certain) dementia, to whatever degree, I can only share the experience we had which was that a trip to ER for ?stroke was the first time anyone used the D word and the first I'd heard of it. So that was in 2013, and mother had been formally diagnosed with CHF in 1995.
But the real point is, that when I flapped around like a wet hen - as I still think you well might, the first time anybody tells you your mother's demented - the attitude of the ER physician, the neurologist, the geriatrician and the cardiologist, not to mention a very good and conscientious GP, was along the lines of "yes, of course; why, were you not expecting it?" Like I should have known it was coming all along.
So although there hasn't been a definitive diagnosis of dementia per se, in black and white, I imagine you'll find that none of the medical practitioners involved will be the slightest bit surprised to hear it.
I wouldn't bother investigating it at the moment. It'd be a bit like asking for an estimate for roof repairs mid-hurricane.
Okay - so I’m being an azz.
This all has me so frustrated - not sure exactly why.
But Dorker, you’ve mentioned a couple times now that this is all new territory for you and sil - true. But you also have dozens of voices here who HAVE been through it. You’ve listened to us before - why not now?
Fact: Im no oracle - no fountain of wisdom and knowledge. When it came to the whole stepping off and letting sil and dh figure out things for themselves - you might as well have been speaking Martian for all I knew of that tactic. But this part ? This part I know. Yeah, this part I know very well. Unfortunately.
I just wish I could spare you some pain and frustration. That’s all.
Doesn't do any good to look back upon the history here . but I can't help but be at a point of pulling my hair out and shrieking .. What would'v'e been the effing harm back almost two damn years ago . when that neurologist found some screening issues in her cognitive abilities ...................
GET THE EFFING TEST!!!!!!!!!!!!!!!!!!!!!!!
I tried .. Lord knows I tried, to get that on the page to be addressed.
Where would it be making any difference at this point . had there been a formal test and a dx' .. that I'm not clear on myself . what difference . what practical matters would we be seeing a difference in at this point, if in black and white, on paper . there had been a dx .. and in place. I don't know the answer to that .
But I do know that expecting someone who has a broken brain to process the importance of drinking water .. or whatever the heck she prefers to drink (in her case, it's always been water .. is mine too .. I dislike soda .. or lemonade or much else, I will always take water .. as has been the case with MIL thru the years). Expecting her to process the importance of same and follow through . is not gonna happen.
And so much of what is ongoing with her .. you can truly hang it . at least in some measure on the hook of dehydration . surely can. At least get her hydrated . .and consistently and .. then see where you are w/her problems. Can't even get that far, absent IV fluids ..
(this as opposed to Alzheimers, which I think is a lot more specific of a diagnosis.)
MIL does NOT drink enough fluids on her own and becomes dehydrated.
MIL does not adhere to instructions to call the nurse before getting up.
MIL does not know how to use the nurse call button.
MIL will not eat enough without prompting and help.
MIL cannot handle her meds at all on her own.
They did listen to me about specific traits, whereas when we throw around vague terms like dementia, or memory loss, it is not as easy for the staff to discover what exactly we have observed, and what needs attending to.
Especially since SW Jessica will be there . and it was my experience at the only other prior Progress Meeting it was called .. we were widgets on an assembly line and they were going to address their bullet points and move us on along on the assembly line to deal w/the next widgets in the line to be dealt with.
So, important that we take the time to come up with a list .. that includes those all important factors we want as talking points.
Having to re-direct SIL . in some of this .. and successfully so.
She'd wanted to know, . "Did you talk to SW Jessica about the low hemoglobin #'s".
No .. I didn't . it's not germane to what is the present issue . yes it was an enormous snafu and PITA . but it's been dealt with .. and her hemoglobin #'s at present .. are 10 .. and that is a vast improvement. It's not what is the "normal" range . but the doctor already said . if she'll eat better, and particularly some red meats . and leafy green veggies .. and hydrate . .some of that will improve. Not germane to the issues at hand, at present, no I didn't bring that up.
SIL: "Oh yea that's right".
Redirecting SIL, her words: "It's like you don't know at this point . her memory . .and the problems there, . .is the general anesthesia . and working it's way thru her system . is it the low hemoglobin .. is it the low BP . what is it .. ".
Me, redirecting: "First and foremost . it's gotta be dehydration addressed and how to get that need met . then you can work from there to determine what's at the root of all the other problems ongoing . but that's the easiest to fix . if we can just get their attention focused on that issue alone . and address it effectively".
Again, redirecting to SIL, her words: "I wonder why they don't give her Pedialyte to drink . that has all those minerals and stuff".
Me: "SIL .. it also has a lot of sodium you remember ..??....and .. the doc yesterday that visited when you and I both were there, talking about her CHF . and sodium and .. so it's a delicate balance they have to walk .. they don't want to overload her with too much fluid and then have to take the fluid off with Lasix".
SIL: "Oh yea that's right".
Me redirecting SIL, yesterday when we were on site . MIL complaining her mouth is so dry ..
SIL's words: "I need to go to Walgreens and get some of that bio ________ (something or other, . some kinda spray for dry mouth) and bring it up here".
Me: (handing MIL the water cup) .. "No you don't, you bring that up here, I'm gonna pour it out in the sink . she doesn't need something that masks her dry mouth by spraying it with moisture . she needs to drink".
I sometimes think she gets too bogged down in the minute of it all .. and doesn't see the bigger picture .. I don't know why that is.
Why do I remember that Pedialyte is not the end all be all, as to hydration . as it has a lot of sodium . and can cause CHF patients more issues. Why do I remember that and she doesn't.
Why do I realize . that bio spray whatever it is .. is only masking a dry mouth issue . drink water . that takes care of a dry mouth quite nicely and is sorely needed here.
Why am I over here redirecting on a hemoglobin issue that has been effectively addressed at this point .. no . there is no hemoglobin issue causing further mental unclarity . that's been addressed .. no there is no hemoglobin issue that is contributing to her weakness . it's been dealt with .. effectively. Her numbers are up .. closer to where they need to be . it's pointless to go chasing that rabbit hole . so stop it. .
Redirecting her . she'd talked to the attending MD and was satisfied in the fact that she feels he is "on it" . as in . .he has superseded that other specialists rx for a med to raise BP at this point . opting instead to get this hydration issue dealt with and then see where we are with too low of BP .. her feeling as though that MD is on it .. as to the fact that the anti depressant has been changed .. from one not prone to cause vivid dreams.
Her satisfied that he is "on it".
Me: "I would differ with you there SIL .. let's talk about the other night when you left there ... and she was in some discomfort . as to her behind . hemorrhoids .. unclear really what was ongoing . you brought it to the attention of staff who said they had a call out to the doctor. That night your mom called you in more pain . from whatever was ongoing there and you assured her they were contacting the doctor .. but by the next AM you arrived there and her now in some pretty severe pain . and no one having adequately addressed it and with dried feces on her hands . and it was YOU that called out to the doctor and reached him on a cell phone # for him that I still don't know how you got your hands on . .. even then . you reached him and he said he'd call the nurse desk right then and there . but it was you two . you and your brother that finally went to a nurse and asked if she needs to be transported to the ER . that she is in tears .. so much pain . where was that MD .. why wasn't something being done . I don't know that he's so "ON IT".
Folks in my mothers orbit just used the term as if an “in fact”. Actually, the first person who said it to me regarding my mother was a hospice doctor who was treating my father. The doctor wanted to talk to me privately - so out into the hall we went and somewhere in the conversation he said “with your mothers dementia...”. At the time I thought “huh” - as it had not occurred to me. I wrote a lot of my moms issues off to popping Oxycodone like Tic-Tacs. But, I filed it away for “later” as at time I was more concerned about my dad.
Much later down the road “Dementia” was commonly referenced by those who dealt with my mom. It wasn’t that I was in denial - I just didn’t know enough about it - to reference it myself. Eventually, I did.
The only time a formal diagnosis came into play was when I was dealing with my brother - who was causing me all kinds of grief - on his once a month visits, I might add - in agreeing to what comes next. He said “I’ll believe it when I see it in writing”. So off to the Geriatric Psychiatrist mom went. And yes - got it in writing.
On a side note - seeing the Geriatric Psychiatrist was one of the top three best moves I ever made. His medication overhaul and revamping made a huge improvement in my mother well-being. Huge.
Anyhoo - I guess I’m just wondering out loud - just how critical is a formal diagnosis?
One other thing you might add to the list of things MIL can’t do on her own, if in fact she can’t, is handle her finances.
If she in fact can not and that was handed off to SIL, when did that become an issue?
My experience, in hindsight, that was THE telltale sign. Dementia.
Maybe not?
I really am not sure.
In fact reading about it all on doctor Google ... seems that dx is made based on that assessment testing in conjunction with other factors of daily living and struggles thereof.
I kinda scoffed at that. Drawing a circle and numbering 1 - 12 along the inner circle - something most of our parents generation had looked at multiple times - every day - for decades upon decades - well, that didn’t seem like much of a test to me.
Until the Geriatric Psychiatrist handed me the paper where my mother had made several attempts at drawing a clock, that is.
I knew my mothers mind was going. Knew it, saw it and heard it almost every day for quite a while. But - I had no idea how bad it was and how devastating dementia really to the brain - until I saw those “clocks”.
So, no. It’s my understanding that simpler testing methods can be utilized than a neurological evaluation. My experience as well.
Edit: I should add and be more specific in saying the doctor who tested my mother did more that have her draw a clock. Mom was in with him for at least an hour as they talked and he did his thing - although I was not present in the room. It was after he talked to my mom - mom went back to the NH with her caregiver and I met with the doctor. He explained a lot to me... but it was those “clocks” that really made things clearer for me.
Dementia can run in families...do you think SIL wants to hear what may possibly be HER life in not too many years?
So she obfuscates, ignores, flaps her wings to get everyone to look over here! and not at the old lady with dementia. Who one day might be me.