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You know it’s dementia. A test isn’t going to offer much except confirmation. You’ll figure out her “level” by interacting with her. Some days it will change, sometimes she’ll cover it up. That’s how it goes. It’s not easy.
It seems you have experience with this disease in your family, but it always helps to find support in how to accept the reality of this disease, stay connected to your loved one, and also to keep yourself well. Teepa Snow has some videos that I found quite helpful. Prayers to you, your step dad and your mom.
Uultimately, this is very much HIS issue. Does mom have POA for finances and health set up? Does she have a living will that tells you what her end of life wishes are?
That might be a hook into a less fraught conversation...you could say you've been reading Atul Gawande's book On Being Mortal and you are setting up your POA and hopes she has done the same.
Sunny, there are some people we can't help, no matter how much we love and care about them. Be well and take care of yourself.
My step-dad is trying to set up a “double” appointment for the both of them with a neurologist without her knowledge. I can imagine the fit she will throw once she’s in the exam room.
She can become so angry and enraged... it is difficult to have any conversation about brain health.
There are things that might be treatable; normal pressure hydrocephalus, certain kinds of brain tumors. She might be having TIAs and bp meds might help with that. But she can't find any of those things out if she won't cooperate and see the right doctors.
Because she is afraid she will labelled "crazy". And then what? Dumped in an institution of some kind?
I often find that with folks who resist diagnosis and treatment that there is a long ago story of a relative who was carted off to a mental institution or other horrible care facility. In our parents' day, it was totally typical for parents to be told to institutionalize their "defective" children as toddlers and never speak of them again. I think there is a whole lot of hidden trauma in that generation from those sorts of actions.
That being said, you can't care more about your mom's health than she does, can you? You can try talking to her about the fact that you won't abandon her, will always see that she gets good care (DO NOT PROMISE that you will never put her in a NH; "I'll find you a good place, mom" is how I would word that).
If you can have a conversation (best in person) about "what about this whole thing with your brain makes you scared, mom?" "Please let us help you to find out what this is and let's get it treated" "What is your plan for your care if this gets worse, mom?" will give you some insight into her thought processes and level of reality.
Assure her on the "crazy" part--have a brain that isn't working properly isn't "crazy" but resisting finding out what is causing it might be very foolish.
One of the tougher conversations I had with my mom happened when she was 65, younger than I was now. She had her first mammogram and they found a lump. She went into mental lock-down and decided that she was going to be a "good patient" and only have one anesthesia, have the biopsy and possible mastectomy all in one go. But it was 1986 and that's not how things were done any longer; she was remembering the oncologists she had worked for at Memorial Hospital denigrating the female patients who wouldn't be "good girls" and just have their d@amn mastectomies without asking a lot of questions.
She also was insisting on going to a poorly rated local hospital when MSK was only 40 minutes away.
After trying to convince her and getting nowhere, I said in exasperation "mom, you are too smart to do something this stupid". There was a sharp intake of breath and I think she may have hung up on me. But she agreed to go to MSK and do things the RIGHT way.
Maybe you can try something like that.
(((((((hugs))))))))