Initial dementia screening

[Recreatingmylife]

My mom with many narc traits is going for a dementia screening at her doctor's office today. She thinks she is going in for a medication re-check. Her husband set up this appointment. He is afraid of her reaction during and after the appointment. I am, too. I highly suspect the raging will begin. Has anyone experienced a dementia screening with a disordered parent?

[sad_dog_mommy]

I am sorry to hear dementia is affecting your family.  It is horrible for the person who has it and equally as bad for those around them.

My step-monster was/is NPD and she knew what has happening to her.  She was terrified of losing her independence!  In the beginning of her decline she got meaner (if possible) and super sneaky.  She cancelled appointments with her neurologist, cancelled bran scans and lied that she passed her drivers test.  Just imagine being on the edge of a cliff and you know you are going to fall but you don't know when and you cannot stop yourself from falling?  It must be very scary.

We used the doctor to deliver bad news so we were 'out of the line of fire'.  He is the one who contacted the state and told them she was no longer able to drive.  He is the one who insisted she could not be left alone in the house.  (She destroyed 3 microwaves warming up heating pads). 

Even though it is early, please make sure her will, power of attorney and other end of life documents are up to date.

((( hug )))

[Recreatingmylife]

Thank you SDM. I appreciate your response. Yes. I know my mom must be terrified. I do have compassion for her. She has also become fixated on hating my step-sister. It is too the point where others are avoiding her, because all she wants to talk about.

[WomanInterrupted]

I did the same thing with unNPD Ray's doctor, when he was in the hospital, recovering from a heart attack he'll swear he never had.  I was Medical Proxy, so an evaluation was arranged, but nobody let on that I was the one who'd made repeated calls, to get the ball rolling. 

They basically ask a bunch of questions that are easy to answer, or snow your way through if you don't really know or remember, like, "What did you have for breakfast?"

Even people on the verge of slipping will come up with an acceptable answer.

They'll also check her balance and mobility - that's what concerned Ray's doctor so much that they had him re-tested in 2 months.  He'd stagger and fall (hard), often, yet refused to use a cane or walker because they're for OLD people.  (He was 85.) 

Ray went for his 2nd exam in January and got a few of the easy questions wrong (stuff like, "Who is the President?" "What is two and two??") - but again, it was his balance that was really worrying, and he was told to come back in March, with somebody to drive him to and from the appointment.

Without trying to be political, that president question can trip up anybody trying to be cute or sarcastic about anybody holding that office - not just the current one.  "Don't remind me!" isn't an acceptable answer, nor is, "Grrrrr!" or, "I wish it was the other guy!" - those will be taken as *they don't know the answer* unless they cough up the correct name to go with the snark - but it will be noted it seemed to take time to think of the answer. 

Sometimes the PDs in our lives just can't figure out that you don't mess with these people - they are SERIOUS. 

In late January, when I came to pick up his ADT key fob, Ray angrily waved the letter in my face and roared, "They think I'm crazy!" 

No dude, you are a danger to yourself and others and we're trying to PROVE IT! 

I treated it with, "Oh gee...you don't say?  Gosh, that's something.  I can't drive you that day.  You'll need to take a cab."     (I didn't even look at the date - he'd just told me in the previous sentence he couldn't control his #1 or #2, and I was NOT going to let him in my car!) 

Ray blew off the appointment, fell, was declared incompetent, and is in a memory care unit.

So your mom might not figure it out right away, but she will, and when she does be as low-key as hell about it, Medium Chilling your way through her anger and rage, while refusing to speculate on who ordered the test.   

If she won't let it go, kick it back to her *doctor* - who probably won't tell her and mention it's just one of those things they do, when people get to a certain age. 

If all she wants to talk about is the Litany of Ray: "That son of a bitch!  He wants to take my house!  He wants my car!  This is America!  I have RIGHTS!  I can do what I want!  I'm not OLD!  I'm not hurting anybody!  Leave me alone!"    - or any other variant, excuse yourself (you're busy and have to go), and end the call.  Repeat as often as necessary.  If they keep ranting, just hang up very quietly, without a word, and don't take further calls for at least several days. 

It gives them time to fixate on something else - and they always DO, IME - but you don't have to hear about it if you let the calls go to voice, or block her number for a period of time of your choosing. 

[Recreatingmylife]

Thank you WI. I appreciate your insight. Yesterday her communication was clear without repeating herself. However, that vacillates.  If she has a major meltdown in front of the doctor, that could be a good thing. I just do not know how she will react. However, I am taking your advice on how to manage her. Again, thank you.

[looloo]

As awful, stressful, and difficult it is (because 99.99999% of the time, nothing you do will be perfect or make anyone "happy"), I will say that after doing this for many years and counting:

The only important thing is to focus on safety.  Of your parent, yourSELF, and others at large. 

Forget about trying to maintain or salvage a "relationship."  Not that you can't be kind or empathetic, but you gotta do what you gotta do.  Enlist the docs to deliver hard news when possible, if you can handle things without even mentioning it, go right ahead.  Lol, I think I could write a book on "stealth caregiving!" 

Good luck...

[WomanInterrupted]

Recreating, I don't think she's going to wig out in front of the doctor.  She'll probably be on her best behavior, to keep the front in place, and I think she'll probably ace the test. 

They may have other issues they'll want to retest for, in a period of time of their choosing - those include mobility/balance issues, and poor  decision-making skills.

A person making lousy decisions is allowed to make all the lousy decisions they want, and is *competent* to do so, but once you get to a certain age, those lousy decisions start to be questioned.  I think your mom will remain on a "bubble" for periodic retesting. 

There comes a point, IME that you have to wonder if it's dementia or is the PD running the show?  Often, it's the PD on steroids, and cranked to 11, because your mom is getting old, has lost her looks, doesn't have the power and influence she once had, doesn't have the money she thought she'd have, all her friends are dead or MIA (through being shunned or ghosting your mom) AND she's angry as hell that the special, picture-perfect life she thought she was OWED was *not* given to her -and now she's got a sick husband, to care for, too?  UNACCEPTABLE!  SOMEBODY will do it FOR me but not ME because I  AM OWED MORE THAN THAT AND I AM ANGRY ABOUT IT!   

So...they RAGE.  And push people away.  And stew. And plot.  Become spiteful, petty, mean and vindictive.  They become *nasty* - and "forgetful" - hoping somebody will jump in and do things FOR them, so they can sit back and complain about everything you're doing wrong! 

They often want *revenge* - which means taking every slight they've ever been handed - real or imagined - and take it out on the nearest Scapegoat - or series of them.  Or the entire FOO! 

The changes - looping, misusing words, forgetting things, repeating herself - may not put her in Camp Dementia, or anywhere near it - but *firmly* entrenched in Camp PD, with the freak flag flying high, but only if she can rage, bitch and scream to those who have seen her without her carefully-constructed mask:  you, her husband, and your step-sibs. 

The Queen is angry and *everybody is going to suffer* until somebody does what she wants, which basically means taking over for her, and letting her abdicate ALL responsibility for her husband and herself, while retaining total *control* of ALL situations. 

That her *husband* requested the test is VERY eye-opening.   

He may not feel safe, or may feel she needs help, being so "overwhelmed" with everything (she's probably not - she just doesn't want to do it and doesn't want *outsiders* helping)  - or he may feel he needs more care than she can provide, and is orchestrating some kind of exit plan (AL, a relative, Hospice, other).

Or  if he's a PD, he may be so damned fed up with her, that he wants a diagnosis slapped on her so he can put her in a memory care unit, and live his life in peace, with his daughters caring for him, while being able to retain your mom's assets through an eldercare attorney.

BTW - that's perfectly legal, and advisable, if your mom has assets - but it may seem like a big slap in the face, to you - but, unless your mom made other provisions, he's IT.  The spouse.

If - IF! - the day comes where she's diagnosed as incompetent, and he doesn't want to/can't care for her - stay out of it and let him place her in a memory care unit.   

Even if he's telling you regularly about her tests that she's not doing well, but isn't bad enough to be declared incompetent/unable to make decisions for herself but IS poorly-off - stay OUT of it. 

He picked her.  HE can deal with the fallout. 

ANY effort to get you involved should be met with 100% resistance:  I can't do that.  You'll have to figure something out.  That's just not possible.  You need to hire aides, get Meals on Wheels, and use the Senior Van.  I can't help out. I can't do a thing.  It's not possible. 

Become a broken record if you have to but *do not dip one baby toe into this situation* other than listen on the phone (as much as you can stand), and kiss it up to God. 

If you feel neither one of them are handling their situations as well as they could, you've got a few  choices:

1.  Stay out of it.  He's already requested a competency test on your mom.

2.  Contact both  their doctors and express your concerns.  They won't be able to give you any info, but at least you'll arm them with the truth, and they can take it from there.

3.  Call APS, explain the situation and repeatedly stress you cannot and will not be a caregiver, in any capacity, even for an hour a week, to do laundry.  NO.  You can't do it - THEY will have to send a social worker to assess the situation, and take it from there.  You will NOT be involved. 

They'll write down that you're "unwilling" - that's a word meant to make you feel guilty and shitty, but as long as you stay OUT of the situation it's only a word - tell them to write down any damned thing they want, but the answer is NO and the ball is now in *their* court.

It doesn't get any prettier - or easier - from here on out, but you *can* mitigate the damage to yourself by not getting involved, not being dragged in, and ending calls once they become abusive, whiny (about health), or become "hints" or outright demands for your help.

Focus on you.  That's the most important thing.  Keep yourself sane, and stay on your path of recovery. 

[Recreatingmylife]

Thank you! YES, WI, he married her. Also, you brought up a very good point that keeps popping up in my mind... is this truly dementia or PD on steroids?! "Do everything for me... and do it MY way!" Has been her life long mantra.

[Recreatingmylife]

Update. I spoke to my mother by phone this morning. She was not in the best if moods. However, she was getting ready to go to a church function. She did not mention yesterday's dementia screening. I do not think she ever will. Maybe that is best for everyone involved with her. Her husband will be the one to let me know. Again he married her.

[WomanInterrupted]

You probably won't hear a thing about the test, until they do a few and she starts complaining that they keep asking her the same annoying questions, over and over. 

When you're in that grey area, where it could be the onset of dementia or the PD is really running the show, *everything* moves into the realm of Plausible Deniability.

And I mean *everything.* 

Everything they do or say seems *plausible* - Practical called it well-rationed irrationality - and every  single thing she says or does falls under the umbrella. 

Yours is not to question why - that's what the doctor is for.  All you can do is protect yourself from it through lowering contact, using Medium Chill and making certain her problems stay on her husband's side of the table. 

If your mom rages at you - end the call.  If she gets waify and whiney - end the call. 

If her long, involved, boring and self-serving stories start to become even longer, more involved, and tend to take trains all over the place to backtracking, flash-forwarding, side-tracking and endless tangents about people and events you don't know or don't really care about - *don't* get her back on track when she asks, "Now where was I?" 

Say, "I dunno..." - and change the subject. 

BTW - IME, that's just a trick to make sure you were *paying attention.*  She knows *exactly* where she left off.  You don't need to remind her! 

Didi and Ray's stories were always long and involved, but became what I called "onion stories" - because they had endless layers, and always tended to start somewhere in the middle, to get me to ask, "What?" or, "I don't understand...what happened?" - *don't make that mistake!* 

Even if you don't know what's going on, pretend to listen, and at the first opportunity, change the subject, or you'll probably be listening to the same convoluted nonsense, with a cast of characters in the dozens, for at least an hour, when the REAL story is she went to the pharmacy and forgot to get denture adhesive. 

I noticed at this stage that the stories became even more about how much of a sad little victim unBPD Didi or unNPD Ray were.  Everybody was out to  get them!  Everybody wanted to cheat and swindle them! 
Nobody wanted them to be happy!  Pity them!  Feel sorry for them!  Rescue them! 

Not a chance, pal! 

Another thing you can do to protect yourself is treat everything they say as *fact* - don't read into stuff.  Don't translate, or cipher out what they really meant.  Don't correct their "forgetfulness" or "confusion" or offer to help in any way - if your mom says she can't remember to take her meds, or which meds to take when, kick it back to her *doctor* and tell her to discuss it with him or her - or perhaps the pharmacist may have some ideas, if the doctor is a bust.

Offer the correct person or organization - not yourself. 

If your mom starts telling your TMI stories about bodily functions - poop is a big one with the over 60 PD crowd - don't be afraid to shut that shit (hee - a pun!  ) DOWN, and FAST!   

"Mom - TMI."  "Mom, that's inappropriate."  "Mom, talk to your DOCTOR about that."  "Mom, I don't want to hear it."  "Mom - gross, now STOP." 

If she  won't - end the call.   

You're trying to end the call but she just won't stop talking?  ONE warning - mom, I've gotta go -  then hang up without another word.  If she calls you back, let it go to voice.  Keep letting it go to voice. Delete without listening - if she's leaving messages, she's probably got nothing important to say, even if the message is, "Call me back.  It's important." 

It never is. 

It's rough when you get into Plausible Deniability Land, but manageable as long as you *allow* yourself to detach, stay out of it, and do as little as humanly possible. 

She won't like it, but it's what happens  when you become more of the essence of what you really are, and what you really are is NOT a pleasant or even moderately tolerable human being.

[Recreatingmylife]

Thank you, WI! Got it! Thank you for these tips on managing her.

[MyLifeToo]

Apologies if resurrecting this thread isn't the right thing to do, but it is  so pertinent to me at this time, I wanted to bring it back to the top. I'm beginning to think it might be time my M was screened.

WI, you have an incredible knack of describing my mother I'm sure you must know her. Are they really all so similar?! Old and raging. Shunning all responsibility whilst wanting to remain in control - I'd never thought of it like that, but, Eureka!! Love the advice re the phone calls, thank you.  Is there no original conversation in the world from a npd lol.

[Seven]

This is where I'm at too.  I let the brothers deal with her, as she has alienated all her daughters. 

She should've had her initial neuro baseline back in 2012 which was ordered by her PCP.  When she got to the neurologist she did *okay* with the quickie questions.  When the neuro told her to come back for a more extensive test, she flat out refused. She still refuses them to this day and always comes out "the doctor said I'm fine".  She moved to sister4 in sunny state.  Sister trying to get her set up with new docs.  Same shit.

Brother5 takes her to DMV to get license renewed. "I passed my drivers test".  No, you passed your vision exam.  If they had her behind the wheel the license would have been taken right then and there.  (Gave up her car when she moved to sunny state; she has since moved back because she misses her "friends", none of which live at the ILF she is in)

She no longer allows me to take her to doctor appts because I'm the truth-teller.  Thank freaking God.

So now it the brothers' problem, and believe me, they see how she treats her daughters. It's sad when the brothers admit that they see how poorly she treats us.

[theonetoblame]

a common 'pro tip' I've heard to help manage these situations is to ensure the messenger and ultimate limit/boundary setter is outside the PD person's social network and in a position of power they can't challenge. In this way responsibility for the diagnosis and subsequent limits (not driving, accepting care) are always delivered by a doctor, public trustee etc. This defers 'blame' outside the family -- the next part is to then step back and let the 'system' respond through these points of authority, which requires active updates to them from the family. For example: Worried they'll blow all their money, call a public trustee for an assessment of financial competence and share your concerns regarding their risk of being victimized. Concerned about outbursts and threats of harm to self or others, try a crisis line and they may surreptitiously send a mental health team to your door. Or, report to your family doctor and request a psychiatric evaluation if it's not super acute etc. Just don't be the messenger or one trying to intervene, we can do a LOT for someone we ultimately care about by recruiting resources in this way. It may take a while for momentum to build in the system but just keep calling and making the reports, typically medical professionals recognize the importance of proxy reports from family.

I see a couple posters are doing this already. The challenge usually comes down to points of perceived risk or possible harm to self or others, it's so easy to get Hoovered in those moments... and to inadvertently put ourselves in the line of fire. If you can't get by with medium chill/grey rock/Teflon strategies best to just report immediately to those with decision making power (if yo haven't already).

[DreamingofQuiet]

Thank you, RecreatingMyLife for starting this discussion and MyLifeToo for bumping it. And WI and everyone else for your hard-earned wisdom and advice. I think my father is becoming senile, and my mother is entering "Plausible Deniability" land. My unOCPD Father is her lifelong (adult life anyway) caretaker, and the fact that he's starting to malfunction is freaking her the hell out.

She's scared and angry, and as someone else mentioned, she wants someone else to take care of things while also remaining in control. And if she can get one more dig in and another ounce of flesh from my dad while she's at it, so much the better. It feels almost impossible to help them without getting sucked into their whirlwind of dysfunction. And I can't afford that, because I've only got me, myself, and I to rely on.

I like the idea of getting outside authorities to deliver unwelcome news. That is brilliant, and a tip I'll take to heart. Right now, they are still managing all of their own affairs, and we don't live in the same town. So, all I can do right now is refer them back to their doctors and whatnot and then brace for my mother's periodic angry outbursts about her hapless husband and selfish offspring who don't care and refuse to help.

The best of luck to all of us watching our PD Parents lose their marbles while trying not to lose our own. 

DoQ