How to get medical staff to understand my mother is lying?

Janner, ah yes, the "I am fine" when one's parents are at a doctor's appointment.

My parents had a great geriatric physician, any time she would ask my parent(s) a question, she would glance at me to see if I shaking my head yes or no. If "no" then she would quiz my parent(s) until she got a good answer. I was always sitting behind my parents in the exam room so my parents didn't know what I was doing :P

My Dad was pretty good at being upfront with his doctors, but not my Mom. My Mom was always in denial that she was aging [in her 90's].

I sympathise.

Q: Do you have any health problems?
A: No, I'm fine.

Apart from the congestive heart failure, chronic kidney disease, hip replacement, gastric ulcer....

Mother later explained that she "didn't count" anything that was controlled by medication. The appointment when a nurse practitioner cancelled her pacemaker implant based on mother's claim that she could walk up to a mile "but I get a bit tired" was the last mother ever went to alone. It was supposed to be a chat about living with heart failure. No examination, no investigations, no corroboration; and interestingly no cancellation letter, either - I found out by luck. I quite enjoyed following that one up.

We have to go through this grey area, only not so much grey as Kafkaesque, while our demented elders are not yet officially away with the fairies, or whatever technical term your jurisdiction uses.

I take it your mother's medical teams are actually *acting* - prescribing, treating, etc. - based on their clinical observations and your contributions, rather than your mother's claims? Assuming that is so, and you and they both have the obvious risks covered, then there are at least three things to be said for solemnly writing down the patient's own account.

1. As you already said, respecting the person's dignity and autonomy, as far as it remains possible;

2. The discrepancies between the patient's own understanding versus the results of scans, blood tests, clinical examinations and reliable witness accounts are in themselves helpful to understanding the patient's mental state;

3. The practitioner needs to develop a relationship with the patient. Upsetting, provoking, challenging or contradicting the patient is not going to help that. Gentle questions and explanations will work better but first you have to establish trust.

So I wouldn't be fooled. The fact that the doctor is keeping a straight face and handing over the notes doesn't for a second mean that the doctor actually believes that your mother is CEO of a tech company (though she may be! How would I know?). But I think you already know that perfectly well - is there a nice soft surface you can go and bang your head against?

You are medical POA now for someone with vascular dementia; it would be so much better now if you would just attend all MD appointments with Mom if you are in the same city, so that you can gently correct crucial information like fall history. Explain the need for this by letter with all MD and Nurse Practioner etc. Because yes, esp with the Narcissistic mixed in, confabulation can lead to medical folks honestly believing a good story.

Who deamed Mom as having Dementia? I hope a neurogist and not a PCP. Whoever diagnosed her, that paperwork needs to be in all her doctors files. If u haven't been going to appts with her, u need to. Right in the room. I always wrote a list of things I had seen. Changes. I would give this to the receptionist for the doctor. Then his questions could be based on what I had written. Your POA should be on file too.

My Mom's Dementia was noticeable. I had asked that no one talk to her about her care. If I wasn't there, I was to be called. I showed up one day to two nurses (think they were students) explaining what was going to happen to my Mom. I told them she lost them after the first word. Her ability to process was really bad. My DH has lost hearing in his left ear and has maybe 20% in his right with an aid. Deaf without it. Domu think I can get doctors and nurses to understand this? No. I called one doctors office and asked the Nurse to put a pc of paper with the words DEAF where it was the first thing the doctor saw in the folder. My DH could not get this man to look at him when he talked.

Most Doctors offices now have "Patient Portals" that you could set up.
The advantage is you can send messages to the doctors offices.
Prior to the visit send a message "reminding" the doctor and the staff that mom has dementia and that she had surgery for a broken hip on...since the last visit she has fallen ..X number of times..and any other information you want them to know.
Also instruct them to also give you a copy of the "after visit" notes.
I might add that if you are in the room with her during the visit and the doctor does go over any follow up information he or she may be talking to your mom but the information is also being imparted to you and this may be a way of keeping you informed but also respecting your mom as an adult that still might be able to make some decisions on her care.

It sounds unrealistic for you to attend all of her doctors' visits because of your own health issues. Her doctors do need to be informed *by you* **in writing** that you are her medical POA and scheduling visits and reporting results must be done with you and only you. Whichever doctor diagnosed her vascular dementia wrote a report that was sent to her PCP, if he was the one who referred her for neurologic testing. Get and copy that report and attach it to a copy of your medical POA documentation and send it certified mail return receipt requested to the new cardiologist. Once you get the signed card, call the office and confirm that the report has been added to your mother's medical record, and request a call back from the cardiologist acknowledging same.

I've noticed when I take Mom to doctor appt. They talk to her directly and ask her questions. Sometimes she can answer but it becomes very apparent very quickly that her responses aren't all there. Many times she will try to answer and then looks to me to confirm what she is saying. If what she says is really far off but seems to be accepted as fact by the Dr. I'll just give him a wide eyed look and a subtle shake of my head. Later I'll leave him an e-note for her record. Many people don't like the computer for communicating with the Dr. But I find it makes life so much easier. She is able to maintain her autonomy and I am able to keep the Dr corrected on the important stuff. Like the 15 falls and 6 ER visits since Jan. When she claims no falls and walking without difficulty. She uses a walker and drags her left foot.

Persons with vascular dementia go through a stage of "confabulation" where they make up information (1) to fill in memory gaps and (2) to save face.

It's clear that your mother is seeing herself "as she used to be" in her prime. Perhaps she was 5'7" as a young woman; after all, everyone shrinks in height with age. Perhaps she was employed full-time and lived alone at some point in her past. It may not be intentional lying on her part; she may actually see herself as a moderately tall, young, vibrant, independent woman.

My father had vascular dementia - and I saw the same behaviors in him.

The medical staff may not be taking correct notes for her condition. The most correct way is to write something like, "Patient stated that she works full-time as a secretary and lives alone in an apartment" - or whatever applies. That way, it is a simple report of "what the patient stated" rather than fact.

Oh I get that & it’s so frustrating! Our Dr thinks my mother is the next best thing to chocolate when she’s in his office, acting all sweet. The Dr does look at me after he asks a question but I don’t really think he cares what I think or say. Maybe they think we have dementia too???? I think a consultation type appt would be good to schedule to discuss mom. Schedule first thing in am before he starts his busy day & isn’t exhausted. Maybe they’ll listen.

Since it was a new Dr, it was likely he had no medical proof to make him doubt her. (Could you request medical notes from the person who diagnosed her dimentia?) Also bring copy of hospital notes on broken hip, to show to any new Drs. That kind of stuff would be objective proof. Otherwise, just stay in the waiting room next time she visits the Dr. so you don't have to listen to her lying. In the end, it's not worth letting her drive you crazy. That's what I ended up doing after my mother got mad at me for telling her Dr the truth. Good luck.