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My mom recently scored 23 out of 30 on her MOCA test which the doctor diagnosed as mild cognitive impairment. Her memory decline has been apparent to me and my brothers for a number of years now. My mother has always been strong-willed and worried about what others think of her. She is in complete denial that anything is wrong with her memory. (I think she forgets that she forgets.) She is missing doctors' appointments, asking the same questions repeatedly, at time has had problem with taking the right meds, etc. I need advice on how to gently and lovingly insist that my mom allow me to go with her to doctors' appointment, help her with finances, remind her of dates and so on without causing World War III! She refuses to acknowledge what is happening to her either because she doesn't realize it or she is very fearful, which is totally understandable. So any suggestions on how to deal with a very sensitive and inflammatory loved one with MCI would be so helpful! Thank you all.

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Consider contacting her doctor. S/he clearly sees what is going on.

Ask if they will REQUEST that you be present at her appointments. Ultimately, if your mom is competent, it's her choice about who she has there, but the doctor can tell her she needs "another pair of ears" there to make sure she's getting the instructions correct.

Sadly, folks like your mom are their own worst enemies when aging. They end up getting their choices taken away from them.
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Your mom sounds very similar to my dad, except my dad now has severe dementia. Could you somehow engage her doctor beforehand at the time of her next appointment? My dad’s doctor told my dad he had to bring me along because he had missed too many appointments. The doctor took it from there, and gave him a mini cognitive test and then scheduled him for a neuropsych evaluation. Early on he told my dad he had dementia and that he needed to set up DPOA and that all scheduling communication would be through me. Dad fought receiving outside help every step of the way (& was often quite nasty) and it was always helpful bc I could say “this is what your doctors say you need to do”… so I could deflect a lot of his anger.
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My mother is 95 with advanced dementia and pretty much incoherent these days, sadly. Up until she got to this advanced stage, she insisted she was perfectly fine and did not belong in Memory Care Assisted Living with the 'other stupid morons' who lived there. This refusal to accept reality is known as 'anosognosia'; read about it here;

https://www.agingcare.com/articles/anosognosia-dementia-patients-cant-recognize-impairment-210090.htm

It would be helpful for you to get financial and medical POA for mom, if possible. Even though my mother has refused to recognize her dementia, she was always dependent on my father to do everything FOR her, so giving me POA was no issue for her. She never wanted to manage her life, so she hasn't; she's relied on me to do it for her, but complained about it every step of the way. Sound familiar? :(

Anyway, here is a wonderful booklet to read; it's a free download called The Dementia Experience, by Jennifer Ghent-Fuller, a 33 page booklet about dementia which is THE best one I've read yet, in plain English that's very understandable & helpful:

https://www.smashwords.com/books/view/210580

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

I hope this info helps you as much as it did me. Very eye-opening info.

Wishing you the best of luck with a difficult situation.
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