Decline or depression? Mom's incapable of making a simple decision.

These can be symptoms of dementia but they are more often the symptoms of anxiety and depression. Severe anxiety is notorious for causing short term memory loss and inability to make decisions. Look up anxiety.

The toll of caring for her husband, even with your help, may be too much. This couple might be so much better in a care setting. It improved my brother's symptoms of his early Lewy's dementia. He got better at once in ALF. Like you, I had already taken over the finances and that helped, but just knowing meals would be prepared, laundry would be done, transit wasn't a problem. All the ADLs (activities of daily life) being taken care of changed things for my brother a lot. The facility told me this improvement wasn't uncommon for their residents.

I would consider a workup. It will be impossible for you to know otherwise. Sure do wish you all the best.

As embarrassing out-loud remarks go, I'd say the one about the Old Hens was rather a sweet one, wasn't it?

But of course your mother's mental health and wellbeing are the serious issues, only I'd suggest that at the moment, while she's subject to overwhelming stresses, it must be impossible to say what is contributing most to her inability to make ordinary, everyday decisions. It could be decline, could be depression, could be simple exhaustion coupled with anxiety about what's to become of the two of them. The poor love must feel like a rabbit in the headlights at times.

It's good to hear that you're looking at options. What has she said about her thoughts?

"She raised a glass to toast my wedding anniversary (months away) right after reading a card congratulating her for her own."

i guarantee you, 100% it's mental decline, dementia starting.
her short-term memory isn't good.

but there's nothing you can do about dementia...
apart from:
...if in the future, her hearing gets bad, try to force her to wear hearings aids. bad hearing = accelerates dementia
...try to have intellectual conversations with her. brain stimulation is good.

hug!!

My mother did not want to go into AL, she fought my brother & I for years, she lived alone in the mountains of NC, watched game shows all day.

She had a slight stroke and became afraid to be alone at night and kept calling the EMT's until they started charging her $600 at a pop. That ended that.

We moved her into a AL here in FL. 3 years ago, and she loves it! New friends her own age, activities, bus trips and she doesn't lift a finger.

It could be depression but most likely a combo of dementia & depression. Might be time to bite the bullet and place them in AL.

My step-mother progressed the same way as your mother is, she is now in MC. Her husband was very sick for several years, she was at his beckon call. He finally passed and she stayed in AL for a year then we moved her to MC.

Take care of you!

My mother lived to 95. She suffered from both dementia and depression both, depression coming on after 2 hospital stays when she decided not to leave her apartment after she got home. Eating very little, embarrassed she'd been sick and wanting to hide out. That was mom acting depressed. I called her PCP explained her symptoms and that I felt she was super depressed, and he put her on Wellbutrin. She was fine afterward and the depression disappeared. This was 2011.

In 2014, mom was well down the dementia highway and that's when her (always difficult) decision making abilities became impossible. Taking her to a restaurant was a nightmare bc of the choices on the menu, then second guessing the choice it took her 30 minutes (And me grinding my teeth) to make 🙄. I had to give her a choice of 3 options myself in order for her to be able to make a decision. And like your dad, then she "should have had" the other thing she didn't order. By the time I dropped her off at the AL, I needed a Xanax myself.

When mom went into Memory Care Assisted Living, they showed her a choice of 2 entrees on red plates (to stimulate appetite). She pointed to one and that's how her decision was made on a meal. When you read here about how how horrible memory care ALs are, I beg to differ. A mc shrinks their large world down FOR THEM and eliminates lots of the difficult choices their brains can no longer make. A smaller, more controlled environment suited to their abilities is precisely what's needed.

To me, it doesn't sound like depression mom is dealing with but effects of cognitive decline or dementia. Those symptoms can take years to develop or come crashing in overnight, everyone is different. Especially with vascular dementia, the steps down the elders take can be quite significant, going from fine one day to very impaired the next.

Best of luck to you.

Whenever a poster uses the word "sudden" it can be a red flag for things like a UTI or TIA. If I were you I'd start by discounting any other physical health issue (UTI is easy to test). Of course it is possible that she also is having memory/decline issues and depression. The goal is to get accurate diagnosis and treat what is treatable.

It's great that you had their hearing tested. Kudos for that!

My Mom is incredibly indecisive when ordering food so I help her pick out her entree and drink well in advance of the waitstaff's appearance and then I relay the order for her. If she gets talking to the waitstaff, she derails the ordering.

So sorry you're having to deal with all of this. Plenty of like company on this forum!

I’d just like to add that your mom is under a lot of stress caring for your dad, and stress is bad for your brain. Things happens to younger people when they’re stressed, too. So not just an issue of age.

if you can afford in home help and your parents are receptive, maybe you could get your mom a break several times a week where she’s not in charge of watching or caring for your dad?

My father started showing some memory and other issues shortly before his death. I’m convinced it was the stress of caring for my mom.

This is aging signs which is related to reduction of the level of dopamine in the frontal cortex part of the brain which is responsible for decision making, abstract thinking, voluntary movement, inhibition among other executive functions, reduction of this type of neurotransmitter can also result to depression,to manage this condition what I can advice you to do is to take your mother to the nearby hospital so that she can be injected with dopamine,,,,,,,, regards Caleb simiyu wekesa,, occupational therapist kenya

They sound exactly like my husband. Very hard, dear.

Others have made good comments, I will just add a brief suggestion I remember reading. Too many choices is overwhelming, so an "either or" is better. But if you are trying to steer a loved one more toward one, list that option last: e.g., "Would you like soda or Water?"

Greetings. First of all, it sounds like you are doing an excellent job. Your parents are lucky to have you. If they haven't thanked you, I will for them. Thank you!!

All answers given are great. One thing not yet mentioned is sleep!! Before my Moms next SLUMS test, her doc wants her depression (lifelong) and sleep (erratic these days) under control. If sleep is not sound and isn't around 6-8 hours, short term memory issues abound, even for young folks. Best to you thru this difficult journey.

Getting a simple dopamine shot will fix the brain? It's not that easy

I’m sorry you are going through this. If your Mom is getting enough rest, then it is definitely some kind of problem in the brain. It most likely is dementia, however I’d take her to the doctor just to rule out anything else.

We don’t go to fancy restaurants any more. First, my Mom doesn’t enjoy it as food no longer taste the same. This is a lady who could take a bite of food and deconstruct the ingredients in the food throughout her entire life and she would regularly try new restaurants. Instead, we have settled on about 5 restaurants and we rotate through them. The owners know us so they are used to our routine. Mom knows the food so it always tastes good to her. A special meal is inviting guests to eat with us.

My sister’s mother-in-law has exactly the problem you have mentioned. She cannot make a decision and if someone makes it for her, she gets upset. They can’t take her shopping, because when she finally gets something, she wants to exchange it when she gets home. She will offer to make something, then want to go to a specific store for the ingredients and then at the store decide that she can’t buy it without looking at other stores for the product. As a result, they don’t take her out and they mail order a lot. For restaurants, they always go out in a decent sized gatherings where others make the food decisions and they share the food, family style.

It sounds like you might want to look into Assisted Living facilities that also have Memory Care. Look for a place where they ensure residents go to meals and activities. My sister’s MIL wouldn’t go because 1) she wasn’t hungry 2) she could not make up her mind to go 3) it was too much effort to decide what to eat 4) by the time she decided to go, the dining hall was closed. She regularly dismissed the person who came to remind her to go to meals, then never went. My sister’s FIL would not go because he was waiting for MIL to go. No one knew that they were not eating meals until he ended up in the hospital due to lack of nutrition and passed less than a year later. Before entry into the facility, he was the healthier one of the two and looked after both of them. Yet in certain areas of life, like food, he would let her take the lead.

Do take her to a doctor to rule out any infections, etc. However, because of her indecision, you will have to start taking over making those decisions for her and your father. Don’t let her medical issues affect your father’s health. Just slowly and subtly, take over all the decision making for both of them.

You sound like you are very capable and observant. Please remember to take care of yourself. I’m hoping that you have someone who you can occasionally share your frustrations with as it will help you with the decision making.

Let someone else help you carry the load: please interview Care.com and Visiting Angels applicants and let Mom help choose her new friend. It sounds like Dad needs the Assisted Living help or Memory Care...........get him evaluated by a Geriatric Psychiatrist and speak to an Elder Law Attorney to figure out how to finance it all.

You can then put Mom in respite care while you vacation.

Aloha!

What you are describing sounds like the beginning of my mom’s dementia journey. She was primary caregiver for her husband, too, and we chalked up her lapses to stress and anxiety. Then he passed away and she got worse, and we thought it was due to grief. But after awhile it became clear that it was more. She has been diagnosed with Alzheimer’s disease (about 3-4 years ago). I encourage you to pursue a move to Assisted Living sooner, rather than later, since your mom will be able to learn her way around, make friends, and adapt to new routines better now than she will be if you move them after her cognitive issues worsen. There is never an easy point in time to make the move, but it does get harder as time passes.

I had a similar issue, though I really can't say whether its depression or not.

I moved in to help my mom when she was facing cancer surgery AND taking care of my Alzheimer inflicted father (similar stage as yours from the sounds of it). I also picked up a lot of the maintenance, management duties of the house.

She was extremely forgetful (would forget major tasks or conversations about agreed upon schedules, etc). For a while I was seriously questioning whether she had dementia or not either and that concerned me greatly.

and ha! I, like you, also try to treat them with things that I would personally have enjoyed only to regret it (turns out their needs are unlike my own, surprise!)

I encouraged and allowed her to spend more time with the people that could help level her; namely her sisters. I allowed her to go travel to be with them and take time off from caregiving to go and just be herself. As her daughter, I am incapable of providing that level of emotional support since I am unequipped for it and don't have enough age to fully empathize & give her the understanding she needs. Fast forward 1.25 yrs later, she is MUCH better and is in a better self aware state. I also allow (sometimes push) her to take responsibility for the things she is fully capable of doing so that I can also ease the load off myself. I could just take over everything but having been a pretty active woman, I think she benefits from having something to keep herself preoccupied.

In any case, maybe helping your ma find herself again could also help clear the air (assuming proper procedural medical tests are cleared).

My mom has depression and dementia. I think they often go together. I'd get her to the doc to get evaluated. The stress of dealing with and caring for your dad is certainly not helping her situation. She could be completely burnt out - I would be! Can their living quarters accommodate a caregiver? A few hours a day could be a real help to your mom. Or I think AL (my mom is in one) would be an even better option. Meals, meds, activities, laundry, etc. It's very helpful and would take a lot of stress off your mom. I'd consider getting a 2 bedroom unit so your mom can have some ME time.

Best of luck.

Also, my mom can not make decisions either. The memory tests really didn't highlight her deficits until her decline continued. I just make most decisions for her and sometimes frame them as "Oh, isn't this one nice mom??" or "I think you might like the lobster roll". Or just taking over decisions when they're just kind of no brainers anyways.

In defense of your father, over my lifetime many times I heard women laughing really loudly in a restaurant and thought it sounded like cackling chickens lol

I just never said it, that might change over time 😇😁😂

Depression can cause cognitive decline since stress steals energy, making basic functions once second nature feel like chores. To figure out more precisely where your mom is on her aging process it sounds like a neurological workup is in order. Then you can create a plan for all of you; your mom may need respite care, and you will have a better picture of when to put plans for their future living arrangements in motion. Everyone is exhausted and on unfamiliar territory; don't berate yourself for taking them out for that nice dinner: a part of you wants things to be 'normal'; try to let your dad's outburst be funny (I'm sure the ladies having fun either didn't notice or caught on to your dad's condition.) Yes, those things do make us feel like embarrassed kids again; just don't put yourself in those kinds of tricky situations again. Have celebrations in settings easier for you and them. Take very good care of yourself.

Just a tip that I do with my mom regarding taking to a restaurant. I stopped that because it was a lot. And Covid hit, etc, What I do now is I set a time when I’m coming over to visit with her (I live away).

I don’t tell her I’m bringing food because she will tell me not to.

I pick a restaurant and then order a bunch of selections so that if anyone else is over there they can have some also, and my mom can keep any leftovers. I know what she likes so I choose for her.

Then I show up with food. I tell her, oh, I heard this place was good and I couldn’t choose and I wanted to sample so I just bought a bunch of stuff.

She always says she isn’t hungry but then she gobbles down a plate (she doesn’t really cook for herself anymore and she likes simple carbs).

If she doesn’t like it, then we complain to each other about everything that is wrong about the food. Lol. When I leave, she insists I take some home, so I do and then I leave most leftovers with her.

This has been a good way for us to have dinner together without all the rigmarole of going out to dinner. (Though I can see how sometimes it’s good for people to get out of the house, but then you can take them for a drive and not have ro stop anywhere)

Pmruns: Perhaps your mother requires a cognitive evaluation by a neurologist. I am sorry that your father made such an outlandish and embarrassing statement at the restaurant.

Agreed that it is likely cognitive decline, but maybe it's a UTI...? Doesn't hurt to have that checked out, and I've heard that can cause confusion and dementia like behavior short-term.

Best wishes--you sound like a good daughter. Try not to get too stressed...easier said than done, I know.

I think your mom has been overworking due to the taking care of your dad,,due to her age also dopamine level in the brain has also reduced this has affected her in terms of making executive functions like decision making,low level of dopamine also causes depression,, what I can advise,is to tell mum to have enough sleep,,do some light exercises,let her listen to her favourite music and also meditation,she also need to have enough rest from taking care of her husband since this seems to be stressing her but she can't speak out

You don't mention your age or your parents' ages. However, if your parents appear significantly older than you, just smile sweetly in public and acknowledge their behavior was noted. People understand that mentally compromised people make inappropriate comments or moves.

As you are noticing Mom slipping, it's time to take some action. It's sadly necessary for both of their safety.

1. involve your siblings
2. Diary her for a month, then take her and the diary to a good doctor. You sit in on the appointment but let her interact with said doctor. Only interject if you hear an inaccuracy, and then return the interview back to them.
3. Start your investigation into care alternatives for them.

All way easier said than done, but for them, you, and your family, necessary. Best of luck to you!

Please get medical and psychiatric exams completed for your mom. Then, you will get your answers and can make a plan of care - for both of your parents.

The embarrassing public remarks are not always due to cognitive decline. For example, my 82 y/o father, regarding a WC bound woman in the doctors crowded waiting room, announced quite loudly "If I ever get like that just shoot me!" His problem wasn't dementia. Just advancing deafness.
"Oh, nobody could hear me", he claimed, when I spoke to him afterward. Looking at other waiting patients, I could tell that most heard him quite well!

How old is your mom? No matter her age, if she’s 24/7 taking care your dad, even with your assistance, perhaps she’s worn out, exhausted and depressed. Perhaps she needs a break, a doctor’s visit, counseling, medication or a spa day. Perhaps hiring someone once or twice a week to relieve your mom and you would help rejuvenate both of you. I know this helped my mom and me and it was only about a month my dad unable to care for himself and he was on at home hospice and just about all his care fell to mom and me. On the third week of care my mom hired home health aids, for three overtime shifts, to sit with dad overnight, so her and I could get some much needed sleep. It helped so much as the last week it was just mom and me and I think we both felt stronger physically and mentally stronger when taking care of dad that final week. Be good to yourself and to mom.