In addition to BPD, my Mother also has Intermittent Explosive Disorder, which falls under the umbrella of OCD. She drags her caregivers out to shop and then returns bags of unwanted items the following day yelling "Bitch" at the store clerk when she questions why Mom didn't sort out all the receipts and items before coming to the store causing long lines. Some of the receipts were from different stores. She can no longer walk very well, losing control of bowels, she's driven up on the sidewalk, memory impaired, paranoid distorted thinking, and calls 911 on a weekly basis and goes to the hospital for breathing issues. Her careprovider who just quit said she was selling her pain medication as well. I have informed her support team, and all agree she needs assisted living, but Mom is hell bent on staying in her apartment. She insists she has all her faculties, and clearly she does not. She is not going to go willingly. How are these situations handled??? She cannot stay home abusing care providers. I am supposed to take her to her doctors appt. today; I've never met him before, but today is supposed to be the big day he tells her it's time. Thanks for any support!
Also, want to add that I spoke with both her doctors, and stressed the fact that regardless of the MRI not showing Dimentia, BPD should clearly show a reduction in grey matter in four areas of the brain. Also, there is a new medication just out called "Tapentadol" which works on Aggression, Pain, and Depression. Studies FINALLY confirm that abused people have a deficit in natural opiates, inhibiting feeling pleasure, so this low dose of opiate may help many sufferers. Thus the opiate epidemic....Hope this info is helpful to readers.
I had posted this before about how a neighbor of ours whose parent was extremely difficult and needed the care of a facility; would not leave her house. It is extremely sad when this happens, they had all four siblings there to help her move and finally had to resort to the doctor giving her anxiety medication so that they could get her to agree to go.
From all you have said, she clearly needs care and to live at a facility. Maybe someone else on this forum will have other ideas. Thinking of you and hope the doctor visit goes well.
I too love this forum for support because I do the caretaking alone and it's real hard. Sometimes you need to hear from others about how to handle things. We are born knowing how to do this.
I also had a discussion with my nephew about putting my Mother in a AL or NH because she is taping me out. I'm not sure how much longer I can stand this crap. My temper is hair-trigger because I've been used hard like a recehorse and put up wet. Yet, more demands are made like a machine that runs flawlessly 24/7/364. (Not happening.) I've been to the emergency room 4 or 5 times since last November with stress related illnesses and last time they sent me to P.T. because it's affecting my physical health. My emotional health is pretty ragged too despite my being a very strong person psychologically. We all need each other.
MRIs rarely show dementia. A clean MRI DOES NOT MEAN no dementia.
Clmtqm: If the doc does not do something serious about your mom's situation, the least he/she can do is take steps to help get her drivers license revoked. Ask him about that by phone. Also, a referral to a geriatric neurologist could be very helpful to assisting your mom's situation. Jeanne can tell you a lot more about that as she has gone through 9 years with her husband and his specific form of dementia.
There are medications that can help with dementia, but your mom has additional emotional problems and someone who can grasp the big picture would be best. Some drugs might be eliminated while other added and then it is a wait and see.
It would be great if you could have your mom someplace that can be sure she has her meds and is followed carefully to rule things in and out. My guess is that would be a closed facility suited to those with mental issues. I don't even know if such things really exist and getting your mom there would be next to impossible if not doctor imposed.
Take the first step with the Assisted Living. So sorry for all you are going through and for the many issues your mom suffers with. Sad to say the least.
Stay in touch, Cattails
1. She must wear a life-alert monitor around her neck. 2. Must have full-time, max hours care provider. 3. Must take and pass a written/drivers test within the next few weeks. If she can't meet any one of these obligations, she goes to Assisted Living. Mom asked the doctor, who's going to put me there??? He said, you can go voluntarily, the easy way, or the State will take you the hard way if you can't control your behavior. (which she can't due to Intermittent Explosive Disorder, and BPD. Without DBT therapy training tools, this will never happen.) The doctor doesn't expect her to pass the driving test, and to be honest, he actually said, "I set her up to fail, because she HAS to have the kind of help AL provides." Seems he was giving her a tiny bit of space to process the reality of the situation? She cannot keep calling 911 2x a week, falling down, abusing and chasing off care providers, and endangering herself and others driving. She said, "I have a beautiful apartment, and no one is touching my canopy bed!" He said, it will be moved to AL. I would think she's in a bit of a panic. She did call last night and apologised for leaving that message on her recorder, and to tell me the doctor visit didn't go well, but wouldn't elaborate. I think the doctor handled the situation well. Any feedback is appreciated.
Hope everyone has a great day.
Now you have to let her situation unfold. Maybe you can provide information on AL facilities, or have your brother do it. Maybe you just stand back and watch now. But getting others to help, like this doctor has, is exactly what is needed. She will fight you the same old ways. She will fight, but less effectively, people who are not her kids.
Keep expecting her to behave the way she has, rather than expecting or even wanting her to change stripes. That will make visible whatever the next steps need to be. And it will make more visible the steps you no longer need to take (going into a personal code red, for example, when you hear she has gone to the hospital or called 911).
You're doing great. You really are.
DEMENTIA TESTS: 3 main tests. Different yet similar….
1. Folstein aka Mini Mental State Exam (MMSE) - 30 point test. Takes about 10 - 20 minutes & looks at math, memory, orientation, basic motor skills. Is copyrighted & needs training to do, so usually done by residents, student MD’s or trained staff @ teaching hospital or nursing home with teaching hospital staff.
2. Mini-Cog: a 3 item recall & a clock drawing test. 2 -3 minutes to do. Should not be used alone as a diagnostic.
3. Memory Orientation Screening Test (MOST): 1. Memory -3 word recall; 2. Orientation - to year, season, time, month etc.; 3. Sequential – memory for a list of 12 items; 4. Time – organization and abstract thinking using a clock face. Takes 5 - 7 minutes. Gives a score from 0 – 29.
Other tests: If Frontotemporal dementia is suspected, can have an Addenbrooke’s Cognitive Exam done. Not all dementias are the same: orientation, attention and memory are worse in ALZ; while language skills, ability to name objects and hallucinations are worse in other dementia’s.
Data analysis found the MOST to be more reliable over time and more accurate in identifying cognitively impaired patients than either the Folstein Mini Mental State Exam or the Mini-Cog. The MOST also measures changes in a patient’s memory over time. This permits the doctor to identify progressive loss or positive responses to treatment.
Having a baseline tests done & repeated is really helpful to be realistic about what careplan to take and see if medication is making a difference over tme. Same with scan on brain shrinkage & what part of the brain. As Jeannie and others have said an MRI cannot diagnose dementia. There is no 1 test that can do that as there are many types of dementia. If there was I'd buy stock in the company and stand back and watch the cash flow in.....lmao!
My mom still has the mini cog done about every 90 days and until last year had a MOST done regularly (her score got to 12 or 13 twice so only once a yr for her now) but she is in a NH and her MD is with a gerontology practice affiliated with a medical school so is a part of a larger study.
Good luck and keep a sense of humor through all this.
See All Answers