Hi Everyone,
Not sure if I'm asking in the right place or not but need advice regarding my mother-in-law. About 2 yrs ago, our family started noticing some confusion in her. She would repeat things she already said and call our younger daughter by the older daughter's name. We initially attributed it to medications for pain since she has an arthritic knee and was on oral morphine based medication. Within a year, she has lost track of time and space thinking that our 21 yr old is only 14 and wondering when she'll be starting high school. She will get mad at us for not kissing her hello when we've greeted her 4 or 5 times already. She is not recognizing people that she has known for years and other examples of forgetfulness along with still repeating things over and over. She is now 78 and her husband is 85. She just had a knee replacement and is in the hospital. She is very confused wondering when her surgery will be (she had it 4 days ago), wondering why her leg hurts, she took her IV out because she didn't know what it was even though we kept telling her what it was. She keeps trying to take the oxygen off and startles when her blood pressure is taken wondering why her arm is being squeezed. Every time the physical therapist puts the machine on her leg to exercise her leg, she wants to know what the machine is for and says that she's never seen it before and why does she have to have it on now. They've reduced her pain medications but even when they had her on the morphine pump, she didn't use it because she can't remember what the push button was for or the nurse call button either for that matter. She does have moments of clarity and in fact was very talkative today, knew everyone and only repeated herself a few times. Her husband is in complete denial and I'm fearful because they are both giving inaccurate information to the caregivers. According to her, she's 5'4" when she's only 4'10", has no medical problems (she has asthma), has never had surgery (she had surgery on her feet), isn't allergic to anything (she's allergic to penicillin), and has good blood pressure (she has high blood pressure and is on medication for it). These symptoms are throughout the day and not dependent on night or day but again, she does have times of lucidity. I guess I'm wondering if this is dementia and if so, what steps should be taken? I've been trying to make the nursing staff aware of this as well as the caseworkers at the hospital but it seems as if the husband is convincing them otherwise. It's hard for me since I'm not living with her everyday but at the same time this is not a sporadic occurrence but everytime we see her. Suggestions? Thanks!

Well, yes, she definitely has dementia, now you have to find out what is causing it. Part of it is that elderly people are often confused when in the hospital, but you say it's been happening for some time. It is not unusual for her husband to be in denial, that's one way to cope. You might try having a doc talk to him, but your current situation won't work unless there's a dementia specialist involved. Most medical people do not understand dementia unless they are in that field or have had personal experience w/it. They are treating her medical problems and really don't know much about dementia. The behaviors you describe are very typical of Alzheimer's, but it could be something else, so you should have her seen by a geriatrician or neurologist who specializes in brain disorders, then hopefully he'll be able to tell her husband what she is going thru and how he can best care for her, altho it will be too much for an elderly man & he'll likely resist your attempts to help. If there is a large university nearby, see if they have a Memory or Alz Clinic and take her there. You really can't do anything much until you know what is causing her dementia and then try to treat that. Someone should really stay w/her all the time while she's in the hospital so that she won't pull her IV's, etc. She won't know how to call for help if she needs it and probably can't unwrap her food to eat. Everything you mention is typical--repeating, not realizing someone is 21 rather than 14, etc. This is all very difficult to understand, but it may help if you go to the web site below and read 'Memory Loss in Alzheimer's, Dementia & Normal Aging.' Whatever is causing her forgetfulness it will all be easier if you understand why and try to keep her life calm, don't keep explaining--she'll just forget--go along w/whatever she says. Come back w/any more questions, someone will always answer.

Thanks for your input. I guess my greatest frustration has been the denial of the husband and his lack of correction when she gives incorrect information. It could be dangerous to her if he is inaccurate about the wrong thing. She almost died a year ago because we called and he told us she was sick with a "small" fever. We decided to visit to check up on her and thankfully were there to call an ambulance. She had become septic and had a fever of almost 105. She was in the hospital for 7 days that time. This time, he was insisting that she be discharged to home even though we kept advising him to have her placed in a rehab facility until her mobility increased (she couldn't even walk 2 feet from her hospital bed). Due to heart complications she is now in ICU but will be placed back on a normal floor barring complications. The cardiologist was trying to ask about her medical history while her heart was out of control and he starting going on about his own blood pressure and cholesterol. Again, thankfully the dr. reeled him in and told him it wasn't about him right then but about her and that he needed the information to treat her properly. The husband replied that her blood pressure was good when she is actually on blood pressure medication due to chronic high blood pressure. Anyway, I read the information and alot of it sure sounds familiar but now to get around his denial because he won't take her to see a specialist. It's the last thing that I would ever wish but I do worry since she has always been his caretaker and now I don't think he can take care of her. Thanks for the info and I would appreciate any other input you have.

Dear bigsky,

Thanks for using the Alzheimer's Association Online Community.

Your situation is a frustrating one. Your mother-in-law is clearly exhibiting symptoms of dementia but her confusion prevents her from seeking help and her spouse is in denial.

I would suggest that you take advantage of the fact that she is in the hospital right now. I suggest you write out the symptoms you have described, along with any others you or other family members can come up with, and present that information to her physician asking that she be given a referral for a neurological evaluation.

I'm concerned that your mother-in-law's spouse was giving inaccurate information to the caregivers as well. Also, you said in your followup message that the cardiologist was trying to ask about her medical history and he started going on about his own blood pressure and cholesterol. There may be something more than denial on his part. I think it would be a good idea if her husband were seen by a neurologist or gerontologist as well.

If you would like to discuss this matter with a Care Consultant you can contact us on our 24 hour helpline at 800-272-3900.

Good luck to you.

Regards,

Charlie