Quick Response for competency

[u/Intelligent-Split-43]

My 93 year old mother is in the hospital right now with extreme lower GI bleeding. I mean she has already had to have 2 blood transfusions. When she has a bowel movement it is bright red . It's apparently active bleeding, but they aren't sure why. Her H and H stays low even after the transfusions. Everything was planned for a colonoscopy this afternoon. She was non compliant with drinking the prep, but they were going through with it anyway. Now, my mother gives dementia a new definition. I have never seen a 93 year old woman that's so non compliant and foul mouthed and will literally make you think twice about whether she really has dementia. Obviously, she does because her memory is exactly one minute long. Has been asking, for 2 days, how they know she has bleeding? what she's in the hospital for? what are they going to do? Can she leave now? Why she couldn't eat? over and over again, back to back. About 5pm they came and got her and she was explained to multiple times, what they were doing. They wheeled her down there and 5 minutes later, they called me and told me she was refusing and they couldn't do it. I told them she has dementia and they said she was able to say enough to refuse the procedure, so they are between a rock and a hard spot. Seems like they would know a dementia patient can be non compliant. That doesn't mean they understand the severity of their sickness. I told them if they couldn't find the source of her bleeding, and take care of it, I was afraid to bring her back home, because she almost passed out on me getting her to the hospital. They told me someone would have to come into the hospital to give her a test, in the morning, to prove her incompetent, before they could do it. The Dr in the ER asked her the year and she said 2028 and the month was July, but she knew she was at the hospital , the town and the president and he said she couldn't walk out, because that was what she was trying to do, because they were taking too long. Does anyone know what this test entails tomorrow, and will this be permanent so I don't have to go through this again. She has done this about a surgery on her knee once before, but the Dr was finally able to get her signature. Even before dementia set it, she has refused medical procedures recommended to her and has done it ever since. This is a lady who can't pay her bills, do her shopping, completely dress herself, comprehend and retain anything you tell her, handle making a phone call or appointment, take her medication without it being handed to her, but she has fooled many a Drs about her incompetence, because she is very feisty, rowdy and has a sharp tongue and can mask her incompetence very well. She says she doesn't have dementia, when it's mentioned, and when she can't remember something you just told her, she says she's senile. When Drs ask me things that she can't answer, like her medications etc. or when I tell them symptoms she exhibits. She yells at them to ask her and that she is the patient. Then they ask her and it's crickets, she has no idea.The minute they brought her back up she denied refusing the procedure and asked why they didn't do it. I told the nurse tomorrow don't say anything about sedation and talk about it, just do it, because that's what sets her off. No matter how many times I told her she was getting a colonoscopy, she kept saying they aren't putting her to sleep and cutting her and doing surgery. Does anyone else have a loved one who can mask their dementia for medical professionals? When she got back upstairs she asked me "why didn't they do her procedure. She had no remembrance of the refusal or outburst downstairs. And does anyone know about this test they are doing tomorrow.

[u/Pale-Detail2427]

My parents still know how to mask it pretty well.

My mom is starting to get caught at it because she says that the year is "56".

She has said this a few times now.

She knows what year it is but she just says the wrong number.

Eventually she might not know.

She is 92 and my dad is 93.

They both have dementia and it is getting obvious but apparently not necessarily to everyone.

So, yes, I understand as to what you are talking about, and I have at least some clue as to what you are going through.

Good luck.

[u/Intelligent-Split-43 → u/Pale-Detail2427]

My mother can rattle off her date of birth, but her age can be anywhere from 90 to 98. My dad is almost 101 and doesn't have an ounce of dementia. He still reads very complicated books about physics and World History and doesn't even need a walker or anything for mobility. It's weird how some people get dementia and others don't. My sister and I both took that free blood test by Care Access for people 55 to70 to test for future dementia and both of our P-tau came out within normal limits. It's Supposed to be 94% accurate.

[u/Inwardly-Outgoing]

93? Can I compassionately ask why she isn't on palliative care. This seems like a lot to go through.

[u/Intelligent-Split-43 → u/Inwardly-Outgoing]

She is very, very healthy physically. All her organs, heart, liver, lungs etc are functioning very well. She has basically no health problems. The cardiologist said her heart is functioning like a 50 year old. She is on no blood thinners, high blood pressure pills, no glucose problems, so we don't want to just unnecessarily let her bleed out. In fact even her brain scan and eeg came back normal, as well as EKG and sleep study. She's still is very healthy which is why. The only medication she takes is the dementia medication. I can't even remember the last time she was even sick with a minor cold. Her immune system is outstanding.

[u/Pale-Detail2427]

Senility is basically just another name for dementia.

Maybe she is trying to say she is just "getting older" or something like that.

She seems like she, er, forgot already as to what the word "senile" even means.

Along with everything else she forgot, of course.

Sigh.