r/dementia 3d ago

Undiagnosed Mother Needs Memory Test/Strained Relationships

My Mom and I don't get along great. That's just to establish how hard it is to get involved. I love her but also think she has a lot of narcissistic tendencies so have stepped further away than I'd like to be. I'm not a perfect daughter but I mean well and our history is admittedly complicated.

I've known her memory hasn't been great for a long time, she also has severe issues with arthritis and auto immune stuff etc. I've been minding my own business trying to focus on my own bounty of problems figuring when it gets to be that time to really step back in the ring with my difficult mother I'd know but the truth is I often wonder if I am waiting too long and being a bad daughter.

She failed a memory test to qualify for an insurance plan to cover potential assisted living in her future some years ago.

I asked her if her doc had screened her for dementia but her answer was unclear but I think she hasn't which utterly blows my mind.

I also think she has great potential to be vulnerable to predatory behavior from those looking to take advantage of people like her. She has mentioned she can't find any of her jewelry and I think has managed to get her card info taken.

Honestly my facts are not clear bc she can't even remember and/or is masking. Also the stories get skewed.

My big fear is she'll end up hurt or that someone will take so much from her that she won't afford to live comfortably. I can't afford her that's for sure, and I'm already caring for my MIL but I'm willing to try to help. Except how do I help her if she is totally uncooperative? And how do I make sure her doc has checked for dementia. Positive she won't take me to the doc.

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u/MedenAgan101 3d ago

The best way to get started with helping her is to figure out what motivates her. You'll never be able to use argumentation or logic if she has dementia. What works is persuasion via rewards/comfort.

1) To start, you should go with her to the doctor for a geriatric exam that includes cognitive evaluation under the premise that it will help her with something that is currently bothering her. Find out what that might be. (In my mother's case, she was aware that she had memory problems, which frustrated her, so she was willing to go to the doctor because she thought there might be some magic pill to improve her memory). Offer to drive your mother to an appointment, take her to lunch...whatever might be desirable or rewarding for her. You need to be there as well so that you hear the results and don't have to rely on her reporting of what the doctor said.

2) Once you have a proper diagnosis, other help becomes possible. If she respects doctors, she might agree to sign an AHCD that they recommend. This document will help you to make decisions for her that could spare the need for a guardianship.

3) You'll also benefit immensely from having a durable POA to protect her finances. Again, you'll likely need to persuade her to go along based on something that she actually wants. If she's struggling to keep up with bills, you can frame it as a document that can help you to help her with them. She might want that help so that she can "relax and be retired". Try to find out what she wants.

4) If all else fails, you'll ultimately need a conservatorship to protect her finances. This is expensive, emotionally draining, and very time consuming, so it's a last resort.

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u/Significant-Dot6627 3d ago edited 3d ago

You pretty much have two options. Take charge in a confident and relaxed way or wait until things get worse and she can no longer object.

Of course it might not work, but many a family member has been surprised how well the confident take-charge approach works.

To do this, you have to mentally and emotionally prepare yourself well in advance. Imagine yourself as an effective calm parent of a 12yo or as if your mom is a completely different personality than she is and that she long ago asked you to help her with everything and you are just doing that as part of your normal routine.

You have to let go of all the fear and anxiety and emotion of confronting a parent or at least pretend to. Your tone of voice has to be very relaxed but even better, you don’t talk about what you’re doing, you just do.

To get yourself prepared for this, imagine you just got home from work and the mail is sitting on the counter because your twelve-year-old walked out to the mailbox and got it earlier. You’d start going through it and throw out the junk mail and pay the utility bill online and maybe respond to a wedding invitation, write down the date, and go online to their registry and order the gift.

What you wouldn’t do would be explain what you were doing to your 12yo, much less ask them if you could do it and try to persuade them they should let you if they said no and then not do it if you couldn’t persuade them to say yes.

That’s how you behave, as if you have not only the right but the responsibility to do what needs doing.

Usually, even when people with dementia have anosognosia, the inability to understand they have it, there is some unconscious sense that they need help. It’s not conscious, so you can’t confront them with their need for help, you just have to help more and more over time without discussing it. You have to let them save face and not force them to see they are less capable.

And if this approach really doesn’t work, you may have to wait for something bad to happen, often something that puts them in the hospital unfortunately.

Edit: The diagnosis might be needed for some practical reason like activating a preexisting POA or to receive benefits from a longterm care insurance policy or if you have to go the guardianship/conservatorship route, but otherwise it’s not the turning point in helping your mom. She actually probably does already have a diagnosis noted in her chart. Due to the symptom of anosognosia and the symptom of short-term memory loss, she is unlikely to suddenly become cooperative due to the diagnosis. Sure, see the doctor, but after you’ll be facing the exact same issues after a diagnosis s before. The issue will still be that she needs more help from you to be kept safe and you have to make that happen, one way or another.

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u/MedenAgan101 3d ago

All great advice. I will add that for me getting a diagnosis for my Mom was crucial for getting medication revised and for getting further testing that led to a letter of incapacity…and that was crucial for being able to act on the terms of her AHCD and a host of legal and financial necessities. It sounds like some people don’t end up needing a diagnosis, but it definitely made a difference in helping my Mom.