Neurologist gave my mom the MMSE test: score 11. Dr. wanted her to have a PET scan to see how long it’s been going on. My Mom canceled it. Any suggestions?

Until she is deemed mentally incompetent, you have your hands tied. Try to make sure she is safe and healthy - given her problems. When she gets sick or injured, you can ask her doctor(s) to test for mental competency as well as get the other tests she needs.

Ginalynn67: With a score of 11 on the MMSE test, your mother is only fooling herself as she does have dementia. Perhaps your mother requires placement in a managed care facility, preferably memory care.

"I guess I just have to wait until she starts forgetting major things".

Are there any safety concerns now?
Using kitchen appliances? Using bank cards/cheques in wisely?
Mobility? Getting around the community?

Put down your end of the tug-o-war rope and walk away: you are not the captain of her ship.

Oh one more thing … if she is well educated especially verbally they learn to cover —- and when I say cover I mean fool people that don’t know of her issues … the Dr used to say “she can cover like no other!” the hello is good the oh I know yes nice to see you I know you(but not say their name ) miss something or mess up and totally wasn’t them or they weren’t aware etc but ask a more difficult question or try to have them follow along in a conversation with others and you will see it. My mom started saying I bought this book to read and then I found I’d already read it ! (But she hadn’t but acted like she was still doing all her normal things but she wasn’t) or ordering food and saying I don’t like it but it’s exactly as she ordered. Repeating? Clicking TV channels a lot - not really following what they are watching and believing she won money on the phone ! Lord I look back and now it’s all clear but in the beginning it’s hard to see. My mom is bossy and she still says there is nothing wrong with her bad doesn’t know how a toaster works . Good luck

Honestly, I would just let it go. Knowing how long it’s been going on isn’t really going to be all that useful. Everybody progresses at a different pace but it all ends the same. My father refuses to take his blood pressure medication and just throws away the bottle every time it’s refilled. He says he doesn’t need it. I used to fret over it but not anymore. He has ALZ and I know how this ends, so why fight over medication that may just prolong his hell. Pick your battles.

You know sometimes you may just not want to know at any age. When taking care of someone it might be best not to tell them what the test is for. It creates less stress not knowing.

If you don't already have POA and she is unwilling to give it, there isn't much you can do right now. Once my mom heard the word dementia, she refused any further testing as well. Many folks react that way. That does not change their reality and the reality is they will get worse. Things will start to happen. My mom got lost while driving and she hadn't been making her house payment. That is when you step in and insist on helping. If they still refuse and it gets to the point where she is a harm to herself or others, you may need to apply for guardianship and or report her to APS.

"Medicare will pay but only if they have been inpatient at a hospital for over 3 days"

And as already said, this is only for Rehab. Medicare does not pay for Long term care, Medicaid does and using only in Nursing home type facilities. Assisted Living and Memory care are not covered. Some States will pay after private paying for 2 yrs. At the point Mom is, she will need to go into Long term care. Als and MCs are limited in how much care Mom would need.

Being dissabled you can only do so much.

Forget the “Narcissism” piece. Dementia is a narcissism all to itself, and she will not change now, except to regress.

I’m assuming that no one has explained to you what geriatric cognitive testing is used for.

Look up the name of the test online, read about it, then ask the doctor how her results SPECIFICALLY APPLY to her case.

How she behaves, what she says, whether she’s “mean”? NONE OF THIS has anything to do with how you should feel or react. She can call you h

She is losing whatever social appropriate behavior she EVER HAD. DON’T engage in conversation about what she does or does;’t “have”. Doing so will not help either of you.

Does ANYONE hold her POA? If not, you may have to wait for the “precipitating event”, when she either sustains an injury or wanders away or some other painful event occurs.

Once again, you are now BLAMELESS in her circumstances, but as her caregiver you must be sophisticated about what all her “stuff” now means, and how to do the best you can for her, without losing yourself in the process.

Investigate residential care sites, what her financial status is LEGALLY, and interim solutions (a “companion” for a couple hours once in a while?) that can give you a break.

There are lots of us here that understand.

GIna, Medicare will NOT pay for AL or Nursing Home.

Medicare will pay for REHAB after a 3 day hospital stay if prescribed, but only as long as the patient is cooperative and making progress.

You may need to consult with an eldercare attorney.

You can love your parents and not end up as an abused slave to them. You deserve to have a life as much as your mom does.

"I hate this being stuck in the middle of good and evil."

I am not quite sure what you mean..?

Plenty of people do decide to do what they can for their LO, at home, for as long as they can. This is a valid choice. If this is your choice - the best fit for your values, then go with it.

"love thy mother and thy father"

Some people do show love by acts of service - but is not the only way to show love!

You can still set boundaries: decide what you will & won't do. You can add in extra help by way of services & extra people too. You can also re-assess the plan whenever required.

Without POA.. this may give you a starting point when considering what you will/won't do.

I keep thinking what my grandmother always told me when I was growing up, love thy mother and thy father. I’m 67 and no one knows her like I do and I know what some caregivers do to people that are mean and nasty and I would just die if anyone hurt my mother. I guess after all these years of the abuse and belittling I still love her, you can kick a dog but chances are the dog will still love you. Maybe the day she can’t remember me and gets
physical with me then maybe I will be done. I hate this being stuck in the middle of good and evil. My Dad passed away 2 years ago from end stages of dementia and I took care of him until I couldn’t.

A score of 11 on MMSE is definitely not fine. Have you shown her that in writing? Would she agree to a meeting with her doctor with you present to discuss? Knowing how long it’s been going on gets you nothing in the short term, so concentrate on the now because she could lose more money, get behind on her bills, and all sorts of other bad things.

Yes, stop telling mom she has dementia bc it serves no useful purpose. People like this will always blame others for their shortcomings and refuse to accept reality anyway, so save yourself the gaslighting she'll dole out.

Download the booklet Understanding the Dementia Experience by Jennifer Ghent Fuller on Google. It's the best 33 pages you'll ever read on what to expect from an elder who's been diagnosed with it. Good tips in there too.

If you have POA for her, you can place her in Memory Care Assisted Living against her will if her care becomes too much to manage. I'd lose her credit card and see to it she has limited access to cash. With an MMSE score of 11, your mom is deep into her Alzheimer's/dementia now and things will only get worse from here. Further testing won't help her or you in any way, so what's the point? My mother had NPD personality traits too and didn't believe she had dementia either.....it was everyone ELSE in her memory care ALF who was stupid and nuts! She died at 95 with advanced dementia insisting that very thing and I'd change the subject when she brought it up.

Best of luck

"The maximum MMSE score is 30 points. A score of 20 to 24 suggests mild dementia, 13 to 20 suggests moderate dementia, and less than 12 indicates severe dementia."

So 11 is really low.

My boss was asked to take some close friend some clothes in a NH she had been placed because of Dementia. As my boss was checking pockets, she found $400 in a coat pocket. So, look everywhere possible. My GFs Mother found her husbands his, wallet and pants under his mattress. They hind things in the weirdest places.

Let is go for now. You now have a diagnosis. It would be nice to know what type because of medication.

Some folk want all the tests, all the Doctors, all the time.. other folk "are fine, thankyou" & avoid.

What will a 'label' give Mom?
Would it change her behaviour? Will knowing she is developing a condition that strips away rational thinking make her any more rational?

Do you want to be her caregiver as things get worse?

If yes, start looking for extra help for you both.
If no, start looking for extra extra help for you both.

CM, thank you. I missed that she already resides with Gina.

When (not if, when) she ends up in the ER, you refuse to pick her up.

I'm not suggesting that that's going to be easy, but you're going to have to refuse to take her back in order for her to get the care she needs.

Knowing how long her dementia has been "going on" is a waste of time and money. There is no cure for dementia, only strategies to work with it and around it. "How long" will make 0 impact on what you both do moving forward. Choices is what will make the difference today, right now.

Decision #1 for you is: do you wish to be her caregiver?

If not, then what is your feasible plan to "re-home" her?
(FYI, if she gets mail in her name at your home, then that is her legal residence and you cannot kick her out with out (probably) going through the eviction process.)

Are you willing to help her transition to another living situation?

If there is a legal mechanism for you to help her, even when uncooperative (as in her assigning you as DPoA), are you willing to manage her affairs, even if not provide hands-on care yourself?

These are big questions and choices. Even if your Mom has always been a narcissist, she now has a diagnosis of a disease that will continue to make her a nacissist. FYI dementia makes people narcissists who were never narcissists in the past.

Maybe start by learning a little about dementia so that you can maybe have better interactions and outcomes with her now. I've learned a lot from watching Teepa Snow videos on YouTube. She provides examples and strategies that I know will help you. Also, here's some guidelines I've also found very helpful when dealing with the 4 elders that my husband and I are responsible for:

Rules for engaging our loved ones with dementia:

1) Agree, do not argue

2) Divert, do not attempt to reason

3) Distract, do not shame

4) Reassure, do not lecture

5) Reminisce, do not ask “Do you remember…?”

6) Repeat, do not say “I told you”

7) Do what they can do, don’t say “you can’t”

8) Ask, do not demand

9) Encourage, do not condescend

10) Reinforce, never force


The overall goals should be to:

1) keep them as calm and peaceful as possible 
     (because they are less and less able to bring themselves to this state on their own)

2) keep them physically protected in their environment and from predatory people

3) keep them nourished with healthy foods that they will accept without fighting or forcing

4) keep them in as good a health condition as is possible, that their financial resources will allow and within their desires as expressed in a Living Will (aka Advance Healthcare Directive) 

5) keep them pain-free as possible and within their desires as expressed in a Living Will (aka Advance Healthcare Directive)

The caregiving arrangement needs to work for both the receiver and the giver. If it is onerous to the caregiver, then the arrangement is NOT working. Alternative types of care must be considered to avoid caregiver burnout. 

I wish you much clarity, wisdom and peace in your heart as you make choices.

Unfortunately, mother doesn't live alone. She is resident in the OP's home and has been for some time.

Ohboyohboyohboy...

Whose 4K did she lose, how, and is this going to make life practically difficult for anyone?

Meanwhile, get advice from the neurologist who wanted her back in his office. It's probably a matter of waiting for shoes to drop, but it can't hurt to ask.

GIna, what will happen is that mom will fall or become ill and will end up in the ER.

When that happens, you inform the hospital that she has dementia, lives alone and won't/doesn’t take care of herself.

AND that you are not going to become her caregiver. They will find a placement for her, although they will try to guilt you into volunteering to care for her. You're an elder yourself, so there is NO Way that your are going to care for an uncooperative dementia patient.