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My mom has multiple medical conditions, all related to untreated diabetes, severe neuropathy, vision decline, congestive heart failure and severe kidney failure. She has dialysis three times a week. She moved in with us about 5 weeks ago after falling three times in a week. She's much more affected than we realized.

I learned that many people with kidney failure had high blood pressure. High blood pressure can cause damage to nerve endings in the brain. For a long while, the brain re-routes things so that that damage isn't noticed. However after long enough there is so much damage that the brain cannot re-route any longer and that can lead to confusion, memory issues and a loss of cognitive skills. My mom is experiencing this. She cannot remember about 40% of what goes on around her. She has also lost the ability to problem solve. If she tries to do something the way she expects it should work, and it doesn't work, she keeps repeating the same solution and of course it doesn't work. Very sad to see in a woman who was always sharp as a tack. Feels like it came on quick, but who knows? maybe it was slower and we couldn't tell any more.

I know that this is common and I also know it may worsen. There is a race between her cognition and her physical decline. They're very connected, so if one seems worse, the other follows soon after. She has good days and bad.
What have you found to help so that it isn't so shocking to her when she realizes she can't remember? Or can't resolve a problem? I'm looking for tips to help her save face a bit.

Thanks

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Oh, don't worry about it mom. Everybody forget things once in awhile. You have a good memory. Remember when ... ? (ask about an event you think she WILL or CAN remember, or if you think she can't, tell her a story about something SHE did for you or someone else that you remember was especially nice)

Sometimes I can't figure things out either (sit down with her) ... here, let's see if we can do it together, sometimes two heads are better than one ... hahaha
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I try to be honest, but say this is something we can deal with, I say "I love you" and remind her that this is a natural part of the aging process, promise I will always be there for her, and then we try to laugh about it as much as we can. A friend who is an Alzheimer's researcher said easygoing people who can laugh at the world and themselves cope better with dementia than "type A" people, like engineers, who have always insisted on precision. I make sure there is good food available, good music, DVDs, books that are interesting and easy to read, and we try to reach out to family and friends as much as possible to keep things light and entertaining. Simple things like gardening and fresh flowers by the bed seem to be reassuring and grounding.
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1) Don't rely on her to administer or take her medications properly...get those stabilized so there are fewer up and down swings in conditions - my mother old school would pocket random meds to "save for later" then would be taken in duplicate or worse or not taken at all. 2) start dating leftovers and throw them out after four days, food poisoning is an issue not to play around with and make sure not at room temp over four hours. Go through all cabinets for expired foods, too. 3) Distraction works for things currently not remembered by having conversations about things in the past (long-term memory seems to be remain the longest) 4) TAKE CARE OF YOURSELF by finding things for yourself to do away from her - at times I found even walking the dog was my only exercise so I made sure to walk a certain amount of time or distance each outing before returning to my mother's needs. 5) pray for others finding themselves in similar unfamiliar territory and 6) continue to educate yourself about Dementia and network resources out there to help 7) validate her interactions/conversations by being attentive to what she expresses and when she repeats a question or discussion be creative in your responses and try to come up with either answering consistantly the same (controlling your emotions/angers) OR answer a new way each time as if their question or comment had never been said before (this helps your sanity). I've done both ways because some things become a level of positive human interaction where other things can lodge in their long-term memory if repeated enough, especially in matters of safety.
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Compliment her anyway, say she's doing the best she can, and drop it. Change the subject and she will forget. As a nurse, I'm more inclined to suggest the mental decline happened silently with her CHF. Because this (which contributes to high blood pressure) doesn't really have symptoms, her heart congestion started with unchecked diabetes which affected her kidneys. It's like a domino effect which all impact blood getting to the brain. The brain will take nutrients first to survive, and the body will suffer. Her prognosis is terminal, so it really doesn't matter what you do and how you do it. It matters more in how you manage your own response to her condition. Take one day at a time and love her for the time she has left. My prayers will be with you and your family.
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I agree with Stephan - honesty is key. I believe a person must know from the get-go that he or she has Alzheimer's or another type of dementia., That said, I believe trying to keep a person as engaged as possible is probably a good thing. One suggestion: a good adult day program. A good program will have activities that help a person to - as much as possible anyway. which is not saying much - maintain his/her cognition and socialization skills. Just a thought although I definitely do think people must know they have dementia.
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I agree with Stephan and cbhillman. Honesty works in our house and a diagnosis was a real help. It helped my husband know that it wasn't him it was the disease, and his was Lewy Body Dementia. So, we blame it on Lewy.

Also once you are have an open honest discussion in the early stages, you can talk about the future and let her be part of the decision process, i.e. when/IF it gets to this or that point, what are our options. I find my husband is more accepting, when we've had those discussions and even though sometimes he doesn't remember them.
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See a doctor and get a diagnoses. It will help. What kind of dementia is it? What medicines does she have to have?
When talking with her, find even a little crack in the subject to introduce a different subject and she will forget what she was mad about very quickly.
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