My 88 year old mother had a stroke several years ago. She rehabbed well physically, but eventually her short term memory began to decline. Any words of wisdom?

A couple thoughts. First, the pros and cons of a powered-lift type chair are legitimate questions. She's forgotten, for example, that the brakes on her walker are like bicycle brakes. She only remembers that she can lock them, and she's forgotten that they are also useful for controlling speed going down hill. Which again brings into question her vision -- or more specifically her depth perception -- because even the slight grade on a handicap ramp seems to her like a steep incline to her. Second, she's never been "a dog person," which I think is unfortunate. We always had pets growing up, either retrievers, because my Dad was a duck hunter (great family dogs, by the way), or strays that we, as kids, managed to coax to stick around with food. Plus, her mom had several small dogs in her later years. And all my siblings have, or had, pets at some point. But Mom simply cannot warm up to animals. I think its a shame, because the love of a dog is unconditional and so rewarding, IMHO. Cats, not so much. But I love cats, because they are fun, wonderful and fascinating in their unique ways. There is nothing like a cat that deigns to allow you to hold it on your lap and stroke it (to your great satisfaction!) Unfortunately, pets will never be a part of Mom's life. So I guess it comes down to finding what gives Mom a sense of happiness and not trying to impose my values or judgement on how she should react or feel. Again, as a layman, I must say that it doesn't seem to be Alzheimer's. She simply she doesn't exhibit the irritation, anger, lack of recognition, or irrational paranoia, (beyond the frustration she feels with her diminishing abilities) that seem to be associated with alz.

Something is definitely amiss if she didn't even recall that her loved ones died.

From alz.org:

"Dementia is not a specific disease. It's an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as "senility" or "senile dementia," which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging."

My understanding is that dementia is a term that one can liken to a large umbrella that covers a multitude of afflictions, with Alz being the most common and vascular as the second most common, as noted in the ALZ quote above. We did not have mom "evaluated" to determine the cause, mainly because there is not much one can do to treat any of these. She was over 90 and it is not likely to be the thyroid or vitamin issue. A few conditions have an underlying cause which CAN be treated, but in general dementia is not treatable. We attempted to maintain mom in her condo, but the aides hired (started with one hour daily, mostly to check on her and ensure she took her meds from a locked daily dispenser) only lasted a few months before she refused to let them in.

What you are describing is what we were seeing. Initially some difficulty doing "routine" things like paying bills, some repetition of questions or comments and so forth. Nothing to worry about too much. The car came up first, and we had to take it away before she injured herself or someone else. Unfortunately since she was living alone there were other issues that over time we could not witness. We did install cameras, partly to ensure no one took advantage of her, the aides were really there and partly to monitor her - one just inside, one outside and one in finished basement. Eventually she started the OCD behavior, mainly at night (sundowning) - initially this was a few repetitions and eventually became an hour to an hour and a half marathon checking the door lock, sidelights, dishwasher and LR over and over and over. The repetition of questions and comments became worse. It is so frustrating to have to keep answering/discussing the same things over and over. Grin and bear it! If it becomes too much for you, one thing that can work is redirection/refocus. This is like moving the needle on a record that is skipping. This is easier to do in person than over the phone, but generally if you can change their focus onto something else you might get some relief. Of course, it might mean repetition of something else! Getting her to focus on something that interests her and can keep her occupied, or going for a cup or tea or coffee can break the cycle, even if it is only for a short time.

We finally decided mom needed to be in a safer place. She was NOT amenable to moving in with any of us, wanted no part of people coming in AND was adamant that she was fine, independent and can cook (not), so she had no desire to move to AL of any kind (for years she would go to the free lunches and check these places out - now that we needed to go that route, nope! That refusal to move is what brought me here in the first place. You were lucky with mom agreeing to move!)

She managed to injure her shin and end up with an ulcer that delayed her move (literally days before we had the move planned and she could not tell anyone how this happened!), but she moved in early January this year. For the next 9 months she kept asking when she could go home to her condo. My younger brother would try to explain over and over why she could not. She would not accept his responses and would keep asking WHY. Typically she harped on him, not me (thankfully!) During visits, despite her really bad hearing (none in one ear, limited with hearing aid in the other), the repetitions of questions and comments continued. However, one day about 2 months ago, she asked if I could drop her off at her mother's on my way home. Ummm, not today mom, it is kind of late and it is not on my way. Maybe tomorrow. Okay. Her mother passed away almost 40 years ago! This is one topic that I felt was better to avoid the truth. Shortly after that query, she asked if I had a key to the place they had lived in before (not the condo). They sold that 23 years ago! Ummm, not with me - maybe at home, I'll check when I go home. Okay. Again, no need to try explaining. Her reality is changing, moving backwards in time as more and more short-term and more recent memories are lost. This is what you have to expect. At some point, home may be where the person grew up! People from the past may populate their "current" memories.

So, it does progress, there just is no timeline provided to us. It is kind of like how kids grow - some walk or talk earlier, some later, some roll over before you anticipate it, some don't, etc. In most cases, the end result is the same - kids grow up and become self-sufficient. People with dementia decline until they no longer know who we or they are and can no longer care for themselves. Each person and/or cause of the dementia has its own timeline, just like kids grow and learn at their own pace.

From what you have described, it certainly sounds like some kind of dementia rather than any age decline. It is not just brain glitches where you forgot where you left your keys or why you came into this room - THAT is normal. You could have her tested to determine what the underlying cause is, but why put her through that? It is what it is, and there is nothing really that you can do to stop it. What you are currently doing with her sounds great! The only recommendation I can suggest was noted above - learn how to redirect/refocus! You do not have to do it all the time now, but it does come in handy. Use it sparingly now and then, but as this progresses you will be more proficient at it AND thankful to have this "tool" to use! Sometimes it requires making little white lies too, but this is not done to be hurtful, but to avoid hurt! That was hardest for me, as I do not like being deceptive in any way, but it is what it is and sometimes works for the best.

Although a lift chair is an option, I have to agree with akdaughter. Would your mother know/remember that it is a lift chair and/or remember how to use it? Given that your mother is having issues with short term memory (troubles with TV/cable/remote, etc), it may be difficult or impossible for her to learn how to use this kind of chair. It seems like a huge expense to have as a chair (which is all it would be if she cannot operate it!) The rent/borrow option is something you could try, but I suspect it will still be a waste as she is not likely to be able to use it. Our mom asked for a walker, like the others in her MC place have. I brought the one she had for our dad. She does not use it, yet. Even though it is in her room now, she just walks by it and leaves the room. Thankfully we did not have to fork over money for it!!

So keep on with what you are doing - sounds like you have a good handle on it. Many of the suggestions here are good to keep in mind too. Best to have all the tools in your pocket for when they are needed!

Your mom sounds a lot like my mom. My mom had atrial fib and was on Lipitor for quite some time until I took her off. I believe meds and a lack of oxygen to her brain probably caused her lack of a short-term memory. She lived to 97.5 and died this last May. I just wanted to say that my mom was very stable and didn't decline (as one would expect with Alzheimers). Her pleasant personality remained the same but she could remember something one day and forget it the next. Her short-term memory was just about non-existent, but every so often she'd surprise me and remember something newer. I never had her formally diagnosed because it wouldn't have changed her treatment.

It was hard sometimes not to lose patience with being asked the same thing over and over and her inability to solve any kind of problem. But mom never was hostile or paranoid or any of the behaviors that can show up with different kinds of dementia. I was blessed in that way. She lived in Independent Living until her death, with a LOT of help from me. She had her daily routine and as long as she kept that routine, she was OK.

Anger is one of the stages many with Alzheimer's experience. There are anti-psychotic drugs that help with that without doping her up. We took my friend to a geri-pysch ward in a hospital to find the right drug and dosage that would work. That took 3 1/2 weeks, but she ended up with something that worked perfectly for her.

My experience with my mom was similar, although a neurologist diagnosed her with “moderate dementia, probably of the Alzheimer type” in 2010. She moved to AL in early 2011. There was a steady decline until late in 2014 when she became angry. I think her anger was mainly due to frustration at losing control over her life and her inability to remember things. One day she called me to complain that I never visit. I was still in the parking lot of the AL facility after visiting her! We had to remove her phone when she began to make repeated calls to me and calls to random numbers at all hours of the day. She was moved to the memory care wing in February of 2016, and did fairly well until this past summer when she began to decline physically. She died October 28, just a week shy of her 91st birthday. She recognized me as someone she knew until the end, but sometimes referred to me as her sister during the last few months. The anger and aggressive behavior was the hardest part to accept. I tried to joke and laugh with her during our visits, but if she started to get angry, I had to make an excuse and leave before she got too worked up.

I agree with bringing familiar music. Music was the last thing that mom remembered. She liked the old church hymns so I bought an Alan Jackson gospel CD and the staff and I played it repeatedly. Even when she had trouble finding and forming words, she could sing along. If I sang with her, she would sing harmony!

Mom had a lift chair, but couldn’t remember how to use it, or even that it was a lift chair. Maybe you could rent or borrow one to see if it works for your mom before investing in one for her.

She needs to see her physician for a proper diagnosis. You will want to know if it is indeed vascular dementia.

Lots of wisdom and good ideas in these replies. It's clear that many share the same experiences, and more. And I'm realizing that things could be much, much worse. I can't imagine how difficult it must be for a spouse, for example, to care for a partner who is essentially unable to communicate. If nothing else, I'm going to try to be thankful and more accepting that it is what it is, and it could be worse -- as Mom always says (repeatedly :-) "You take what you get and don't throw a fit." And no doubt it will get worse over time. So acceptance and letting go of frustration sounds like a key.

I like the thought that she's happy when I visit, even if she won't remember it. if she's happy for that brief time, good enough. I also like the idea of getting her off cable. Although watching TV is about the only thing she can do, sometimes she gets the cable box and power to the TV out of sync, so there's just static. Then, the other day I stopped by and she had the TV on Channel 1127 -- there's definitely nothing on that station she watches. She's got dozens of recorded shows, however, because she obviously hits the record button while tying to do something else, turn the TV off I assume. Or the remote will just be missing, and she'll have no idea where it is (usually the bathroom). It does make me chuckle sometimes, and I can tease her a little -- but never to the point of making her feel bad. She does sometimes use humor as a way to cope, but I know there's deep frustration with her diminishing abilities. She frequently says, "I used to have a brain," and sadly, being in this condition was the biggest fear she had as she aged.

And thinking about things like misplacing the remote and her then pointing to some random object and asking if that's it, I'm wondering if her vision is getting worse. She also can't see her digital clock very well (it shows the time in big numbers, then day, date and month in smaller figures.) She often squints at it while asking what month it is. Getting her vision checked is something I could be proactive about and it might actually help her.

Also, a powered chair that would assist her in standing is a great idea that never occurred to me.

And of course, I'll continue to monitor how she's doing. Her beginning to lose longer-term memories is concerning.

Anyway, a lot of food for thought, and simply reading the perspectives of others who share similar experiences has been very beneficial.

My friend, Jim, has similar problems. I am his POA and have him in a memory care apartment where he is receiving excellent care. He his physically healthy, but can't remember from one moment to the next what he has been telling me, so I hear the same things repeated over and over. I listen patiently, add my two cents as he goes along, and after about 30 minutes, leave to check with the head nurse or some other care-giver in case there is something I should be looking into. There are no children or close family members near, so it is me as his friend that sees to everything. He is a well-educated black man and we joke about being brothers of another color. It's more than a joke, of course. We very much feel this way. He loves to read, but reads less and less because of not making sense of it without that short-term memory. He speaks coherently but can only speak about a few things. We go through a list of things he and I are thankful for and always end on a positive note. I am grateful he is not alone and eats with his "friends" 3 times a day and that the staff monitors him daily and tells he nurse of any changes they note. He never asks about his wife or parents, so we don't go down that path. He remembers what happened to her and when isn't important to him. I don't mind the repeating himself, but I only have to listen for about a half hour at a time. I would just keep responding in a loving way and voice and have patience. My friend does not have Alzheimers according to the tests and symptoms, nor frontal temporal dementia like his wife had--just a failing memory. Both Alzheimer's and FTD follow particular, recognizable stages, and he is doing none of that. It sounds like your mom isn't either.

My words of wisdom, develop a good sense of humor! Next practice counting to 10. Last but not least enjoy every day you have, because the next may not be as good. It really doesn't matter why it happens, the end result is the same. They simply loose their many of their memories and ability to do things for themselves. I went through this with grandpa in the 90s, grandma shortly after, and now mom is going down the same path. The only thing different this time I have a grandson assisting. Thinking if I teach him well how to be a good caregiver, just maybe if one day I go down the same path, he will know what to do.

My MIL is 91, physically healthy but with very similar memory issues. We just do what we can, visits, short day trips, church, etc. to make her happy. She gets depressed easily. This week we invited our entire Sunday School class to her home for the Christmas party. It was the best present anyone could have given her!! We all had so much fun! Many people her age have outlived their friends, siblings and there are few in attendance at their funeral; not her!! The church will be full!! Her diagnosis is age related dementia. Four years ago she was looking after her husband. She just gave up driving last year after her 90th birthday. She’s been on Namenda but it didn’t help. The dementia is really picking up speed. I don’t believe there’s anything anyone can do. Hope you have a blessed Christmas!🎄

It is possible to have more than one form of Dementia. My Husband was diagnosed with Alzheimer's but I think he has vascular dementia as well. I think it is an easy way out for some doctors to diagnose "Alzheimer's" and look no further.
Alzheimer's is a slow and steady decline where as Vascular dementia can be steep dramatic declines. My Husband had both, slow steady declines then all of a sudden he would not be able to do a task he had done the day before. (He walked on a Sunday and Monday he could not/would not walk)
As far as the medications go. He had been on Aricept for quite a while. Later Namenda was added but that did not last long due to the side effects. I did not notice a decline when he went off Aricept but who knows what the decline would have been like without it all along. 
Personally just from reading your post she sounds like she is doing a lot better than many. If she knows you and can ask about your kids and have a complete conversation you are lucky. (Does not matter if she forgets is in a few minutes) Conversation is the key. My Husband had been non-verbal for almost 8 years and it was frustrating for me and I can only imagine for him as well not being able to express frustrations as well as pain, hunger and other basic needs.
And...does she have a DNR or a POLST in place? If so make sure there is a copy with her at all times also post one in her apartment and keep one for anyone that takes her out.
Give her a hug for me.

Ask your recreational aides about pet therapy (if she has no allergies). Pets bring comfort and happiness to everyone!

Your description of conversations with your Mom sound so familiar. And your Mom sounds a lot like mine as well. She will ask many of the same questions, i.e. about the kids, grandkids, etc. Sometimes she remembers their names (that's a good day!) and sometimes not. But the one thing I have noticed is that she will always remember how someone makes her feel, even if she doesn't remember what they talked about. So, as Eyerishlass said, your visits will be enjoyable and regardless of what you talk about, she will remember that she felt good about it. I've come to the realization that the best I can do is answer the same questions without getting frustrated and make the time we're together fun. Hey - the pressure is off for coming up with something new and different to talk about, right?! My Mom was diagnosed with Alz (after just one session with a geriatric neurologist) but I'm more inclined to think it's vascular dementia, especially after reading some of the responses here. All the best to you and your Mom.

My dad has vascular dementia and after another fall had a CT and it showed quite a bit of white matter in his brain. His decline follows the pattern of decline with this disease from the frequent falls to urinary incontinence. No medications will slow it or stop it. It’s generally gradual but can have sudden "step downs" which we’ve seen. His STML is really bad and he asks things over all the time or repeats the same stories. I just accept it and go on and don’t let it ruffle me as he can’t help it. I do get tired of hearing negative stories repeated though.
Dad likes to reminisce and I often bring up topics to get the conversation going. He still reads his magazines and watches TV but I can tell he doesn’t do it as much as usual.
So I would guess your mom has vascular dementia. You said she has a hard time getting up...have you considered a recliner chair that raises her to standing? You could have Home Health assess her by bring in an OT or PT to see what can be done.

My mum also had a stroke. She remember things from years ago. But not recent things like if and what she has eaten today. Or if we have been out this week even when we go out most days. She has been referee by her Dr to a specialist. They have diagnosed her with vascular dymentia. It goes down hill in steps rather than the gradually decreasing dymentia. So can be as is for quite a while, then it drops down hill all of a sudden. Don't know if this helps you at all. But wish you both well.

Wow, I was browsing the site late last night, and my rather lengthy post was basically spontaneous, not really thought out and borne of a need to just get some stuff "out there." And I wake up to find so many insightful, encouraging and informative replies! There's comfort and encouragement just skimming through them all, and I realize that is exactly why I posted -- to find some support and encouragement, as well as information. Thank you all. I'm going to take my time to read them more thoroughly, but I have a couple of quick responses.

When doing some research (how I found this site), I did consider vascular dementia, as well as the possibility she's had subsequent small strokes that no one caught. Some of the symptoms don't seem to fit, but I'm going to do more research. She has been seen several times by at least one, possibly two neurologists. I can't say if they were geriatric neurologists, but that's how she got on Aricept. Both times she tried it, she got super depressed. With her declining mental and physical condition, there's always been elements of depression, and she's currently on Lexapro. But it was worse on Aricept. At that time she was still living alone, and during most visits she'd end up in long bouts of crying, with an inability to articulate why she was so (or more) depressed. I've never seen increased depression listed as a side effect, but from the perspective of her kids, she was not improving, there was a pretty clear connection to her depression and the Aricept.

I have worried about alzheimer's of course, but she's been seen by several docs, and she does get regular check ups. Mainly for blood pressure, cholesterol, thyroid, etc. And she hasn't shown any changes in her basic personality. She retains her sense of humor, doesn't complain about the caregivers or her treatment, and generally remembers close family -- although she can't remember who my sister's been married to for the last 30+ years, but part of that I believe is because they moved across state 6 or 7 months ago, and she's only seen him at big family gatherings.

So for now, I'm looking forward to finding a little free time to really read all the replies. I can tell there are many good ideas for coping, lowering or dealing with frustrations, activities I haven't thought of, and ways of adjusting my own attitude and expectations that will help.

srjohnson,

Your mom sounds lovely. I say that because you mentioned she was in an ALF. So she agreed to move without months and months of trauma and drama. Good for her and for you!

I know the forgetfulness is frustrating for you as it would be for most folks. It's difficult not to get impatient having to repeat yourself constantly. I agree that it doesn't sound like Alzheimer's. Alzheimer's is more insidious and life-shattering. Like mental illness on steroids. However it does sound like more than just mild cognitive decline (MCI). If a diagnosis is important to you take your mom to a geriatric psychiatrist or neurologist.

As for making your visits more enjoyable or meaningful, they ARE enjoyable and meaningful for your mom. True, she forgets what was said 5 minutes later but in the moment she's inquiring about your kids (as she remembers them), she's realizing her husband hasn't been around for years because he's dead (without going through the grieving process from square 1), and she wants to know if her own mom is still alive. Again, not falling apart emotionally when you tell her that her that her mom is not alive.

Your mom still has her social graces (which tells me right there it isn't Alzheimer's) and is interested in the goings-on of the family. You hit on the solution in your post. You have to stay in the moment. Literally. As maddening as it can be to repeat yourself over and over you're showing your mom kindness and respect and love by being in that moment with her. I know it isn't easy and it's exhausting but you're already doing the right thing.

Maybe old photos would entertain your mom (old photos are the go-to for people with dementia). Photos from her childhood if you have them or photos from your childhood. She may not remember the photos but talking about who's in the photo and what they were doing might capture your mom's interest for a short time. But if she continues to not remember photo after photo after photo it would be best to put them away so as not to frustrate her.

How about music? That's something you can do with your mom without having to talk. I once burned some CDs of Big Band music for some patients of mine and they loved it. Of course nowadays we don't have to burn CDs, we can just put the music on our phones. But maybe if you know of some music she'd enjoy or how about the soundtrack to a musical she's seen?

It's not necessary to see your mom with tricks up your sleeves to keep her entertained but these things might give you a break from the non-stop repeating and might be nice to whip out on occasion.

It presents a picture much like Alz. She needs an evaluation.

Yes, sounds like some sort of dementia. Has she seen a geriatric neurologist for a diagnosis?

I am only guessing, but possibly your mother has vascular dementia. It is different from Alzheimers disease, and is caused by poor blood supply to the brain. It is very commonly associated with heart disease and stroke.

I was puzzled myself, looking back, that it wasn't until my mother's second stroke that anybody said the words "vascular dementia" to me - but it explained so much! Ask your mother's doctor if this is a possibility, and if so where you can find information and support for patients and families.