Neuropsychology Appointment

On the way to the clinic mom told me she’d never received information regarding the appointment, and asked how I knew where we were going etc. I told her Dr. O had sent me information. She seemed only slightly put out by this, probably because she wasn’t retaining what she had just asked.

The front desk asked for the questionnaire they sent out in July. Mom started to gently object that she had no such thing as I handed the receptionist the paperwork, plus the letter I’d written to the doctor, in order to give him a measure of context regarding the last 13 years. We were sent to a waiting area. Soon after, Laura, the gal who does the actual testing, came to get us. Laura told me to return in an hour, and got busy with mom.

The doctor greeted me at the appointed time, saying that mom was taking longer to complete the testing, and we’d reconvene shortly. 20 minutes later, as we walked down the hall, he said, “I hear your mom is very unhappy about being here, and is expressing that she doesn’t understand what the point of ‘all this’ is.” He explained the three of us would meet to go over the questionnaire I’d filled out on mom’s behalf. This struck terror in my heart as I thought he was going to ask mom about each checked box, and circled answer. Of course, he used the document as a guide, and had a 40ish minute conversation with mom. He was amazing with her. She kept her prickles sheathed the entire time.

Mom’s sense of reality, as usual, was completely turned around. She thought she’d been living at the AL community for about four years, told the doctor she lived at her mainland house full time after dad passed away, said dad died from a kidney ailment (which is what her father died from), couldn’t stay on track while answering the doctor’s questions, but was consistent in what she told him, even if it had nothing to do with what he wanted to know about, etc. She assured him that she’d have no problem learning how to use a cell phone or new computer program. Mom, when she had a cell phone, couldn’t remember how to turn it on, much less make a call with it. I sat next to mom 99% mute, only chiming in with a smile or small piece of humor when she looked to me for an answer or reassurance. While I did not actively watch the doctor’s face, when mom’s answers were off base, I did the wide eyed thing to let him know he was hearing fiction.

The doctor asked mom if he and I could have a couple of minutes to chat while she and Laura finished up. Mom was fine with this idea. The doctor used my letter to guide our conversation. The two things he said that struck me most were:

•  He thinks mom has moved beyond being able to be in denial about her disease. He doesn’t think she has the ability to understand she’s ill or impaired any longer, which negates being able to deny it. Subtle.

• He asked me if I knew whether or not mom knew the move to assisted living was permanent. I had to pause and consider this. I replied, “I think she likely has moments where a fear wells up inside that the move is permanent, but then she forgets what she’s worried about.” He agreed with my assessment.

He asked about her financial vulnerability, charity spending, if she had her estate documents in place, trying to burn down the house, leaving the stove on, the car accidents, and her drinking. I then responded to a few of the most egregious tales she told him. I think he gets the picture. He also asked if I had everything I needed, and then offered this: The Dementia Action Collaborative – Dementia Road Map. He’ll have a report to Dr. O soon.

Mom was pretty wrung out by the time we got back to the AL community. Rather than join the Women’s Group, she decided to put her feet up in her apartment. I returned home.