A Bit of Background on Mom and Dad

My mom was 88 at the time of her fall. She'd been using a walker for 8 years or so at that point. I'd noticed and mentioned to Dad that spring that he was pushing her into restaurants all the time when we met for lunch. She used to walk as long as it wasn't far.

Dad was her primary caregiver throughout this time period. He was 92.

Mom's dementia was not the classic memory impairment of many folks her age. She did have occasional blanks, but her biggest impairment was in reasoning. She was a bit like a five year old who knew she was an adult and remembered her previous control of her life.

She no long drove, my parents ate lunch out each day. My dad hoped to bring enough home leftovers for diner. Breakfast was coffee and something easy. My mom always had a sweet tooth so this meant pastries for her.

She had other health issues as well, heart-failure, and last year a series of micro-strokes that made her more difficult to understand.

The previous summer when she had those strokes, I became mildly concerned about Dad. He seemed overmatched dealing with my mom and her issues. He didn't seem to understand that her decision making was impaired. He had a hard time with the number of drugs she needed to take. He didn't understand how the pharmacy worked (surely if they filled a prescription my mom was to take it). Their mutual doctor's nurse called me because she'd had such a confusing call with my dad over the meds.

I took over the drugs, eventually finding a pharmacy willing to put the daily pills on a punch card for her. Dad never seemed particularly concerned if she lost the card and missed doses. I wondered at least once if he was trying to hasten her end.

I was also concerned that many of the things he had done previously were evaporating. He no longer walked daily. Reading seemed to be gone.

I raised those  issues in the fall of the stroke year with my Dad's doctor. I found myself sent from the room for the administration of his MOCA. I had sat in on my mom's check ups with mom for several years with the same doctor. The doctor assured me "Your dad is fine."

At that point I accepted the doctor's assurance. I had an MD friend that suggested at the next visit I ask for a longer assessment. She knew my dad was a retired microbiologist who taught at a medical school. She thought it possible he could fake out a short test like the MOCA. I noted those suggestions and planned to request this the following year.