Can psychosis in dementia patients happen suddenly?

A UTI can cause psychotic behavior in the elderly.

daddysfavorite: Yes, my late sister in law, who suffered from Alzheimer's, experienced abrupt
psychosis when she unfortunately contracted the Novel Coronavirus, which claimed her life on March 20, 2021.

Usually persistent psychosis has a basis in changes in health condition in folks with dementia. Parkinson's disease causes Lewy Body dementia which is part of the disease process. Vascular dementia may exhibit psychosis if there are new insults to the brain. Alzheimer's dementia usually does not manifest in psychosis unless it is an adaptation in late stages. Usually, I suggest looking for health changes like pneumonia (which can decrease oxygen to the brain), infections, imbalances in blood chemistry, changes in medications...

Since you are noticing a huge change in behavior, please take your loved one to a doctor for evaluation. In other words, go to the ER. This can be a symptom of stroke.

To there person saying that Medicaid will take over your home, I think you mean Medical. Medicaid doesn't do that. It can be confusing to distinguish between the two.

My mom did not have a uti when she developed psychosis. That is what made it so weird. The psychiatrist based on the time line called it brief psychotic episode and mom got on zyprexa. We all agreed that her lack of self care (not drinking water, not taking meds, lack of sleep and not eating only snacking contributed to this episode. She was also stressed by my overbearing sister. However, when the pat weaned her off, she became paranoid and was in misery of terrors. We put her back on zyprexa and she normalized but her normal aging of memory loss and pot self care did not return. We keep her in a bubble of
bliss with no collaboration with us. We only talk about memories that she has. My sister promised to see a counselor before seeing mom again per my moms request and my sister said that will never happen. It has been 18 months and mom is stable and happy.

I agree a uti or dehydration should be looked for as the cause. Both have brought sudden delusions and hallucinations on in my mom.
Good luck!

It can be experiences, but the first thing to check out is a urinary infection. UTI's can create over night psychosis.

Check for a UTI. My mom's behaviors always intensified when she had one. She would always ask about her long dead parents and long gone sister with sundowning.

Off topic you state that mom signed her house over to your brother. She cannot give assets or cash away if Medicaid is providing her any benefits. If she were to need long term care, she would be penalized the value of the home. She would not be eligible for Medicaid coverage until home value is repaid to use to pay for her care or home care equal to the value of the home is provided by others.

Another point of interest in reading other posts you have made. In one you state that mom had and uses bed rails. If Adult Protective Services were to inspect for any reason, the use of rails will cause brother problems. The use of them can be very dangerous and cause falls and even death which is why they are illegal to use. The use of them is considered entrapment and confinement and is illegal to use in most states as it is considered elder abuse. I don't know about Arkansas.

For sure it can happen suddenly ..
delusions hallucinations and may become a chronic part of dementia.
I would check for UTI also because those always affect dementia .
if hallucinations don’t bother them ..
just go along with it and redirect conversation… it doesn’t help to tell them they’re not true … because they’re very real to them . If they’re
very disturbing .. there’s medication
seroquel small dose is good one… but be careful some of the newer antipsychotics are contraindicated and cause dangerous side effects with dementia!!!!
find good neurologist or geriatric psychiatrist!!!
good luck .. it’s a very difficult and heartbreaking journey !!

Defintely follow above information about checking in with a dr. My mother presented these symptoms and I had to insist that they check for uti, as she had no other symptoms. Sure enough...

My biggest piece if advice is to not to try to convince her of your father's death. Change the subject, play into the fantasy, etc. She truly believes he is still here--imagine reliving the pain of losing him over and over. This is not helping anyone.

My moms UTIs bring on very strange behaviors so I would always check that first. She does not have dementia but a large stroke and with her brain injury the UTIs bring on confusion - sometimes delusions (tells me she was smoking outside) when she hasn’t smoked since 2019 when she had her stroke. So I would ask for a urine sample at the first sign of fast changes. Then go from there.

This behavior is more due to Sundowning, I think, than anything else. My mother has advanced dementia and acts similar, and I don't consider it 'psychosis'; just what advanced dementia and Sundowning LOOKS like, you know? She insists her dead relatives (except dad) are still alive and ignoring her. I can tell her 1000x they're dead and in heaven, playing cards & drinking wine, but 20 minutes later, the same statements come out of her mouth. Taking your mother to a graveyard 6 hours away won't accomplish a darn thing! She'll be back on the same subject the minute you get her back in the car, I guarantee it. A broken brain means she simply cannot process information. Once she gets an idea stuck in her head, it's there to stay & you can't chop it out with an axe.

Stop thinking anyone did 'something wrong' to overstimulate her or whatever. Her brain is misfiring, more so in the late afternoon (Sundowning) into the evening hours, and causing her a great deal of confusion. She's going back in time to when she had a useful purpose in life; when she had animals to take care of and a husband to cook for. A point in time when life was good and she wasn't sick, when her brain was working properly. That's dementia. She can continue going back in time to when she was a young girl and living with her parents (which is where my mother is right now), when life was simple and care-free. She's always 'riding the train (the subway in NYC) to go see mama & papa' who have been dead for 36 and 60 years respectively. I don't correct her, b/c she'll forget all about those statements by the next day or w/i the next few hours ANYWAY. That you can count on.

Instead of showing mom photos of headstones and reminding her of death, just change the subject or offer her a snack (make those suggestions to your SIL). Remember that whatever is told to her will have to be repeated over and over and OVER again in any event, so keep it simple and uncomplicated. I often tell my mother that her family members are 'not available at the moment' or living in another state and can't be reached, rather than they're dead. If she's carrying on and on about calling them, THEN I'll tell her they're with God and playing cards and drinking wine. Depends on the situation the story I tell her.

Barb is right; def have her checked for a UTI (which is always negative with my mother); it can't hurt to check for organic problems first, THEN you will know her behavioral issues are due to dementia. Also have your SIL take note of smelly urine, or concentrated urine, frequency of trips to the toilet, etc.

Wishing you the best of luck with a difficult situation. Dementia is truly an awful affliction that I hate with every ounce of my being.

Daddy, if your mother's mental status has changed suddenly, someone needs to be in touch with her doctor.

Sudden onset of delusions and hallucinations can be symptomatic of a Urinary Tract Infection in elders with no other symptoms present. These UTIs can turn septic if not treated.

Please call her doctor or have SIL call doctor asap.

both I think. She is living with my brother and his family who take excellent care of her. My sister was there a week and a half ago and took her a mechanical cat , which she thought was real for a while then understood it was not. Then a few days ago she asked to vape - had not asked to vape in months as far as I know, though she did it all the time when she lived here.

She seems to sun down at about 3:30 but my SIL is very good at talking to her calmly and keeping her in a quiet environment, but last night Mom insisted she saw Daddy yesterday (has been dead since 2018), and that they lived just across the bridge in the town where they moved from in 2004 (mom lived in Arkansas until May of this year). She kept telling them that Daddy was not dead, and she had to get home so she could feed her pets (she had 3 cats and 2 dogs).

Brother and wife showed her pictures of her at the cemetery by the headstone and showed where she had signed the house over to my brother, but nothing would satisfy her, so they promised to bring her out today (at best a 6 hour drive) so she could see the headstone and they may take her by the house to show her that there are no animals there and that none of her clothes are there). She had forgotten it all by this morning, but true to their promise, they area bringing her out.

I'm in the middle of working now, but just wondered. My RN nurse said psychosis isn't brought on by vaping or seeing things that remind her of the past (the mechanial cat), so I wondered. Anyway, I will check out the link you sent.

When Mom went to Memphis in May it was for a few weeks, then a few months, then became last week it became very clear that I am not able to take care of her the way my SIL is, so I've been processing my anger/grief by changing her livingroom/bedroom area so it doesn't look like it did and plan to put my exercise equipment back in it ( which was in it before she and Daddy moved in in 2018). But JUST IN CASE the Lord sees fit to allow her to return to my care, I will clean out my craft room which is big enough to hold her hospital bed and a twin bed for me to sleep in so when she wakes up I would be right there. But I digress.

I doubt I'll every measure up to the care my SIL is giving her, but maybe I'll be good enough at some point after I retire.

Here is a really good article:


https://www.webmd.com/alzheimers/features/dementia-psychosis-alzheimers-delusions

Is your mom having hallucinations or delusions?