76 year old parent who will NOT allow assessment or go to Dr. to discuss; dumps doctors that want them to be evaluated, says spouse (my other parent) and I are crazy; lashes out daily, verbally abusive, accuses spouse of cheating, accuses me of lying and taking sides. Accuses us of getting into computers, phones, etc. that we have no passwords to access. Refuses to get help or deal with losing memory, losing reasoning. Getting lost while driving. Accused staff people in the hospital last year of stealing phone and getting into it. Can’t remember bank accounts or passwords. Messing up finances. Snooping and sneaking all of the time. Will not share medical
info. Argues incessantly. Exhibits narcissistic-type personality traits and behaviors. Cannot get through to them. Situation is getting impossible with no diagnosis and a complete refusal to acknowledge what is going on with them. I tried to confront and that went south fast. Now runs around telling everyone how terrible I am. Sends me nasty text messages at all hours of the night. Doesn’t go to bed at night - sleeps all day then sits on FB all night. Acting like nothing is wrong - it’s all us. Had stroke many years ago; wondering if this causes it too? Complete personality change. Definitely depressed and hateful but then will turn around and be very nice. Dr. Jekyll/Mr. Hyde. A lot of ups and downs and seems like an addiction to drama. Family is at a loss. Their friends don’t see it yet so we are left to deal and cope on our own. How do you manage during this time period when they out right REFUSE to deal with reality, accept or ask for help but then consequences of an inability to make appropriate decisions fall on us? They have been scammed by predators, send money to people who are scamming, cheating on their spouse through these scams and just a whole host of other problems that go on and on and on. I think what makes this the worst is that they are still pretty functioning. I wouldn’t say high function but pretty close. I’m at a loss and appreciate anyone’s advice or insight if you’ve been through this too. Is this dementia? Thanks in advance - really exasperated and I think it’s only the beginning.
FIL, like your LO, functions pretty well cognitively. A lot of his issues are physical immobility and very poor decision making. He is also a raging narcissist. We are further along - he has alienated everyone at this point, except for family that feels an obligation and transient paid caregivers. I could have written so much of your post.
So what do you do? Is it dementia? Well the only way to know that for sure is to get an assessment. There are ways a doctor can do a baseline assessment but you would need to be covert and we haven't managed that. In fact - all of his doctor's notes say "well -adjusted 87 year old blah blah" so he pretty much showtimes his doctor. But we haven't really pushed for it at this point. We have come to the conclusion that a lot of what we think are dementia behaviors are honestly really bad decisions/choices he makes because of beliefs he holds due to his extreme narcissism. So we are reserving judgment on dementia at this point - though we do believe there is definitely some age related cognitive decline and definitely see dementia like behavior with UTIs.
So we pick something and focus on that. We started with medical. Because he is 99% immobile and completely incapable of taking himself to the doctor, we tag team and take him in pairs. He refuses to wear his hearing aids. So we asked to be added to his HIPAA. We did it all above board with his permission - but we still aren't sure if he was really paying attention when he agreed to it. But that's ok - he agreed to it and the nurse was ok with that. So we got access to his medical. So now we have a handle and permission to talk to doctors. So I suggest tackling one issue at a time. That was the big one for us.
There are going to be somethings you just can't change.
Also there are somethings you are going to have to not accept responsibility for if he is truly competent. We had a conversation with APS several months ago because we were all going to be out of town at the same time and had to hire 24/7 caregivers for FIL and were afraid he would dismiss them or refuse to allow us to hire them, so we called and talked to APS about our options, because we were concerned about him, but also about our responsibility to him. We were told that he is still legally competent, and allowed to make his own choices. And if he chose to make an ill advised decision- it was up to him to do it, as ridiculous as it would be. And that there were of course repercussions to making that ill advised decision.
The hardest part is accepting that you aren't responsible for fixing the problems they create if they are indeed competent to make those choices. They have a right to make stupid decisions. So maybe the first thing is to try to figure out if there is a way to covertly get a baseline evaluation? There are folks here who might have advice on how to make that happen. We haven't tried yet, but a call to the doctor beforehand or a note slipped to the doctor during the visit might get you there? Good luck. I know it isn't easy!!
The same way that there isn't when a child refuses to do something. Would anyone withhold medical attention from a child because they refuse to go to the doctor? No, they wouldn't.
First order of business is take her car keys away. Granted, she will have a tantrum and carry on and you'll have to deal with the asinine stubbornness, but think of it as saving someone's life.
She can't be allowed to drive anymore because it's not just about her life being at risk. She's lived a full life at 76. What about the young mother with three small children in the car or the college kid she hits head on and kills because she's having a 'senior moment'? Take the keys away.
If you have to take her kicking and screaming and drop her off in an ER, then do it. It's for her own good. The next time she 'lashes out' and starts behaving abusively and erratically to you or your father, call 911.
Tell them she has dementia and is mentally ill and that you fear for her safety as well as your elderly father's. They will take her to the hospital and she will get evaluated. It's a step in the right direction to help her and possibly get some care resources too.
This is the only way to handle a situation involving a mentally ill person or a senior with dementia who refuses to see a doctor or have any kind of evaluation to help them. You do it by force.
Handling it this way sounds harsh. It is harsh. Mental illness and dementia are harsh diseases not only for the person suffering with them, but to the people who love them too. Sometimes this is the only way to get them help and care. You and your dad will feel terrible about it. No one wants to see their loved one hauled off in an ambulance kicking and screaming, but you'll be doing it out of love because your mother needs help.
Good luck to you and your dad. Please keep us posted.
A brain with some damage may not know it has been damaged. Does that make sense?
"Had stroke many years ago; wondering if this causes it too?"
Yes it can. There are known links between stroke & vascular dementia (VaD). Also between elevated blood pressure or T2DM & VaD.
Doesn't mean everyone with those issues will get VaD. Doesn't mean your Mother has - but it's possible.
"Complete personality change. Definitely depressed and hateful but then will turn around and be very nice".
Strokefroundation.org.au;
'Emotional lability' is common after stroke. This is when emotional responses don't seem to make much sense or are out of proportion.
Vascular Dementia seems to effect people in different ways. Not your typical memory problem issue people think as dementia. Loss of reason & judgement can be evident first. Family often pick this up years before a Doctor will (in a 10 min consult).
Without co-operation from your Mother to see her Doctor, it is very hard. You could trick her there, but she can still refuse any screening test once there or referral for scans/Neurologist. You may have to wait until 'an event' happens that requires ER.
In my Mother's case, we noticed little things. But the slurring prompted ER visit, then brain scans conformed stroke.
Is there anything dangerous or extra worrying about her behaviour today?
If he becomes violent or becomes threatening call 911 ask that he be transported to the hospital. Once there he can be evaluated. And you should meet with the Hospital Social Worker. If you do not think it is safe for others in the household that he be discharged you need to discuss that.
Hopefully mom can change passwords to bank accounts and I would freeze credit cards. And she should get a credit card in her name, one that he does not have access to and can be used while others are frozen.
The reason I ask is I also live in Florida, and my mother is very similar to yours. She was diagnosed in early 2019 but to this day she "HATES" that doctor, refuses to ever go back, and I guarantee she will never agree to another neuro-psych evaluation. She too is in angry denial, even though her reasoning is out the window.
I have an appointment with an elder care attorney tomorrow so I can find out what I have to do in Florida, specifically, to get my mom placed into facility care. If you too need info, just PM me, I will be glad to share what I find out.
He exhibits similar behaviors, i.e. showtimes , flip flops, etc. Family has acknowledged and dealt with him the same ways as far back as I can remember. Strokes and COVID protocols have exacerbated these traits significantly. Gets angry and suspicious when anyone has a conversation he cannot hear. Misguided accusations. I’ve gotten more blunt the last few years and it leads to anger and resentment.
If I take the empathetic approach, I understand that his antics are representative of the loss of friends and family, isolation, and depression due to his lack of physical independence. Family handles this the same as before, avoids difficult conversations. Perhaps they set their boundaries long ago. The more I try to have poignant discussions, the more he digs his heels. This is mentally and emotionally exhaustive.
If I try the ‘stand firm’ approach, he gets defensive and broods, laments and acts the victim. This leads to heightened anxiety and frustration.
Im torn between the different approaches on a day to day basis.
There are other dynamics that require resolution as well and I am focused on this aspect of our situation.
I know that this will be a daily grind for us for the foreseeable future.
Best regards to you and your family. Hope it all works out well!
Why is she planning to make the trip? If it's to see somebody in WI can you call them and ask them to cancel? Explain the drive would not be safe, but your parent will not acknowledge their deficits and could they find an excuse to cancel?
My mom cannot walk and has hemiplegia - which to be honest is probably the only reason I have been able to protect her from doing things like your dealing with. We are meeting with a therapist this coming week (my mom is open to it and has always been open to talk therapy throughout her life) and I’m hoping they will be able to guide us going forward with neuropsychologist testing as they have both at this location. But as stated by others - if you think these behaviors are increased lately it really could be a basic UTI that creates and even higher level of madness. You could try getting the over the counter urine test strips and see if your parent will allow you to test urine at home or even try convincing them to drop a sample off at their primary care dr.
You may have to call 911 - our first UTI I had to call the ambulance as (honestly I was unaware in the beginning that a UTI could cause such cognitive decline) and needed to make sure she wasn’t having another stroke. The paramedics were great with her and since I have learned so much about how an infection can cause such a severe cognitive decline. I am also in Florida - Palm Beach - you are not alone. Keep us posted and wishing you the best.
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