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She lives with me (her son) and my family (my wife and kids). She has her own room and shares everything else with us. I noticed for the past year or so she doesn't want to change her clothing and her bed sheets. When I approach the issue she gets very defensive and tells me how I am always on her case. She keeps wearing the same T-shirt inside the house for the last 4 months and there is no way to encourage her to change it. My wife and I bought her Xmas gift package of a new T-shirts, but she doesn't use them.


I take her to the store once a week and the shopkeeper caught her putting stuff in her bag and not paying for it. When I asked her about she said that she paid for it which she did, but only when the store owner caught her. He told me later that they see her do this every week when she goes there.


I wanted to schedule an appointment for her to see a doctor, but she wouldn't hear it because as she says, "I don't need a doctor for anything". She takes meds but has automatic renewals on them so she doesn't see the urgency. Other things I notice:


She eats a lot of toast with jams daily and in the morning would drink 2-3 coffees (back to back) if I don't watch or would go through half a bag of candy like its nothing. I am confused about what to do and how to help her as I can see that there is something happening with her.


Any info or suggestions would be much appreciated.

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We went to a doctor and she found that her blood glucose was high and gave her prescriptions she thinks that based on her age and the symptoms I described that she might have dementia beginning stages but she is not sure. she suggested some tests and waiting for her to schedule that.

I lately noticed another behaviour. When I am not home (days I work from the office) she would keep knocking on my kid's bedroom and once they open the door and she would ask them "Do you need anything". She would do this 5-6 times a day. I asked her to please stop knocking on their door since the kids are at the university and they need quiet time to study and she would say "Sorry I won't do it again" but yet the following day would be the same story. Interestingly when I am home she doesn't do it. How does she remember that I am home and doesn't knock on their door?
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I wouldn’t put her through an MRI scan . It’s not going to make a difference in how she is taken care of . Dementia also doesn’t always show up on a scan . I do recommend getting her placed in a facility , her care needs will only increase . She can not be left home alone .
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There are test that do not require the person administering the test to speak English. (any scans done a "tech' would do. BUT inform them when you schedule that your mom does not speak English and ask for an interpreter.)
Other testing that is done may be verbal so when those are to be scheduled ask for someone that administers the test to do so in your mom's native language. (If this is not possible an interpreter should be available. YOU do not want to be the person to do this.
But all the indications that your mom has dementia are there. So the next question is...is it really necessary to confirm it with long drawn out testing. That would be up to you. In some dementias it is important to know what type of dementia you are dealing with.
Personally at this point I would not put mom through long involved testing.
Please be aware that any scans that are done may require your mom to be sedated. A light "calming" sedation but she will be a bit "wobbly" and a fall risk for several hours if not a day or so after. Elderly people, dementia and sedation do not do well together.
Do plan on needing to monitor her.
Do plan on having to get help in the way of caregivers.
And if you can not care for her safely at home you will probably have to look into Memory Care facilities.
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I managed to get her to the doctor and her glucose and HBA1C numbers were high so the doctor gave her pills for it. I also shared with the doctor how she uses pads and hides dirty pads all over her room even though we have a small bin in her room. This gets really smelly and when I ask why she is doing this she just stares at me so every time I take her to the store on Sundays my wife goes in her room and looks around and finds their dirty pads everywhere.
Anyway, the doctor says that she thinks that my mom has dementia but I am confused about how she diagnosed this. She said she will schedule her for additional tests but it might be hard since my mom doesn't speak English
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Found this:
Pathological stealing can be a prominent feature of neurological disorders that involve the frontal lobes.2,5 The most common cause of pathological stealing appears to be FTD, a common dementia in the presenium characterized by disinhibition, inertia, lack of empathy, compulsive behaviors, and eating disorders.

Mom cannot shop anymore without supervision. I would not be taking anyone out to shop wearing the same T-shirt for 4 months. She needs to be banned from the store.

Maybe your Mother needs an in-home assessment, which may help you to decide if her care has become too much for you, or if she requires care of a professional. With an assessment, other choices may be offered, such as in-home caregiver.

Contact Area Agency on Aging, maybe located at your Senior Center offices.
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Laziness=not changing one's t-shirt for a few days.
Dementia/Alzheimers=not changing one's t-shirt for 4+ months.
Mother is eating sweets full time (going through an entire bag of candy like it's nothing), another sign of changing tastes that go hand in hand with cognitive impairment. Stealing and lying about it, check. Refusing to change her bed linens for a year and being okay with living in squalor, check. Not noticing the stench emanating from the bed or the body, check. Refusing to bathe is another classic symptom of dementia. One or two oddities can be chalked off to laziness or 'who cares'....all of these? Most likely dementia; if it quacks like a duck.........etc.

Here's what I'd do: use a white lie and tell mother those meds that are automatically renewed are NO LONGER automatically renewing as of January. Medicare is also requiring her to have a physical in order to keep her insurance in force, o/w it will be cancelled and she'll have to start paying $100 per prescription starting immediately, out of her own pocket. Elders with dementia are extremely, shall we say, frugal? :) Whatever means you need to use to get her into the doctor's office, use it. Let the PCP know ahead of time that you suspect AD or dementia is at play, and that mom needs a mini cognitive evaluation test which is short & sweet & concise. Once you get an idea of where she falls on the MoCA or SLUMS scale (1-30), you'll have a better idea of what's happening. NOT that she'll get better with this behavior, she won't. She'll only get worse, unfortunately, as the dementia progresses.

I suggest you read this 33 page booklet which has the best information ever about managing dementia and what to expect with an elder who's experiencing it:

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Wishing you the best of luck getting mom into the doctor's office for a full physical and cognitive work up.
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Some of the initial issues that crop up with the dementias are things the person has done routinely. We use short term memory as if it were a printer, to retain the information we file into long term memory. Long term memory is the thing that we use to know that we already picked up the mail today or put away the groceries. When the short term memory is broken, you've run out of ink. You're printing blank pages that can't remind you that you have or haven't done something. In that case you will fall back onto longer term or deeply ingrained memories. Some of those will be rote tasks you've done for years. Have you always put on a clean outfit? Have you always changed your sheets every Monday? You will assume you still are because you don't have a memory that tells you that you aren't. And that might be where your mother is. She won't believe you if you tell her she's not changing her shirt, because she always has. She can't sense time passing or recall what has recently happened.
I would recommend making sure your mom's meds are in order-my mother was taking her daily vitamin and thinking it was her thyroid med-she'd been out of it for months.
I would try to fib to get her to the doctor-the cause of her confusion needs to be ruled out. Sometimes a UTI can present as dementia. I told my mom we had to go see the doctor because it was required by Medicare, and gave the doctor a note before the visit detailing the behaviors. If the cause of her confusion isn't something easily treatable, a more in-depth exam by a neurologist or neuropsychologist should be performed.
Here's some reading and videos:
https://www.alzconnected.org/uploadedFiles/understanding-the-dementia-experience.pdf
Early signs: https://www.youtube.com/watch?v=pqmqC-702Yg
Anosognosia: https://www.youtube.com/watch?v=5nw3YUDQJuY
https://tamcummings.com/stages-of-dementia/

Stage 4: https://www.youtube.com/watch?v=coiZbpyvTNg
Stage 3: https://www.youtube.com/watch?v=TIkTO4d8YyI

Adv dir. https://www.youtube.com/watch?v=ii73c8k63Ag

Moderate Dementia. https://www.youtube.com/watch?v=6cZTgG6kDjs

The forums here, and at: https://www.alzconnected.org/discussion.aspx?g=topics&f=151
are helpful.
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All the examples you give are typical with dementia. Probably Alzheimer's.
She should have a physical. I would notify the doctor of your concerns in advance.
Do you have POA for Health and Financial matters?
If not best see an Elder Care Attorney to get all the necessary paperwork done. If you do not have POA it can be difficult to place her in Memory Care if and when the time comes. It may come down to you having to become her Guardian.
Tell her that the "automatic refills" will stop since she has not had a physical. Tell her also that Medicare requires an annual physical to keep the insurance policy current.
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To be honest a lot of what you describe sounds like maybe a bit of plain laziness. It's much easier to make toast and jam than a proper meal. Pullng on an old t-shirt everyday as opposed to planning what to wear. Also sounds like she just doesn't care. I don't know what to say about the shop lifting. Maybe, she thinks I'll look around a bit more and stick this in my pocket till it's time to pay. I remember once I was walking around with an article in my hand and was looking around a bit more before paying. Suddenly I was walking through the mall with this item still in my hand cause I forgot to pay. I went back and paid but could have just taken it. No one even noticed.

Your mom needs some interests. Something to motivate her to want to do things. When we become bored with life, laziness sets in. Just my opinion. Take it or leave it.
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Thanks for your reply. I understand that your wife doesn’t do the care. This is affecting your wife and children. Even if they don’t complain to you, they are internalizing it.

This must be stressful for you. Yes, your mom does need a social outlet but I don’t know if shopping is the best option for her. Clearly, she isn’t capable of doing this activity.

She isn’t capable of feeding herself properly either. She needs to see a doctor. Preferably a neurologist to check for dementia.

Are you familiar with Council on Aging? Call them and they will do a ‘needs assessment’ for your mom.

If you do decide to place your mom in a facility. You can visit as often as you like. She will be able to socialize with others.

I hope that you will be able to get her to a doctor soon.
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Can you send a message to the doctor as a concerned person. Let them know you suspect moderate dementia and give reasons. Also ask if they can stop automatic prescriptions so that she is then obligated to see her doctor. I am finding that doctors are now cutting people off on scripts if they do not visit, especially with computerized charting becoming the norm.
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GETTING HER TO THE DOCTOR- You tell her that she must have a physical to continue receiving her social security check or to keep her insurance or for you to do her taxes or that the doctor will no longer allow her to “automatically renew” her prescriptions, and by the way, what kind of doctor is allowing automatic renewals for an 80 year old woman?

She needs to know that if she won’t go voluntarily you will call an ambulance and have her TAKEN to the doctor.

It’s very tough to begun the parent to your parent, but it’s time, for her welfare, to consider doing that.
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Clearly there are some problems, but they don’t seem too bad. Usually by this time in ‘age related decline’ there would be very difficult behaviors, your wife would be resenting doing a lot of hands-on care and work, and your children could well resent the way the household revolves around grandma. Much much worse than not changing a smelly Tshirt!

The comments that might help depend a lot on the total of what is happening. Please could you post again with more information? Yours, Margaret
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stribor50 Jan 2023
My wife is not doing any hands-on care or anything like that. My mom takes care of herself, shares meals with us, I take her to the store, etc. When we are at work she keeps eating toasts with jam all day long until we come home at the evening and my wife cooks dinner which then she shares with us (we all eat together)

Besides not changing the shirt or her bed sheets (very long time), shoplifting (one instance which happened 2 weeks ago), occasionally forgetting whether it is evening or morning (happened only 2 times so far), and constant need so something that is sweet (jam, coffee, candy etc) I don't have anything to post.
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I am so terribly sorry that you are dealing with this awful situation. It’s incredibly frustrating when we want what is best for our loved ones but they won’t listen to reason.

The first thing that comes to mind is to have a complete physical, along with a neurological evaluation. She must have some type of dementia because you know that her behavior isn’t normal.

What exactly have you tried to coerce her to get to the doctor?

Why is she shopping at a store where she is stealing from? Are you taking her? Doesn’t the shop owner get upset?

Is caregiving affecting your marriage and family?

Do you feel obligated to do the ‘hands on’ caregiving? Have you considered placing her in a facility? Have you contacted Council on Aging in your area?

Best wishes to you and your family.
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stribor50 Jan 2023
I asked her to go see a doctor because she hasn't been to a doctor in a long time. I think going to a store weekly is a way for her to go out of the house. She goes there and buys things (15 - 20 dollars) and leaves them in the fridge or pantry until they expire and then the smell gives me a clue that this needs to be removed or my wife tells me that the item expired and most of the stuff goes into the garbage. I take her to the store and I usually just wait in the car. It is not affecting my family life but my mom can be nosy and ask my kids the same question 10 times ("do you want to eat something" as an example)

Yes, I do feel obligated and don't want to put her anywhere because she doesn't have any friends or relatives here but me and my family.
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Your mother’s present behaviors indicate the need for a medical exam with blood work and urinalysis.

The time comes when “need” becomes more important than “wants”. A physical is now more important than worrying about her being mad (she WILL be mad) or crying and saying that you are terrible or you don’t love her (she may cry or scream or swear- be sure your children are not around to be audience.

This is a difficult process to begin, and you must be loving and compassionate but absolutely firm.

Many of us have gone through this. Sometimes the outcome is relatively simple but sometimes it can reveal more problems needing to be addressed.

Good luck as you move forward.
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stribor50 Jan 2023
How do you take someone to the doctor if they don't want to go?
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