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A friend of mine has had numerous back surgeries in the past 3 years. A year or so ago I noticed she would ask me the same question 2 or 3 times in a single conversation. It has progressed to a point that now she doesn't make much sense at all. Sometimes she will call me as many as 10 or 15 times a day and the conversation is basically the same every time. She admits to forgetting things, but then says she is getting better. She sometimes says she finally retired from her job, but of course she hasn't worked since the 1st surgery. When I dispute something she says, she gets very angry and defensive. She will hang up on me and then call back and not remember we just spoke. She will sometimes go on and on about what a good friend I am and how much loves and misses me, and then send a text to another friend of ours saying I have never been a true friend, At one point, I lived about 15 minutes away from her but now I have moved and it's over an hour's drive, yet she wants me to come visit. She is married and her mother lives in the area also and neither her husband or mom know what to do to help her, so nothing is getting done, She refuses to follow any advice I or others offer. If she has a doctor's appt., she may or may not go according to her mood. She was recently in the hospital and a mass was detected in her breast. When I encourage her to have it checked out she just talks about her back pain and doesn't want to discuss anything else. If I push it, she gets angry and won't talk about it. I have been very blunt about how I feel ( I had breast cancer myself. ) I told her the back pain she can live with but if she has breast cancer it can kill her. Unfortunately, her back surgery was botched and she can barely walk and is in constant pain. She keeps insisting she just found out about the mass, but she was told well over a month ago. She is only 61 and her previous job was top secret gov. work. I really don't know what I am asking for here. I don't know if her memory issues are due to all the times she was under anesthesia, if some of her meds. are messing up her brain or what the issue is. I get annoyed that her husband hasn't done anything, but he just doesn't know what to do. She has had a MRI and EEG and both were normal.
I know this is long and only really skims the surface. I just know she needs professional help and refuses to seek it. I feel like one of my dearest friends is totally gone. I want to help her, but I am getting stressed out just dealing with her phone calls. Maybe I just needed to vent.

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You're describing a 61 y.o. person with severe cognitive impairment. Perhaps early onset Alzheimer's. MRI can't detect Alzheimer's, because many times, the brain looks anatomically normal despite a severe dementia. MRI is valuable in diagnosing vascular dementia, but not Alzheimer's. Her well-being is not your responsibility. I assume she has relatives, including a husband and her mother. You should have a conversation with his family about your concerns. That would be as far as would go if I were in your shoes.
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You can be a good friend.
You can listen.
Do not disagree, with "her reality"
You can encourage her to take care of herself.
If she is married I am sure her husband is well aware of her health problems. I am sure he is aware when she has a doctor appointment. It is his responsibility to arrange care for her NOT yours.
There is a very good possibility that your friend has dementia of some type. And it may have been made worse by the anesthesia that she got for the surgeries.
If you have concerns that you think are not being handled by the husband you can talk to the facility Social Worker and express your concerns BUT do not expect them to give you any information if you are not listed on her HIPAA forms.
The best you can do is keep being a friend.
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Her husband is not powerless. He needs to get her to the doctor for a physical. He can tell her it's a follow-up for the back surgery, but he needs to have her checked out. Her issues could be early onset Alzheimer's, a reaction to anesthetic, or even urinary tract infection. They make some people seem to go crazy.

The husband needs to start stepping up to the plate and taking charge. Her choice to seek treatment is no longer valid. He needs to simply take her. (Definitive statements -- "We're going to the doctor today -- not "Shouldn't you go to the doctor to see what's going on?")

He should send the doctor an email outlining his concerns before her appointment, so he knows why they're really there.

I hope they've gotten their affairs in order (powers of attorney, wills, trust, etc) because if she has dementia, she will not be deemed competent to sign any of those things. The husband should consult a trust and estate attorney ASAP, but get her to the doctor first.
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Barbarasfriend Feb 2022
Her husband has tried his best to get her to different doctors, but he cannot physically force her. One time they were ready to go out the door and she just said she wasn't going. Another time he took her to a psychiatrists and the doctor ask what he had been observing and my friend got angry and walked out of the session. She told me she felt it was rude that the doctor didn't speak to her directly.
As far as her signing a POA, there is no way in hell she would ever do that. She is very headstrong and doesn't believe her mind is getting bad.
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I should have added to my post yesterday that we only know what Barbarasfriend is aware of. She may not be aware of what the husband and or the mother know and what they are doing. The family is under no obligation to inform all of Barbara's friends what is going on. It would be nice if she does have a diagnosis of Dementia so that when she does call friends they are aware of her status and more importantly when she stops calling why she may have stopped.
But I think to be under the impression that the husband is doing nothing is a bit unfair to him.
As far as the possibility of breast cancer, if she does have a diagnosis of dementia it may be that they have chosen NOT to treat it with surgery, radiation or chemo whatever the course that would have been chosen if she did not have dementia.

I always say there are 3 sides to a story. "his, hers, and somewhere in the middle is the truth.
there is another side of this we are not aware of.
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Barbarasfriend Feb 2022
Her husband and mother are quite aware of her behavior. I didn't mean to blame her husband for not doing anything. He has tried to get her to doctors, but she balks at the last minute and won't go. He finally got her to go a week or so ago and the doctor had her records and wanted to do a breast exam and she refused. She has walked out of appointments and refused to wait in the waiting room for one. Her mother and I speak on the phone and she just worries what will happen if she doesn't get help. She is in her 90's but still sharp mentally. Her husband had to call 911 one time and when the EMTs came they ask her if she felt like hurting anyone or herself and she said no, so they said there was nothing they could do.
I just don't understand how she could go down hill so fast. I always thought dementia was a slow process, but it seems like she has progressed in a matter of months. As far as the breast thing goes, she has not had any diagnosis made as far as it being cancer. She just knows something is there, but refuses to acknowledge it. Her husband tells me some things, but he is afraid it will get back to her that we talked and set her off. Their marriage has been rocky for a long time and I admire him for sticking with her through this, but she keeps telling him she wants a divorce and I think he is considering it. Lord only knows what would happen to her then.
I guess my main question is " does dementia move that fast ? "
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Barbarasfriend,
thank you for responding to my post. It does answer some questions that I had.
I think the husbands best option at this point is to talk to the doctor, get them to agree that at this time your friend is not competent and her husband should step in and if he is not POA he should obtain Guardianship.
IF things go back to "normal" and your friend returns to her baseline cognition the Guardianship can be revoked.
If you are talking to the husband about his option and you know him well enough then suggesting that he see an Elder Care Attorney or an attorney that is well versed in Guardianships, Trusts and other such things.
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Barbarasfriend Feb 2022
Thank you. That is a good suggestion. I will discuss it with him. It is difficult to communicate with him except through text messages as she would be very upset if we spoke on the phone. The biggest hurdle for him is she doesn't have a PCP at this point. She has given up on her previous primary care dr. and is reluctant to find another (or she doesn't like whomever she sees.) She thinks she can just go to a surgeon and tell them she has a mass in her breast and demand they remove it. I told her it is much more involved than that. I will suggest to him to see an attorney who specializes in guardianship, etc. Thanks for your help. I know she will always have back pain but I really want my old friend back mentally.
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UTI?
Confusion, behavioral changes in seniors.
May not have the usual symptoms of burning, frequency, pain, urgency, & fever.
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