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Talking to paranoid Mom's Dr with her present...
My mom is not diagnosed, but I have no doubt she's in the early stages of dementia (or something with similar symptoms). I moved her in with me because her former neighbor told me he caught her climbing off her roof, alone, onto a precariously placed ladder, because she was looking for a recording device that some homeless people had placed up there to spy on her. It has been a few months, and now she's looking to move several hours away. I feel like I have a small window of opportunity here to get her to agree to receiving help before she's too far gone and causing big problems. The problem is, she's in complete denial - or can't recognize that anything is wrong.
The last time she went to a doctor's appointment, I said I would appreciate it if she talked to him about a cognitive assessment. This was met with anger, frustration, paranoia, and cruel accusations (which is, sadly, becoming quite common). When she got back from her appointment, she said the doctor had given her a test "and there's nothing wrong with me", and he asked me to come to her next appointment - I assumed to discuss alleged cognitive symptoms. The following day (which is important because she often has nighttime hallucinations that she thinks really happened) she told me that she mentioned a financial stressor, then the doctor suggested that might disqualify her from Medicaid and that she should consider getting a lawyer. This stressed her immensely and she didn't want to go back - mentioning that she might get arrested if she did. Later, when I brought up making the followup appointment, she talked her way out of it in every way that she could - it was only to check her medication and she felt that was fine; it was only to talk about her stress, but she's not stressed any more, etc. I had to stick to the idea that I was concerned about the idea of losing Medicaid and wanted to get that straightened out. As she got more upset and flustered, she said "is this just because you want me to take the longer test?" I'm assuming that's a more-in-depth cognitive assessment that I hadn't known about. That's what makes me think there's more to my being invited to this appointment than the doctor inquiring about household finances. She eventually, very angrily, scheduled the appointment.
My question is, how am I supposed to discuss her symptoms with her doctor, with her present, without causing stress/problems? She used to ask me to point out symptoms I noticed, because Alzheimer's runs in the family, but when I started to, she would blow it off and then start hiding those behaviors from me. She also had a dream/hallucination (that she thought was real) in which I yelled at her for many of her symptoms, she said "it was crushing to hear", then thought I was going to sue her for it. And like I said earlier, she often gets extremely upset and defensive. Now I'm going to team up with her doctor, right in front of her, and say all those "crushing" things that she doesn't believe are true. However, I feel like it's my only chance to escalate myself to the level of caretaker - if her doctor facilitates it. I can't talk to him in private if she doesn't sign the proper forms, and she won't sign them if she thinks nothing is wrong. I know I can't force things to go my way, but I feel like I at least have to try right now, before she moves away and falls off her roof or something. Any recommendations, suggestions, ideas, or commiseration would be appreciated. Thanks.
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Can you mail a letter to the doctor?
Apparently the only thing I can do is leave a message with a receptionist over the phone that will then be relayed to the doctor. So far I've had mixed results with people and am not very confident with that system.
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1 ReactionGood evening @anotheranonymous, I see that these are your first posts on Connect. By any chance have you read about Habit, a program for managing cognitive impairment? I am looking into that for my life partner and me. As I was going through the assessment appointments, I was also beginning to have difficulty with what is called "executive functioning". The result was unfortunate because I was forgetting appointments, not returning phone calls, and struggling with my medication doses and frequencies. Some are injections, some are capsules, some are liquids. I made a mess of it and was up most of the night not knowing how to get back on track.
It was time for the review and both my life partner and my daughter were invited. They were amazed at the presentation which led to the cooperative implementation of special "tips and tricks" to keep myself on track.
I now see a Behavioral Therapist twice a month to check up on my "performance". We are also on the waiting list for relationship counseling which focuses on acceptance and assistance.
Have you considered therapy for your Mom?
May you have happiness and the causes of happiness.
Chris
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1 ReactionWhen we see my husband's geriatrician, I have a private session with the doctor (or APRN, depending on whether it's an annual visit or interim) while he's being tested -short tests- and chatted up. Then she sees my husband alone for a bit then we all get together. These visits are scheduled for 45 minutes, unlike other doctors' appts. (The neurologist's vists are shorter and we are always altogether. ) I'd call the office ahead of time and see if you can have some private time with the doctor. I'm sure this happens all the time - that the caregiver needs to talk with the doctor alone, but you have to ask.
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4 ReactionsIf possible you could voice your concerns over the phone or e- mail your concerns prior to the appointment.
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1 ReactionIs this her primary care doctor? If you don't need to have a referral, I'd try to find a geriatrician. This is their specialty and we've found them compassionate and a great resource. We love my husband's primary care doctor, but geriatrics is not his specialty and he was wise enough to recommend a geriatrician, who is up to date on the latest medications and strategies for maximizing quality of life.
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1 ReactionMy husband was having serious memory issues along with hallucinations. He insisted that it was OK for him to drive. We set up an appointment with a neurologist and I was very concerned that my husband could appear normal, and he would continue to drive. So, what I did was I started a daily list of conversations we had and concerning things that he would imagine and speak. That way the doctor would have a much better understanding of my husband's illness. I emailed the neurologist with two pages including dates of things that were being said and done. I did let my husband know that I was doing that. Thankfully the doctor told my husband that he was too ill to drive.
Is there any way that you could email lists of conversations that you have had and things your mom has done before the appointment? That way the doctor would have a better understanding of what is going on.
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4 ReactionsOMG, this one is me not too long ago. I wrote out everything in detail after my husband started threatening my life and hand delivered it to the front desk at the doctor's office. The receptionist did NOT want to take it. She refused it until I told a little fiblet and indicated that it was the doctor's birthday coming up or recently...something about it being his birthday. Anyway, it worked and HE made it possible for me to have a one on one with him. I know it doesn't feel right going behind their backs, but the alternatives aren't that great either. We don't need mother on the roof again right? The roof thing is one of the reasons I cannot leave my husband by himself any longer. He truly believes that he needs to clean the gutters with the leaf blower and inspect the roof often. Hand it over yourself if you have to, hand it to the nurse, she will make sure the doctor see's your note, email??? If that would work for your doctor. Phone call - I don't know, the call ends and there's nothing on the doctor's desk to remind him of your issues with mother. Good luck and I'll keep you in my prayers. BTW - He listens, He led me here
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3 ReactionsDoing a power of attorney paper based on her being incompetent has to be the way to go ! Go see the doctor alone and explain what is going on to him ( or her ) . Ask the doctor if he would agree that mom is incompetent ,and would he witness to that if asked . If none of that would happen.... you are at the end of your rope ! Sadly, we can only do ..... what we can do !
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2 Reactions@anotheranonymous, I thought I would check in with you. Your mother is lucky to have your care, although she may not be able to express her gratitude. Your situation is a challenging one. But as you can see, you are not alone and several members have already shared similar experiences and offered ideas of how to discuss with your mom's doctor about her increasingly paranoid behaviors and cognitive issues.
Have you since been able to email or schedule an appointment with your mom's doctor with and without your mom? How are YOU doing?
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