As a reminder, I am not a physician. You should not substitute my opinion for your own judgment. But I do love these questions. They clearly demonstrate that these issues are complex problems with shifting dynamics and no easy answer. Yet for all their individual nuances, they are nearly universal.
My wonderful mother in law has been diagnosed with early stages of dementia. My husband and 7 year old twins have been living with her for the past month while we have renovations done on our home. We have noticed significant changes in her mental state; some alarming (leaving water on the stove to boil and going downstairs to visit with a neighbor). Prior to us moving in, we all noticed instances where she was forgettting things and she has since become good at not speaking when she is not sure – hiding it in my opinion. But she has not been able to do this while we are living with her. We have told her other children of our concerns and they insist that it is due to our being there and there being a change in her routine. I certainly agree that, as you discuss on your site, routines are important, but we have not disrupted her routines much. We are gone in the a.m. all day until around 8:00 at night usually. Her “routines” of eating, etc., are all the same. Is there disruption? Certainly. But we are concerned that this is more of a situation where we are there to see the extent of her problems and that they will not all go away once we leave. She lives alone and there have been two instances with the stove since we have been there that we were able to see. We are concerned about saftey more than anything. The other issues (not knowing it is Easter as we are opening easter baskets with the kids, not knowing it is a weekend and asking if the kids are going to school, not remembering I am in the house and scaring her, etc.) are not a safety concern and we roll with it – never call her on it, but gently answer the questions, etc. So, my question to you is, is this all due to our being there or is it more as we suspect? Thank you!
I think the fact that she already has a diagnosis of early stage dementia is where the answer to your question starts. Here are some common symptoms:
- Memory loss
- Talking is better than problem solving
- Denial is the dominant defense mechanism
- Personality changes
- Inability to carryout highly familiar tasks
- Decreased abstract reasoning and executive function (judgment and insight)
- Decreased temporal orientation (date, time, season)
Your presence in the home may or may not affect her cognitive abilities. And the deficits you are now witnessing may or may not be new. The point is, there is no way for me to tell you if the stress of your family moving in with her is the cause of her cognitive challenges, or if it’s the dementia at play. I would consider having her evaluated by a professional (neurologist, psychologist, occupational therapist) and let the objective data support your findings. Discussions with family members always go more smoothly with the input of an outsider. I would definitely consider putting FireStops over the stove. I’d be on the lookout for financial and driving issues too.
Kudos to you, Marnie, for your gentle, supportive approach in dealing with her errors. Keep her safe and feeling validated, and hang in there!