About once a week, my mother has been having a dementia type episode.

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She refuses to eat or take her meds. She accuses the caregiver of poisoning her food and she's angry and suspicious of everyone around her. She has diabetes, is very visually impaired, uses a walker and is normally very sweet. She fell almost a year ago and had bleeding in her brain. That's when things went downhill more rapidly. She has UTIs very often. She now has a foley catheter because of the UTIs, but it isn't really helping. Every time she has a dementia outburst, she ends up in the hospital because she refuses to eat or take her medications. Currently she is waiting for a psych consult in the hospital ER. She has so many physical problems that it's so overwhelming. The doctors don't seem to know what to do and ask us (her kids) what we want to see happen. Really? Is a psych consult really what she needs? Her main doctor doesn't think these episodes are related to the UTIs. Has anyone heard of using a dementia specialist? What do they do? Has anyone had this type of problem with their parent and found a way of dealing with it without the need to run to the hospital ER? Any info would be helpful?


I can't say enough good things about consulting a dementia specialist. This may be a geriatric psychiatrist or a behavior neurologist who specializes in dementia. Once she has a specific diagnosis then finding someone who specializes in that disease is very valuable. Perhaps the psych consult will narrow things down enough that a referral to a specialist will be possible.

When she isn't eating or taking her meds, what do they do with her in the ER? In general the ER experience is traumatic, confusing, and distressing for seniors in general and especially for those with dementia or other cognitive problems. I would try to avoid the ER if at all possible. (And it isn't always possible, I know.) For your mother, could she not be taken to see her regular doctor in the clinic? Not eating doesn't sound like an emergency that couldn't wait until morning or even over the weekend. (But of course I don't know the whole story.)

When your mother is in one of her paranoid periods, could you go along with her a bit? Could you say, "Mother, I don't think anyone is trying to poison you, but just in case, here is a tuna pouch sealed in the factory and also some sealed applesauce, and some pudding. You can open them yourself and you'll know they haven't been tampered with." And keep sealed bottled water around for her.

How long do these outbursts last? If it is only a few days you may be able to weather them without an ER visit. Perhaps just getting a urine sample in to her clinic to test for UTIs would help.

I sincerely hope the psych consult will provide some additional clues about what is going on and that you get directed to a doctor who can come up with a treatment plan and advice to you about how to handle these outbursts.
All good advice. Thank you! My brother feels that my mother needs to go to the ER every time this happens because she isn't taking her medications. Her doctor never said otherwise.
wendyk123 please discuss with her doctor the specific circumstances under which Mother should be taken to an ER. While all medications should be taken as prescribed, it is more serious to miss a dose (or a few doses) of some medications than of others. Again, discuss this with her doctor. Ideally your mother's regular doctor is a geriatrician. If not, you might consider making that switch unless you are all very impressed and comfortable with her present doctor.

Going to the ER nearly every week has got to be very hard on your mother (and not too pleasant for you, I would suspect). I hope that with the psych eval you'll get closer to resolving the underlying problem and/or you can learn ways to deal with the issues without this drastic response.
She has a psych eval scheduled at the beginning of January. That was the first available time slot they had. She is currently being moved to the psych unit at the hospital. Hopefully they will be able to shed more light on what is happening and how to proceed when my mother refuses to eat or take her meds. Thanks!

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