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My 90yo mother with visual, hearing, and cognitive impairments lives alone in her condo (at her absolute insistence - AL trial was an epic fail), with home aides three days a week. I live 1000 miles away, my brother lives in Europe. He and I are both financial and healthcare POAs. I manage all her bill paying, scheduling of appts, etc. Her cognition/emotional state is deteriorating but she refuses to see her PCP for anything. I have searched and called and filled out pages of forms and managed to get her an appt with a geriatric specialist who can do *proper* cognitive testing for an evaluation…in 3 months (sigh). They recommend a family member attend the appt. Neither of us can travel to do this, so we will discuss options for telehealth or by phone. But the main issue is: my mother distrusts and despises all caregivers, medical professionals, et al. She tells everyone she ever talks to how awful we are, tells each of us stories about how mean and bossy and controlling and scary the other is. She complains endlessly to us about all her ailments and difficulties, but then denies all of it to professionals. Basically, she tailors what she says to her audience of the moment, and the story changes with each telling. My brother agrees with me that if one or both of us tuned in by phone or telehealth, Mom will confabulate, distort, manipulate everything she says or admits to because she knows we are listening. It would likely be even more pronounced if we were physically present. At least the doctor would not have *that* element of distortion to sort through. Mom has even said to me, after regaling me with symptoms of tingling, dizziness, panic attacks, sleeplessness, itching, etc., that “but then no one believes me because you all think I’m crazy.” At the same time, she fights taking any meds for anything, and tells healthcare personnel that she’s fine, nothing is wrong, etc. So I guess the question is: do we attend this appointment virtually, or not at all? Which might be likely to produce a more valid result? And hope to speak to the doctor separately afterward? This doc specializes in cognition/dementia issues, so presumably knows how to figure out this kind of issue…but I don’t! Thank you, everyone, for this place to vent, ask, and get understanding and sympathy.

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If this is REAL testing with MoCa or SLUMS tests, there is no way to "confabulate" your way around it. The results will be clear.

What is more clear is that your mom at 90 either IS NOW declining or will very soon and you will be getting "the call" which is something many of us here have already had. That call will be from police, coroner, building management, hospital or some such.

I am afraid, if family is to hope to manage for mom, a trip will be necessary at some point. If not, she would be much better to at some point be a ward of the state. You really cannot manage any of this long distance. I got the call from So Cal to No Cal, and it still required the trip and my presences often.

So sorry and wishing you luck.
Let us assume your worst fears are correct, and mom can talk her way out of this?
The worst is that at 90 she may die at home. There are worse deathes, such as sitting endless hopeless days in a nursing home. As an 82 year old ex RN who saw her partner stoke out before her very eyes a week ago last Thursday I can tell you there are worse things than death.
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Yes, you need to attend. Make sure the doctor knows you need a letter of diagnosis on clinic letterhead, so that your and your brother’s PoA can become active. Your Mother sounds like she has paranoia, which is a feature behavior in early dementia (my Mom is in the same phase).

I wish you success in getting her proper care.
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