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When more action is required? re: aging Aunt


Tenaj
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My dh's aunt has been increasingly showing signs of age or dementia or something else.  She is unmarried and is a "snowbird"  so lives far away from us during the fall/winter/spring and then moves up here for the summer months to be near the rest of the family.  We've had some casual to serious discussions about some alarming symptoms we've seen going on with her.  This is new territory for my generation so I thought that I could get some input from some of you who know more than I.

Some examples: 

(1)  Mistaking her key fob (she still drives) for her garage door opener when trying to open the garage door for my son.  She repeatedly pressed the "trunk" button even when he pointed out to her that it wasn't going to open the garage.  Finally in disgust she threw the keys into a draw and walked around to push the button on the inside of the garage.  My son told me about this and then several days later she was disgusted with my son for trying to tell her that her key fob (in her hand at the time she was telling me) wasn't her key?  I'm assuming from this that she realized that something was wrong with the conversation because there was really no reason for her to bring it up to me.

(2)  I was driving her and asked her to call someone else in the family to tell them we were running late.  She rummaged in her purse, pulled out her cell, laid it in her lap, rummaged some more and pulled out the cordless phone from her house.  Then she picked up her cordless phone and explained she couldn't call anyone because she didn't have any service.  I joked with her that she had to use her cell phone to call and she argued saying that she uses the cordless all the time when she is out and about.  This explained a few incidents where she claimed that no one was answering different phones at different times when we knew she was in her car at different appointments.

(3)  Trying to take a picture with her cell phone (which she has had for at least 5 years) and instead of using the screen she turns it over to the back and tries to "push" the lens in order to turn the camera on.  This has been a repeated problem this summer.  She mutters about the camera never working on this thing.

There's lots of other forgetting and misplacing that are more common.  Some time issues, some keys lost.  Oh, one other thing was that she was here for two weeks before she mentioned that her headlights on her car weren't working.  We discovered that she had forgotten how to turn them on!  That one was scary.

So, is this normal aging stuff (she is turning 83 this year) or is this something more?   Most of it seems to be centered around technology which is probably short-term memory?  

 I seem to have been elected as the one in the family most likely for her to listen to so I've been researching and there is memory clinic nearby that could do an evaluation but how do I convince her.  She really sees no problem . . or at least hasn't admitted it at this point.  We are up against time . . she's talking about returning to FL at the end of August/early September.  My kids are adamant that we shouldn't let her go back to FL where she has good friends but no family . . but I'm not sure how we stop her?  Plus, being in Florida is good for her in general because she can get out and about easily because of the good weather.  We did find out from one of her good friends (who is 95!) that the friend has to direct our aunt around driving in Florida because she can't remember how to get to places and she has noticed other memory issues.

The friend and I both identify the start of the problems going back two summers ago when she suffered a bad fall during which she had a small fracture of her neck.  That seems to have healed fine but the memory issues that started then are definitely getting worse.

Thanks for any help or experiences you can give.

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This is a very big deal and she needs to see a doctor immediately to begin figuring things out. This could take time. Just because these things are happening does not mean she cannot go back to Florida. You don't know what's wrong or what treatments are available.

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To use one example: 

Forgetting that a fob can be used to take open a garage door is somewhat normal (people your aunt's age grew up without fobs).  Forgetting how to do it is ... same.  But insisting that the wrong way to do it in the face of the evidence that it isn't working is a different--and worrying--kind of thing.

(From my life). Forgetting how to make coffee in the coffee maker...that's a bit concerning.  Thinking you make coffee by pouring water in the toaster...that's really bad.  

One of the clearest examples that helped us from a website:  Forgetting where you put your car keys--relatively normal for aging.  Forgetting what a car key is for...dementia.  

One of the other worrying signs is belligerence in the face of being corrected.  Dad, you don't put water in the toaster to make coffee.  YES YOU DO I HAVE DONE THIS ALL MY LIFE AND IT JUST ISN"T WORKING BECAUSE IT IS A STUPID BROKEN MODERN NOT LIKE THEY USED TO MAKE THEM COFFEE MAKER.  WHIPPERSNAPPER!! 

I can sort of make light of it as it is 15 years or more ago that it happened. But 15 years ago...it was really difficult and scary.

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She's now a danger to herself and others, so whether it's natural old age stuff of dementia or whatever, she cannot drive and care for herself 100% anymore.  She hasn't been driving with her lights on at night, so take the keys away however you have to. Do it directly or indirectly or whatever, but lives are at risk with her on the road.  She.can.not.drive. As tough as it might be for you emotionally, you absolutely must make sure it's impossible for her to drive. She needs eldercare to some degree,  so you'll need her evaluated by a specialist and then you'll need to consider her options near you and in FL, and decide if she needs to relocate or not. It's a very long road you're about to walk. 

I'm so sorry.  This is a hard thing to deal with and it won't get any easier down the road. You might benefit from a support group for people who handle eldercare for their relatives.

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I would be blunt and say that you are noticing several things and would like for her to undergo a medical exam because you are concerned. She should have had an annual Medicare dementia screening recently, but that really only picks up severe problems.

What are her aging plans? Who has power of attorney for decision making? What kind of facility would she like to be in when the time comes? Where are her important papers.

She’s 82; memory problems shouldn’t be a surprise at this point. It’s time to have the hard conversations and start planning.

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First- I would get an appointment with her doctor for a complete exam and also mention the issues since the injury.  She needs to be evaluated and also to make sure the injury didn’t cause another issue. 
 

But I want to tell you that this will not be easy. It is a mentally/physically draining job that has been given to you.  Be prepared to be yelled at or belittled. They are frustrated and will take it out on you.  It is not you.  Have a cry, find a way to deal with it in whatever way brings you peace. A good friend has a few hours on a certain day to help her reset herself with a head massage, wine and her favorite takeout. I know you know this but many on here have been through it and you can always vent here. 

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Struggling through similar issues with my mother-in-law. I am a loss as to how, or if I can broach the topic with her. Being blunt about the topic of memory loss can elicit a hostile, defensive response. Tread lightly.

Encourage your aunt to schedule a check up appointment with her primary care physician and accompany her to the appointment. At this appointment you can guide the conversation to her memory issues. I would even slip a note to the receptionist if your aunt is not receptive to the appointment.

Gather the necessary paperwork to gain medical and financial powers of attorney. These are two separate documents that need to be notarized when your aunt still has some of her faculties. Do this soon.

Once there is a diagnosis, there is the question of care. Facilities are expensive and not always the best. Wills, home ownership, etc. need to be put on the table. Selling a home to pay for care you cannot provide at home is an option. I've done both in-home care and a lockdown facility, and I prefer in-home care, but I could not care for a parent with Lewy Body Dementia and take care of young kids too.  There are hard choices to make. Your kids are watching. Compassion matters.

Best of luck,

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It’s nearly impossible to do in-home care for someone with dementia who is still mobile unless you can afford overnight nursing care or have 3-4 adults who can trade off shifts. 

Having said that, sometimes it’s something simple like a UTI.  Just tell her you think she might have a UTI because she’s had a sudden increase in mental confusion. That really can make a normal brain seem like Alzheimer’s and it can completely reverse in less than 3 days of the correct antibiotic. 

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I'm sorry, that's so hard.  And it's not normal.   My dad is 93 and he struggles a bit with short-term memory but is otherwise very sharp and remembers everything and drives well and lives alone.  He pays his own bills online, although I do help him whenever he's locked out of his accounts for typing in the wrong passwords (about once/week :D).  He also is very aware of his limitations and doesn't drive at night and only on neighborhood roads.  

If she isn't driving, do you think she's safe?  When she's in Florida, is she living with a friend?  I'm in favor of helping someone keep doing the things they love as long as they and others are safe.  

For example, could you or someone arrange to fly with her to Florida (no car), and help her get settled in her apartment there?  Does she have access to public transportation?   Is she usually with other people there?  For my MIL, it progressed slowly for several years, and she was actually able to be fairly independent -- but no car, and people checking in on her often. 

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11 minutes ago, Katy said:

It’s nearly impossible to do in-home care for someone with dementia who is still mobile unless you can afford overnight nursing care or have 3-4 adults who can trade off shifts. 

Having said that, sometimes it’s something simple like a UTI.  Just tell her you think she might have a UTI because she’s had a sudden increase in mental confusion. That really can make a normal brain seem like Alzheimer’s and it can completely reverse in less than 3 days of the correct antibiotic. 

When working in aged care I worked with a few people with early stage alzeimers who were still able to live in their own homes. They were on medication to slow it down. They had someone come in every day to make sure they had taken their medication and eaten.  They also had meals on wheels delivery. A family member would check on them in the evening and help prepare a meal. 

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7 minutes ago, Katy said:

It’s nearly impossible to do in-home care for someone with dementia who is still mobile unless you can afford overnight nursing care or have 3-4 adults who can trade off shifts. 

Having said that, sometimes it’s something simple like a UTI.  Just tell her you think she might have a UTI because she’s had a sudden increase in mental confusion. That really can make a normal brain seem like Alzheimer’s and it can completely reverse in less than 3 days of the correct antibiotic. 

This.  She needs a UTI check. That’s the best way to get her in to the PCP office for a check up.  You can mention the “symptoms” then, possibly even while she gives her sample, if you are creative.  These are concerning symptoms!  

Also, who is her MPOA?  Has she designated anyone? Have a conversation about that.  If so, you need to have a conversation with that person, if not … help her get some paperwork done now, certainly before she leaves.  You can tell her you’re doing yours, has she done hers?  Get emergency contact info, all that stuff.

I know I always jump in to these threads and suck the life out of them with this unthinkable warning, but this has to be said: if she is having memory issues like that she should not live alone without a lot of support.  For all the reasons we all know, and then an extra reason that most of us can’t conceive of … she’s a target.  Sexual assault is alarmingly more frequent than we think in senior living communities, all types of them, even the expensive ones.  Women with memory issues are targets. If they do remember, people don’t quite believe them, but often trauma worsens the memory issues, and it just comes out as anxiety.
 

Trigger warning: I would never have known about this until it happened in my family.  My mother’s memory issues were pretty minor, in the grand scheme of being able to live independently.  She loved her community, her apartment, and with a lot of support from me - she was able to live on her own.  I had no idea that doing so, with known memory issues, made her a target.  Her assailant was never caught, though the detectives have a clear suspect, just no way to get a warrant for his DNA.  The assault landed her in hospital for three days, delirious, and created an immediate decline in memory.  She remembered just enough, and I had to fight hard to have the docs and police listen.  No. One. Believed. Her.  One really kind police officer agreed to go check out my mom’s apartment to put her mind at rest, after two others had ignored us.  He came back to the hospital 8 hours later to tell us my mom should never stay there again, her bedding and pillows were taken for DNA testing, there were signs of an assault everywhere, and my 78 yr old mom went for a sexual assault exam (she was so brave!).  It was a nightmare.  The main detective working on her case learned enough to know my mom was targeted due to her memory issues, and said that it’s not uncommon. So, here I am, #mymothertoo, and telling everyone I can that our female elders are at risk.  (Somehow, I used to feel that sexual assault was not a worry after a certain age, you know?  Naive.)

I know that’s a downer, sorry.  Elder care is hard without thinking about that scary topic, too.  But, OP, hearing that your aunt lives away from you most of the year, with known memory issues … makes me worry for her.
 

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1 hour ago, Melissa in Australia said:

One of the things that may help to convince her to go to the doctor is that there is medication that can slow down some forms of dementia. 

Yes, I was just going to say this!!!  I have started my dad on it after seeing the neurologist!  It will not improve his memory, but the sooner it is started the better for slowing the progression down.

Yes, she is starting to become a danger to herself and others.  It's a hard time for everyone involved for sure.

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Next is talking to scammers on the phone and giving away who knows what. This is a really hard time for you because she's unlikely to cooperate. She will pull herself together at the doctors or refuse to let you go in with her.  If you can keep her near you and work through the medical system it will be easier than trying to deal with things from afar. She really shouldn't  drive and she can't call for help on her phone. She really can't manage on her own. I'm so sorry.

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16 minutes ago, Seasider too said:

Thank you for sharing this, Spryte. I am so sorry you, your mom and your family have had to walk this road. It’s important  for those with older family members to understand just how vulnerable they can be, and that there can be some sad trade offs for that freedom to maintain the appearance of independence. In addition to actual physical assault, there are evil people out there with many methods of taking advantage of older folks, leaving them bereft of resources. 

I hate being a downer and bringing it up, it’s such a crummy topic.  Hopefully it can help people be aware though.  I sure was not!
 

Oh yes, we went down the getting scammed road with my mom, too.  What a crazy mess!  It’s so easy for older people to fall prey to people with bad intentions of all kinds.  
 

Yes, OP, the phone scammers are real.  And the “boyfriends” who appear out of nowhere (that was my mom at 74, yeeesh, we’ve been through it all).  It gets hairier, and they are more vulnerable the worse the memory gets. I think there’s a long period when the dementia is coming that loved ones just don’t see, and usually caregivers need to step in before they do.  It’s hard to tell when the right time might be. I didn’t see it, for sure.

MIL hid her dementia like a champ for years.  She gave away everything.  Jewelry, furniture, you name it.  She’s always been into donating things, but it got really out of hand.  I think she got a little dopamine rush from giving things away.  CNA liked the puzzle table FIL gave her… That afternoon CNA’s boyfriend backed up his truck to the assisted living apartment balcony!  No kidding.  We just kind of laugh at it now.

 

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Thank you so much for all the replies.  You are confirming what I suspected.  She was here tonight and yet another instance of a lot of confusion came up that we didn't know before.  Her PCP is in Florida so I am going to have to try to get her in somewhere up here.  I:m going to check on the UTI angle tomorrow.  She has had trouble with this before.  She went to an urgent care last week without telling me about a cough.  I'm,// have to check and see if they happened to check for an UTI.

The phone scammers have already been a concern with her.  She calls me several times a week to tell me about scam calls and what should she do in response.  Emails are another issue. One of the issues we are having is that she is giving her address up here wrong so bills are messed up.  Right now it's her taxes that are lost in the mail but we don't know if she gave the place the right address.  Many times she gives street names that rhyme with hers rather than the actual correct name.  

@Spryte. Thank you so much for sharing your family's experience.  I remember when this happened to your mom.  

 

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My boyfriend's mother has Alzheimers. She has gotten in the habit of not answering her cell phone (her only phone) unless a name shows up - so he puts everything into contacts for her. 

As far as the driving, yeah, I'd be hesitant to let her drive under those conditions. Even if she knows the roads &  drives well enough, the slow reaction time and confusion could lead to accidents because she can't respond to other people's driving. 

 

 

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48 minutes ago, elegantlion said:

My boyfriend's mother has Alzheimers. She has gotten in the habit of not answering her cell phone (her only phone) unless a name shows up - so he puts everything into contacts for her. 

As far as the driving, yeah, I'd be hesitant to let her drive under those conditions. Even if she knows the roads &  drives well enough, the slow reaction time and confusion could lead to accidents because she can't respond to other people's driving. 

 

 

A tip, for anyone with the phone issue … And, OP, you could do this for your aunt and set it up before she leaves for FL …

MIL stopped answering her phone (she now doesn’t even remember how to use it), and we finally got her an Alexa Show.  We had it shipped to us, did all the set up, and then shipped it to her (during Covid lockdown).  The maintenance guy connected it to the facility’s WiFi. It’s brilliant.  It sits facing her usual spot, and we can use ours (or an app on a phone, if you don’t have one) and “drop in.” DH set it up so we can just drop in on her. She enjoys seeing us and talking, and no effort on her part.  We can also send photos to the device, and the nurses use it to play music for her.  It’s been a lifesaver.

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12 hours ago, Melissa in Australia said:

When working in aged care I worked with a few people with early stage alzeimers who were still able to live in their own homes. They were on medication to slow it down. They had someone come in every day to make sure they had taken their medication and eaten.  They also had meals on wheels delivery. A family member would check on them in the evening and help prepare a meal. 

It’s possible but not ideal.  Most of the older people who go missing are people with memory problems that wander off.  I have a relative that stayed home until she forgot she left the stove on and managed to start a kitchen fire.  She was oblivious to the smoke pouring out of her home and the smoke alarms going off. Even living with family, it’s very difficult when people are mobile because they often get days and nights confused. 

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25 minutes ago, Katy said:

It’s possible but not ideal.  Most of the older people who go missing are people with memory problems that wander off.  I have a relative that stayed home until she forgot she left the stove on and managed to start a kitchen fire.  She was oblivious to the smoke pouring out of her home and the smoke alarms going off. Even living with family, it’s very difficult when people are mobile because they often get days and nights confused. 

of course there is a stage that it is no longer possible. Like I said the early stages of Alzheimer's and there is medication that can slow the progression down

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(I haven't read all of the replies...)  Just jumping in to add my experience.  When people talk about not letting your aunt drive anymore, about taking her to a doctor to be evaluated for dementia (or anything, really), about having her sign off on you being her POA, etc., be prepared for pushback.  She doesn't have to allow you to do anything, and she may not be swayed by your views.  The bar for taking over another adult's life is set pretty high -- for good reason. 

It took my siblings and me over a year to convince my mother that she needed to give up driving.  In the end, we were able to clinch the deal by getting one of the grandkids to offer to buy her car from her.  She has mild cognitive deficits that worsen when she is very tired or when she forgets to take her medication (blood pressure meds seem to be the significant factor there), but she refuses to allow someone bring medication to her.  Her senior living apartment staff has on-site home health, so it would be easy and pretty affordable.

Time and patience -- talking about issues again and again has been the most helpful technique.  It takes time to adjust to a new (and for old people, scary) reality.  It all just seems so clear to us:  You are a menace on the road.  You will kill someone.  It's time you stopped driving.  I'm taking the keys.  You can't live alone.  You might hurt yourself and no one will know you need help.  If you have early stage memory loss, there are medications available that may slow down that loss.  Yikes!

We may mean well, but that doesn't make it easier for someone who is already a little confused and for whom everything is moving too fast.

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36 minutes ago, DoraBora said:

(I haven't read all of the replies...)  Just jumping in to add my experience.  When people talk about not letting your aunt drive anymore, about taking her to a doctor to be evaluated for dementia (or anything, really), about having her sign off on you being her POA, etc., be prepared for pushback.  She doesn't have to allow you to do anything, and she may not be swayed by your views.  The bar for taking over another adult's life is set pretty high -- for good reason. 

It took my siblings and me over a year to convince my mother that she needed to give up driving.  In the end, we were able to clinch the deal by getting one of the grandkids to offer to buy her car from her.  She has mild cognitive deficits that worsen when she is very tired or when she forgets to take her medication (blood pressure meds seem to be the significant factor there), but she refuses to allow someone bring medication to her.  Her senior living apartment staff has on-site home health, so it would be easy and pretty affordable.

Time and patience -- talking about issues again and again has been the most helpful technique.  It takes time to adjust to a new (and for old people, scary) reality.  It all just seems so clear to us:  You are a menace on the road.  You will kill someone.  It's time you stopped driving.  I'm taking the keys.  You can't live alone.  You might hurt yourself and no one will know you need help.  If you have early stage memory loss, there are medications available that may slow down that loss.  Yikes!

We may mean well, but that doesn't make it easier for someone who is already a little confused and for whom everything is moving too fast.

Thank you for these thoughts.  I was mulling over what the first step should be and I think a gentle and casual conversation might work.  She is a fiercely independent person but I have noticed little more willingness to listen lately.  For instance,  She was at our house last night playing games.  For the first time ever, at about 7:45 when it was still light I suggested she might want to go home before dark.  At first she wanted to play a little longer but after a moment she decided it was a good idea.   Maybe she will be more amiable to help than I thought.  

I just really don't want this to happen!  Her mother suffered from dementia but it didn't start until after she was 90 🙁

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17 minutes ago, DoraBora said:

We may mean well, but that doesn't make it easier for someone who is already a little confused and for whom everything is moving too fast.

This makes it so hard, it's true. 

When we're talking about an activity as dangerous as driving, I think some sort of temporizing approach that gets them off the road, but doesn't feel as scary and permanent, is justified. At that stage my mother's doctor decided her shoulder (which had been injured in a fall) needed to be stabilized by having her wear a sling/brace. The injury and pain were real; in their absence, I'm not sure what we would have done. But they provided a reason for her not to be driving, which the doctor reinforced for a *long* time. She gradually accepted life without driving-- never willingly or happily, but she did get accustomed to it.

Family needs to be on board with whatever approach you take. After the car sits idle for a while, the battery might just run down (don't replace it). Or maybe a college student needs to borrow the car for a semester while she can't drive (don't return it)*. Or maybe her keys just get lost (darn!). Or you could substitute a different key, which obviously won't work (what on Earth could be wrong?). Everyone needs to be supportive of her wish to drive, sympathetic about her predicament, helpful in driving her where she needs to go (except for buying a new car).

You're absolutely right about the bar for controlling another adult's life being high. There's a conflict with the (also very high) responsibility for safety inherent in driving, which is a privilege, not a right. I think we have to navigate these shoals with compassion and care. Of course taking the ability to drive from a competent adult would be criminal, but when someone is as clearly impaired as the OP's aunt, I think there's a duty to intervene, in a compassionate and supportive way.

When we face these decisions, I think we have to ask what the person we're concerned about would have chosen on their own in their prime. Most of us would want someone else to prevent us from driving if we were impaired. Most of us would be horrified at the prospect of causing death or serious injury to others. I think we have to judge others' wishes based on *them, when they were at their best*, rather than on *them, when they are clearly impaired*.

*I'm not suggesting stealing her car. She retains legal ownership. But she really needs to not be driving.

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13 hours ago, Starr said:

Next is talking to scammers on the phone and giving away who knows what. This is a really hard time for you because she's unlikely to cooperate. She will pull herself together at the doctors or refuse to let you go in with her.  If you can keep her near you and work through the medical system it will be easier than trying to deal with things from afar. She really shouldn't  drive and she can't call for help on her phone. She really can't manage on her own. I'm so sorry.

Go to youtube and watch some of the scam baiters like Pierogi or Kitboga. Some of the scammers they talk to are truly evil in the way they treat people who they believe are elderly and confused. I've convinced my elderly parents to only pick up the phone for people they know and we are now using a Grandpad for family members.

OP, I'm very sorry. I'm right there with you with my own parents and it's really hard.

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19 minutes ago, JanOH said:

I just really don't want this to happen!  Her mother suffered from dementia but it didn't start until after she was 90 🙁

I know what you mean.  It may really be that your aunt has a UTI or something that can be cleared up so that she'll become clearer again.

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10 minutes ago, Innisfree said:

This makes it so hard, it's true. 

When we're talking about an activity as dangerous as driving, I think some sort of temporizing approach that gets them off the road, but doesn't feel as scary and permanent, is justified. At that stage my mother's doctor decided her shoulder (which had been injured in a fall) needed to be stabilized by having her wear a sling/brace. The injury and pain were real; in their absence, I'm not sure what we would have done. But they provided a reason for her not to be driving, which the doctor reinforced for a *long* time. She gradually accepted life without driving-- never willingly or happily, but she did get accustomed to it.

Family needs to be on board with whatever approach you take. After the car sits idle for a while, the battery might just run down (don't replace it). Or maybe a college student needs to borrow the car for a semester while she can't drive (don't return it)*. Or maybe her keys just get lost (darn!). Or you could substitute a different key, which obviously won't work (what on Earth could be wrong?). Everyone needs to be supportive of her wish to drive, sympathetic about her predicament, helpful in driving her where she needs to go (except for buying a new car).

You're absolutely right about the bar for controlling another adult's life being high. There's a conflict with the (also very high) responsibility for safety inherent in driving, which is a privilege, not a right. I think we have to navigate these shoals with compassion and care. Of course taking the ability to drive from a competent adult would be criminal, but when someone is as clearly impaired as the OP's aunt, I think there's a duty to intervene, in a compassionate and supportive way.

When we face these decisions, I think we have to ask what the person we're concerned about would have chosen on their own in their prime. Most of us would want someone else to prevent us from driving if we were impaired. Most of us would be horrified at the prospect of causing death or serious injury to others. I think we have to judge others' wishes based on *them, when they were at their best*, rather than on *them, when they are clearly impaired*.

*I'm not suggesting stealing her car. She retains legal ownership. But she really needs to not be driving.

These are all good ideas, and I'm not suggesting we just throw up our hands about unsafe driving.  It's just difficult.  I played FBI and followed my mom around as she drove.  She didn't seem particularly unsafe, but she did get lost - she's lived in this city since 1958.

Though she was resistant to the idea of giving up driving herself around, we suggested (again and again) that she make use of the transportation services included in the rent at her senior living apartment.  "Just for practice."  We also got her signed up to use Go Go Grandparent, a ride concierge service that helps seniors get an Uber or Lyft using their mobile or landline.  Covid ended that, and she hasn't really needed to go too many places.  Her apartment takes a busload of whomever wants to go to TJ's, Target, etc., and they drive her and a few others to church on Sundays now that they're back in person.

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1 minute ago, DoraBora said:

These are all good ideas, and I'm not suggesting we just throw up our hands about unsafe driving.  It's just difficult.  I played FBI and followed my mom around as she drove.  She didn't seem particularly unsafe, but she did get lost - she's lived in this city since 1958.

Though she was resistant to the idea of giving up driving herself around, we suggested (again and again) that she make use of the transportation services included in the rent at her senior living apartment.  "Just for practice."  We also got her signed up to use Go Go Grandparent, a ride concierge service that helps seniors get an Uber or Lyft using their mobile or landline.  Covid ended that, and she hasn't really needed to go too many places.  Her apartment takes a busload of whomever wants to go to TJ's, Target, etc., and they drive her and a few others to church on Sundays now that they're back in person.

Yeah, following her was a good idea. It's just so hard. I wish (for many reasons!) our society weren't so dependent on cars. Removing access to driving does remove independence, and I completely understand why people are loathe to do that. I'd hate it too.

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There was a stage with my FIL where we were terrified he would kill himself or someone else while he was driving. Several of her kids had a family meeting and discussed it in very frank terms---that she would be blood guilty if he killed someone if she was allowing him to drive.  So she started hiding the keys.  She would say, 'oh what did you do with them?'  And fake help look for them.  It was exhausting.

He became angry and agitated when he couldn't find keys and/or realized MIL was not giving him the keys.  She tried every diversion in the book. But one day he went to the garage and opened and then violent slammed every. single. door on the vehicle.  Scary.

One day he took off on the riding lawn mower down the road in front of their house. It is a 2 lane road....not a residential street exactly, but not high speed.  Anyway, she got in the golf cart and chased him down.  When she got to him he was sitting on the mower chit chatting with a neighbor who clearly was aware FIL was 'off'.  MIL managed to convince him to follow her home without incident.

Another day he found the keys to a truck they rarely drove and plowed it into the ditch in front of their house. 

One time before she started hiding the keys he took off in their Yukon saying he was 'going home.'  And he was angry. (just from the disease, there was no real reason for him to be angry).  They put out a silver alert immediately but it took about 3 hours and a concerned citizen before he was found.  He had driven 3 hours away....it was dark and raining and he stopped at a fast food place and told a customer he did not remember how to turn the windshield wipers on.  He had driven through some of the most treacherous area of the Ouachita National Forest.  She called the police to 'help' him with his windshield wipers and they saw he was wearing an Alzheimer ID bracelet and connected it all to the Silver Alert.

I honestly do not know how my MIL endured that stage.  😞 

Edited by Scarlett
Windshield wipers ON--third try
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9 hours ago, Katy said:

It’s possible but not ideal.  Most of the older people who go missing are people with memory problems that wander off.  I have a relative that stayed home until she forgot she left the stove on and managed to start a kitchen fire.  She was oblivious to the smoke pouring out of her home and the smoke alarms going off. Even living with family, it’s very difficult when people are mobile because they often get days and nights confused. 

I do not have dementia but get severe brain fog at times.  At those times, I never cook on the stove anymore.  I only use microwave because I will not burn the house down.  

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My aunt was at the house yesterday and I was able to broach the subject.  She was surprisingly agreeable that she realized she was having trouble and very willing to go to a Dr.  I'm so relieved but now need to find somewhere for her to go.  Her PCP is in Florida.  She did go to an urgent care Dr last week whom she really liked - I wonder if that Dr. Could write her a referral?  Anyway, I have much research to do.  Thanks for all your help!

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7 minutes ago, JanOH said:

My aunt was at the house yesterday and I was able to broach the subject.  She was surprisingly agreeable that she realized she was having trouble and very willing to go to a Dr.  I'm so relieved but now need to find somewhere for her to go.  Her PCP is in Florida.  She did go to an urgent care Dr last week whom she really liked - I wonder if that Dr. Could write her a referral?  Anyway, I have much research to do.  Thanks for all your help!

Wow!  That’s wonderful!  And opens the door for you to help her more and more.
 

Could you take her to your own GP?  
 

Also, heads up, there’s a short cognitive test they will do in the office - things like drawing a clock, repeat three words after a short time, date/president.  I have been present for 4 of those tests (3 different people) and seriously, unless someone is very, very far gone … everyone aces those.  Don’t put too much weight on it.  And definitely take a list of your concerns with specific examples.  I usually talk to my mother or IL prior to the appt and let them know that I’m doing that.  My people are always grateful, and just want help.  But you could feel your aunt out that way, to see how she will react.  Maybe have her add her concerns to the list.

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37 minutes ago, JanOH said:

My aunt was at the house yesterday and I was able to broach the subject.  She was surprisingly agreeable that she realized she was having trouble and very willing to go to a Dr.  I'm so relieved but now need to find somewhere for her to go.  Her PCP is in Florida.  She did go to an urgent care Dr last week whom she really liked - I wonder if that Dr. Could write her a referral?  Anyway, I have much research to do.  Thanks for all your help!

I'm glad to hear that, but you need to be prepared for that to change quickly.  Sometimes they agree because they think a doctor will prove you wrong and tell you they're fine.  If they hear you're right from a doctor you could be in for some seriously difficult attitude and behavior. If there are issues and end of life legal documents aren't already in order, it could be more challenging getting it done.

Be sure to get her to a doctor who specializes in dealing with elderly people at all stages of cognitive decline. As stated upthread, people can pass many of those tests and still have significant issues. A specialist will be more familiar with earlier stages.

Seek out a support resource now because people who have been farther down the road than you can give you more useful advice about how to proceed, what to avoid, what to look for, etc.

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7 minutes ago, Seasider too said:

Yes about that short test! A neurologist is who you need for a true assessment (you may not be quite there yet but might want to start looking for referrals).

One thing to know - any POA paperwork needs to be drawn up and signed by her before she has any lengthier evaluation that might result in her receiving any diagnosis that might render her incompetent to execute those documents (especially if there’s any chance something will be contested). 
 

Your first step taken - the big conversation and her cooperation- that’s terrific! Next you need to do the things that will allow you to help her legally - get your name added to her HIPAA paperwork at the doctor’s offices and work on POA. That’s my recommendation, anyway. 

My parents have been adding me and my sister to the HIPAA list for years and let me tell you when they had their accident it was a lifesaver.  I had to talk to soooooo many doctors and  nurses and it was not the time to be running around getting things signed.

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2 hours ago, Spryte said:

 

Also, heads up, there’s a short cognitive test they will do in the office - things like drawing a clock, repeat three words after a short time, date/president.  I have been present for 4 of those tests (3 different people) and seriously, unless someone is very, very far gone … everyone aces those.  Don’t put too much weight on it.  

On the flip side, I was absolutely shocked to be present for one of these with a person who was still living on their own and DRIVING who 100% failed the test.  I knew there were issues but those issues were very well masked.  Had someone asked me before the test if they would have passed, I would have confidently said yes.  They are not flawless but they do cut through the muscle memory masking that dementia patients often are very good at.

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14 minutes ago, Seasider too said:

I think it can even vary by time of day.

Yes, I used to deliberately schedule appts at my mother’s best time of day.  Doc said that was probably not the best plan, as they need to see what she’s like for the majority of the day.

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