Whether she has Alzheimer's or another type dementia is for the Drs to
decide. If she had a stroke she might have vascular dementia. That is what
my MIL has.

From your description it is my opinion that she already needs to either have
a relative tuned in to dementia issues checking on her daily, be living with
a relative 24/7 or living in some type assisted living facility.

Our LO did crosswords for her entire life. After she had a micro stroke and
developed dementia we always wondered how she could continue doing
crosswords, often without the dictionary. Checking over her completed
crosswords gave us the answer - she was just writing down whatever and
calling it good. Sometimes a few words were correct but often her crosswords
did not make much sense at all. We never said anything. If she enjoyed doing
them, let her have at it.

I would not call giving you a head of lettuce to eat being able to cook her
own meals. When our LO was still living alone we would never eat food she
brought out of the refrigerator because you never knew how old it was, how
often it had been thawed and refrozen or whether it was just food poisoning
looking for a victim.

That she is having medication incidents that are bringing her to the ER is
another alarm bell. I would guess that if you were watching her closely for
a couple days you might be shocked as to how she goes about monitoring her
glucose and medication intake. She needs real help monitoring her sugar
levels, diet and AF drugs.

The car wreck was another loud alarm bell. You are fortunate neither she nor
an innocent person were not killed. There were probably earlier signs, like
getting lost on simple drives, that she did not need to be driving.

You need to obtain and read the book  The 36 Hour Day (sister should read
also) and then implement the changes you think will work best for your
family. If you are 4 hours away you can not do much except get the ball
rolling in the right direction. Don't count on things staying at the level
they are now because they won't.

You have many difficult decisions to make.  Good luck.   AW

The 36 Hour Day info from Amazon   http://tinyurl.com/2ufcno

If you stand back and squint at the situation for a bit - the bells in
your gut should be clanging for a 3 alarm fire.

Your mother should not be living alone. She is really at the point
where she needs someone there with her 24/7 (i.e. either living with a
family member or in some sort of assisted living). As you probably
know, there are many types of assisted living, including facilities
that offer graduated care, so the person can maintain a degree of
independence, but get whatever level of support and supervision they
need.

You already have vivid evidence that she cannot manage her own
medication or monitor her own condition. She is on dangerous
medications, and has some serious health issues, and this alone should
give you pause. If she's having periods of disorientation, she can
overdose, have a fall, leave the stove on or taps on, or just collapse
entirely - and no, its not good enough to have a loved one call her
daily. She needs eyes on her to monitor whats going on several times a
day, and she should not be left with medications in her current
cognitive state.

You also have reason to believe her judgement is impaired, and that
she may not be capable of properly preparing meals for herself
consistently i.e. how sure are you that she is eating properly, and
that the food preparation is hygienic - i.e. properly washed, properly
cooked, not keep past its prime etc. She is a diabetic and elderly - a
proper diet is important, and cooking is a complex activity. We had a
relative who had all her marbles, but got into the "tea and toast
syndrome"...except that her tea and toast came with chocolate
bars...and it DID seriously impact her mind and her health before her
son stepped in.

Further, you have evidence that she is not dressing appropriately -
which is also a red flag that personal hygiene may be hit and miss.

She needs eyes on her daily to make sure she's okay, is getting three
good meals a day, is clean and safe, is bathed, is dressed properly
for the weather and the situation. Being just a phone call away
doesn't cut it at this point (and I'm not being harsh - I've been in
your shoes with my own mother in law, as we kept her living in her
apartment as long as we could, with us just a call and a 15 minute
drive away).

Don't wait until something awful happens like a fire, or an overdose.
You've had enough overt evidence that a change in her living situation
is needed. I would pursue the medical end, but don't wait for a
diagnosis or assessment to get you moving - your family has enough
clear indicators in hand that Its Time for a change in her living
situation.

M.

You have gotten some excellent advice from the people here, but please be
aware that there are medications she can take now that may slow the progress
of the disease, but not cure it.

Also that she needs a full gerontological checkup to determine exactly what
is causing her cognitive issues.  The good news is that there actually are
illnesses that look just like alzheimers but are reversible with treatment.
The bad news is that they are rare, and more often it is what it looks like.
You need to know which it is so you can proceed.

I also agree that she cannot be left alone anymore.  No matter how it
appears that she can function alone, she cannot.  My mother in law burnt all
the handles off her cooking pots, and once forgot how to turn off the water
faucet in the bathroom.   She kept turning it this way and that, and luckily
my husband caught her struggling with it, and went in to shut it off.    She
also got sick from eating spoiled food or from taking too many pills or
both.

Good luck to you and your family in this difficult situation.  We, (all of
us here) have all been in your proverbial shoes ourselves.

There isn't much I can add to what people have already
said except to say that some Assisted Living residences
are really nice places to live.

If you can find a good one and your Mom can afford it (it
costs a lot more than living outside), she'll be relieved of
all cooking, cleaning and shopping, she'll be able to make
friends with people who are always around.  There are
usually some sorts of activities every day from music to
cards, to exercise classes, etc.  There will be a nurse who
can ensure that she gets her correct meds each day.  And,
very often, the buildings and grounds can be quite lovely,
maintained by professional gardeners and repair people.

Leaving a home one has lived in for years is very hard, but
this could still be a very positive step for her.

   Alan