Mom has no dementia diagnosis but intermittently doesn't know her husband?

The pain medications could be the root of the problem, or as suggested it could be an infection or another medication. She definitely needs to see a primary doctor for a physical, and perhaps a psychologist (if a neurologist has said there is no dementia).

As you recognize, this is highly abnormal behavior, so looking for the cause makes sense. Sometimes it takes more than one doctor to get to the bottom of things. This is not to denigrate the doctor, but they can't all be experts in everything. Good luck to you,
Carol

Something is going on with your Mom's memory. First thing, have her checked for an urinary tract inflections..... such inflections can cause all types of havoc in an elderly person. Once cleared up, most elders are back to normal [whatever is their normal state was prior to the infection].

Because you say mom says he's a "charade", it makes me think it might be Capgras delusion. It's where a person thinks a loved one has been replaced with an imposter. Here's a link to an article...hope it helps a little.

Definitely discuss this with the MD. Yes, it could be the pain medication, or an underlying condition affecting the brain. If she has gone through chemo, it does affect memory.

You don't mention her age, but I would mention it to the doctor. Sometimes people can cover well about memory issues for a period of time. I have worked with people who are in the early phases of dementia who can hold it together long enough for an assessment or a visit that is a couple hours, but as soon as as they don't have an audience they have lapses. Keep an eye on it and talk with her doctor now. I have experienced clients with considerable decline very quickly. You might notices other area of difficulty if you pay attention.

Has she had trumatic brain injury or possibly "hardening" of cerebral veins suppling oxygen to brain.
Do take her to Dr.to check this out.This is actually a symptom.

This is symtom of a disorder. I can not Dx . But, The brain does not like to Not identify things and tries to be logical.
The brain itself will fill in the blanks.
If there is no memory it will make on from past experience. especially when injury from lack of oxygen.
Spouce will say sister cooked breakfast for before school when growing up as child. Now after 7yoa lived with grandparent not sister.
Sister says hes making up lies because things he says never happened.
They always manipulated him.To point of getting his inheritance 401k cashed in at earliest they came from out of state to get him to take to another state to get 401k left from stepfather that was left to be able to take care of him.
Because, what he did for his mother when the other siblings disowned her for marring stepfather.
Because, forgotten memory filled in with logical want to be plesant thoughts about relationship.
Now in disorder husband not recognized should be husband . Told husband. Brain knows has emotional attatchment should recognize husband. So brain says, I don't recognized this person as my husband, I am told it is my husband whom I most certainly would recognize.
Locical conclusion for brain, trying to trick me with Impostor; I would know husbands face.
Another disorder there is with lack of facial recoginition recall too, result of brain trauma.But, don't think this in your case.
Please address this with doctor.Maybe have husband come in while Dr. there if "imposter syndrome "is that constant to observe behavior.

There is a type of delusional disorder that occurs in one specific area. The person is apparently normal in all other areas. It can appear in middle age later life. Some times it is a specific paranoia such as that their spouse is cheating even though they are elderly and there is absolutely no evidence to support the conjecture. Some times it is that someone is "in love" with them even though there is no evidence. Sometimes it might be that people are breaking into the house and moving things or taking things. There are many other variations. It might be a good idea to get a psychiatric check up as well as talking to her doctor. If it is specific delusional disorder then there are medications that can help.

Once medical issues are ruled out, then one learns tricks to cope. If she does not know who he is do not force the issue, say he a good family friend, who is staying with her for a while. Have lots of pictures up with them together. Start conversations you know from the past she likes talking about. The in the moment thing is not that she remember they are married, but they get along. There are times when all of us look at our spouse and wonder who they really are. Maybe it the new shirt or haircut throwing her off. We all remember people different ways. Ask her is she remember her wedding, or her family, these leading edge questions can help. Play their favorite song. Do not make it a huge deal, cause the stress will not help. We all have that day we look in to the mirror and see a very different fae than the one in our memory. think of it like that.

An interesting and informative response. My late husband, who had Alzheimer's, asked me, "How long have we been together?" Although he didn't recall that we were married three years before, he appeared to recall that we were close. I appreciated that.