Besides B12 shots, Thyroid Hormone & Sodium level adjustment, what else might help stop sudden onset delusions?

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A few months ago I wrote as mom, 92 and totally sharp was suddenly having weird episodes of deja vu and also connecting unrelated people in elaborate stories. Had brain wave test and MRI both normal. Discovered B12 was off. Shots helped. Was doing great. Episodes stopped, gait better, even her hearing was sharper! Missed two shots and it started up again. Sodium levels found to be slightly off. Took sodium pills. Did better as soon as sodium got in normal range. Then started taking thyroid hormones as levels were slightly off. A few days later delusions worse again. Scary ones for her. Have appt. with kidney specialist scheduled (kidney function is slightly off but not by a wide margin) and trying to get one with geriatric specialist. Any ideas short of sudden onset dementia? May be grasping at straws here. In between these delusions, she is doing her taxes, paying her bills, cooking her meals, reading insurance policies and sounding great. But then suddenly convinced she has HIV (???), that someone purposely stuck her with a needle, that there are tests that were taken and when the doctors "FIND OUT" they are going to make her stay in the hospital. Doesn't want to tell anyone and get the nurses who tried to hide the truth for her sake "in trouble". Weird stuff like that. And it seems that as soon as you get her to realize that one delusion wasn't true (the dr tested her for hiv just to win her trust) the story morphs into a related delusion so she's back to square one thinking she has it (within minutes of accepting the results she pushed forward the date of the "needle attack" to after the test was taken so she is still "in danger of having it." My mom was never a hypochondriac or an alarmist or a storyteller. NOT a drama queen in any way so this is just so out of character. She is losing weight. Is eating healthy meals. Any ideas what could be causing this beyond the obvious sudden onset dementia possibility which I realize I must now begin to accept as a possibility? Any ideas would be appreciated. I realize I am probably in denial but just trying to think of any and all possibilities before resigning myself to that. Yes, I know that having had her 100% sharp until 92 is a rare blessing. It still doesn't make it easier to accept and I feel I owe it to her to explore all possibilities of what could be causing this and how to reverse the progression. Thanks for any ideas you can toss out there.

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"I feel I owe it to her to explore all possibilities of what could be causing this."

I agree, and it sounds like you are doing an awesome job of exploring all the possibilities. Is she back on schedule with the B12 shots? Keep pursuing each possibility, and do follow through with a geriatrician.

Various acute illnesses can cause erratic behavior. With all the testing she's had I assume that things like a uti or other kinds of infections have been ruled out.

Dementia is a possibility. I don't think you are in "denial" by exploring every possibility. That is just smart.

She is having recurring delusions. Are they all about the same subject?

Does she ever have hallucinations, either along with the delusions or separately?

She is eating well but is losing weight. How long has this been going on? Can she afford to lose the weight or is it getting to an unhealthy point?

Are there any other "odd" experiences? Does she still have her sense of smell?

What problems was she having with her gait? How is that now?

Does she seem to have any problems with depth perception?

She is paying her bills, doing her taxes, etc. Is that consistent, or does her cognitive abilities with these things seem to come and go?

Are there any changes in her speech? Not able to find the right word, using words inappropriately, Perhaps cursing when she never used to, or using "fancy" words you haven't heard her use before?

My husband had sudden-onset dementia, and I am just trying to think of additional things to look for.

You are doing a great job. Hang in there! Whatever conclusions are reached, take one day at a time. It sounds like you have fine coping skills.
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