Benefits to a dementia diagnosis?

[Laura Corin]

I'm not sure if my mother has dementia.  She is certainly losing her memory, but I don't know where the line between that and a specific illness lies when you are 93. Practically speaking she is safe (living with us), no one can defraud her (Husband has access to her bank accounts and keeps an eye to make sure there are no strange outgoings), she doesn't drive and doesn't use the stove.  She has fallen a couple of times but not in the last year since she started to use a stick.  She asks the same question repeatedly but not on the same day; she sometimes gets confused in unfamiliar locations; she goes to the supermarket on her own by taxi but sometimes loses her purse, stick, bag, etc; she has started to use the wrong words sometimes (having been a writer, very intelligent and very articulate); today she forgot how to tie her shoe-laces - she remembered in the end, but it took a while; she can still manage her own medicines with the help of lists that she marks off herself.

 

Anyway, she has mentioned her forgetfulness to the doctor.  He said that he was happy to refer her for testing, but it was up to her.  She decided not to do anything at present.

 

For reference, she has written a will, her finances are in order, my brother and I have POA registered (not yet invoked) and she has written a living will, so the legalities are in place in case she starts to officially lose ability.

 

Should I be persuading her to get testing?  She tends towards depression and I think she would prefer to avoid the question rather than know the truth.  I want to honour her wishes unless there is a strong reason to do otherwise.  I know there are drugs that can slow progression, but I don't know how marked the difference is.  She is otherwise remarkably healthy for her age.

Edited September 16, 2017 by Laura Corin

[eagleynne]

If all the legalities are in order I see no benefit to getting an official diagnosis at this point. It wouldn't change anything and there really isn't anything to be done about it. I mean there is no cure. She would be in exactly the same situation she's in now, just with the burden of knowing something's wrong with her. And frankly almost all people who live to 90+ years develop some degree of age-related dementia. Now, if at some point she can no longer live safely with you for some reason then you would probably need an official diagnosis in order to get an appropriate nursing home placement.

[OneStepAtATime]

If she were younger there are things that might be done to slow down the process but at that age I don't know that there would be any benefit at all.

 

On the flip side of the coin, at this point if she were diagnosed with dementia and then needed to sign any legal documents her signature could be challenged or considered invalid.

 

I don't think I would bother with testing.  As mentioned by eagleynne, she would still be in the same situation she is in now.  It sounds like the bases are already covered so a diagnosis wouldn't net much unless she wants it for herself.

 

I would hesitate to let her go anywhere by herself anymore, though, if you suspect dementia.  She could have a momentary lapse, get totally confused and end up a very long way from home, possibly in physical danger or a danger to others.  I know that stinks but there have been other boardies who have had to deal with similar situations.  It is frightening and painful and can lead to all kinds of bad situations if a loved one suddenly turns up missing due to dementia.  And sometimes they are never found.

[Annie G]

Mil's dementia brought on anxiety and fearfulness that could have been treated with medication if they had allowed her to be treated. They were afraid of a dementia diagnosis so they hid it. 

 

Through multiple hospitalizations the doctors didn't mention the dementia because they assumed it was being managed though another physician.  She didn't get any meds to help her with anxiety and fear until the last three weeks of her life. Now FIL is finally coming to terms with how much better her last months would have been if he'd had her treated. 

 

If something like that ever becomes an issue with your mom you probably don't need a diagnosis but would it make it easier to get help treating the symptoms? I don't know how your system works.  It might not ever happen- lots of people don't have those issues.  But sleep disturbances, anxiety, hallucinations....some things can be helped with medication.  But at 93 going through a long eval probably isn't necessary. 

[Laura Corin]

 

I would hesitate to let her go anywhere by herself anymore, though, if you suspect dementia.  She could have a momentary lapse, get totally confused and end up a very long way from home, possibly in physical danger or a danger to others.  I know that stinks but there have been other boardies who have had to deal with similar situations.  It is frightening and painful and can lead to all kinds of bad situations if a loved one suddenly turns up missing due to dementia.  And sometimes they are never found.

 

Thanks.  I am thinking of talking to her about about having a tracker attached to her handbag so that we know where she is if she goes missing.  Right now she is rational and might actually find it reassuring.  

 

I don't think we are at a stage where we have to worry about her endangering others - I haven't noticed any confusion about crossing roads, etc - but I will be aware.

[TechWife]

The only reason I could see a benefit to having her tested would be to determine if there was a cause for her dementia that could be corrected, and that isn't so much a test as it is seeing someone who specializes in geriatric medicine. It is possible that her GP is enough of a specialist in that area, I am not sure about how your system works in that regard. What I mean by a cause that can be corrected is this: Is she taking a medication that is known to impact cognitive function in the elderly? If so, does the benefit of the medication outweigh the risk and the presentation of dementia? When she fell did she have a blow to the head that could have caused a brain injury that could be easily corrected? Does the benefit of the correction outweigh the risk and the presentation of dementia? 

 

As someone else mentioned, there are legal implications to having a diagnosis of dementia on record, so if she proceeds with diagnosis make sure she understands them. Also, you can have a conversation with her GP as to when and to whom he would be legally obligated to divulge a dementia diagnosis. 

 

I think you are on the right track in a desire to honor her wishes. 

 

For safety, it would be helpful to make sure she has an ID with her when she is out of the home (even if you are with her, she may start to wander without notice). You could ask her if she would be willing to wear a GPS tracker - I think you can get a bracelet or a shoe tie or something similar. This depends on her willingness at this point and her compliance in the future though. If she wears it now, she may be more willing to wear it later. If you introduce something new to her as person with advanced dementia, she may not be compliant. Can you contact your local police department and let them know that she has dementia and give them a picture of her in case she wanders and someone else brings her to the police department (when you are at work, for example)? I know that in the long term you would take precautions if it became unsafe for her to be alone, but there is a first time for everything and it's that first or second time that a picture of her might come in handy.  

 

Best wishes. 

 

 

[Laurie4b]

Before just thinking it's inevitable, there are some things to get checked.

 

• Certain medicatioins can cause memory issues or can accelerate an underlying process. Google for the Beers List by the American Geriatric Society. In the US, there are a lot of primary care docs who are not familiar with this list. Some categories of antdepressants are on that list (Paxil is one) as well as anxiety meds of the Benzo family and many over the counter drugs such as Benadryl. Do you have gerontology as a specialty in the UK?  If she is on any of the meds that have been shown to cause or accelerate dementia, get her off. It may or may not reverse but hopefully can keep it from progressing faster. 
•  
• Have her thyroid function checked: not just TSH, but Free T3 and free T4. Thyroid issues cause cognitive problems. 
•  
• Have ber B12 levels checked. Out ability to process the B12 in our foods decreases with age and if it goes too low, it definitely causes memory issues. If caught soon enough and reversed mental decline will reverse. 
•  
• Also have Vit D levels checked. 
•  
• Have a dentist check for peridontal disease. It is implicated in many diseases including cardiovascular and some types of dementia. 

None of those are woo-woo recommendations, but not all doctors check them. 

 

The drugs for Alzheimer's have a very modest effect so if she'd rather not know, it's probably not going to do any harm. 

 

OTOH, I think it's weird that the doctor didn't do a test in the office. The Mini Mental Status Exam consists of a handful of questions and tasks and can be administered in a short period of time by a primary care doctor. 

 

Your mother is at the beginning stages from what you describe.

 

There is very strong evidence that exercise slows down or even walks back the symptoms some. Both cardio and strength training are good for different effects on the brain. And yes, a woman her age can get into a strength training program and progress. Same with some cardio. Obviously the doctor should prescribe it or refer her to a professional who can safely oversee it or prescribe to you what to do.  At the international Alzheimer's Conference a couple years ago, one of the presenters declared that they had no drug that came close to the impact of exercising, even after diagnosis. THere are several studies showing the benefits, not just a couple. 

 

Other things that may help:

 

• Mediterranean or MIND diet. Both involve limiting  sugar, high fat dairy, and lred meat. Both include fish 1-3 x/wk. Blueberries at least 2x /wk. Green leafy veges daily, preferably in raw form. 
• Keeping her social connections strong
• Keeping her mind stimulated 
• Making sure that she is getting as good a night's sleep as possible
• Maintaining excellent dental hygiene

 

All the things I've listed have a solid research base. 

 

If you want to look at some stuff that is more alternative, you could try the new book by Bredesen. I think it's called Say Goodbye to Alzheimer's. I have found some of his recommendations do not have a clear research basis though. At least he doesn't "show the math." 

 

Edited September 16, 2017 by Laurie4b

[Seasider]

There are Rx medicines that can help if warranted, that would depend on whether or not she will choose to add another medication to her current med load. In the future a dementia diagnosis can help you qualify for certain services such as adult day care, but I do not know what you might have in the UK system It might be worth asking your social worker attached to physicians' office or insurance company (UK equivalent) if there are any such benefits where you reside. I know your healthcare system is different.

 

[Yikes! Edited to correct horrendous voice texted errors!]

Edited September 16, 2017 by Seasider

[Storygirl]

I agree with other posters. Having a diagnosis may help you prepare for what may be to come, as her caregiver, but at this age, it's questionable whether meds would help enough to be worthwhile, and they can have some unpleasant side effects. Anxiety meds may be helpful at some point, however. I was reluctant to start them for my mom, but when she went into the nursing home, they put her on them, and it made a positive difference for her.

 

You may want to look into whether there could be a urinary tract infection. It's common for that to affect memory, for some reason, and it's a simple, non-invasive test.

 

[kiwik]

Here (NZ so possibly similar) I would try and get a diagnosis because (a) like others pointed out there may be something else going on or at least contributing that is making things worse, and (B) there may be services you can access that might make life easier in the future. Good luck.

[Laura Corin]

Before just thinking it's inevitable, there are some things to get checked.

 

• Certain medicatioins can cause memory issues or can accelerate an underlying process. Google for the Beers List by the American Geriatric Society. In the US, there are a lot of primary care docs who are not familiar with this list. Some categories of antdepressants are on that list (Paxil is one) as well as anxiety meds of the Benzo family and many over the counter drugs such as Benadryl. Do you have gerontology as a specialty in the UK?  If she is on any of the meds that have been shown to cause or accelerate dementia, get her off. It may or may not reverse but hopefully can keep it from progressing faster. 
•  
• Have her thyroid function checked: not just TSH, but Free T3 and free T4. Thyroid issues cause cognitive problems. 
•  
• Have ber B12 levels checked. Out ability to process the B12 in our foods decreases with age and if it goes too low, it definitely causes memory issues. If caught soon enough and reversed mental decline will reverse. 
•  
• Also have Vit D levels checked. 
•  
• Have a dentist check for peridontal disease. It is implicated in many diseases including cardiovascular and some types of dementia. 

None of those are woo-woo recommendations, but not all doctors check them. 

 

The drugs for Alzheimer's have a very modest effect so if she'd rather not know, it's probably not going to do any harm. 

 

OTOH, I think it's weird that the doctor didn't do a test in the office. The Mini Mental Status Exam consists of a handful of questions and tasks and can be administered in a short period of time by a primary care doctor. 

 

Your mother is at the beginning stages from what you describe.

 

There is very strong evidence that exercise slows down or even walks back the symptoms some. Both cardio and strength training are good for different effects on the brain. And yes, a woman her age can get into a strength training program and progress. Same with some cardio. Obviously the doctor should prescribe it or refer her to a professional who can safely oversee it or prescribe to you what to do.  At the international Alzheimer's Conference a couple years ago, one of the presenters declared that they had no drug that came close to the impact of exercising, even after diagnosis. THere are several studies showing the benefits, not just a couple. 

 

Other things that may help:

 

• Mediterranean or MIND diet. Both involve limiting  sugar, high fat dairy, and lred meat. Both include fish 1-3 x/wk. Blueberries at least 2x /wk. Green leafy veges daily, preferably in raw form. 
• Keeping her social connections strong
• Keeping her mind stimulated 
• Making sure that she is getting as good a night's sleep as possible
• Maintaining excellent dental hygiene

 

All the things I've listed have a solid research base. 

 

If you want to look at some stuff that is more alternative, you could try the new book by Bredesen. I think it's called Say Goodbye to Alzheimer's. I have found some of his recommendations do not have a clear research basis though. At least he doesn't "show the math." 

 

Thanks for all that detail - very helpful.  She's had a good range of blood tests and nothing came up.  I'll check with the doctor that everything was covered.  I checked the list of medications and she's fine - she takes very few, actually.  She had a urine sample taken fairly recently (a month ago, I think) and it was clear.  

 

Her diet is more or less mediterranean anyway and always has been. She sleeps really well and has seen the dentist regularly.  She has never been very social and has resisted making more social connections since she came to live with us (she had no friends where she lived before).  She reads the Observer (heavyweight Sunday paper) cover to cover each week, but I'm not sure how much she takes in these days.  I can't get her to exercise more (I have suggested various ways of getting more activity).  Thanks again.

[OneStepAtATime]

Thanks.  I am thinking of talking to her about about having a tracker attached to her handbag so that we know where she is if she goes missing.  Right now she is rational and might actually find it reassuring.  

 

I don't think we are at a stage where we have to worry about her endangering others - I haven't noticed any confusion about crossing roads, etc - but I will be aware.

This only helps if she doesn't lose her handbag.  Is there a way to put a tracker and ID in something she would wear, not something she carries?

[Laura Corin]

This only helps if she doesn't lose her handbag. Is there a way to put a tracker and ID in something she would wear, not something she carries?

I could talk to her about it, but it's a question of what she will accept. If she resents the idea because, for example, she doesn't want to be an old lady with a lanyard, then she won't take it anyway.

[G5052]

Under those circumstances, I would keep it at the back of my mind, but I wouldn't pursue it.

 

There are indeed significant emotional ramifications with that diagnosis that you have to be prepared to address. My mother needed the diagnosis because she was so dangerous behind the wheel and needed to be stopped before she killed someone. When she was diagnosed and lost her license to drive, she became extremely depressed and suicidal. Later when I had to step in for my father because she wasn't taking good care of him, it did help that I could give those I was dealing with her diagnosis (vascular dementia), what tests she had done, and who did the final diagnosis. In her case, it was a combination of a neurologist who ordered MRI's and a neuro-psychologist who did several hours of testing. She was much younger though (in her 70's), and there was more concern. For her, the testing took over two hours and was exhausting. I don't think I'd push that on someone without some thought. 

 

I have another relative in their 60's that has had clear MRI's but has gaps in memory and distorted thinking that I suspect would show up in neuro-psychological testing. At one point they agreed to that because they wanted to know, and then they said no. I respect that. 

[katilac]

I would check to see if there are possible services you might utilize if she gets the dx, but if not, I'd probably not pursue. I do think it's a depressing thing for older people to consider. 

 

Mil's dementia brought on anxiety and fearfulness that could have been treated with medication if they had allowed her to be treated. They were afraid of a dementia diagnosis so they hid it. 

 

 

If I had a relative like this, I would urge them to at least report the anxiety symptoms, because the way it would be treated does not differ if you have dementia. And I don't know any doctors who would refuse to treat anxiety just because you refuse to pursue a dementia dx. Either way, they will start you an antidepressant. If needed, they will add in another medicine to be taken for breakthrough anxiety.

 

The only precaution would be to go with an SSRI, because older types have been shown to increase confusion in some dementia patients. This should not be an issue at all, the doctor should offer SSRI automatically because they are more effective and have fewer side effects, just something to be aware of. 

[StephanieZ]

Well, IIRC, you are in the UK? If so, then I understand that the health system provides some degree of in-home-aides/etc . . . So, if you need that sort of assistance at some point, a diagnosis will be necessary.

 

Frankly, unless there are health services you need a diagnosis to access, then I'd let it slide. 

 

BTDT . . . getting the diagnosis doesn't help much and is, indeed, depressing. It can also be socially isolating, as, IME, the vast majority of "friends" run for the hills at the whisper of dementia/Alzheimer's/etc.

 

Important Caveat: There are numerous medical conditions that can mimic dementia. Vitamin deficiencies, thyroid issues, depression, UTIs, etc. So, it is definitely useful to get tested for all that stuff in case there is something to treat. If it's possible for you to talk to her doctor and suggest that testing/screening for treatable issues, then you may be able to get that happening w/o "telling" your mom that she has signs of dementia. 

 

For your own benefit, I'd encourage you to read a *little* about dementia/caregiving. Not too much, as so much is negative and depressing. But, when issues come up, or you are confused by her behavior, or you feel yourself upset/angry/depressed (all natural and expected) about stuff . . . I'd encourage you to seek out information/support for yourself. There are also "geriatric psychiatrists" that might be able to help with your mom if her dementia leads her to more problematic behaviors/depression/etc.

 

IMHO, if she's pretty happy, stable, and her behaviors/feelings/etc are OK for her and OK for you and your family, I'd leave it. 

 

(I was my mom's caregiver for her 4 years of life w/Alzheimer's, and moved her in with us for the last 18 months of her life . . . So, I do know from where I speak . . . We did NOT take the route I am suggesting . . . but my mom was only 72 at her diagnosis, so it was quite a shock . . . If I knew then what I know now, I'd have spent less time on treatments and doctors and more time just going with the flow . . .)

[Annie G]

I would check to see if there are possible services you might utilize if she gets the dx, but if not, I'd probably not pursue. I do think it's a depressing thing for older people to consider. 

 

 

If I had a relative like this, I would urge them to at least report the anxiety symptoms, because the way it would be treated does not differ if you have dementia. And I don't know any doctors who would refuse to treat anxiety just because you refuse to pursue a dementia dx. Either way, they will start you an antidepressant. If needed, they will add in another medicine to be taken for breakthrough anxiety.

 

The only precaution would be to go with an SSRI, because older types have been shown to increase confusion in some dementia patients. This should not be an issue at all, the doctor should offer SSRI automatically because they are more effective and have fewer side effects, just something to be aware of. 

 

I totally agree except the anxiety was directly related to the dementia and because they were afraid of the diagnosis and wanted to protect MIL from embarrassment, they couldn't talk to a doc about the anxiety because it was directly related to the dementia. For instance, if she heard a news story about a shooting she might spend a whole day worrying that dh was in danger because she thought it was HIS office that had been attacked.   Or if there was a murder mystery tv show (even an old one like Perry Mason) she would think the murderer was a family member. The anxiety was through the roof but how do you get treatment without the doc wanting a dementia assessment? 

 

It's complicated.  And it was even worse because we suspected Lewy Body dementia and there are a lot of drugs they shouldn't take, such as haldol.  It was a tough time.  

[Katy]

Yes.  Some kinds of dementia are reversible through proper diagnosis and treatment.

 

Other kinds can have the symptoms treated and life quality improved.

 

If it isn't a kind that can be reversed, having a history of treatment can lead to faster services.

[Laurie4b]

Thanks.  I am thinking of talking to her about about having a tracker attached to her handbag so that we know where she is if she goes missing.  Right now she is rational and might actually find it reassuring.  

 

I don't think we are at a stage where we have to worry about her endangering others - I haven't noticed any confusion about crossing roads, etc - but I will be aware.

 

There are also inserts that you can put in shoes that are trackers. 

[Janeway]

I'm not sure if my mother has dementia. She is certainly losing her memory, but I don't know where the line between that and a specific illness lies when you are 93. Practically speaking she is safe (living with us), no one can defraud her (Husband has access to her bank accounts and keeps an eye to make sure there are no strange outgoings), she doesn't drive and doesn't use the stove. She has fallen a couple of times but not in the last year since she started to use a stick. She asks the same question repeatedly but not on the same day; she sometimes gets confused in unfamiliar locations; she goes to the supermarket on her own by taxi but sometimes loses her purse, stick, bag, etc; she has started to use the wrong words sometimes (having been a writer, very intelligent and very articulate); today she forgot how to tie her shoe-laces - she remembered in the end, but it took a while; she can still manage her own medicines with the help of lists that she marks off herself.

 

Anyway, she has mentioned her forgetfulness to the doctor. He said that he was happy to refer her for testing, but it was up to her. She decided not to do anything at present.

 

For reference, she has written a will, her finances are in order, my brother and I have POA registered (not yet invoked) and she has written a living will, so the legalities are in place in case she starts to officially lose ability.

 

Should I be persuading her to get testing? She tends towards depression and I think she would prefer to avoid the question rather than know the truth. I want to honour her wishes unless there is a strong reason to do otherwise. I know there are drugs that can slow progression, but I don't know how marked the difference is. She is otherwise remarkably healthy for her age.

one advantage would be if someone tried to fraud her, and she has had the legal right to make a decision taken away, then it will be easier to undo the fraud.

[TechWife]

one advantage would be if someone tried to fraud her, and she has had the legal right to make a decision taken away, then it will be easier to undo the fraud.

A dementia diagnosis does not remove a persons right to make decisions, or any other rights. In the US, that can only be done by a court and it is, rightfully so, a lengthy process. Most people have loving family members that can take care of the person and their affairs when it becomes necessary. The court cases are the exception, not the rule. I don't know how that would work in the U.K.. Edited September 17, 2017 by TechWife

[bettyandbob]

Would having a diagnosis provide access to assistance? Would you and your mother want that assistance?

[Laura Corin]

Would having a diagnosis provide access to assistance? Would you and your mother want that assistance?

 

Thanks.  We don't need anything at the moment.  At a later date (if she needs care at home or to be moving to a care home) then she will need an assessment to work out what costs the Scottish government will cover and what she will have to pay for herself.  In general, the government covers care and nursing needs, and the individual covers hotel costs.  The actual assessment if carried out by a social worker, but presumably medical reports feed into that, so it would be worth having up to date assessments at that stage.

[G5052]

one advantage would be if someone tried to fraud her, and she has had the legal right to make a decision taken away, then it will be easier to undo the fraud.

 

Actually, in the U.S. a dementia diagnosis doesn't mean that you lose your right to make decisions. My mother was in a mode of writing a check to everyone who asked and leaving her personal belongings including her credit cards all over town. And there was nothing I could do without her agreement.

 

Guardianship is only done legally when the person agrees, or if they require someone else to give them a bath, dress them, and feed them. Early dementia doesn't qualify unless they agree.

[Laura Corin]

Actually, in the U.S. a dementia diagnosis doesn't mean that you lose your right to make decisions. My mother was in a mode of writing a check to everyone who asked and leaving her personal belongings including her credit cards all over town. And there was nothing I could do without her agreement.

 

Guardianship is only done legally when the person agrees, or if they require someone else to give them a bath, dress them, and feed them. Early dementia doesn't qualify unless they agree.

 

That's interesting.  Here, a power of attorney kicks in when the person lacks capacity to make a particular decision.  A dementia diagnosis doesn't necessarily mean that you don't have capacity, but if, for example, you are giving money away to people who you would have denied before, that might be evidence that you now lack capacity in that particular area of your life and your chequebook can be taken away from you.  Here's a scenario from some government guidance:

 

Paul had an accident at work and suffered severe head injuries. He was awarded compensation to pay for care he will need throughout his life as a result of his head injury. An application was made to the Court of Protection to consider how the award of compensation should be managed, including whether to appoint a deputy to manage Paul’s fi nancial affairs. Paul objected as he believed he could manage his life and should be able to spend his money however he liked. He wrote a list of what he intended to spend his money on. This included fully-staffed luxury properties and holiday villas, cars with chauffeurs, jewellery and various other items for himself and his family. But spending money on all these luxury items would not leave enough money to cover the costs of his care in future years. The court judged that Paul had capacity to make day-to-day fi nancial decisions, but he did not understand why he had received compensation and what the money was supposed to be used for. Nor did he understand how buying luxuries now could affect his future care. The court therefore decided Paul lacked capacity to manage large amounts of money and appointed a deputy to make ongoing fi nancial decisions relating to his care. But it gave him access to enough funds to cover everyday needs and occasional treats.

[foxbridgeacademy]

Like PP said there are possible other causes for dementia-like symptoms that can be treated. Vitamin deficiencies, dehydration, etc... I'd probably take her in to a specialist to rule those out then stop short of an actual dementia dx, if that's what she wants.   

[FaithManor]

Locally, a diagnosis allows caregivers to get a few in home health services that aren't available otherwise, and to use some drop in adult care at the community center for seniors with dementia. We also have a nursing home in the county that has an absolutely top notch dementia wing. They take amazing care of their patients, but there is a waiting list and without a diagnosis, no getting on that waiting list. Since dementia patients can move very quickly from being able to be cared for in the home to being out of control, unsafe, and needing a 24/7 staff to supervise them, it is vital to get on the list early.

 

This is why if my mother showed any signs of dementia, we would pursue a diagnosis right away. If I lived somewhere without any dementia services or without a viable option for a medical facility with a dementia facility, then I would not be in a rush for a diagnosis unless symptoms became worse.

[Laura Corin]

Locally, a diagnosis allows caregivers to get a few in home health services that aren't available otherwise, and to use some drop in adult care at the community center for seniors with dementia. We also have a nursing home in the county that has an absolutely top notch dementia wing. They take amazing care of their patients, but there is a waiting list and without a diagnosis, no getting on that waiting list. Since dementia patients can move very quickly from being able to be cared for in the home to being out of control, unsafe, and needing a 24/7 staff to supervise them, it is vital to get on the list early.

 

This is why if my mother showed any signs of dementia, we would pursue a diagnosis right away. If I lived somewhere without any dementia services or without a viable option for a medical facility with a dementia facility, then I would not be in a rush for a diagnosis unless symptoms became worse.

 

I don't know how waiting lists work here.  I'll look into it.

[Katy]

Sometimes new dementia symptoms are the only sign of a UTI and a course of antibiotics can bring them back to normal.

[SparklyUnicorn]

They have medications.  My grandmother (90) takes them, and I guess they help.  I don't know that they make HER feel better, or if the people around her feel better.

 

I agree with Katy.  Sometimes it's something else.

 

 

 

 

[Laura Corin]

Sometimes new dementia symptoms are the only sign of a UTI and a course of antibiotics can bring them back to normal.

 

Thanks.  We have experience of UTIs and their effect - in this case, the symptoms have been coming on slowly for some time, and during that time she has had a urine test.

[G5052]

That's interesting.  Here, a power of attorney kicks in when the person lacks capacity to make a particular decision.  A dementia diagnosis doesn't necessarily mean that you don't have capacity, but if, for example, you are giving money away to people who you would have denied before, that might be evidence that you now lack capacity in that particular area of your life and your chequebook can be taken away from you.  Here's a scenario from some government guidance:

 

Paul had an accident at work and suffered severe head injuries. He was awarded compensation to pay for care he will need throughout his life as a result of his head injury. An application was made to the Court of Protection to consider how the award of compensation should be managed, including whether to appoint a deputy to manage Paul’s fi nancial affairs. Paul objected as he believed he could manage his life and should be able to spend his money however he liked. He wrote a list of what he intended to spend his money on. This included fully-staffed luxury properties and holiday villas, cars with chauffeurs, jewellery and various other items for himself and his family. But spending money on all these luxury items would not leave enough money to cover the costs of his care in future years. The court judged that Paul had capacity to make day-to-day fi nancial decisions, but he did not understand why he had received compensation and what the money was supposed to be used for. Nor did he understand how buying luxuries now could affect his future care. The court therefore decided Paul lacked capacity to manage large amounts of money and appointed a deputy to make ongoing fi nancial decisions relating to his care. But it gave him access to enough funds to cover everyday needs and occasional treats.

 

Yes, not in the U.S. Now if the individual wasn't taking care of themselves and those they cared for because they had spent out their funds irresponsibly, then you would indeed have a case for guardianship.

 

The director of the home where my mother was said that they strongly urge that individuals turn over the finances to someone else when they come in. There is a bank there that is known for being very responsible that way if there's not a close relative. Both the director and my parents' lawyer had good things to say about them, as did the social worker at the hospital. Some facilities in the U.S. actually require that before you go in. But because Mom was in a private facility with somewhat loose rules, it was brought up in the intake, but not required as long as you were going into the regular unit. The dementia unit required that.

[TechWife]

That's interesting. Here, a power of attorney kicks in when the person lacks capacity to make a particular decision. A dementia diagnosis doesn't necessarily mean that you don't have capacity, but if, for example, you are giving money away to people who you would have denied before, that might be evidence that you now lack capacity in that particular area of your life and your chequebook can be taken away from you. Here's a scenario from some government guidance:

 

Paul had an accident at work and suffered severe head injuries. He was awarded compensation to pay for care he will need throughout his life as a result of his head injury. An application was made to the Court of Protection to consider how the award of compensation should be managed, including whether to appoint a deputy to manage Paul’s fi nancial affairs. Paul objected as he believed he could manage his life and should be able to spend his money however he liked. He wrote a list of what he intended to spend his money on. This included fully-staffed luxury properties and holiday villas, cars with chauffeurs, jewellery and various other items for himself and his family. But spending money on all these luxury items would not leave enough money to cover the costs of his care in future years. The court judged that Paul had capacity to make day-to-day fi nancial decisions, but he did not understand why he had received compensation and what the money was supposed to be used for. Nor did he understand how buying luxuries now could affect his future care. The court therefore decided Paul lacked capacity to manage large amounts of money and appointed a deputy to make ongoing fi nancial decisions relating to his care. But it gave him access to enough funds to cover everyday needs and occasional treats.

Here a power of attorney only gives the person the ability to conduct business/make decisions on behalf of the person granting it. It doesn't prevent the person from conducting their own business or making decisions on their own. They can be revoked at any time. If it is believed that someone is incompetent and as a result they are mismanaging their own affairs, then a family member or friend can ask the court to declare them incompetent and to become their guardian (in charge of their physical body and well being) or their fiduciary (in charge of their finances). Both of these appointments remove legal rights from the person and they become a dependent in the same manner that a child is.

[Laura Corin]

Mum likes the idea of having a tracker in her bag. She wears it across her body and hasn't lost it yet.

[Sunshine State Sue]

I just want to say that your mum is blessed to have such a thoughtful and caring daughter.  :001_cool:

[Laura Corin]

I just want to say that your mum is blessed to have such a thoughtful and caring daughter.  :001_cool:

 

You're very sweet.  We've had some very rocky times over the last two years but we've reached some kind of truce.  Reading recently about the increase of selfishness in people with dementia has helped a bit.