Is it possible to know the difference between when a LO with early dementia is being lazy or really not remembering?

"I get mixed messages when she says she wants to help in anyway she can then how grown children should take care of their parents no matter what and how at her age she shouldn't have to do anything she doesn't want to do. That's why I asked the question. Confused"

Dementia can do that to us - leave us confused! When mom first said it was too difficult doing everything, I offered to take over her finances for her. She declined, saying it gave her something to do! When she referred to my daughter as her cousin, I corrected her, which I now know is the wrong thing to do (she basically clammed up - couldn't process it.)

It is more important for you to learn more about what to expect and understand than it is to have her tested again. You are aware of many of her shortcomings already and the tests they do may not enlighten anything as they may not be testing what her deficiencies are. She also may not even be able to focus on what they are asking her. If she asks to help and you say do this, yet she drifts off, her focus ability is gone. It is, in some ways, like dealing with young children, who often have the attention span of a gnat! Often when we were driving to or waiting for an appt, mom would rifle through her wallet and purse, over and over again. She did that while we were at the bank so I could close her account. She also developed this odd OCD behavior at night before bed (she still lived alone, but we had set up some cameras to watch the front door area and captured this.) It started as one or two iterations a few nights and became a nightly marathon, 1 - 1.5 HOURS, checking the door lock, sidelights, dishwasher and something in the living room. Over and over again. She wasn't even aware she was doing this! It also revealed the clothes horse was wearing the same clothes over and over again, up to 6 days once!

The article ElizabethY posted is very good, and uses some good examples. I responded to some posts about what I've read in it so far and experienced with my mother. What I've read so far (I plan to finish it and check out the other link posted by cwillie as well) is useful, even if you know a lot! My mother is just finishing year 4 in MC, so I'm aware of and/or have experienced many of these issues, but can always learn more.

Learn all you can, but understand that every person's "journey" is going to be unique to that person. There are common behaviors and symptoms, but not everyone has them and there's certainly no clear time frame for when to expect any of these. Mom was the first one to move into the rebuilt facility (MC unit for her) and those who moved in shortly after are already gone. Even some who moved in more recently have moved on. Mom harped on YB to take her back to her condo for the first 9 months, then suddenly wanted to be dropped off at her mother's and started asking about her previous residence (25 years after it was sold!) She's been in that "time frame" for quite a while, and I can peg her living her life about 40 years ago, based on queries about her mother and a younger sister (her mother's been gone about 40+ years, and the statements about her sister were clearly in that same time frame.) So, in her case, she seems to regress in sudden drop offs, then plateaus. Sadly due to the lock down, I have no way to know if she has regressed further. Her hearing was too bad so she has no phone and I'm not allowed in. I had a short outdoor visit in Aug around her birthday (97) and a more recent short visit indoors (post stroke), but between the masks, distancing and her hearing, it isn't clear she even realized I was there.

Check out the articles. If they can help you better understand, I think it could be more useful to you than putting your mother through more testing. They see her for a short time, while you see her all the time. Testing only focuses on what they deem needs to be tested, where you can observe more everyday behavior and shortcomings.

First of all, don’t feel guilty about your frustration.

Even if something isn’t someone’s fault, things become frustrating when you have to deal with it on a regular basis.

So honor your feelings of being emotionally and physically drained.

Take breaks when you need to. No one can go full speed ahead continuously without crashing.

Caregiving is draining. There isn’t anyone who doesn’t feel this way from time to time. It’s completely normal.

Make an appointment with a neurologist for an assessment of your loved one to address your concerns. Your primary doctor can refer you to one or ask around.

Wishing you all the best.

This question makes me sad.

You are mad because she is trying to help? Even if she doesn’t help, at least trying is on her mind.

When you were a child, did you always follow through with every promise to help your mom? Did you always see she needed help when you were standing alongside her? Were you a bit lazy perhaps? A bit preoccupied with yourself? My guess is you were performing then about the same as your mom is now.

My other guess is that you’ll really miss this someday. As the years tick on, there may come a day when she can no longer try, then no longer communicate, then one day you won’t have her at all and you’ll weep for the memory of wonderful now.

These are her days to rest. Take care of her like she took care of you.

Please don’t take this as criticism- just a different perspective to consider.

Hello,
I hear you, and I get so frustrated too. The not getting the mail thing would be very frustrating.
It's hard to reconcile how my mom was to this zero short-term memory mom I have now, who watches me run around like a chicken with it's head cut off trying to get stuff done.
I think the offer to help is made because it's a polite habit, and the intention is probably sincere in terms of following through, but it runs smack into the reality of being unable to execute. Here's an example of how it affects my Mom's ability to help, with a Thanksgiving Day theme:
She offered to make the cranberry sauce, and this morning she rattled off the ingredients-''it's simple, water, sugar, cranberries!''.
When it came time to make the recipe I put the stuff on the counter for her and she couldn't figure out what to do. It's as if looking at the ingredients laid out was a puzzle and she couldn't figure out what the first peice was.
This gets referred to a lot here, but it was very helpful to me.
http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf

She maybe further along with the dementia than first thought. When she offers to help, suggest a short simple task to perform as she might not be able to remember multiple steps of a more complicated task. She may see what you are doing, but not recognize how to help W/O being told. Try to be patient & be more direct with a specific task or show her how to do it & have her demonstrate it back to see if she's able to repeat it. The brain is just not working like yours.

It is possible that she can not focus. Very difficult to remember.

Imho, it is possible that her listening skills are not up to par/diminished. While she is able to ask you the question as to whether you need help, she is unable to hear your response - for whatever reason. Prayers sent.

Hand her a basket of towels and tell her to fold them. If she gets sidetracked, steer her back to the towels. Try a list on the frig. Get mail, dust furniture in her bedroom (only list one room). Some simple quick tasks. Even if she does a crappy job, so be it. Direct her back to the list.

It's very frustrating, but that's what dementia is.

No she is not remembering she even asked you most likely. My husband is that way. Also they forget how to do something simple. They do want to help, but sometimes remembering to put one foot in front of the other is max for the day. Ask her what she would like to do. That might help. Or I hand the silverware to my husband and ask him to lay it on the table. Or hand him the napkins as ask to put on table. They loose their memory at different times for each person. You just have to get in their world at all times, don’t react, stay calm, don’t expect they can comprehend instructions, etc. You will be able to handle it easier and hopefully keep any anger or other emotions under control. I was my mothers caregiver and now my husbands. Oh, another thing....don’t expect! You can not expect anything, because that part of the brain isn’t working right.

The "tapes" definitely resonates with me. I call my Mom daily each morning. Living 350 miles away its the best I can do in between visits. Each call is the same. Like a recording that she just hits "play." If I say something that's not in the usual script, she just sort of laughs and then inserts one of her standard comments about the day's weather. At first, I thought maybe she just wasn't hearing me. But the "tapes" thing rings true. Makes so much sense now.

I have a funny story related to this...my mom (85) constantly offers to help and says she doesn't want to be a burden. I do everything myself because realistically it's easier on me, and the stuff I ask her to do are simple things (feed her cats, wash their bowls, etc). But she constantly offers and yet has no initiative.

So the other day I see her with a notepad and she says she's writing a list of all the things that SHE needs to do to be helpful and it's a huge list. I'm curious, but I wait.

First thing, she comes in to say top on her list is to change her air filter. So then she asks me how to open it. What size filter it takes. Where do I get a new one.

I realized, in reality, the list is just more stuff for me to do. I sort of giggled when I realized it was brilliant on her part (if not unintentional).

I have the opposite! I’m came to live with both parents and my mom insists she does NOT need my help with anything! She is either upset or judgemental about the way I clean (her way is right and perfect...always has been...and I have never met her expectations). I seem to be ok with cooking dinner—she has never liked cooking. And I’m ok with being a driver—she has never driven! My father doesn’t let me do much either. He has always needed to be in control. I spend my day trying to stay out of their way!! (I will soon move to an apt 10 min away. Hoping it helps!)

I believe that the standard mental status questionnaire given in doctors offices is far from definitive for dementia. One may remember the name of their town (having lived there most of their lives). They may remember today's date. (They wrote it down and looked at it many times because they had a doctors appointment.) If it was an ordinary day they might not know the day of the week or the month. Perhaps they can remember 2 out of three words
given a few minutes ago (because they kept repeating them to themselves and had nothing to distract them),

Yet when confronted with the automatic coffee maker in their own kitchen, they may suddenly not remember how to use it. They start to do a task but halfway through think of something else that needs doing and begin to do whatever that is. If shopping, they buy items over and over because they forget they bought the same thing yesterday. They don't know if they are receiving the right change if paying cash.
They may tell themselves that they are "fine" (even if their life is one of constant frustration because of things that "don't work right") and they certainly want others to think they are still capable. Especially that!
It's a terrible, frustrating disease. It requires understanding but lowered expectations and extraordinary patience from family and caregivers alike.

Short. easy tasks - that she may do or not may do - may be all she can do. Try it throughout the day. She may need cuing on how to do the tasks, but consider that she doesn't "hold onto" instructions very well in her brain. Having structure in her life will help and the routine will become her strategy for maintaining some normalcy.

My mother has dementia.  It is very possible that she has forgotten what she ask for so when she's all over the place doing different things that what she originally asked humor her.  Dementia is real and very mean disease, be patient with her.

I find that the personality my husband had before the memory issues are the same as they always were. He is still a huge story teller ( now they are exaggerated and not always true ) . He is very self centers but always has been . His diagnosis was mild cognitive impairment and that was a 2 day test taken more than 2 years ago. It was not the 5 questions they ask in the doctors office. It took me the better part for the last 2 years to actually believe he can not help it and to know in my heart the his brain is broken . Focus is a major problem and short memory is gone . We ate out last night at a place that gives you the cup to fill your own drink .. He walked away from me with the cup to the soda dispenser. Half way thru the meal he asked what he was drinking because it was almost gone and it was good . My answer was , I don’t know, you got it your self . He really did not believe me . I could have really pushed the issue but He really did not remember. It was not a ploy for me to get up to refill it , he really did not remember. The hardest part for me is letting it go and not insisting he admit be was wrong .. Trying to prove I am right and he is wrong brought be to a caretakers group . I have learned a lot from other people going thru the same thing and the professionals that facilitate the meeting are wonderful .My suggestion is to find a meeting, they are on line these days . Good luck .

Are you just answering "yes" to her question? If so she may not know what to do.
If you are making dinner and she asks, hand her potatoes and ask her to peel them. Or give her a stack of plates and ask her to set the table. If you are cleaning give her a dust rag and have her do the shelves, or hand her a broom or the vac and have her run that over the floor.
I have read that it can take 40 seconds for a person with dementia to process what was just said. 40 seconds does not sound like a long time bit it is, in 40 seconds I am past the first part of the conversation and onto a second or third.
If she has problems with the potatoes, setting the table, dusting don't let it frustrate you. Let her do what she can and forgive/forget the rest.
Life is short enough to let little things like this stress YOU out. The more stressed and up set you get the more she will.

Yes, I have dealt with that myself.  I think the "wording" or verbal skills are still there and they are on auto-pilot to say it, but they don't know what it means and can't follow through with it.  My mom is literally sitting there watching me make her bed, pull all of her dirty clothes out from every crevice of her apartment and will start droning on about how she misses doing yard work. It's just talk.  If I said can you go to the bathroom and get a bar of soap out of the cabinet, she would not be able to do that.  It's like they have an old tape in their head and they push play..."do you need help".  My mom was telling her brothers family that she still does her own laundry.  My mom hasn't done her laundry in 8 years.  It's just talk.

What you are experiencing is very typical. With aging and dementia their brain is "broken". Take a deep breath and realize you are dealing with a person who is truly struggling. I wish I could say it gets better, sadly, no, it declines more.
Take this as a new normal. Try giving her a few, very few tasks she can help you with, do not expect her to help much. Again, with aging and dementia, she is really struggling.

Testing by neuro-psyc specialist recommended by Mom's doctor is the best way to find out if, what, and what stages are happening now. Hoping you are relieved by getting some answers that way.

Thank's for your kind response. My mother is 82 and she dresses herself, feeds and bathes herself but I no longer allow her to cook for safety reasons. Yes my mom has been in for the cognitive exam and they tell her she's within the norm considering her age. She does see her doctor regularly and if she complains of anything I make an appointment for her immediately. My mother has never been that motivated and stayed a home body even after my dad passed 28 years ago. She never was really interested in anything outside of mine and my siblings lives which is complicated because we all have our own separate families now. I appreciate your feedback and reaching out to me.

Well said by Country Mouse.

As I read her explanation it reminded me of my Grandson and his ADD. When he was a kid you didn't give him tok many tasks at once. Even when medicated. Now he isn't medicated (because of epilepsy meds) and he is worse. I have had to learn to give him only one task at a time. Don't give him too much info. He gets overwhelmed. This is the samevwith someone suffering from a Dementia. They have a hard time processing what you are saying. So u have to keep it simple. If she asks u to do something and you feel it something she can do for herself, kindly tell her that. She wants a bottle of water. She really has forgotten where they are. "Mom, you can get one out of the frig" If she can dress herself but she forgets where her clothes are, lay them out for her. Have her do as much for herself as she can.

I think you'll find it less frustrating if you base your expectations on something else.

The question is not why she can't do something. It's whether she can, or not.

E.g.
Can she be relied on to pick up the mail every day?

No, she can't. So don't expect her to. Don't *rely* on it. Ask her, by all means, but don't let it matter if you end up doing it yourself.

That way you save yourself the botheration of trying to figure out if she's being bone-idle or really can't remember to do it; and you also avoid trying to force her into more than she can handle, and resenting her the while.

If you believe (and I wouldn't argue at all) that it is important to her wellbeing that she stays involved in daily household routines, then break tasks down into simple steps and prompt her to carry them out. If she's able, great. If she isn't, leave it be.

Suppose, for example, you ask her to dry the dishes. And suppose she starts fine, but then puts down the cloth and wanders off round the kitchen, fiddling with things. That's annoying because it doesn't get the dishes dried, and there may not be any obvious reason why she can't carry on, but the fact is she can't sustain the focus on the task - a slightly different thing from not being able to "remember" what she's doing.

It isn't until little links in the chain fray and break that we come to realise just how complex our humdrum daily routines are.

Unfortunately Alzheimer's and dementia are often thought of as memory problems but memory loss is just one symptom, it sounds as though your mother has a loss of executive functioning which helps her to follow through with her intentions. I'm linking an article from verywell health "How Executive Functioning Is Affected by Dementia" that may help you understand what is going on:

https://www.verywellhealth.com/executive-functioning-alzheimers-98596

I'm sorry for the distress you're experiencing right now...can you provide a little more information? How old is your mother? Has she had an actual cognitive exam given by a physician? Yes, memory loss can cause your mom to act like that but if she has never had a cognitive exam pls take her in for a thorough exam (including for a UTI) to discount any other health issue.