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My grandmother was diagnosed with mild onset dementia about three years ago. CT scans had shown TIAs to be the issue and she was prescribed Risperidol for the hallucinations/paranoia/delusions. She was better and off that within a month. Fast forward three years and, almost overnight, she has declined immensely with the same symptoms. The CT scan, blood tests, and urinalysis have come back all normal for her age. She is back on the Risperidol (at a higher dosage) and there have been no changes. She is still cognitive in her daily routines, always knows what medicines she should be taking and when. Things got so bad we had to admit her into a geriatric behavioral unit in a hospital and she only gets out of her room when her hallucinations have her afraid that someone is trying to kill her from the ceiling (or similar situations). She has been in there two weeks now, without any improvement. I have requested an MRI, but the neurologist only did a dementia evaluation. The medicine is no longer working, her delusions and paranoia are scaring her to death, and she isn’t sleeping well because of it. There are so many varying issues that I don’t even know what to focus on to see any type of improvement. Does anyone have any advice? I’ve suggested cardiology and neurology because I think the dementia is vascular, but because her ekgs always return normal, they see no need to further examine her. We don’t want to check her out of the hospital when she is not better, but we aren’t seeing any improvement and wouldn’t know what to do with her in the meantime if we did take her out in order to see specialists. If anyone has any similar experiences, please give me your input! We are at our wits end and it’s breaking our hearts.

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Thank y’all for responding. She has had a urinalysis done and everything was clear. She didn’t seem to have any slow decline though this episode has been far from what we’d consider dementia and leaning towards a psychotic break. She is cognitive it’s just she debilitated by her fear. This has all happened within a month, so there hasnt really been a slow drop in her health. But when someone refuses to accept the help and only get out of bed when she’s scared, how can you get them to actually listen and realize that she may be putting a lot of this on herself?
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While it has hopefully been looked at, do make sure they have done a thorough screening on your Grandmother for a UTI. While I have no personal experience with this, so many here on the forum have posted such huge problems with Dementia patients having hallucinations with urine and kidney infections over the years, so I just thought I'd mention it. Good luck with your Gran!
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I see from your profile that your grandmother is 89. How old have most people in her family lived? I would ask the doctors about hospice care at this point in light of what you have shared.
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Not medically knowing our grandmother, would be hard to say. It seems she has had a long decline and has for years been in very bad shape. This could be small strokes or vascular events with her history. This could be ANYTHING, but none of it good. They seem to have done a decent workup. There may be nothing further that can be done. How old is your grandmother? Have you discussed palliative care or hospice with physicians? Wishing you luck. Sorry for all you are going through but there would be no way we could diagnose what we think is happening when her MDs with a workup are unable too. Sometimes medications alone will cause problems. So sorry.
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