Nervous about my mom's upcoming neurology appointment, I know she's going to try and bluff the new doctor. What to do?

Several issues:

1 - who has POA? if nobody then you'll have to do something - this could be the only reason to tell her she has dementia because while she has some ability to do this then hurry to help with this because sooner or later she won't legally be able to do this

2 - these drs & staff aren't fools or newbies - they have seen the showboating before & have ways to ferret out the truth - write out your concerns & quietly hand the envelope to the receptionist if you can't drop it off beforehand with your contact information in it - your mom may realize her problem & be embarrassed to talk about with you there OR you may be quite right that she plans to lie through her teeth but these plans often fail because she will have a hard time making a plan & carrying it through [because if she could then dementia wouldn't be an issue!]

3 - moving seems to show up dementia - as I understand dementia, it isn't caused by the move but rather surfaces when the familiar is removed then it is hard to re-adjust to the new place - the bathroom is in the 'wrong' place, light switches are moved, the kitchen has been rearranged - it takes a while for the damaged brain to re-adjust

4 - good luck & check out 'TEEPA'S GEMS' as Teepa Snow is a dementia whisperer & she has much usefully information

Contact the physician prior to her appointment. Write or call. Remember they can not release information to you unless She signs a release of information (roi)but you can tell them what you are seeing. Ask Dr to recommend ROI and POA then talk to your Mom about importance of both as she ages. Our dr. requires ROI be assigned annually. Once POA is activated the ROI is no longer required.
Remember to discuss driving issues with Dr if applicable. Some will advise DMV. They will also be the bad guy or gal and say no more driving taking the burden off you
 You are not the only person dealing with parents in denial, That I am 110% sure of. More often than not this occurs.
Educate yourself as much as you can on dementia. Lots of forms (110)
Watch Teepa Snow videos on YouTube. Shes an expert on working with dementia patients. I idolize her. Read the 36 hour Day. You need to know what's ahead.
Tell Mom they're could be other things going on besides dementia. Something as simple as vitamin deficiency can do strange things rp people.
Now go watch Teepa and best wishes.

I wrote a letter documenting dates and incidents, as well as daily observations on my mother’s memory loss and hearing problems. I gave it to the doctor before her appointment, which helped him target questions and also tailor his approach to her based on how i told him she would respond and likely lie about her issues.
He was outstanding and i finally will be able to get her to do brain scan and sleep test to ascertain what the real issues are. Wish me luck, she has a terrible way of weaseling out of these things.

My MIL has tried to fool them several times and insists she go in by herself. Each time they tell her the truth ... and the family is advised as her son was POA.
I had the same concerns and as the doctor told me...this wasn't his first Rodeo.
He was very kind to MIL too, gentle and good.
She is getting another round of testing as her confusion and memory is much worse now after 18 months.
She says she is sharp as a tack.
But she doesn't always know who I am.
They are right on it!
Have a bit of faith.

Is it possible to email the doc with your concerns ? Lots of hospitals have that ability these days.

Dementia is NOT inevitable as one ages. There are many mentally intact elders. As for your mother "masking " her mental decline, a good neurologist should be able to discover her loss of capacity.

Yes I have. I visit the doctor's office beforehand with a typed list of questions or a brief list of my observations (sort of a heads up so to speak) addressing your concerns about your mom. Otherwise the doctor is not getting the true picture of what is really going on. Also, it becomes a complete waste of time and money for everyone involved.

I just went through this last summer. I knew things weren’t “right” with Dad but things got worse when he moved in and I could see how he functioned day-to-day. To make matters worse, as a retired medical professional, a dementia diagnosis carries a real stigma for him. Prior to the appt, I contacted the office and discussed my fears that he would cover up etc . On the day of the appt, they asked that I sit in. They asked him a lot of questions and then asked me for my view which was quite different. The neurologist is highly trained dealing with this issue. I suspect they will want your input. It was hard for me to answer some of the questions as I knew it would upset dad but now 6 mos later, Dads accepted the diagnosis and things are calmer - for both of us. With a proper diagnosis, we’re treating dad’s diagnosis as best we can and I have a clearer understanding of the causes of his behavior and the path we are on.

Once a person reaches a certain age, memory loss is inevitable whether it’s dementia, Alzheimer’s, or Lewy body. Yes, some drugs may help but there is no cure. Why is it so important to make sure that your LO is told that this is occurring? It won’t change a thing! In most cases they won’t remember anyways and they’ll continue to insist that everything is fine. Instead of insisting that the doctor be made aware of every sign and symptom, and provide a diagnosis, devote that time to finding a good environment for your LO. The cards will play out.

When my Mom had an evaluation with a geriatric neurologist, he only had me in the room for the first 10 minutes or so. Then he tested her for the next two hours using exams specifically designed to determine if her level of cognition. When we went back for the results, I was amazed at the intricacy of the questions. And, even though I knew my Mom was declining, I was shocked at how poorly she did. She is also a master at hiding what is going on. But, there was no way she could hide it with the questions she was asked. If you don't feel this neurologist or the tests he performs are able to give you an accurate evaluation of your Mom's cognitive function, ask her PC for a referral to a neurologist who will. Of course, this won't change what is happening, but at least you will know what you're dealing with and be able to make more informed decisions for your Mom's future care. Best to you and your Mom.

Let her doctor know ahead of time, of your concerns. They will do a mini mental. tell the doctor what you would like for your mom to do like make you POA ( ask him to give it as an 'order'). Hopefully he will ask to speak to the both of you together if he feels she has cognitive issues. What I have learned, is that whenever possible get the 'authority to be the bad guy. you will have enough battles on your own. When my dad, one brother took my mom to a geriatrician to find out what was going on and he gave her Alzheimer's diagnosis, she looked at me and said, "You brought me here just to tell me that!" Several days later when I wanted to talk about how we should prepare deal with it, she told me to never use the word, Alzheimer in her presence and not tell anyone (especially her mom, who would say to me that something was amiss with mom and i should get her to a doctor.). It is amazing to me how the mind can't process something correctly, yet can come up with a logical excuse of why it happened the way it did, After some time the explanations become less logical. The other thing I have learned perhaps because they can't make logical sense of things they are very attuned to emotions. Ex; My mom 6 years after my mom had the ALZ diagnosis, she was living in ALF, but I would take her back to the farm when I visited my dad. During a visit my mom asked dad, "Are you my dad?" Deaf Dad says "What?" I quickly intervene saying it is time to get back to the ALF. As we walked to the car Mom said to me" You know, I miss my dad. I miss everything. Everything is such a mess." She knew from my tone of voice she said something inappropriate, but at the time of saying it, there was no recognition of its lack of logic.
Summary: Be aware of your emotions and how you are displaying them. Let everyone else be the bad guy with the bad news, when you can. Find creative ways to save their pride and feeling of independence as long as possible. I, at one point put high priority about safety and cleanliness, but have come to feel if others are not at risk and I have done all I can do without decreasing mom's
contentment, let it slide. Her quality of life is going to get worse, so attempt to make it the best it can be. Look for the blessings. One of mine was that my mom had to quit working because of it, so I got more leisure time with her than I would have, she was more open with her thoughts, as long as it was not about the ALZ.

Yes, Dear....My Own Mom's Sad Situation and "Denial" And how She Snowed the doctors to get more meds when they should have cut her off and sent her to a Specialist but when she refused. They "Killed" Her with Kindness.
We are Burying My Mom May3d...Please, Save your Own at Home MOM. She is Worth it.

Hi Again,
There is much more that I can say and share but I am getting ready for work now. Please feel free to ask me any questions if you feel comfortable enough to do so.
Wishing you strength and courage on this journey that has no manual.
There are similarities, but no two cases are exactly alike. Each case is as individual as the individuals involved.

Dear Exhausted Piper,
I moved my 85 yr. old mother in with me in March of 2018 after my dad passed away in October of 2017. I had mom evaluated by the insurance company that I set up for her shortly after moving in with me and learned she had already been suffering short-term memory loss, which truly upset her to the point of tears. When the evaluator told her, she began to start crying and I immediately asked her, what's your mother's name? She replied correctly and, I told her, You remember what is important and nobody cares about a hamburger, peach and a pencil. That comment lightened the situation and I gave her a hug.
Later last year on October 20th, I took my mom to the movies and noticed she was quietly but repeatedly asking me the name of the movie. I simply responded each time and figured she may have been tired and that is what caused the excessive questioning. However, when we exited the theater, she asked me where the woman whom brought her there was and if dad was back at the house sleeping. She was also referring to people and family members who were clearly not there and deceased. When I explained that I was the one whom brought her, she replied, "No, you met us here." I asked her if she knew who I was, and she replied, "Of course I do, you're XXX." Mom thought I was her sister, whom died more than 15 years prior and I realized later that the dad she was referring to was her own.
I took her to dinner thinking that perhaps she was tired but, strange and inaccurate comments and questions continued. When we got home, I called her doctor and could not get an appointment early enough. I kept correcting mom in the beginning but there was no rationalizing with her - she was in denial and utterly confused. She did not remember my dad passing and refused to believe it. Everything coming out of her mouth was a confused fantasy and inaccuracies.
I ended up telling her the following morning that I'd heard from dad but he did not tell me where he was and simply gave me an address we had to go to. Of course, it was a made up plan for me to get mom to the emergency room of a neighborhood hospital. Her doctor could not see her fast enough and I knew something was seriously wrong.
A nurse evaluated her upon arriving and they admitted her immediately. I stayed with mom in the hospital because I did not want her to be frightened or further confused. A CT scan, head x-ray and other tests revealed that mom had suffered minor strokes, which affected her brain. The strokes basically launched her into moderate stage dementia within the span of a movie.
When they released her, they basically sent us home with no preparation for me on how to deal with someone whom had dementia. I went out of my mind for a few days until I arranged for an aide to come in and help me. No one in the hospital told mom that she had dementia - they told me.
After the hospital, I took her to a different neurologist because I found the ones in the hospital to be inadequate and dismissive. I went to that appointment with her and the aide. When mom asked me why she was there, I explained that it was just a check up to make sure she was okay and that I was being checked out too. I took steps to speak to the doctor, nurses and any assistant(s) so that they would not say the word "dementia" in front of her because mom was not aware or accepting of it. Thankfully, with a lot of work on my part, they complied. I did not allow them to speak to her without me in the room.
Once the dementia meds kicked in, things got a little better but, of course, dementia is not curable. I downloaded a book from Amazon called "The 36-Hour Day" as well as others to help me become more enlightened. The underlying advice in most seemed to be, keep them calm, happy and safe. Don't point mistakes or inaccuracies to them if it makes them feel bad or unsafe. Pick your moments. Some moments may be more lucid than others. .

Before my dad’s first appointment with the geriatric specialist we made a list of his medical history and his concerns. He had previously lived in a different state and while there was told that he had “mild cognitive impairment” which he remembered. I was also able to write some of the things I had noticed on this list. My father’s vision is poor, so he never looked at the paper before the visit. My father minimizes his challenges and is still pretty independent.

Unless your mother is unsafe, maybe the goal of this appointment is to develop rapport with the doctor and come up with a plan of tests. So as the “bad news” comes in she’ll be a little more open to hearing it.

YES! for 2 years. My mom is still in denial. Sometimes I think she forgets she has a problem. Just recently, she has started saying things like "you know how my memory is..." She won't see the neurologist any more, because he took away her drivers license. She blames me for taking her, and refuses to go back. Her doctor explained all about what was going on (vascular dementia) and then she just forgot it. So, try not to stress about it, learn to roll with the punches (this takes time and I'm not that good at it either)and remember you have to find a balance in living with yourself, and living with your parent who is living with this crappy disease. I wish you the best.

If she can successfully bluff them, then that speaks to her competence. Not only is she able to identify the situation she is in, but she's able to come up with strategies to deal with them. That's competence.

SendHelp,

What a great idea. If the doctor recommends she join in the room it solves everything. Wonderful response!

There is nothing wrong with you giving the doctor a head's up ahead of time via his nurse and in writing. The office will be used to seniors who 'fake it' and need input from family so they know when the senior is blowing smoke.

I worked in medical offices for years and it was amazing the 'stories' a patient would tell us, thinking they could pull the wool over our eyes.

I see it with my Dad, who is doing incredibly well at age 90. All his shoes are slip on, because he cannot bend down to do up laces anymore. If bits of paper fall to the floor, he cannot pick them up. He has a gripper tool for larger items, but it does not work for flat paper. Dad's long term memory is incredible, but he sometimes gets words like Yesterday and Tomorrow mixed up. He knows what he means, just cannot find the correct word.

The doctor can take charge, and ask you to come in the room, saying, " come on,
we need you in here!"

If the doctor is getting nowhere with a cognitively challenged patient, they will often come and get you.

This is something you can ask the nurse.

when my mother went for geriatric evaluation, they actually gave her memory tests. When they evaluated her for memory care, again it was a test, a series of questions . They’ve seen it all before and know . If she can fool them , she probably isn't that bad yet. She can try , but she won’t succeed lol!
With her, they did want to evaluate her alone because otherwise they look to the family for cues. It’s hard not to pipe up with the correct answer so if she doesn’t know , just smile or don’t look at her, ie pretend you are looking at your phone or something.

Piper,

Sendhelp has a good point if you can just get mom to her appointment would be a good start and like she stated it is hard to fool a specialist!

When I took my hubs to his first/last neurology appointment, an MRI was ordered that disclosed many issues, which we addressed once I got my hands on the copy of the MRI.

I was unable to be "prepared" for HIS appointment, and the medical assistants there said, no problem, it does not matter.

I decided, if I was to survive, I could not go behind his back trying to convince the doctors, or anyone, of his condition, and the need for intervention.

The M.D. psychiatrist who first interviewed him knew his diagnosis within the 30 minute interview, and explained (to me) his thought process sounded good on the surface, but notice that he never answers the question, and it goes NOWHERE.

Doctors know, especially specialists.

Maybe, this first time, you could just get your Mom to the appointment?
She must be really nervous too, maybe tell her you will take her to lunch afterwards, or for ice cream?
You have re-confirmed the appointment?

Then you are all set!
Of course, if she is doing anything dangerous, report those as facts, without making a conclusion or an opinion.

A good friend told me her mom would sit behind her husband, who had dementia, in the room while the doctor asked questions.  The mom would shake/nod her head to the questions the doctor was asking her husband.  The husband had no idea she was doing that and the doctor was able to get some honest answers.  Of course this won't work with every question but it might help.  She also had pre-written notes to give the doctor and she either handed them to the nurse on the sly or emailed them in before the appointment so the doctor could review them.  Best of luck.

Had a similar situation with my mom. She had an appointment with a geriatric specialist to do her assessment. She was fine with going until she received the paperwork they wanted filled out prior to her appointment. She flipped out....saying she wasn’t crazy, just couldn’t hear (she had hearing aids, and refused wearing them because they “hurt”).
She has unofficially been diagnosed from a past hospital stay. Long story short she fell, broke her hip and is now in rehab. Rescheduled to be seen in July.....long waiting list.
Make an appointment with an elder atty. ASAP. Try to get both health and financial....saves time and you never know when you will need it. Good luck.

Good luck with everything, Piper. As I said you are well prepared. Doesn’t take the pain or anxiety away but it helps.

Make an appointment with an elder attorney ASAP. Attorneys are able to determine whether or not the person in front of them understands the legal ramifications of the legal papers they are signing. Get all of her important paperwork done such as living will, will, and durable POA both medical and financial.

In fact, I'd bring up the legal paperwork with her neurologist tomorrow. You may have to be blunt and say that you moved her in next door to you but that you cannot be expected to take on the responsibility of caregiving for her without the authority especially not if dementia is on the horizon. Insist on not being kept in the dark.

Yes, my mother use to let me go to her Drs appointments, but than I notice the signs of dementia and she started not wanting me to go to the Dr appointments anymore.

However, I was able to call her Dr's office and voice my concerns they put a note in her file and when she went for her visit her Dr order a CT scan. She could no longer hide or lie that there was nothing wrong. Now, she has me go because she no longer understand what the Dr is telling her.

People lie to Drs all the time. I have seen when pts are asked are you staying on your diet? They say, "Oh, yes I am. I have cut out fatty food, no salt or sugar. Then the blood work comes back with numbers so far out of range...one blood tube after being center-fuse looks like a milk shake in a tube. Plus, they usually didn't lose any weight.

Here is my point, your mom can fool a lot people, she can lie to her Dr, but she can't fool the test results. The test will paint the whole picture. Her Neurologist will get to the truth.

And if mom let's you talk to the Dr afterwards then make a list of questions that you need answers to.

I have found that the truth always comes out! If she does have dementia she will only be able to hide it for so long.

Good luck!

Piper,

I know you are upset. I would be too. But I have to say, you sound prepared. That is a big plus. You’re going to get through this. It’s the waiting, the not knowing stage that is so hard! Once we know something, then we can take the next step. Waiting in limbo is always the hardest for me.

Piper,

I hope for both of you that she decides to let you go in with her. Maybe at the last minute she will. I am so sorry that you have to deal with this. My heart goes out to you.