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I feel like I live in the land of Loony Toons. Everything seems upside down, but I don't know how serious it all is. My mother has been going more off the deep end the last 2-3 weeks. She seems normal enough except being more emotional. She cries at the drop of a hat and threw a tantrum this morning that shook the house. I can handle these things, though they aren't pleasant.

My mother's obsession with something being wrong with the floor has gotten worse. She thinks the house is on stilts and cracks between the floor boards are letting cold air in. Nothing is wrong with the floor, besides being old. She has had this obsession for over 2 years. I bought huge rugs to put down in the rooms she uses. They cover almost the entire floor and are quite thick and heavy.

A few minutes ago I went into her room and she has her whole floor covered with comforters and towels. The rug and bar floor were totally covered. I could barely walk on the floor without tripping. This is what worries me about the craziness. It is an accident waiting to happen.

We went through this before I bought the rugs. She would put towels down, I would pick them up, she would put them back down. I keep handling things like this is something normal, but my insides are saying that living has gotten to be frakking nutty. And actually I don't know what needs to be done -- ultimatums? NH? Living with it and hoping for the best? I thought about talking to my brothers, but they don't care. One would tell me that it isn't so bad, that old people do this, and the other would say do what I think best. I would much rather hear from people who have been through this type of thing about things to do.

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I've not been thru this particular situation...and I, like you, would be worried about her fall risk with all that stuff on the floor.... what meds is she on? Is there anything that can help that anxiety..... tough choices for you ..... in and of it's self, it's not as serious as some things they do... but this would make me crazy..... and I guess there is no redirecting her.....
What has her Dr. said about this???? At some point this would be so crazy making I would , like you, feel I need to make some tough choices just to keep my sanity.....please let us know what happens, and hopefully others will come on and share similar experiences.....

My worst situation was Ruth always trying to leave.... could not even go to the bathroom that she wasn't out and down the road.... that was simple to fix... all door had double locks that I had the keys for.... but she would pace the floor for HOURS trying to get out.... and getting more upset by the minute.... felt like I was locked up in an asylum...WITH the crazy.....

No one would believe the things that go on in our homes would they.... just nuts.... do what you need to do to keep from loosing your mind....lots of hugs
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jesse,
i think you should contact doc very soon. i see the "almost " stage of terminal agitation there, or the terminal restlessness that precedes it by only a day or two. i dont understand why hospice isnt already involved. certainly sounds like the final weeks of dementia to me. hospice could be a great comfort to you both because of all the infernal visits by nurse, soc worker, aides. those visits make the patient feel cared for and they enjoy being the focus of attention at this time. my mom liked the company and only napped lightly so she wouldnt miss a visit by them. when the dying process begins an air comfort bed is brought in and confort meds are on hand and ready. hospiss provides anything that becomes necessary to include an aide so you can sleep the last few nights. a broken bone is the destiny of too many elders in their final weeks as their mobility falters and their balace becomes affected. broken bones hurt like hell and are the end of the line for the elder anyway as once they become bedfast they will lose the muscles and will never be getting back up. your vigil must be pretty constant already as shes stumbling around and acting out around the clock. i spent about the last 3 months with mom needing this constant attention. id have to nap when she napped to keep my babysitting gig intact. its a trippy time and definately show time for the carer. i dont know what else to say except get hospice in there. this is what they do -- insure qol thru the final days and make sure the shutting down is pain free. ( knocked out colder'n an icelandic cod )
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" floors " indeed. my mother said she couldnt sleep in her room with no ceiling or roof. it all probably doesnt exite you too much as this point because youve become conditioned to crazy already. thats a good thing. if she starts going off like a popcorn machine of phsycobabble and it doesnt soon pass, an injection of haldol was the ticket for us. didnt knock her out, just took some of the wind out of her sails and kept crazy at a dull roar. i remember hauling home 2 haldol injections so mom lasted 60 days after trippin balls set in.
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Thank you, Ladee and Capn. I am not sure if she is ready for hospice or not. She is still in the moderate dementia category, with most of her memory intact. I do plan on calling them in when her time grows near if she is still at home. I believe very strongly in hospice.

Ladee, her doctor has been on maternity leave. She'll be back next week and we have an appointment. I need to talk to her about what is really going on with my mother. My mother is so meek and normal acting at the doctor's that they don't get a clear idea. Maybe her doctor will have an idea for a good medication for the obsession. She currently uses Ativan, but since she has been on benzos since she was in her 30s, it may be like water to her.

The things on the floor are a huge concern. My mother says she will not trip, but she is so unsteady on her feet already. She shuffles when she walks, barely lifting her feet 0.5" from the floor. Her walk is very similar to someone with Parkinson's, but more side to side. She holds her arms stiff at a strange angle to keep her balance. (She is severely stooped with spinal stenosis.)

While I am writing this, I am remembering my father's last fall. My mother had dropped a towel on the floor after her bath. He went to his room and tripped on it. Those towels can be very dangerous, but she doesn't understand. Maybe I should remind her about Dad falling on one of them. That might register. I also learned from her that a few years ago when he fell and broke his hip, it was because he tripped on a towel on the bathroom floor. I might have to start locking up the towels and blankets, and dealing with the tantrums.
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Haldol or Seroquel -- I do wonder if they might work without making her fall. I don't know much about the latter drug.
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Jessie..... My mother in law has increased confusion when she has a UTI. (urinary tract infection). Since she is moderate dementia, you may want to see if you can get a doc appt tomorrow. She could have some other infection brewing. The obsessions are hard to deal with......this is what she perceives and all the talking to her won't help. You may want to have the doc try something a little milder.... like zoloft or celexa. We had to put my MIL back on celexa(citalopram) for agitation and it seems to help. Gonna be a long night for you........hang in there!
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Jessie -it is time for a revaluation of your mother and her needs? It does look like a high risk for fall situation. I have seen that you have been getting more and more concerned. I doubt ultimatums would work, but you never know. The time may have come when home is not a safe place for your mum. (((((hugs))))
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Jessie~My mom was obsessed with her financial and medical files. She went through them daily, hiding them in different places, accusing me and sis of stealing them. Then mom started calling a couple of her lady friends accusing them of stealing the files too. I called the dr that day and took mom in to get her on an antidepressant for her agitation and anxiety. He prescribed Citalpram as norestforweary said. It worked. Mom is still on a low dose with no side effects, however, it can cause the urine to be orange. The dr. said it is not anything to worry about. My mom has been taking it since 12/31/12 with great results. Big hugs to you, this is a hard phase.
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what your calling moderate i would call late stage. the floor covering is not moderate crazy. its delusional and sometimes hallucinogenic behavior and more indicative of late stageby my experience .
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Jessie, what was the outcome of that crazy night?
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norestforweary, the next day I picked the things up. She didn't put them back down until yesterday. It started again. Today we went to the doctor and had a slight UTI, so my mother is on Bactrim now, which worked for her last time. Maybe we'll see some improvement if it was a UTI setting in. That would be wonderful.

She has an appointment with her regular doctor Monday. Her doctor has been away for 4 months on maternity leave, so I feel we are starting over. The doctor only saw her twice before going on leave.

One thing I am having some issues with is the dependability of her clinic in Birmingham. It is the McDonald Clinic with UAB. When I call them to make an appointment, I always get the voice mail. Sometimes they will call back; most of the time they won't. The same is true for ordering refills on prescriptions. The service is so hit and miss that we've looked for another doctor. Many doctors don't know anything about old people, and many gerontologists now won't take Medicare -- shocked me. I really feel that we don't have a PCP for her, because the doctor is so inaccessible. I'm glad we have the urgent care facility here. It cost a lot, but at least we can get in.
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JB if she continues with her idea that cold air is getting in, one off-the-wall idea I had was to get her foot warmers. You can buy heated inserts to put in shoes or heated booties you put in the microwave. If her feet were warm, maybe the idea that cold air is coming in would go away? My mom doesn't have dementia, so my idea may not work at all, but I thought I'd throw it out there anyway.

I'd also consider getting some audio/video of her in her hallucinations that you could privately show to the doc. You wouldn't even have to video her face, just her voice talking, so the doctor can hear what you're dealing with. Good luck with getting a better doctor who is more responsive to you and your mom.
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I think the covering the floors constantly sounds a bit like some OCD behavior alot of AZ pts get. For my Dad its the car one day, missing $$ or "something"he can;t remember but we have to search for anyway. Dad is nowhere nearly ready for hospice, it's just part of his disease! And boy is it sometimes impossible to redirect him! Namenda did help tons.. I am all for meds!
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Well, guys, I think I've been hoodwinked again. Either that or this was the fastest curing of a UTI in the history of man. After starting her medicine yesterday afternoon, she was cured this morning. I'll keep her on the antibiotics just in case.

I wish I could see the test strip the clinic did on her yesterday. I would like to see how positive it is. As it is now, all I can say it's a miracle! :)
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My Mom fell 10/12/13 & 10/19/13. We were Medivac'd to the nearest city where she was in orthopedic surgery for 5 1/2 hrs. Today's 2/21/14, we are still in recovery. I work full time & had to hire caregivers for 3 1/2 months at $1,000 per week! Not fun. Don't let her fall! I agree with everyone that you should take her to the doctor and recording her is an excellent idea!
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So JB did you see any change in your mom's behavior now that she's "miraculously cured" of her UTI? Is she still putting down rugs and towels?
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My mother has had the similar shuffling steps since last summer when she was officially diagnosed with normal pressure hydrocephalus just based on her walking movements. She has since mentally and physically deteriorated rapidly and broke her ankle a month ago and will probably never walk again, but thankfully no surgeries were needed, just casting for a month. Unbelievable how quick things can change for the worst.
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SoCalGal, did they put in a shunt for your mom?
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blannie, she took up two big towels yesterday. I was pleased. She put one down last night. So right now we are one towel to the good side... unless she has put more down since. The comforter is still on the floor.
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Blannie, my mom declined the shunt at the time due to the procedure itself, risks of infection, possibility of shunt blockage and the fact that it wouldn't necessarily reverse her effects, just slow them down. She was still cognitive at that stage and wanted no surgeries at her age of 86. Still question whether it would have hurt or helped, it seemed like a gamble at the time.
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SoCalGal, I have been reading on NPH. I am going to ask her doctor if it is a possibility. If she does have it, I don't know what we would do at her age. She has the three main symptoms -- gait, some trouble with incontinence, and dementia. I linked her troubled gait to her spinal stenosis, poor eyesight, and balance problems. No one has looked to see if it might be anything else, though. It would be good to know what is going on with her brain. I have the same concerns about surgery at her age.
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JB if you google "NPH + 60 Minutes" you'll see a very good piece on NPH. I had seen the piece a few years ago and had a neighbor who came back one spring from AZ and looked like he'd aged 10 years over one winter. And he had the shuffling gait. I immediately thought NPH, but how do you go up to someone and say, "Hey, I think you have a weird condition that a lot of doctors don't know about." I didn't find out until about 9 months later that he DOES have NPH. He had the shunt put in and made a great recovery, but then about a year later, he started going downhill again in a rapid way. They couldn't figure out what was going on and he went into the nursing home for a while. He's eventually gotten better and has come back home with his wife. I also have a former co-worker who's dad has it. So it is out there. Good luck with figuring out if your mom has it...I know the shunts can help, but there are downsides to that kind of surgery, as Socalgal mentioned.
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blannie, I've been looking at videos on gait. My mother doesn't have the typical NPH gait. I've looked at videos of other gait problems, but nothing matches it. I will definitely recognize the NPH shuffle if I see it. It is unmistakable when it is advanced.
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Jessie-
You asked about Seroquel, and I will tell you that for us it is a miracle drug. Mom started it two years ago at 12.5 mg a day, at about 4:00 pm.At that tim mom was obsessing about doors and window being locked and would check them again every few minutes. The locked door obsession has been replaced with worry about her children, now all in their 50's, or she hasn't talked to her parents in a long time, or she doesn't remember that she married the man that is here 7.5 years ago. Mom is now taking 75 mg daily, still at about 4 and the obsessing stops once the medication has been in her system for 45 minutes to an hour. Bedtime for her is usually about 6:30 and it also helps her get a better night's sleep. On occasion she still goes completely wacky, then I also give her a small dose of xanax, but that only happens once a month if that.

I would definitely talk to the doc about it, but keep in mind, it may not work for her. As those brains get more and more scrambled it is hard to know how they will react to a new medication.
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Jessie.... glad to hear it was a UTI. It is totally flabbergasting what a UTI will do to an elderly's mind! So glad antipsychotics were not started for a UTI! When she starts acting like that again, you will know what the problem is. As far as prevention, cranberry juice (we give to my mother in law 3 times a day) kills the bacteria that causes her UTI's. Hope you can find a gerontologist for her..... have you checked with a local nursing home to see who they recoomend as good?
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Jessie,
Oh BTW, bactrim can cause diarrhea.... so give her some yoghurt to replace the good bacteria in her system.
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Thanks, norest. She won't drink cranberry juice, because she is diabetic. I tried the cranberry pills with her one time until she started refusing to take them. She doesn't like yogurt. If you ask her, she will tell you that she likes all food. But in actuality there are only a few things she will eat. "Not fit to eat" is one of her favorite expressions when it comes to different things I fix. I only cook one meal a day right now, so I try to make it as nutritious as I can while keeping in mind that she's a country girl. She loves her fried chicken and pork chops. Wouldn't you know I like grilled chicken and don't like pork chops? We are so different.

gladimhere, what you went through with your mother makes me realize that mine is mild. I don't know how you handled it. That would have driven me off the edge. I have to admit that if my mother ever becomes too bad that I will have to have help from a NH. I'm not tough enough, so I know I would crack. People who can handle it are remarkable to me.
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Thanks, Jessie. I love this site and learning from all here as well as offering my experiences to every one else. We all just need to remember to take what we can use and either throw the rest away or save it for another day. I do wish family, particularly siblings got it the way you folks do!
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LOL....Jessie..... my mother in law forgot she did not like cranberry juice and yoghurt!! I just put it in front of her and she eats it or drinks it.... then she says That was good!
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My mother had moderate delusions, prior to going to the NH. She insisted that the china cabinet was off balance and all of her valuables were going to break. She is 100% better in the NH and I find that it is kinder to her, to not have her confused and scared. At 94, she is pretty normal, now.
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