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My dad is 86 and lives with us. He had prostate cancer and hogkins lymphoma. He gets chemo every 21 days for about 5 hours. With that being said. He is completely different at home than at doctor appt. At home he is weak and falls a lot also very forgetful he forgot he fell into closet and blamed me cuz it was broken. He is obsesses about his BM he has them then thinks he didn't so he stresses. At the doctor though he can put on a good show for the 20 min appt. He's the funny old guy. I try to talk to the doctor about what's going on and he will contradict me at every turn. His voice even changes at home it's weak but at the office he try's to make it more forceful. I tell him I can't get him the help he needs if he keeps this up and he agrees but does it anyway at the office. I hate going to the doctor with him cuz I feel I look like an idiot. Is anyone else dealing with this???

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Been there. First off, document all of your observations, dates, times, surroundings, etc. on paper. Then mail to the doctor with a letter stating your concerns about dad's health and go ahead and state that Dad has very lucid moments for short periods and though may appear okay for short dr visit -- is actually struggling at home with everyday activity and management during the day.

Tell the doc as part of your letter that you are requesting a more in-depth examination (physical and mental) for dad. The dr should devote about a one-hour appointment and based on your letter can help assess dad's abilities.

I had this done for my mom for same reason -- she was confused at home, hallucinating, deceptive, etc. -- but wonderful (referred to as "showstopping") for the 20 min dr appt.

I documented about 6 mo of observations and then made an 1-hr appointment for mom. Dr. used my letter to tactfully ask mom some questions; had her perform some tasks; then referred her to a neurologist for further elder follow up examination and then diagnosed her with mild dementia.

That at least tells you where you are so that you and dad can jointly make plans (plan A, B and C!!) for your options and future care needs and desires.
Get your legal docs in order
Start reading on elders, dementia, ALZ
Understand dad's finances, assets and what that means to you, dad, and his future care needs (don't underestimate! costs)
Take a good look at dad's living situation/conditions and how you can help make those better and more accessable
Watch some Teepa Snow youtube webinars to undertand the future
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This is well documented by a lot of people on this site. They refer to it as showboating. I think that sums it up. Our loved ones, even the ones already passed, have done this very thing. I think there is something still in them that does not want to appear weak or needy in front of others.
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Dupont, this is a problem. The people we're caring for can put on a show for people at the doctor's office or at church. They can seem normal enough if family comes for a short visit. This can be a bit embarrassing for us caregivers, because we have voiced a concern that life is not going so well. Then when they seem okay to everyone else, it can make it look like it is us.

Is your father seeing someone knowledgeable about older people? I found that the geriatric specialists are not so easily fooled by the showtiming. It is nice to have someone on your side that knows all is not so well. These doctors will go beyond the 3-question test of cognitive function and give something that is more in depth. The test my mother took was about 15 minutes long. I did not stay for the test, because I knew she would look to me for cues. I think the results were more accurate with me not there. It showed she had significant cognitive decline -- something I had known for years.

Many doctors don't follow up with a neurologist. In a way I wish they would with my mother, because she doesn't fit the stereotypes for any of the dementias. I think that I will ask if they would prescribe a scan to see where the damage might be. It might answer many of the questions I've had about my mother's bizarre behavior.

But anyway... you are not alone. Let your doctor know what is going on with your father. He probably knows about showtiming, so it won't be a surprise.
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Thank you all... It's nice to know I'm
Not alone. His appointment went ok. Though when the doctor called me into the hallway he tried to wheel himself into ear shot. I think his doctor got the gist of what I'm dealing with. I will start a journal of his falls and such for our next appt. Agin thank you
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Mom does the same act : turns on the smiles and charm with people who come to the home for maintenance, plumbers, etc. She's needing surgery for a severe rotator cuff/shoulder displacement after a fall. With her doctors, the PT, OT, and home care nurse ~ she's the friendly, charismatic, charming, generous, kind person that i always loved. Now she's started insulting me and demeaning me in front of her healthcare ppl. She needs to get stronger for her surgery, fell 5 times in Feb. She won't eat - only puddings and Ensure. Her mood swings are horrific and i'm scared, and in search of a local support group - not so much to vent, but i truly need to understand how i can be better as a caregiver. i think she knows what she's doing when she says or hurts me. There's a clarity in her eyes, and filled with anger. Her anger is directed at me, which is the most frustrating part. She used to be kind, compassionate, loving and just made the room light up by entering. She was a people-person, and that's the biggest loss. It really hurts that she won't do anything at all, whether it's dusting, or even smiling. The charm comes out only for strangers or her doctors / healthcare providers. She;s charming, complimentary and encouraging with my sisters over the phone ~ so her anger, hitting me, throwing things, the verbal and physical abuse, really hurt! i just need to toughen up - is that possible? i truly miss my Mom and love her ~ i live with her, but she doesn't communicate with me at all, let alone 'pitch in'. She's changed so very much within such a short time.

Dupont, PLEASE document the dates and what was happening at the time of the falls. The doctor may need to adjust meds or needs to be aware so that any safety issues [remodelling a bathroom, etc] can be addressed, too. Sometimes bruises are caused by the meds. Documentation or 'diary type' writing would serve you well, as those threads of falls, cognitive changes, demeanor etc., are woven into the daily activities. i keep a log of what we did that day' in a journal - of what Mom ate/didn't eat, where we went or what we watched on TV - just an overview. But i do include emotional charges /flare ups, too. It may protect me some day. Thealthcare workers hear her barbs and snipes directed at me, and it really makes me feel lousy [i hear you, JessieBelle ~ i now feel OK about my feeling betrayed]. It doesn't help that the nurse says 'she doesn't know what she's doing' -- Mom's very stubborn. i love seeing her around other people ~ i think: there's Mom ~ oh why can't she be nice to me? Tired of tears ... time for education so that i know what to anticipate, and can plan for it now. She threatens to put me in a home, and hopes that i die there ["...and tomorrow's not too soon"]. Then she's charming the neighbors, that day's visiting healthcare worker, etc. They ask her questions, and she tells them to ask me [did you eat this morning, etc]. They ask if she does her PT in-between the therapist's days, but she doesn't. Then she tells the nurse that i'm lying. But the nurse confided that if she were doing the exercises, she'd the muscle tone would be better. [i forgot about objective observances in the fray of the day]. Where does the negativity, anger and hatred come from? She's lost interest in just about everything she cared about. i truly wish i had the brevity of you, Sophe509. But if i asked her to use a recorder or video, she'd only throw it at me. And yeah, there's the multitude of repetitive questions. i need to find a way to become better at this. i'm all Mom has. She's all i have. Blessings to you all ~
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crickett, I know where you are coming from. My mother is nice to everyone, but treats me like dirt most of the time. I keep asking myself why I am staying, because I certainly don't want to spend too many of my golden years being treated poorly. She is so sweet with other people that they would probably be surprised at her behavior when they aren't around.

Tonight I read something that really clicked with me. I don't want to hijack this thread talking about my mother, but I ran across case studies of late-onset bipolar disorder. Some of the cases sounded like they were talking about my mother. Then I started thinking about her behavior when she was younger. She may have always been bipolar, instead of borderline. Drugs and isolation let her hide it from everyone better, and she learned to act normal to everyone but her family. She had a lifetime of showtiming for others. No wonder she preferred to be away from people. It was too exhausting. Now with the dementia thrown in, even the showtiming is starting to fail.

Showtiming can cover a host of problems. It's only when a PCP or psychiatrist gets past the showtiming that they can be helpful. A caregiver is important here, because they can let the doctor know the truth. Dupont, it sounds like you did a good job getting through to the doctor about your father. Maybe the doctor can help him more now. Your father might be mad, but it is for his benefit. It would be nice if all patients were honest, but they lie and showtime so much. This makes me think of the TV series House, in which one of the primary premises was that patients lie. That can be so true.
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Thank you I'm so so stressed he has an appt today. I will start a log of falls etc... Great idea.
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I think they also know they can get sympathy from medical providers, and they like "hamming it up" and flirting with the women.
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Also, many computers and cell phones have downloadable applications that allow you to record their voices or record them on a video tape. I put the iPad on the counter top, turned it on, told Mom I would like to record would she be OK with that, got her permission and then had *quite* the session. I then emailed this to the doc. He found out what she was like when not showboating. It's just amazing...she is nearly incapacitated when I'm around or the caregivers are around, but boy, go to the doctor and watch out...the smiles come out, the cognition shifts into high gear and she drops the demented persona. An experienced doctor will believe you; the others need the video/audio evidence to help educate them.
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Totally been there too, Dupont24, Especially when well meaning folks tell me how great mom looks and how "sharp" dad is. I just smile and say thank you, but it really gets to me! Or how about when people say, "Just have your mom call Uber" She can't use a cell phone anymore or not lose it, or remember where she needs to go. But I just smile and say, "Good idea." Until people have waked in our shoes they don't get it. All of you, dear friends, totally get it!
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