My Mom fooled the doctor about her Memory – How does that happen?
When my mom came to live with me, I changed her primary care physician to my own personal doctor. His office was near-by and I was already familiar with the office staff.
Shortly afterwards, I phoned for an appointment so Dr. Smith could meet Mom and assess her stage of Alzheimer’s. Not wanting to speak about Mom’s symptoms in front of her during the appointment, I requested the nurse give Dr. Smith a note of my intentions and Mom’s diagnosis.
I had already transferred Mom’s medical records and believed Dr. Smith would glance over those prior to our appointment.
Fortunately, Mom was having a good day when we arrived for the appointment. Currently we were at the stage of good days, bad days, and a few catastrophic days, so I felt fortunate this would be a “good day” and Mom would be on her best behavior despite the protest I’d had to overcome to get her here.
When Dr. Smith entered the room, Mom stepped forward, offered her hand and introduced herself without waiting for me. In an almost flirtatious manner she answered Dr. Smith’s questions and kept a conversation running for several minutes.
She spoke brightly about her history over the last 82 years, “she had never been hospitalized, she had never had any kind of surgery, there had been NO heart disease, cancer or Alzheimer’s in her family, she was extremely healthy, and extremely feisty for her age.”
She asked about his life and they were both surprised to learn that they had many family and acquaintances shared in common. Dr. Smith spoke of an “out of state” relative and learned that Mom not only knew his relative but had carried on a mail correspondence with that person for many years.
Listening over my shoulder I was more than pleased. I kept my head down and continued to fill in the blanks of Mom’s “Correct” medical history on the form the nurse had given me.
I could tell by the chit-chat behind me that Dr. Smith was impressed with my mother.
Considering Mom’s stage of Alzheimer’s, her vocabulary was fantastic and recollection of events even better. I had rarely met another Alzheimer’s patient who spoke as well as Mom while in the later stages of this disease.
I hoped Dr. Smith was keeping mental notes because I’m thinking all this chatter will be crucial for his assessment later.
Finally, Dr. Smith turns his back to my Mom and speaks to me, “She’s a delight. You know–“ he lowers his voice so only I can hear, “some of these doctors make mistakes. It’s easy to slap a diagnosis of Alzheimer’s on someone who’s older and just happened to have a slip of memory on a single day.”
He took my hand in his and patted it. “Your mom is fine. I wouldn’t worry about any Alzheimer’s, either. Her memory is just fine,” he assured me.
My jaw dropped! I was speechless.
Dr. Smith had just implied that mom’s physician had made a mistake–or intentionally given her a false diagnosis of Alzheimer’s. I was astounded. My mother had totally fooled him with 10 minutes of gibberish that didn’t contain a single word of truth.
I handed Dr. Smith the Correct record of Mom’s Medical History that I had filled in while Mom spun her Fairy-tale Medical History to the doctor. When he lifted his eyes from Mom’s Real Medical History —his jaw dropped.
My Mother’s Medical History included:
- Hospitalization for removal of Gallbladder
- Hospitalization for Hysterectomy
- Hospitalization for Breast Cancer/Mastectomy
- Hospitalized for 2 childbirths/I was born in my grandmother’s house
- Her sister died from Heart Disease
- Her mother and brother died from Alzheimer’s
My mother had no memory of any of these things. And was totally certain she had spoke the truth to Dr. Smith. When a person with Alzheimer’s can no longer remember a past event, they invent a new one.
Mom had never met, nor was she familiar with any of the people connected with Dr. Smith and his family, including his “out of state” relative that Mom had claimed mail correspondence with for decades. She was only agreeing with him. When she saw the approval in his eye–she made up more stories. Much like a child, she wanted to be right, she wanted to be normal, she wanted to pretend that she could remember.
As you can see from my story, not all doctors are wise to the abilities of the person who has Alzheimer’s to invent or change history. Doctors know the symptoms of Alzheimer’s, they can give the tests for Alzheimer’s and they can diagnose Alzheimers.
But you must live with a person with Alzheimer’s to really know what they do and how they behave. Until you’ve lived with someone who has Alzheimer’s, been a caregiver for that person, and loved that person, you have no idea what it is like to be someone with Alzheiemr’s, nor how easy they can fool you.
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Thank you so much for sharing this story. My mom can fool people like a champ. Then we get home and she can’t remember any of it. I appreciate your insight, it really helped me tonight.
I know the feeling. That’s what Mom would do. Tell a large tale, then forget it. And I’d feel like I was crazy.
Glad you figured it out!
Sandy
I have worked with the elderly for the past five years, many of whom have had varying degrees of memory impairment. Many seniors are very adept at “covering”: masking the depth of their impairment through polite chat and appropriate emotional and affective responses. it is important to not get angry or frustrated with them for trying to “fool the doctor”: this is not intentional: it is an unconscious coping mechanism. This is why it is so important to pay very close attention when dealing with an elderly relative to assess how they are doing and if they are able to care for themselves. It takes careful listening, questioning and observation to detect the earlier stages of dementia. when people are concerned about an elderly relative, I always say “GO SEE THEM!” For a few days, if possible. A chat on the phone or just dropping by isn’t enough. And relying on their spouse isn’t infallible either: very often spouses cover for each other. Go spend a few days with them. Talk to their friends and neighbors. If possible, check out their bills: are unpaid bills piling up? Look at their check book register? Does the balance look reasonable? Can you make heads or tails of the entries? Look in their refrigerator and check some expiration dates, sniff the contents of containers: is food going bad and they do not realize it? Is the house and yard being kept up to their usual standards? ask about friends and relatives; are they staying in touch with people who are important to them, or are they withdrawing? do not rely on the elder’s self-assessment of how they are doing: if they have dementia, their judgement is off!
Amanda,
Thank you so much for such an enlightened reply. I hope everyone reads your comment thoroughly because you have great insight into caring for someone with dementia.
All the best to you,
Sandy
Oh my. This is spot on, a year ago, but we didn’t recognize it. After my mil collapsed in public, the three children (all living in different states) stepped up and in. We’ve now been living with her for four months. We’re just realizing the depth of these difficulties–she has always been a very private person so it has been hard to see. But you’ve just described it. Thank you.
I loved this story! My Mom was the opposite – when I took her to the doctor, she always looked at me for answers. I tried to let her talk and fill in the gaps but she’s just shut up. Anyone who knew Gertie would laugh at that – the woman NEVER shut up!
Lori, I’ve read a few of your stories at (goodgiftsforseniorcitizens.com) and love them all. Gertie sounds like a real charmer.
I was so glad I brought Mom’s medical summary that day. Otherwise, the doctor would have that me a big ole fibber.
~Sandy
My mom did the same thing – she would be chatty and telling the doctor all sorts of things that sounded reasonable while I would sit behind her shaking my hear. One day I walked into her assisted living common room and everyone said “We though you were in Austraiia” Of course I wasn’t and had never been, but my mom had everyone believing I was there at some sort of conference. She was a very very bright woman and was able to cover up her memory loss with completely plausible stories that were absolute fiction.
Hi Jill,
I know. A couple times I would tell my brothers about Mom’s big “tales,” and I was never really sure they believed me. Sometimes I could only giggle when someone believed some of the outlandish stories.
Great memories later, though–
Thanks for your writing, Jill. I enjoy hearing when others were just the same as my Mom.
~Sandy
OMG, sometimes the doctors can be so easily fooled if they don’t have a long history with the patient. I remember a time when we were in the hospital with Mother Dear and the doctor on call came in for a cursory visit. As part of the conversation, he asked if she knew the date. Unbeknownst to him, she looked right over his shoulder at the big daily calendar on the wall. He was impressed until I was a tattle tale and called her out on it!
Ahh, that is too funny!
Yep, I was surprised with my doc, especially since I had called ahead and spoke with his nurse. I told her about Mom’s Alz and said I’d give them her medical history later. Nope, he took it upon himself to ignore me and take her at ‘face value.’ She had him totally convinced that she’d had a long standing friendship with his brother in another state and they corresponded regularly. I had to turn my back to keep from busting out laughing. The funny part was, Mom wasn’t lying– she believed every word she was saying.
I always wondered if he was so eager to dash another doctor’s diagnosis after that.
This is called “social facade” and is very often the case with Alzheimer’s patients, especially those who are highly intelligent. In our community, we have many retired university faculty members. The person comes to the neurologist for “memory issues,” often with one of their concerned children. The doctor will talk to the person and wonder why on earth anyone would think he/she had memory issues. Often, even the Mini Mental Status Exam (MMSE) fails to show the issues they have. However, if the doctor does a variety of tests — MMSE, clock test, neuro-psychological testing, etc. — the doctor can usually tease out the memory problems. This is why it’s important to choose a physician of whatever variety (FP, internist, geriatrician, neurologist, geriatric psychiatrist, etc.) who has significant experience in diagnosing and managing AD patients. Those who are not as familiar with the disease will not be able to identify the nuances of the disease process until the person is in the later stages. Conversely, doctors who are not as familiar with the disease process may improperly diagnose someone with Alzheimer’s who in actuality has some other completely treatable cause of dementia — depression, vitamin B12 deficiency, etc.