Dehydration or Dementia?

So, my mom has end stage renal disease and is on dialysis. I just had her designated "palliative" at the beginning of the month. She has been unwell all week - I even kept her home from dialysis on Wednesday.

Today I sent a note up to dialysis with mom telling them she was very sick and confused, and very dehydrated. I suggested that maybe she needed some fluids. They have done this once before, under the nephrologist's orders, after I took her to the ER. She was quite a bit better after having a saline drip while on dialysis. Today one of the nurses phoned me back and said there's nothing they can do, and that I needed to take her to the GP and get a referral to geriatric psych. I asked how psych was going to help with her physical issues....the nurse just repeated there was nothing they could do and that I had to go to the GP and get the geripsych referral, and get some meds for her dementia.

I went to the GP's office to get an appointment. She is on holiday till April 4! I could get an appointment with the other doctor but not until March 26th. They said they'd call me if they have a cancellation next week - which they will; they're pretty good that way.

Mom is really whacked out right now, all week. She can't even get up on her own, she has no idea what's going on. I don't think she's pee'd in a week. She's had huge, thick bowel movements where normally she has loose stools - she sh** all down the front of the toilet once, then didn't clean herself, and got back into bed covered in feces. She was totally unresponsive when I tried to help her get her coat on this morning. Like not even hearing me the 12 times I asked her to put her arm into the sleeve, and when she did hear me, completely not comprehending me. She grabbed my sleeve and pulled on it when I was buckling her into the car. I had to guide her through every step of getting into the car, very slowly, right up to "put this hand here, put that hand here...." She doesn't even understand getting into a seat.

I know she has dementia but this is above and beyond where she's normally at. Does this sound like normal dementia, or does it sound like dehydration? Part of me thinks the nurses just didn't want to call the nephrologist on the Friday before Spring Break to authorize a saline drip.

Anyway, when I go pick mom up from dialysis, I've already decided I'm wheeling her right down to the ER for a hydration assessment. I cancelled this evening's home support. I just wonder what you all think? I'll have my phone with me and I'll check in here....