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Have to repeat same things I’ve said, forgets wallet. Doesn’t enjoy things he used to. We’ve talked about it a couple times and he recognizes it but now I feel like he compensates and wants to ignore it but it’s difficult not knowing what really is going on

If this is one of the many forms of dementia you cannot expect the person to reasonably understand or discuss what’s happening. That’s part of the disease process, loss of understanding and making sound judgements. Plus, many of us have the tendency to not want to face scary things, and feeling like you might be losing your mind is pretty huge. Tell whatever white lie is needed to get your family member to the doctor for a complete medical evaluation. Contact the doctor prior to the appointment, using the patient portal or sending a message, and advise of what concerns you have. Ask for a cognitive exam and referral to a neurologist for more complete testing. Also consider if depression is at play, it’s common and may be part of what you’re seeing. Another thing for the doctor to evaluate. No more talking to loved one about this, it’s not productive for either of you. I wish you well in obtaining an accurate understanding of what you’re seeing
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Hopingforhelp1 Sep 17, 2024
Thank you for your advice. He has gone to Dr and has had and some lab tests - b12, hormones and other standard labs. He told me he wants no pity or treatment of any kind, does not want to see neurologist which could be why he is not telling me more because I will press for tests and early treatment. I just want him to be honest if things are worse than what he is letting on so we can plan for future or do I wait until things get worse and something happens? This also is affecting our relationship.
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I agree with everything Daughterof1930 wrote to you.

One way to get him to the doctor is to tell him that what's going on with him may be treatable with a simple course of antibiotics, like for a UTI. Or, he could have diabetes, high blood pressure, etc. -- all of which are treatable and he may return to how he was. Medicare offers a free annual wellness check, so it won't even cost him anything. There is no one test for dementia so to get an accurate diagnosis, his doc would need to eliminate all other health issues first.

I've personally done the "secretly pass note to doctor" thing with both my MIL and Mom. The medical staff was happy to accommodate family who are struggling to help family members. Both my MIL and Mom did not need to see a neurologist in order to get meds for depression/anxiety -- which were very helpful and made a big difference. But a patient cannot get them without a full physical first.

If your family member has as assigned PoA, this person should be notified of what's going on. If he doesn't... he needs to get to an elder law attorney to get this put into place so that he doesn't get assigned a court-appointed legal guardian in order for anyone to manage his affairs and make decisions on his behalf. He will have more control if he is proactive. As time passes, and his possible dementia progresses, he will lose this window of opportunity.
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In a response to Daughterof1930 you provided more info:

"He has gone to Dr and has had and some lab tests - b12, hormones and other standard labs. He told me he wants no pity or treatment of any kind, does not want to see neurologist which could be why he is not telling me more because I will press for tests and early treatment. I just want him to be honest if things are worse than what he is letting on so we can plan for future or do I wait until things get worse and something happens? This also is affecting our relationship."

Well... he can say stuff like he doesn't want pity or treatment but that won't solve the problem of him getting the appropriate care as he declines -- not to mention the poopstorm he will leave for his loved ones to manage.

It needs to be impressed upon him that he can put legal controls in place so that he gets the best care for himself. People tend to focus on the death part, but not what precedes it: the decline and dying process -- which can go on for a long time.

He may not be telling you more because he may have the beginnings of memory impairment. Doctors ramble off a bunch of instructions at the end of the appointment so maybe it's confusing him so it's easier to pretend he doesn't want to tell you. Maybe he can't. Does he have a friend or male relative who may be someone he'd allow to accompany him? Or, help him set up a medical portal online, and then he can easily check his past tests and diagnosis.

Even if you "wait for things to get worse or something happens..." unless you (or someone) is his PoA then he WILL become a ward of the county and probably transitioned into a crappy county Medicaid facility. It doesn't have to be that way if he just does a few wise things now, like assign a PoA and go see his doctor for depression/anxiety meds.
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Hopingforhelp1 Sep 17, 2024
Thank you. I am his POA- I’d say he is in beginning stages of possible dementia. He is able to understand and keep track of results so far but I think memory is worse than what he is letting on. I think there is depression also. Knowing this info do I just wait until he’s ready to talk about it or wait until something happens where he has no choice to speak up ?
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Hi hopefullforhelp, I really have no good answer for you, other than it does sound like the beginning of some dementia.

I would lean everything you can on dementia to see if you see other signs that you didn't realize. Also, start recording everything you see to have ready for the doctors when the time comes.

I'm very sorry 😔
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Welcome to the Forum.
I hope you will fill in your profile about the person you care for and about yourself; it will greatly help us answer you if you intend to stay around in the Forum.

We really need to know more about Uncle:
1. Who does he live with. Other than yourself, what support system does he have?
2. Are others noticing the change?
3. Do you feel Uncle is a danger to himself? Does he get lost? Forget to turn off the gas?
4. Does Uncle live alone? Who checks on him? How often?
5. Does Uncle have a POA?
6. Does Uncle still drive?
7. Who else in the family is involved with/concerned for Uncle?

Truly, you cannot help those who do not want to be helped. At the point that you fear your uncle is a danger to himself I would consider a call to APS asking for a wellness check to assess mentation, ability to function alone, and tell them that he has not been cooperative in getting any assessment and you fear for his safety.

I think that's about all you can do. We all die. Whether we die of a housefire, wandering off in inclement weather, a fall, or die sitting in the easy chair in a nursing home, we all are going. As to which is the better option, few of us really can know, or have a vote.

I would check on Uncle with a daily phone call. If unable to reach for a day I would check; ask if you can have a set of keys for said check-in. Ask if he will cooperate at least in this.
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If family member of Medicare age, has the doctor done the annual Medicare Wellness Visit? (known as AWV) Internet shows it as essentially a detailed, question-based assessment of a patient's current health and risk factors and is free for patients with Medicare Part B. You can look online for more info. If you suspect a decline, slip a note to the doctor and ask that they do a little more than the routine draw picture of clock showing certain time of day, repeat a few words back later in visit.
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Good Morning,

It's time for an evaluation. A trip to the Geriatric Neuro-Psy doctor, Geriatrician or Primary Care Doctor for an assessment. Return in 6 months and they will compare any cognitive decline, etc.

Even when they (the doctors) diagnose Dementia, Alzheimers, etc. not a lot of info is provided afterwards just maybe a handout of "day" respite programs. I found I was on my own and had to think fast.

Do they live alone? Are they eating? Do they appear clean? Do they lock their door at night? Are there bills paid on time? Is their checking account in order?

Are you the closest next of kin? If not, it's time to make a few phone calls and fill people in on what you observe.

AlvaDeer and I think alike!
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Nothing you can do to improve his memory. Learn to live with it
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Hi Hopefullforhelp,

If they won't go to the doctors and get tested sometimes you have to just wait for a fall or some kind of emergency.

I am wondering the same questions, others have asked .

Have you educated yourself on dementia, if not I think that should be your first step. Go to Google, YouTube, books, just anything that you can find.

There may be other symptoms that you don't realize are symptoms of dementia.

You could also write a note to the doctors on what you are seeing and to please evaluate him/her. I most cases family sees it first.

Don't forget to take care of you!
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I lived out of state when my brother developed memory problems. I needed to get a diagnosis so I set up an appointment with a neurologist. I wrote a letter before the appointment with examples of his memory issues, like forgetting where his daughter lived a month after co-signing on her house, not recognizing a family member he particularly loved when I mentioned her name, etc. When my niece took her dad to the doctor they spent only ten minutes there before the doctor wrote the orders for an MRI, which revealed a huge brain tumor. Although I now know he likely would not have done this, I was afraid he would present so normal (“show time”) that the doctor would not have been very concerned. I think this especially happens with primary care doctors who aren’t trained to deal with memory problems. Sadly it may take an unfortunate event to get the family member’s attention about his memory problems, so he’ll be more agreeable about seeing a doctor. I wouldn’t bother seeing a regular doctor. He needs to be seen by a neurologist.
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I have found that I can talk in a firm, direct, calm, voice and just state what's what. I will repeat myself as many times as it takes. I make statements and don't ask questions: "Your wallet (or whatever) is here in the house. We'll look for it together." "We're having mac and cheese for dinner tonight" instead of asking what he would like. (I know what my husband likes, and I choose among those meals.) "You have a doctor's appointment on Wednesday morning at 10:00. "The person I care for seems to appreciate that I am making decisions that he doesn't have to think about.
This works for me sometimes and it is done with love. It also eliminates endless questions, but this is just one piece of the pie.
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Hopingforhelp1: I'm so sorry that your uncle is showing signs of memory loss. Perhaps a follow up for the B12 blood work could be scheduled.
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You could tell him that unless you have some clearer medical information, you will assume that it’s the beginning of dementia and plan accordingly. You will tell him what you plan, he can make comments, but you will go ahead on that path unless you and he both know what is going on.
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Try and find someone he will talk to
tell him you’re very worried and he looks like he’s in pain and you just want to help and see if after mulling it over he changes his stand

failing that I would organise a doctors visit and hopefully that would produce something

Good luck
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I think the approach--including whether or not to pursue formal diagnostics--may depend at least partly on the age and functionality of the person and the age/health/functionality of the carer. My husband will be 95 in a couple of months, and I will soon be 88. We are OLD. He is in fairly good physical health for his age but has short term memory loss (which he recognizes). So far, I have most of my marbles, except for occasionally misplacing my car keys or glasses, but I have physical limitations.

I'm not sure that going through the somewhat complicated process of obtaining a formal diagnosis for him would make much difference given where we are in the "life cycle" and our living arrangements. If I were to die, our son would likely need to place my husband in a board and care situation or memory care. I don't think he would do well on his own for long. I do the grocery shopping, food prep (such as it is), laundry, light cleaning (we have a housecleaner every 2 weeks), most cat care, appointments, driving and errands.

Our finances are mostly online; our son would have access to our bank accounts to pay bills, if needed. We prepaid for our cremations 25 years ago. We have long term care insurance which would help financially if one or both of us needed placement--as long as we don't live too much longer. That's a BIG question mark!
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Ask him/her to get an appointment with his/her doctor. Offer to go with your loved one. Explain to the doctor the symptoms you observe. Let the doctor evaluate and treat whatever diagnoses the doctor makes.
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If you can, get family member to medical provider for assessment.
If they are assessed to be 'unable to care for themselves / their own welfare' you need to get a letter.

Concurrently, get all legal documents in order - see attorney if needed.

You want to be very careful when it comes to finances, check writing, credit card use, answering the phone (or internet) re scammers. Consider blocks on accounts and/or at the very least now, adding your name as a 'co-signer'. Although it sounds like this person shouldn't be managing ANY of his/her finances.

Read / educate yourself on dementia:

1) Google TEEPA SNOW - read her website, her You Tubes, buy her books.

2) Review / You Tubes of others - searching for "how to manage loved one's dementia" - lots of information available.

3) First get assessed. If resistant to going out / med appt., say it is going for an annual check up or whatever will get your loved one there. Or if really difficult, say you are going out to lunch and then ... we are making a stop before lunch.

4) The key is when dementia behavior affects the person to potentially cause them injury, i.e., leaving the house and not knowing where they are going, having outbursts (confused, frustrated).

- Assess medication if on - and / or adjust (talk to MD)

5) Consider getting caregiver in to give you a respite. YOU WILL NEED IT.

6) Call local dementia association (Alz ?) and ask for support.

7) You need to know that you must take control and not abide by what they say (in most situations) as they are unable to assess their safety needs.

8) Be compassionate, understanding, calm (as possible), while making major decisions. NEVER EVER ARGUE. It is a no-win and causes unnecessary frustration for all concerned. This is not easy. We all need to learn as we go.

I took Teepa's on-line webinars years ago as well as read / watch her free videso. She really knows how to communicate with people inflicted with dementia - and she shows us all how to do it.

Gena / Touch Matters
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