New here - intro & question

llouJuly 5, 2009

I've been reading previous posts and think this is sure the place to get some good words of wisdom.

Trying to be brief, I have a 91 yr old dad living in assisted living directly across the street from me (incredibly convenient) and an 88 yr old MIL living about 12 miles away.

Todays question, and as time goes one, there may be more, is about MIL. She is currently living alone, and still driving. She was widowed about 7 years ago. No friends, no life, no hobbies, no social outlet except hubby & I. Older son calls, but rarely visits. She is doing OK, she gets meals, takes care of herself, etc. but in the last 6 months we've really noticed a big step down in memory & comprehension. She repeats the same thing over and over within a 10 minute conversation, then when you see her later, she goes over it again. New concepts are getting harder for her. She lately has a lot of trouble differentiating between her debit and credit card. She was fine with them till they sent her new ones in the mail. I can't tell you how many times we've gone over this.

I guess the questions are:

1. Do you correct her when she repeats or just keep saying OK. I'm not sure when to interfere. She asked me to go with her to a doctor's appt in 2 days. I was with her just last month with the same complaints, but she forgets. I tell her nothing is different, remind her of the last appt. but it just doesn't get through. I'm a little embarassed to be back for the same thing.

2. Although she is doing fine now, we wonder if she will get confused one of these days and not remember how to get back from the store. (We have secretly followed her when she is driving, and suprisingly she did great and her license was just renewed last fall) Do we step in to take a license away when there is currently no problem but you can't help anticipating that one will rear it's ugly head. We may have no legal way to do that.

Many of you are dealing with so much more than this, but I'm sure have been in this situation before. Thanks

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Hi- My mom is almost 89. She also repeats things within 2 min. of having asked. This goes on all day long with all kinds of things. We do tell her she's already asked and I will actually say, "You tell me the answer to the question you're asking. Think about it for a bit because you just asked that question 2 min. ago." Sometimes she's able to remember, other times, not. But, I figure I'm getting her to use her mind a bit by doing this. Otherwise, you can go crazy and truly, with my mom, I think there are things she can remember if she uses her brain and thinks. Most of the time, she thinks I'm my fathers niece. She confuses me with her and will call me by her name. Tells me she remembers where and when I was born. I stop her and say, "Mom, I'm not so and so.... I am your daughter and you are visiting me at my house. So and so lives in Arizona." She will quickly correct herself and say, "I don't know why she's on my mind." She can cover her mistakes quickly and sometimes she truly realizes that I'm not who she thinks I am. Anyway, we do correct her. I am sure the time will come when correcting her will be useless.

As for the driving, mom has never really driven. I'd be afraid for your MIL only because I'd be afraid of her forgetting where she's going, or the rules of the road... or even her faculties failing and drive into a group of people, house, store, etc... I worked as a Physical Therapist Asst. yrs. ago. We had an elderly patient who would come in for PT and we knew she shouldn't be driving. She could barely hold her head up unless she 'propped' it between her shoulders (quite a feat). Her mind was failing quickly. All of us in the office talked and decided to notify the authorities. She was called in and given a road test. She failed. Her license was revoked and a friend would bring her for her therapy and help with groceries and stuff. We truly thought it was the best thing for her and others on the road. We kept picturing her driving into the Physical Therapy bldg. one day! She would hit the curb many times as she turned in to park and it was very frightening since the Handicapped Parking was right in front of our doors. You are the best one to decide this. You will know when it's time to do something about her driving.

    Bookmark   July 6, 2009 at 10:56AM
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Dementia can be difficult to understand if you've not been close to it before. Hard to evaluate its depth or its practical consequences because of its seemingly infinite number of levels and because its manifestations seem to come and go. And most of the time they look just fine.

I've been living for more than a decade with 97-years-young mom. Also knew all of her friends but they're all gone, now. I'm not a professional, but I offer these opinions about your questions.....

1) Yes, correct her...gently and lovingly. In my case, mom asks me what day it is a dozen times a day -- it's no big deal. Main thing is to avoid becoming annoyed because of the repetition or the triviality of the subject. Don't refrain from interacting or act irritated or grumpy because then she'll become increasingly hesitant about interacting with you. Remove the word "embarrassed" from your thinking about any of it. She's no longer in quite the same world as you are but your verbal participation will still help her to keep connected. This will help keep her on track and by keeping the conversation going will allow you to see how the condition is progressing.

2) I care for my mom in a retirement community. Lot's of people here your mom's age and older. Giving up driving is a HUGE deal. They all know it's the end of their independence so they resist it.....until they have an accident. Most are just property damage but often much worse. There isn't one in ten who will stop voluntarily. One 92-year-old plowed through the wall of the community center sending 6 people to the hospital. It was the second time he'd done it. He was adamant that he was a good driver and was being treated unfairly because authorities pulled his driving privileges. I'm sure you know your own stories.

Usually its a combination of factors that make them hazardous. They can't see well. Their ability to evaluate and react to situations on the road is often severely impaired. They can't swivel their heads and shift their eyes as quickly as they used to. Many have numbness or impaired sensation in their legs and feet and can't tell which pedal they're pushing. And they almost all have spells of more intense mental impairment than normal that come and go -- almost like daydreaming in the degree of inattention. Since they've almost all been driving all their lives, they can accomplish most of what they need to do by rote and reflex -- but its not the same as it used to be. When something happens that demands immediate reaction -- the nature of driving -- they often can't handle it. They look and act "normal" but they are, in fact, rolling road-hazards. Their awareness of their surroundings can be slightly impaired to almost non-existent. They're not carelessly inattentive -- they're simply incapable of being attentive. They are clear and present dangers to themselves and others. On the plus side, whatever they do is usually done slowly so normally-functioning drivers and pedestrians can usually avoid them.

I don't know anything about your MIL except what you've said and I'm certainly not saying she's anything like I've just described. What I am suggesting is that you continue to pay close attention to her driving abilities. Nobody else will. If/when the time comes that you may see she shouldn't be driving anymore, I encourage you to do whatever you need to do to keep her off the road.

    Bookmark   July 6, 2009 at 4:13PM
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Thank you so much for input. I'll try gently reminding MIL that she already told me whatever it is and see how that goes.

AS to the driving, boy that will be tough. It was hard getting my dad to quit, but he was obviously a bad driver so there was no doubt. Actually, he had never been a very good driver :) He got very ill and couldn't physically drive for a short time during which my sister sold his car. That worked! He likes to help people and was glad his car went to someone that really needed it.

Hubby will have to be the one to deal with his mom, but we certainly appreciate all input.

    Bookmark   July 6, 2009 at 7:57PM
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No need to remind her that ground already covered...that may make her feel embarrassed. What I intended to suggest is to simply make sure she has actual information when she asks for it. Even if its a repeat for you, it isn't for her. The important thing is that she NOT feel any discomfort from talking to you about anything. Remembered discomfort will lead to her not mentioning things. She may or may not recall that she already covered that ground but she shouldn't here it from you. At some level, she knows she's deficient. What she must know at all times is that its OK to say anything/whatever to you because she will never associate any bad feeling with it.

It sounds a little childish, but all that stuff is in there at some level. Verbally everything must be able to come from her without any negative consequence. Her world is shrinking. This is one negative you don't want her to focus on.

    Bookmark   July 6, 2009 at 8:06PM
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asolo, you are a saint! Those are very wise words and I can only hope I can keep them in mind as I deal with my own MIL. I'm not a patient person at the best of times, and get snappish with her way too often. Your description of "her world is shrinking" is so accurate and beautifully put.

llou, dementia has many causes and can happen with surprising rapidity. Take the opportunity to talk with her physician about it. There may be a physical reason which could be corrected easily.

When she is "on" you REALLY need to have her fill out a Durable Healthcare power of attorney/Advanced Health Directive as soon as possible. Without it, if she becomes 'non compos mentis' you will have no way to get information about her condition legally, let alone order anything done about it. The HIPAA (privacy) laws are worded vaguely enough about implementation that many doctors/nurses will give you info when they know you're a relative - but unfortunately, you can't always count on that, especially in an emergency. It is always better to have the legal proof that yes, you can be given confidential medical information without fear of liability issues.

I'd suggest you make a permanent label and stick it on her car's dashboard (where it can't be seen until you're near or inside the car) with your emergency contact info - name and 24/7 phone. That way, if she is lost and can't remember what to do, any stranger will be able to help her. If you can stick on in her wallet as well, that would also be a helpful 'fallback' for her and others.

Does she have a cell phone? Do you think you can teach her to use a simple one, like the Jitterbug?

Repetition is an annoyance, but unfortunately very common with dementia. I usually just stop my MIL after the third time and say firmly, "Thanks, but you've already told me that and I remember."

    Bookmark   July 7, 2009 at 11:15AM
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Asolo gave you great advice. It's important to keep your communication channels open with your MIL so you really want to avoid embarrassing her or making her feel foolish. Just go ahead and answer the questions or listen to the statements, no matter how many times they're repeated.

After the first repeat, don't bother going into details, trying to make sure she understands what you've said. Don't try to review things and expect her to remember. It's obvious that she doesn't either understand or she can't retain what you've said. So a polite but short response is all that's needed.

The one thing you want to avoid is creating tension whenever she talks to you or asks you about things. That will make her retreat into herself even more and she'll end up keeping possibly important information from you (such as health concerns) just because she doesn't want to be humiliated by lectures and reminders of her diminishing capacities. Just keep the tone rather matter-of-fact.

Driving is really scary. I certainly sympathize with you. I worried about my mom for years. Her cognitive abilities were diminishing and she had serious vision problems. Her eye doctor was no help at all. Even though she couldn't make out the big "E" on the chart, he still wouldn't do anything. Her general practitioner was the same. She had a cell phone but couldn't' use it. But I had my name & home phone number in her wallet and also on a label stuck on the cell phone. I'd get calls from kind strangers or gas station attendants whenever her car broke down. It was a frightening period. Eventually she moved into an assisted living facility and gave up her car. We all breathed a huge sigh of relief when that happened.

    Bookmark   July 7, 2009 at 8:51PM
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My mom has dementia and talks about the same things over and over and on most the subjects she is wrong. We tried correcting her, but it just makes her angry and forgets she is wrong 5 minutes later. You just have to sit there and listen to her ramble. My mom walked to the grocery store after she gave up her driver's license. One day she stepped out of the store and had no idea which way to go for home, a kind woman drove her around until Mom recognized her street. She had enough good sense to know she shouldn't do that again. She is 97 years old and lives alone. My sis lives a few blocks from her and visits her every day.

    Bookmark   July 8, 2009 at 4:26PM
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