Elderly Mother Vehemently Denies Memory Loss : Refuses Referral For Memory Test

Question

Asked by EastCoastAir

Elderly Mother Vehemently Denies Memory Loss : Refuses Referral For Memory Test

I am the eldest of four children. I am our nearly 85 year old mother's healthcare surrogate and have for decades, paid all her living expenses. In the last few years her memory has steadily declined. Her personality has changed and she has been physically assaultive and verbally abusive to people in public as well as to all of us. She is intelligent and able to "present well" in front of her physician when she sees him for ten minutes. However, at her senior center she has had to be subdued by the police, taken in an ambulance for "heart" problems that are due to hysterical screaming and behavior. Our mother has become defiant, irritable, juvenile, irrational, and then instantly, like a child, whining for attention. She has no boundaries socially. Her physician noted in her file the words "dementia" and "memory". She found out and he removed "dementia". Her driver's license was revoked by a police officer. She recently melted a stainless steel pot on her apartment stove and a few weeks later, left the kitchen faucet on all night and flooded her apartment as well as the second and first floor apartments. I had to place her in a Holiday Inn for a week while construction and a remedial mold company tore out walls, ceilings, floors, and carpeting. She denies it was her fault and said the tenants were lying. Later, an EMT who rushed her to the hospital and is also a fireman, told me he has seen people like our mother before and she needs to be evaluated. He said next time it will be a fire and it won't just be her own safety, but that of others at risk. I have worked three times with Elder Services, a social services organization in her area. I have appealed to her doctor three times. He offered a referral for her to have her memory tested but she flatly and angrily denied the referral. According to her, it is OUR memory (every one else's) that is at fault. Our mother repeats the same thing numerous times in a matter of one conversation and yells and screams at us if we remind her she told us already. I have found new boxes of aluminum foil and Saran Wrap in her freezer and when I asked why they are there she said "someone must have put them there." She does not recall making doctor's appointments, forgets where/why she is: we were in a grocery store in the fall and she turned and asked, "What am I doing here?" She lives in a senior apartment complex by herself. Our father is deceased and they were divorced many years ago. I could go on and on with details but the bottom line is no matter how gently I try to let her know she has memory loss and should/could have a memory test that could enable her to receive proper healthcare/medication early on, she screams and slams the doors, phone down, curses, and tells me I am evil and she will never speak to me again. Every door to helping her is closed because she refuses testing. But, she is now a danger to herself and others as the fireman told me. She is not the mother we know. She goes in and out of being that person and most of the time she is someone we no longer can rely on for any sane conversation. She screams, curses, is belligerent, and now, wily. I have always been her champion and support system. I just spoke to her physician today. After three requests for a memory test, I sent him a detailed letter describing her behavior and recent events. He told me she has refused all tests. Her doctor could, in my opinion, strongly suggest a memory test is preventative medicine for patients her age, but he responds that she will only refuse. Social Services/Elder Services tells me they can do nothing without the physician referral. Her physician is going to ask her again but I am afraid she will only respond negatively as she has before. The family court says they can do nothing without a doctor's assessment and referral. So, in the meantime, she is worsening and in the emergency room regularly with symptoms of vegas nerve syndrome, panic attacks, (she's become paranoid that people are outside her window at night, rapping on her window and trying to scare her"¦she lives on the third floor in a very safe area.) Question: What can I do? Where can I turn for help? I've tried everything!!! I read everything I can and nothing, nothing is helpful. I work in hospice/palliative care/nursing homes/hospitals/ as a volunteer pet therapy care provider. I was my mother's healthcare surrogate and our mother has always trusted me and had faith in my integrity to help her and to do the right thing for her. I am tested in HIPA law annually and understand that our mother's rights are paramount. We want her to receive medication for memory loss early on if something is indeed sliding away from her, and to let her live independently for as long as she is capable. We love our mother very much. We are at the end of knowing what to do. Every hope is dashed when she says there is nothing wrong with her and won't agree to a memory test"¦even if it's to help her. Of course we know why"¦she's afraid and also, naturally stubborn. She is not a woman who would ever admit that she has something afflicting her mind. NEVER. Being gentle and soft spoken has sometimes worked but this is a volatile issue"¦How can I approach her without having her scream and hang up on me? We live six hours apart. I will go to her and take her to the memory test if necessary. Please, ANY suggestions will be gratefully appreciated. I read quite a bit, know what needs to be done to help her, but need to know HOW to get her to get the help she needs!! Thank you very much.

Answer

Hi Eastcostair, My heart goes out to you. You've obviously done nearly everything possible and nothing works. Since you imply that your mother has always been somewhat difficult, I'd say that your her dementia may complicated by an underlying mental illness. Have you tried a psychiatrist? I realize that getting her to see one sounds like an impossible task but her doctor doesn't seem to have the fortitude to stand by his diagnosis. The fact that he keeps removing the dementia diagnosis at her request baffles me. A neurologist or psychiatrist wouldn't likely be as intimidated by her and would stand by whatever diagnosis that he or she came up with (I hope). Since the police have been called, it seems that the officials have enough evidence to take over and are just passing the buck, so to speak. If you can't get her to another doctor you may just have to pull back and let her get into enough trouble that Adult Protective Services has no choice but to take over. You could call them and tell them that you can do no more so the problem is theirs. I know that this sounds drastic, but you have an extreme situation. Alerting authorities and then washing your hands of the situation may be all that you can do. Good luck, my friend. This is one tough situation. Carol Related: Elders Hiding Dementia Symptoms from Their Doctor Overcoming Denial to Seek Potential Dementia Diagnosis