sorry, but this is the one time when you need one, to make sure
tha dealing with her assets complies with Medicaid rules so they
will pay for her care once her funds are exhausted.  believe me,
you really do need one;  if she has low income, you may be able
to find legal advice at little or no cost.

Robyn, all lawyers are not alike.   Sorry you got involved with a bad one,
but I have to tell you that our experience was just the opposite.   The guy
we chose was a local judge as well as an elder law specialist.   He was not
only a lovely person, but honest and knowledgeable.   I have NO idea how
we'd have managed without his help, and without all the proper paperwork in
place.

Well, I think that i can help you a little, but isnt easy:

The Chronic Progressive Dementization, (CPD), the scientific name of
that vulgarly called alzheimer, is a quite different question than
depression, different types of psychosis and obviously of sometimes
surprising behaviors of the normal aging, and in the long run much
more serious.

Although the final phase of cerebral disintegration is similar, there
are two types of processes: the one that occurs in young adults or
greater adults, and another different one that it happens in very
greater adults, around 80 years or more. In these, at the final phase
the problem it is "simply" the loss of the vital motivation, the
exhaustion of desire to continue living. Abandonment of dreams, as
Miguel de Unamuno would say on the cession of such dreams that Don
Quixote in favor of Sancho did, and then, obviously, dying.

Persons with risk for a CPD (alzheimer) are those that generally have
an introverted personality, few and restricted social relations, with
and isolation tendency, coping deficit for difficulties and losses,
tendency to depend on others, to had constructed their personal
identity in the shade of another one (the woman of the doctor, the
husband of...) or some other equivalent transference, tendency to be
obstinate to proper painful events or of the others?s life, which is
diagnosed in general like depression.

THEN, IN ANY WAY IT TOUCHES TO ANYONE.

There is nothing of chance?s dependance, neither suddenly nor no
magician in it. Logically with advance into years the probability that
these people suffer a painful loss increases, obviously, like
everybody. With its coping deficit the risk increases enormously when
they have a painful loss, for example her husband who gave or lent the
personal identity, or a  son or daughter who gave sense to their life,
of their work that justified the existence to him, of their corporal
and mental capacity to which he had bet or concentrated, and when not
counting on a familiar network and a social network that stopped its
fall after the duel impossible to elaborate and to go on, the person
collapses.

It is the beginning of the aim. It can have 40 years old (the younger
case than we have was a woman of 38 years), or 80 yo. It does not
related to aging, but only that when they advance the years is more
probable that we suffer painful losses. Until this moment its brain is
totally normal, does not show absolutely anything abnormal and is
totally useless to want to see something in images or less even in
electroencephalograms, that it is something so coarse and inadequate
as a toad arrives of a luxurious piano of tail.
The landslide of the person, its "delivery" as much in the dictionary
of the Real Spanish Academy like in the original dictionaries of all
the languages, is expressed in the idea to wish to die, in the
fixation of the attention in its own one and wished death. Then the
abnormal thing begins, the unnatural thing, the destructive thing,
because in fact we are programmed biologically, ancestrally, for all
the opposite, as it is to explore, to fight, to defend to us, to hunt
(in the literal sense and the symbolic sense), to attack, to ask to
us, to inquire to us, and our attention concentrated in each objective
part of a basic alert status that we never lose, except for when we
slept very well. We are not programmed to give to us tamely, as it is
not it in any animal.

How takes place then the cerebral damage that leads to the death?

To understand this we need to explain some very basic things, although
surprising little known. In the first place that we have nine senses:
vision, hearing, equilibrium, tact, space perception/orientation,
taste, sense of smell, sense of strange it (or familiarity sense) and
of the corporal perception. All these senses, and perhaps others more,
are active in the basic alert status and they have two components: an
automatic one of immediate reaction (one falls in love a light and
blinking, it smells sulphydric vapors, the substance that is put to
the gas tubes to detect a loss immediately, and I separate, etc.), and
another component of recognition, in which the stimuli are sent to the
brain and there it is collated if that information has been loaded.
They are the sensorial recognition systems we have.

Then, EVERYTHING WHAT WE DO, EVERYTHING WHAT WE THOUGHT, BY MORE BANAL
OR INSIGNIFICANT THAN IS, IS RECORDED IN THE BRAIN IN FORM OF NEURONAL
NETWORK IN WHICH  PARTICIPATE  NEURONS OF THIS SENSORIAL RECOGNITION
?S  SYSTEMS OF THE NINE CHANNELS, INEXORABLY.

And those networks that are armed in our brain also were reinforced
when we return to make the same act or the same thought.
But in addition BECAUSE IN FACT ALL IS CONCECTED WITH ALL, WHICH WE
ARE GOING TO DO WAS CONNECTED IN MORE OR LESS STRAIGHT FORWARD FORM
WITH WHICH ALREADY WE HAVE DONE AND LOADED LIKE NEURONAL NETWORKS IN
OUR BRAIN.

Some of those connections have a great importance in the every day
actions and others very remotely: although the door seems to be very
heavy, already we know that the force that we must make to open it
isn't so high. Or for example the natural attraction by rhythm that
are multiple or sub multiple of the heart rate (that we listened for
the first time in our mother's uterus), seems like related with this
indeed. That is to say, to live means to be stimulating everything
somehow what we have done, lived and thought. It seems exhausting, but
it is a fascinating question.

However, when a person fix attention to death, that is something
abstract that does not rquiered any motor or cognitive reply, AND
RESORTING TO THE NATURAL AND AVAILABLE MECHANISM  DISPOSED IN ALL
PERSONS THEY TO BLOCK THE RECEPTION OF OTHER STIMULI WHEN WE
CONCENTRATED THE ATTENTION IN SOMETHING INTENSIVELY ATTRRACTED, THESE
PEOPLE HAPPEN TO BLOCK, at the outset in oscillating form, with
variations throughout a day or of days, THE SENSORIAL STIMULI OF THE
DIFFERENT CHANNELS. It is a biological basic mechanism since we must
be concentrated in the tiger that attacks to us and we cannot disperse
with the colored birds that are jumping back: it's a survival
principle. Who know more the utility of this principle is the
pickpockets of the human agglomerates: one of them produces a smaller
but clear aggression on the victim. In reaction the victim is put in
guard and concentrates its attention on the aggressor, while his
companion removes the wallet or cuts the portfolio's strap, because we
have blocked the tact and the corporal perception when putting to us
in guard in front of the aggressor and concentrating the attention in
him.

The displacement of the attention towards different objectives is a
normal and a routinely task, but in the people who enter CPD process
they are persistently blocking the reception of stimuli by the
different sensorial channels and the consequent arrived to the brain,
so that the neurons of the sensorial recognition systems that comprise
of the sensorial networks doesn't receive stimuli, with which in the
long run lose the synaptic connections and the networks are disarmed.
Something equivalent to the atrophy of a muscle we never use. This
avoid progressively all the recognition tasks. No longer they
recognize, no longer have capacity of recovery of recent events (weak
neuronal networks, with low sensorial stimulation), and however still
can recover events of the past. But not anyone, but THOSE IN WHICH THE
LIVED EVENTS (SENSORIAL NETWORKS ARMED IN THE PAST) WERE POSSIBLE WITH
A GREAT STIMULATION (EMOTIONAL), PROLONGED REINFORCED AND CONNECTED
WITH MULTIPLE OTHER SENSORIAL NETWORKS, LIKE THE DOOR OF OUR HOME AT
OUR CHILDHOOD, by where we did not shelter, by where we shook to
arrive all smeared, by where we arrived to eat, etc.

Thus faults of the systems of sensorial recognition were the more
consistent biological indicators to detect that a person is in
dementizaci?n of this type.

THE PROGRESSIVE DISINTEGRATION OF THE NEURONAL NETWORKS IN OUR BRAIN
BY STIMULATION DEFICIT OF THE RECOGNITION SENSORIAL SYSTEMS IS THE
ESSENCE OF THE DEMENTIZATION PROCESS, AND LEADS TO THE DEATH BECAUSE
AN AUTOMATIC ESSENTIAL SYSTEM HAS CONNECTIONS WITH SENSORIAL NETWORKS
YOU, THAT WHEN ALSO THEY GET TO BE AFFECTED, CAUSES THE DEATH.

Then isn't properly a disease ("signs and symptoms that responds to a
well-known cause"), isn't genetic, it doesn't have relation with aging
(confusion comes from that to greater age is the probability of
suffering painful losses, that are a very frequent trigger one, since
we have already said), does not begin with any damage in the brain but
that concludes in the long run in this, isn't a problem of the memory
but of the attention, and before this one of the desire, and before
this one of the satisfaction search, and before this one of the
biological and psychological impulsions arranged by the will, and even
before the basal state of alert that characterizes to us. One of the
last forms of the expression of the process is the problem with the
memory, but in fact the difficulty to recover events is the last link
of a very long chain, and to have concentrated in it and not in the
attention's deficit of can be the reason of the delayed to understand
the process, we think.

And finally, isn't irreversible, since it is possible and it gives
clear and forceful result, to elevate to those people the self-esteem
and the attention to him, and to permute the abstract idea to him of
death wished by the one of real life that surrounds it, the shade by
the light that surrounds us to all to little that we lend a little
attention, taken care of and love, and inserting it in a new extolling
routine for the dairy life. It is not easy, is an abyss of difference
with giving a tablet, but it is tremendously positive as much for the
affected ones as for which we worked with the protocols derived from
the psycho-social neuro sensorial disintegrative theory of the chronic
progressive dementization (alzheimer).

Prof.Lic.Luis Mar?a S?nchez,
Neurobiologist, Director,
Alzheimer?s  Project Argentina
TE 0054 3442 431442   stopalz@gmail.com    www.stopalz.org

Robyn, you have very little chance to convince AD patients about anything
they don't want to do.  The only way to handle things like that is to
surprise them.
Don't tell them before hand anything that is planned or they will definitely
be against it.  If there is something they like to do, tell them that is
what you are taking them to do; then take them where you want them to go.
(We don't call that telling a lie.  It is a "loving deception" because it
makes it easier on everybody concerned.)  Take her out for ice cream, or to
visit a friend, or to just go for a ride to see something she would like to
see---anything you can think of that would keep her interest long enough to
get her in the car and take her where she needs to go.  You don't ask a
child's permission to take them somewhere, and she doesn't have the mind of
a child.  Her brain is sick and she really has no control over it.  However
you have to do it, get her to the doctor for her appointment.  You are going
to have to do many hard things to take care of her.  Of course, she thinks
she can take care of herself.  All of us who have been there know you will
have some sleepless nights, and lots of decisions to make which definitely
won't be easy.  Just do the best you can with the information you have at
the time, and never, ever feel guilty about anything you have to do to
protect her and make life as easy for her as you can.  In the meanwhile your
life wont be easy, but it will only get worse, sorry to say.  You certainly
have my sympathy for being caught in this situation.  Just know that she
really can't help it, and be as loving and patient as you can.
Gwen

(snip)

I'd make a private

As others have mentioned you and your husband (and the Dr in some
circumstances) need to decide in advance exactly what you need to accomplish
then say whatever it takes to accomplish your goal. If she takes
prescriptions meds, tell her the Dr needs to see her before he will refill
her pills. Just figure out what works and surprise her with it. Help her get
ready but try to avoid discussing anything that would give her a choice
about going or not.

The good news is that the more demented she becomes then eventually the less
suspicious she will be or as interested in money. Her brain capacity to
worry about these type things will probably be gone. The you will be on into
continence issues.

Tonight we told my MIL we were going out to eat. She said ok and got ready.
We were not watching her and were not hurrying to get her in the car. She
dived back into bed and refused to go. We blew it by our not paying closer
attention. You will find that dealing with a person with dementia is one
long series of very frustrating episodes and you will need to learn many
coping strategies or she can drive you nuts. The only thing my wife and I
ever argue over is dealing with getting the MIL to eat. We have learned that
we have to step back and if she doesn't want to eat, she is in no danger of
starving at this point in time. She can drive us both nuts then go take a
nap and when she wakes up she is very pleasant and does not remember one bit
of her previous spiteful acting out. This is par for the course with
dementia and you have to learn to not let it upset you or take it
personally. Her brain is broken.   good luck with your aunt.    AW