My 81 yr old Mother is in the mid stage of dementia. She has to be reminded to do most anything that is beyond her daily pre-set routine. Although she is not confused, I constantly have to remind her of many daily necessities. For the sake of sparing words I will use one example. She has doctors orders to do daily exercise for a bad back condition, they are due 3 times a day.
To simplify the frequency of exercise I have suggested that she do them after each meal. This has resulted in my having to remind her often that her exercises are due after a meal. She is a kindly soul but is very independent and doesn't like to be constantly reminded. To fix that, I posted reminder notes where she would be sure to see them.
Even though she understands that the exercise is important and claims she likes to do them, I still have to verbally remind her often to do them. It's as if the reminder notes don't exist.
After over 7 months of verbal and written reminders the problem still exists and she sometimes becomes troubled, anxious and defensive when I ask her why she fails to follow written notices when we are supposedly dealing with a memory problem only.
Today she has tearfully accused me of being abusive.
I'm starting to feel like a military drill instructor. What can I do?

, what a great idea!! Sweep the ceiling for cobwebs! Now that is creative.

20 oz. I sympathize with that one.

Oh and one more thing, paranoiah is a symptom. Don't take it personally. I suggest you don't ask why. Just sigh and nod. She doesn't know why.
The other night dad poured a 20 oz cup of juice. I got irritated because of his incontinence and said "Dad, why do you use such a huge cup, that's 20 oz." He says, "I don't believe that". I measured it out.
I shouldn't have. But I got annoyed. You are entitled to your feelings too.

Hi Doc and welcome.
Dad's dementia started many years ago, but it was hard to convince the Dr's until he started showing up there confused.
Your mom probably does have some confusion, so planning and schedules have a new meaning.
My dad checks the calendar the clocks about 15 times a day. Just to be sure I guess.
Maybe you can change up the exercises to disguise them..for instance; Dad recently started Physical Therapy for balance and strength.
He complies fully at the clinic, but not at home.
So the therapist says just give him chores that match his needs.
Instead of lifting a dowel above his head repeatedly, I have him sweep the ceiling for cobwebs, or clip the bushes.
It's not as controlled but it keeps him moving.
Good luck.
Talk to her Dr's before doing this.

Welcome, Doc. Glad you found your way here!
There's a fine line between doing what is considered "best practice" and "due diligence" and what is tolerable for each individual. Many elders resist doing exercises, keeping watch on meds, sugar, etc. They didn't wanna do those things much before and they sure as heck don't wanna do 'em now.

Our parents are having to deal with the reversal of roles - instead of telling YOU what to do, now you - her SON! - are telling her what to do. I tried to put myself in my mom's shoes sometimes. Even though we loved one another and were close and she knew I had her best interests at heart, I think she just plain got tired of my face 24/7 and being told what to do all the time. Our parents were independent adults and now, not being able to do for themselves, having to rely on and take "orders" from us (and everyone else!) just has to suck, yaknowhutImean?

Dementia is not a disease, but a collection of symptoms caused by some disease process or injury. In most cases, it is relentlessly progressive. At certain points, reminders, notes, etc. work. As the disease progresses, they forget the note, cannot override their impulse to NOT do what it says to do in the note, may not really understand the words in the note or visually perceive the marks on the paper correctly, etc.

You, as her caregiver, have to understand and roll with this because her condition is so much more than a simple "memory problem." Most diseases that cause dementia symptoms - Alzheimer's Disease, Vascular Dementia, Pick's Disease, Lewy Body disease, etc. - are progressive and terminal. As the brain cells die one by one, the loss is not only to memory function, but to other bodily processes as well.

There's a difference between "can't" and "won't." Sometimes we mistake our LO's refusal to undertake certain things as "won't" when really it's "can't." Using my own mom as an example, I could have reminded her all the time to drink water, do exercises, etc., but after a certain point, to me it became almost cruel. If every time they see us we're there to push pills, food or some therapy, they get to a point where they don't enjoy seeing us at all - and who could blame them!! If the exercises aren't happening 3x a day, perhaps you can get her to do them with you twice a day. Or once. Eventually, she may not be able to accomplish them at all.

It helps to look at your mom, not only as a patient, but especially as a person. We have to be mindful and respectful of "quality of life." When life becomes an endless parade of meds, exercises, doctors' appointments, etc., it kinda loses it's fun. While proper therapy is very important, people HAVE to have a little enjoyment or the whole deal just isn't worth it!!

Many blessings to you for your loving care. Looking forward to getting to know you & yours.

Thanks for your quick and thoughtful replies. Mom's forgetfulness has been an issue for about 6 years now, it's taken that long for her to get to the mid stage of dementia.

The condition was brought on by a combination of issues. Hypothyroidism, ADDHD and of course maybe her age had something to do with it too.

The ADD teamed up with the dementia and created quite a task to deal with. Therefore, I have problems with her paying attention to the fact that she is forgetful, so she not only forgets that she forgot but can't recall most things that passed her by due to the attention deficit.

I understand there are a few cases out there where the patient's denial over dementia becomes a behavior issue. Mom isn't in denial, she is a victim of a combination of cognitive and attention deficit disorders. She's not generally aware that there even is a problem because she doesn't seem to notice one most of the time.

When she does notice, she becomes depressed and thanks me for my support. That realization is quickly forgotten the next day.

Most of the time she thinks that I'm being a control freak and claims that her memory problem isn't bad enough to require any assistance.

Today she became very upset with me because I asked her if she was remembering to clean herself after a urine accident. She had allowed herself to become quite sore a short while back but now she thinks I'm accusing her of being unclean since I've began to keep an eye out to prevent irritation.

If I try to be more interactive with her, she gets all concerned about me going out of my way and tells me I don't have to do that. She says she can manage it on her own. It's hard to deal with that independent streak.

I guess what I'm doing here is just simply venting my frustrations. I fear that her limited state of awareness combined with forgetfulness and her strong independence will someday turn to combativeness. Most of the time she really thinks she can go it alone.

When I point out the printed reminders she says she knows they are there. She also says she doesn't know why they fail to remind her and doesn't seem to care that they don't. Mom can be quite the stinker at times.

Hey Doc welcome in
I think sometimes where the problem lies is in the reminders and how we communicate them.
How about getting a mat out and starting the exercises yourself and asking mom "would you like to join me"?
I always did/do all exercises with my MIL and my patients and its much more effective, sometimes I have to get them motivated but once they realize Im right there pushing myself they lighten up and are more willing to do it.
Try it out and see what happens.

Hi, Doc. Welcome to ECO. So written reminders aren't workin' for ya. It might help us to help you if we knew alittle more about your Mom's situation, cause of dementia, general health.

The New Care Giver's Meeting Room is a good place to introduce yourself and the circumstances, but diving in is OK, too., It is just a tad too easy for a newby to get buried in other rooms, before we greet you.

None of this is easy, and a frail, elderly woman with dementia might be quite different from your previous experience (which sounds very interesting and useful, by the way, peeked at your profile).

Bless her heart, this is all very frustrating for Caree and carer. Depression is a biggy, sometimes we can avoid it by changing tactics. Sometimes, it does require medicinal help. Changing tactics is usually the first step, so I hope you will fill us in. There is a mountain of experience here between all of the members and someone usually has an workable plan.