Mother Memory Problems concerned and recall Grandmother's Dementia may be same issue

[debra1533]

Hello I am Debra. My mother 81, reallizes, she has short term memory problems. A VERY independent person in business; she's retained the attitude through retirement.. She's in Santa Cruz CA (10 hrs from us) She had a fall July 20th which resulted in hip replacement. She's currently in post surgical rehab facility. We moved July 5th, expecting to go back in a month, and move her and apt up to Oregon. Husband had to go back July 26th for a week, to move her apartment contents with dog and bring them back to us without mom.
Her condition - recognized by nurses and our visiting friends is she has obvious short term memory problems. Change after surgery has been dramatically worse. Perhaps anesthesia or result from fall and surgery. She realizes in past 1 1/2 years she is forgetful and cannot grasp information she needs. More than 2 years ago went to an appt I made with her internist and, she had a "good day" and basically said --- as Dr. agreed, she's fine. My hope was for meds which would try to halt it where it was. Did not happen.

Now, in a recent conversation - she believes she's in her own apartment and her routine. All responses to questions were met with insistance she was in her apt and not in faciity. How should I respond? Should I attempt to bring her back to reality (if possible) or just let it go? How is it determined (which type of tests, evaluation) what it is? She is there with visiting doctors and psychiatirst as well. What should I ask to be done? She will come back when she can walk and travel the 10 hours. We need to set up assisted care nearby and have to have idea of what kind of room she needs. Probably there another 2 weeks. She is quite cooperative with physical therapy and occupational therapy.

My concern as well, when I was 14 maternal grandmother had fall while in assisted care facility as kids did not trust her with a stove. She saw herself as a young girl and identified everyone as people from that time in her life (outside reality.) What do those symptoms sound like?

Any ideas are welcome. Thank you

 

[Cat27]

Welcome to TP Debra

You can't bring her back to reality. Imo you just have to let her be.

 

[Amy in the US]

Hi, Debra, and welcome to TP. I am so sorry to hear about your mother and your concerns. There is a lot of good information and advice available on here. It sounds like you are in the United States; everyone here is very welcoming towards us Yankees but you should remember that when you're reading other posts and responses, there are differences in how the UK system (medical, legal, and social services) works as to how it works here in the States. Having said that, dementia knows no international boundaries and the collective wisdom here is great. I hope you'll get some good advice and support.

As Cat said, the short answer is, you cannot bring your mother back to reality, if there is indeed something neurological (like dementia, in whatever stage and form) going on. For right now, I wouldn't distress your mother by making a fuss over it. Just gloss over things and be ready to roll with the punches, conversationally. I know this is FAR easier said than done, by the way.

You are correct that a trauma (like a fall and a broken hip and surgery) and/or general anesthesia can make things worse. Your mother may recover back to her pre-fall self, but it can take a long time. Or, this may be her new baseline. Or not. Impossible to predict, unfortunately.

If I were you, I would ask that a neurological assessment be set up. This could be with neuropsych or a geriatric specialty group or a neurologist who specialises in dementia/geriatric patients. I would approach the nurses at the rehab clinic, who you think are the best/brightest/most responsive, and ask them all who they would recommend. I would ask the same question of any doctor or therapist or other medical professional who is currently treating her at the rehab facility, and also of her GP/primary care/internest, if you think she/he will be helpful. Be loud and vocal and INSIST that she is having memory problems and you want her assessed.

I cannot tell you exactly what they will do, but probably a combination of obtaining a medical history, some memory and mental status tests, some oral, some on paper, and perhaps an MRI, as well as some medical workup to rule out memory issues from physical problems that aren't neurological (for example, thyroid conditions and certain vitamin deficiencies, among other things, can cause memory loss and other problems). I'm sorry that's not terribly specific but I'm not a doctor, nor do I play one on TV.

Since you suspect she needs care, I would also push for a functional OT assessment; my mother had one of these while in the hospital (in the Senior Behavioral Health Unit, formerly known as the Geriatric Psychiatric Ward, during an enforced stay--and don't be afraid of this if it's ever indicated, by the way, they were fantastic) and they assessed what she could and could not do, right down to driving, bill paying, cooking, and so forth. It was immensely helpful in finding a facility with the right level of care.

I'm sorry, I cannot help with a guess about your grandmother, but I can understand that it sounds like there may be a family history and of course that must be very worrisome for you.

I wish you luck and good care for your mother. If you get a chance, please come back and update us, and you can always come back and ask more questions. At some point if you are dealing with some form of dementia, you might contact (or go online to) the US Alzheimer's Society; they can put you in touch with local groups and resources and they also have a 24 hour hotline you can call if you need to talk to somebody. It is 1-800-272-3900.

 

[Kevinl]

Hi Debra, welcome to TP
It's quite common that after an operation the dementia gets worse, it's too late now but if the doctors had been aware they may have used different anaesthetic techniques.
If you do a search on here for "anaesthetic" you'll find quite a few stories like yours, as she doesn't appear to be diagnosed then the doctors to be fair to them weren't in a position to know or they might have treated her differently.
Amy gives some sound advice as things work differently in the US to how they work here in the UK.

Good luck with it all.
K