82 year old mother with panic attacks. What should I do?

"This isn’t bad memory. This is not listening. Because she can sit down and tell me how I should stop eating salt because some doctor on TV said that it will lead to deafness. So she can process info when she wants to, but not when it’s something I tell her to do."

Dementia isn't only loss of memory. It's also loss of executive function and a lot of other abilities. Your mom seems to be exhibiting loss of executive function. Also, she needs to get a thorough check of her hearing ASAP so you can rule out hearing loss. Did you know that hearing loss is a major contributor to dementia? If she has hearing loss, she must get the best hearing aids she can afford. Try Costco. And then she must wear them even when she is alone with no one to talk to.

She can take meds to prevent panic attacks, and she should if that's one of her problems. As for her difficulty in processing info being selective, that's another thing dementia does. It changes day to day.

Please educate yourself on all the things that dementia is before you decide that she doesn't have it. There's more going on with her than you want to admit, and burying your head in the sand gets you nowhere. Start considering placement for mom. Since you must work, keeping mom at home may not be an option for long.

You are deep into denial. You are wanting to make this that mom is comparable to a child who is so busy he/she isn't paying attention. That isn't the case. She is likely in the early stages of failure, and she is panicking at the thought of not being able to hand things. She is frightened. And she can handle that when you are around in easy reach.

The solution here is an easy one. You have friends in your area. One of those friends is going to have to be introduced to Mom and when you leave is going to have to be the friend of the family who calls once in the a.m. and once in the p.m. to check in with Mom, make sure the pump is reset. Ask if everything is OK. And on a chalkboard Mom is going to have to have the phone number of this friend.

This isn't going to get better. This is going to get worse.
Now, if you are seeing a lot of daily panicking from your mom then it's time to see the doc and address this issue. Anxiety is a part of life FOR US ALL--the degree is the question.

Do not stay in denial. It's a bad place to be as this starts to increasingly be a problem.

Mom is doing far less well than you believe, she does have a cognitive decline as many do with advancing age. It doesn’t always manifest in mental abilities lost across the board or in entirety, there are commonly areas of strength and weakness. The living arrangement isn’t working anymore, it was always too isolating for her. I recently told a friend whose mother is being both demanding and unreasonable, you’ll be the enemy jumping through hoops trying to make it all better, and still fail, or be the enemy by moving her to assisted living, where she’ll have a whole group of ladies to bond with and gripe about their ungrateful, mean daughters. The end result is the same. Mom shouldn’t be left vulnerable to loneliness, isolation, and panic. Time for a new living environment, hearing evaluation, and hopefully some good cognitive testing.

You need to get mom to her doctor and get a referral (if needed) to a Neurologist.
There is some cognitive decline happening. This is not selective hearing or not listening, this is not comprehending what she is being told. And also retelling information incorrectly. (sump pump instructions, a doctor saying having to much salt can cause deafness...blood pressure concerns maybe but not deafness.
I think her saying the teacher was disrespectful is a cover for her not comprehending what was said in class.
I do hope mom has assets because you will need caregivers in the future, possibly Memory Care facility.
You might want to look into the Senior Service Center near you and see if she qualifies for any services. See if there is an Adult Day Program near so that she can get involved with that.

"Having trouble processing information" tells me that it is not due to her inability to listen to you--selective or not.

And it is not due to her being 100% healthy, as the tests at the ER show.

Have they performed any tests for dementia? She may be able to pass simple dementia tests, as so many elderly with dementia have done, and she could still present as healthy.

At any rate, your mom's brain is changing. You are seeing the beginnings of this change.

I am basing this conclusion on her age and the behavior you have written about in your post.

It is hard to see our parents and family members change. What I recommend is explaining your findings to a neurologist, and work with that doctor to find an anti-anxiety medication that will help alleviate your mom's concerns. Even a pcp can prescribe anti-anxiety meds. But I suggest a neurologist because of what you're seeing in your mom. A pcp will eventually refer her to a neuro doc.

It was difficult for me to accept that my parents's brains were changing. I ignored their behavior. Until I was knee deep in it, and they required more and more care.

It's time for her to go into assisted living if pushing a button is too much for her to handle. You and your husband can't be with her 24/7 because you have lives. Medicaid and SSI will not pay for her to be in assisted living, but it will pay for memory care at some point.

Being a wife and your Mother's Caregiver, plus the Primary earner in your home is a heavy load. Kinda unrealistic and unsustainable, even if you are Super-woman
in everyone's eyes.

Maybe your husband is available to take on a bit more?

Plan the "re-set" when he will be home?
Reset it now, and then when he is available, on a routine basis,
reset it to that time once every 24 hours.
Did I get that right?

There is always "Respite Care". That's when Mom goes to a facility temporarily
while you take the time off. Someone else cares for her on a temporary basis.
Maybe two weeks?

Sit down with her doctor and talk calming meds and get her screened for dementia. If it's not working for you, it's OK to let her know she needs to move into assisted living. You have done all you can and it is obviously not working. Time for a change. Another option is if she has family in her home country that would take her in and care for her.

I think as you get older, you can discuss so many things everyday living and then also forget so many things. That makes you unsure and panic but afraid to tell loved ones whats really going on so they they reply with anger or something snarky. I agree this is just the beginning of your venture but to make it easier on you, your mom and husband take care of small things and yes have someone come in for a couple hours a day to get her situated and comfortable at house until you get back. Good luck to you!

I am so sorry that this happens to so many of us! I cared for my Father for 4 years, and he was able to stay at home with us, as he wanted. I was very glad to spend the extra time with him. I was not working a full time job like you, and had some help from my husband and kids. The panic attacks when she is alone must be very scary for her, and she really has no other choice than to call for help, so I agree that a doctor can help with medication. (Sometimes meds have side effects that cause additional problems).
I think having your friends or neighbors giving a quick check on her would help.
Great idea on resetting the sump pump for a time when your husband can do it. She may have quit the class from a hearing or compression issue, or maybe the person was very disrespectful??? I agree with your Mother that many people will will disappoint these days. So many people are just so selfish. I think you helping your mom is great, if you are able to do it. Thinking of ways to fix issues as they come up, getting some help from others that are willing, and maybe even some short time help from Care.com. I wish your family the best!

🙏❤️🍀

My mother’s decline started to show with short term memory loss. In the beginning my brother, who didn’t see her often because he lives across country, would get mad because he thought she just wasn’t listening. She was still able to pass herself off as being fine but I was seeing the start of her decline. I asked her doctor to test her cognitive function and the conclusion was that she had mild cognitive impairment. We then hired help for her to take care of things like cleaning and walking her dog, which she appreciated. We didn’t tell her they were there to keep her safe as well since she said that she didn’t need that much help. First it was a few times a week and eventually daily. She gradually needed more help to remain safe. She then started to become anxious and paranoid at night and would call me often during the night. At that point we realized that she needed overnight care as well. My brother was handling her finances and he concluded that it would cost less to place her in memory care than to find reliable 24/7 help for her. Living in fear and anxiety is not a pleasant way to live, no matter what is causing it! She had memories of what nursing homes were like when she volunteered in one during college and she was resistant to moving. I found a very nice memory care facility for her and we finally were able to move her about a year ago. She is doing so much better! She doesn’t have the same generalized anxiety at night since there are always people around to reassure her that she is safe. It took a while to convince her that the staff really was there to help her 24/7 and she did not need to call me then have to wait until I could get there, but now she seems to know there is always someone nearby.
I don’t know what language your mother speaks but for many people on the staff where my mother is living English is their second language. You may be able to find a place where someone on the staff can speak her language which would be more reassuring for her. The same goes for if you start with in home care. You also don’t have to tell her the real reason you have someone checking on her and helping her out regularly! I was lucky in that one of my friends who is an RN was willing to be my mother’s first caregiver. By starting with someone she was familiar with it was easier to get her to accept help. Someone suggested having a friend or neighbor check in on your mother, which also might work. We actually hired my friend since she had far enough to travel that she’d spend a couple of nights with my mother. My mother discovered that it was nice to have someone around! My mother’s hearing isn’t the best but she kept losing, forgetting, and eventually (we think) throwing away hearing aids by accident. She can still manage to follow a conversation as long as there isn’t too much background noise and we also make a point of trying to speak in ways that she can hear clearly. Sometimes she is just too tired from the effort it takes mentally to follow along. I wish she would wear hearing aids but replacing them constantly would be too expensive! She isn’t what anyone one would consider deaf or even having obvious hearing loss so we gave up with that battle. They did help when she did actually wear them though. The biggest clue as to her hearing loss was the volume of the TV when we visited. We were constantly having to ask her to turn it down so WE could hear!
You may need to figure out an excuse to get your mother to agree to a doctor’s visit but that is definitely a good place to start. I would tell the doctor what your concerns are ahead of time so you don’t need to say them in front of her. Don’t assume that she is just being obstinate, she may be covering up for the start of real problems that she is afraid to face well enough that you are not seeing the whole picture. Her anxiety could very well be from the sense that she is no longer able to control her life and that she needs help but fear and denial are blinding her.

So, first of all, I would like to share my experience, some of which is similar, and offer some ideas which may or may not work for you, or for which you may or may not be ready. My Mom also has cognitive impairment, into moderate I think but not official diagnosed -- but the decline has been slow and long. She's also on Medicaid, in New York; and FYI if she's on Medicaid you should be able to get her Medicare premium waived if it's not already as well as SNAP benefits.

I agree that sometimes what appears to be deliberate "not listening" is just the "pothole" nature of cognitive decline. Some days, some conversations, some types of information, are better or easier to process than others. Every time I walk into my mother's apartment -- and she still lives alone, with a part time aide (fully covered by Medicaid, btw), and I live nearby -- I have to remind myself that I don't know who's gong to be there that day or that moment: the woman who is capable of having a fairly sophisticated conversation about the NYC mayoral election, the woman who just accused her aide of stealing her swiffer wipes, the woman who can use email but forgot how to charge her computer mouse, or all three.

The panic attacks and the inability to think are a vicious cycle -- noone thinks well when they're panicked, and the decline of prefrontal cortex capacity makes one less able to self regulate. If she's open to medication, that might be a good first step, although try to remember that anything that works today or this year may or may not continue to work. Also, if she won't take your suggestion for that and feels like she just needs you to be there 24/7, maybe she would listen to a doctor if she has someone she trusts.

It is important also to remember that an empty pitcher fills no glass. You are doing your best, which is all you can do. She may not respond or react the way you would like or hope, and of course you don't want her to be miserable, but I find that sometimes I just have to find a way to accept. If my mother refuses or is incapable of accepting help, engaging in social activities, or whatever, and is unhappy as a result, there is nothing I can do. And if something happens while I'm on vacation, well, that's a risk I have to take because I'm not a spring chicken myself and I will not put my entire life on hold for her. She's 93 years old, but her physical health is such that she has every likelihood of living to 100.

There may come a time when your only option is a nursing home, but it doesn't sound to me like you're there yet, and in any case you can't force her without having her declared incompetent. Also, I find support groups can be very helpful, and if there's a senior center or the like near you, you may be able to locate caregiver services or resources for yourself.

Good luck!

P.S. Is it safe to just turn the sub pump off until the new thing comes?

Magnesium will help. Magnesium alginate comes in pills, gummies and a powder to mix with water. Works like a charm. It would be great if she'd chew a gummy.

Is there a possibility of getting family members to help you? You seem to have a lot you are juggling.
Adjusting the sump timing has probably been done as that was an excellent suggestion.
simple things to rule out are:
UTI
high blood pressure / low blood oxygen level
pnumonia
infection

A neurologist who is versed with aging adults is a good next step.
Please don’t assume she is being problematic on purpose. She probably feels like she is losing control and is scared.
what a lovely home it sounds like she is in! Take any good help you can get- push for it if you have to.
Peace be with you all.

M “says that “people always disappoint me and I don’t need anyone.” Perhaps you should join the club – disappoint her and let her prove that she doesn’t need you. You say that she “has panic attacks every time we are not home”, so it’s not a medical thing that can come on at any time, only about you not being on hand. Yes her health and mind are declining, but this is also about control.

If she goes into a care facility, there will always be someone ‘home’ when she has a panic attack, she won’t be sent to ER, and you won’t be pressured into an emergency work interruption. Don’t lose your own sanity, because this is going to get worse. Toughen up! At least consider it!

Medicaid DOES cover the cost of assisted living in many states. Contact the Elder Care Locator, 1-800-677-1116, or at http://eldercare.acl.gov, or eldercarelocator@n4a.org, to find the Area Agency On Aging (AAA) that serves the city/town in which she resides. The AAA will be able to refer you to resources (including the AAA in your area) that are available to assist your mother, including Medicaid eligibility and behavioral health counseling that may help her identify and process any subconscious issues causing or contributing to panic attacks. After assisting my father through disabilities (in his 70’s) in the early 1990’s, I am a firm believer in good/effective “geriatric behavioral health services” for seniors. Hopefully behavioral health services targeting seniors is more prevalent now, in 2025, than it was in the early to mid-1990’s. IMO (at 80 y/o, with my own history of panic attacks throughout my younger years) many Seniors need to process feelings collected along their Life Journeys just as much as younger people do (earlier the better) in order to minimize psychological barriers that may cause or exacerbate behaviors that contribute to caregiver and other essential support stress/burnout, and negative family dynamics. Blessings to you and everyone who is committed to walking the last “lap” of life with others. Caregiving for three generations of my own family members has enriched my life in many ways, and I am grateful for every “peak” (challenge) and “valley” (good times). Hopefully it has given me some “tools” to use throughout my own final “lap”.

Ohmygosh. You are in denial and expecting too much of your mother!
If you have noticed that she doesn't get it when you explain something simple, and she gets agitated when removed from her familiar setting, you are ignoring the fact that she has developed some form of dementia, and requires a whole new approach.

Has the ER done a brain scan or consulted with a neurologist? If not, That would be your next step. And even if it is "just" panic attacks, or whatever the reason, it cannot be ignored or willed away. It needs to be addressed.

Maybe your mother is just needy for your attention and she doesn't know how to get it, because you are so preoccupied, other than acting out.

If this behavior is causing you stress, then you need a new living arrangement.
If you can't find time for your mother, and don't have the patience for her antics, find somewhere else for her to live. She could be in a senior living apartment, or in assisted living, where she will have other people her age to engage with. You don't need to resolve her social needs. If you want to help, maybe you can find an adult day care or senior center nearby where she can go during the days for socialization.
If you do get her examined and assessed by a neurologist, and there is some dementia here, then you should learn all you can about it, about the progression, and how to interact with a loved one with dementia. There are so many online resources, and we here on this forum have a wealth of experience with this! We can answer just about any question you encounter along the way.

my mom is also an immigrant mother. I am first generation. Before mom was diagnosed in 2021 we also had er visits for panic attacks. I see similarities here. You stated she has Medicaid. Call them and see what programs are available to you. We are a month into have health aides come to moms. It’s a god send and she can stay at home which is what she wants. Plan plan plan.

Define "Medicaid".
Many people do not understand.
Medicare. Medi-Cal. Medicaid.

Also not understanding happens with:
S.S. Social Security.
SSDI. Social Security Disability.
SSI. Supplemental Security Income.

I'm a caregiver for my mother who is 101 1/2 and have ben for almost five years. There's some natural fear/anxiety setting in, natural meaning this seems to occur in formerly self reliant elderly people as they age and doubt their own abilities.
You might want to consider having someone come in and spend an hour or two with her when you are away. She might resist at first. This might be a time to try medication. My personal favorite is Trazodone but Xanax also has its place. Will she take her medication? Hard to say. Do you have power of attorney? You need to. Because you need to get control over the ER visits. If you are the POA you can say no, please leave her in place, she is having an anxiety attack. Being perfectly healthy and only 82, you may or may not be able to get assistance from a local hospice. My mom has been in and out of hospice two or three times over the course of the last nearly five years. We are now aware that she is, at her core, 100% healthy...just really old, and declining ever so slowly. This is not a great situation for you and mothers have this way of making us feel guilty even when we are doing our dead level best and losing our sanity in the process. See if there are cultural groups in your area. The other elders in the group won't reach out, they will be just like your mom...but the sons and daughters who are in the same boat that you are may be willing to arrange for visits that start out as you the younger generation visiting but hopefully evolve into a friendship between your respective elders. (My mother had an amazing life, from WWII to being on a first name basis with President Reagan, so when she declined it was nearly impossible to get her to accept what was happening...then vision and hearing decline makes communication very difficult so I understood why she was not interested in making new friends).

Your mom’s behavior sounds a little like my mom. Without taking the focus from your mom here is how I observe my mom: has always been in charge, doesn’t care to be around people. My mom has melt downs when she can’t find certain items that may be right in front of her I leave notes which seems to help I encourage her to write in a journal routines are good. My mom used to do artwork but just stopped. My mom was diagnosed with possible cerebral amyloid angiopathy. I believe my mom has some depression and memory issues. Dr prescribed Sertraline starting 25 to 50 daily seems to help my mom. Also I bought her large read out clock with date day time They have these clocks with reminders for meds etc. just to share as suggestions . When my mom started acting differently I had no idea what was going on and she is a good fibber. When I inserted myself into her care and gave her some control she seems to be calmer. My mom still has her moments I had to step back to observe and then test what to do and say to keep her calm. I’m her only care giver. I hope and pray my sharing helps for you and your mom. My mom is seen by neurologist and neurosurgeon a couple times a year for each primary etc so I have this support.