My mother in law's mental decline has been extremely rapid. What do we do?

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My mother in law was diagnosed with Lyme and a UTI. In August, she took 3 week course of Doxycycline - her knee improved, she forgot she had a UTI. We have asked her repeatedly to see a primary care Dr., made her appointments that met her specifications for location, etc., and she cancelled them. Finally got her into a PCP, had a cat scan, they requested she have blood work done and they referred her to a neurologist (in another 2 months!). She left her husband last week and can't remember WHY! When my husband spoke to her today, she was so flustered she couldn't remember anything. Her mental change has been so extremely rapid (she was FINE this past May!!!) and she keeps talking about going to stay in Florida by herself. What do we do? She desperately needs treatment but she knows there is something wrong and she is too scared to follow through. In all of my research, there is a slim chance that the memory issues can be related back to the Lyme disease (we have no idea how long she has had Lyme, we didn't know she even had it until her knee blew up in July and she required a trip to the ER) or even an active UTI but we need to "convince" her that she needs help. She is only 73, very active, and still driving (which she won't be able to much longer because she can never remember where she is going, even when it is to a family members house that she has visited for many years). We live in NH, she lives in MA (about an hour and half away) and her other son lives in TX. She has a single sister who is opiod dependent, doesn't leave the house, and is unreliable in a medical emergency (her son had a heart attack and she waited for her husband to get home from work for the day to call 911 - he died!) I can't leave my MIL with her much longer and we are too far away for her to be comfortable, even though she is MORE than welcome in our home.

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Thank you for the update, and for taking such swift action on her behalf.

The tears could be a sign of post stroke, could maybe last a year, but there may be improvement with rehab. That is just what I have heard in the past, I really don't have the facts. I hope she can improve, but it sounds so right that she is with you.
Should she be left alone right now?
Keep up the good care, and remember to take care of you!
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UPDATE - Mom moved in with us over this last weekend. She hates being alone during the day, we hate leaving her alone (today is day 2 of myself and husband being at work, yesterday she cried when I got home because she missed me). She is very emotional, it is hard on all of us. She is more advanced than we had been led to believe - she obsesses over small details that have little to no impact over daily actions (like why we don't hang our clothes outside to dry - we have a dryer and our electric bill is low as well so no need, or how I am going to make her gain weight by cooking good food), she folded the dirty laundry for us yesterday (I fully expect today's dirty laundry to be folded as well - you gotta giggle at the silly little things when you can!), and tried to clean her hair clip with toilet bowl cleaner (which I took away and helped her clean it with peroxide and water). I have notes littering my home about where light switches are and to remind her to flush the toilet or how to turn the fan on. I have the unfortunate experience of having loved and lost an Alzheimer's patient (lost my grandfather 9 years ago today as a matter of fact) but my husband is new to this and is quite surprised as how she behaves.

She had blood work last week (we have not heard back from her primary, mom doesn't remember if she peed in a cup for them), her CT scan is this Friday (they are searching for infection or cancer with these thoracic and abdominal scans) and husband will obtain healthcare proxy at that appointment, but Neurology appt is not until 11/27 - we are on the short list for cancellations but I am looking into providers in my area to see if we can't get her in sooner as the location she is scheduled at is 1.5 hours away where she was living before she moved with us. Mom has agreed to stop driving until we can get some better answers, regardless of what those answers may be. Her ex-husband (they secretly divorced last year and didn't tell anyone...supposedly for financial reasons) has really failed her in the whole "in sickness and in health" part of a marriage as he never pushed her to seek help or treatment, he just watched her decline. However, I try to keep in mind that he is almost 15 years older than she is and has his own health issues that he is getting treatment for so I can't blame him for having trouble seeking help for both of them, especially when she fought him on it (which is odd because she doesn't fight US on it!!). Mom's sister doesn't share...we are 100% sure of that, mom is not interested in the least and talks down about her sister's habits, mom also never took her own pain killers after having abdominal surgery a few years back. Since leaving her sister's house, her anxiety has subsided significantly. I found a somewhat local adult center near us that I will be speaking with in the next day or so.

I SINCERELY appreciate everyone's input! You all are a great fountain of knowledge and support.
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Lyme's disease is a very serious illness and if not addressed, it can and will worsen. My own BIL was "off the charts" with the disease  because his doctor was misdiagnosing. Also, she left her husband? Why?
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Could you find a board and care home in her home town? This way she would be around competent people and they should be able arrange medical care for her.
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The single sister, opioid dependent-she lives with Mil?
It would not be unusual, imo, to share drugs with someone as a means of control, or Mil could be using the drugs, even by mistake. If she doesn't know she is taking drugs, withdrawal could be brutal on her mental state, a possible explanation as to her being flustered. A drug test can confirm.
No matter the cause or diagnosis, please put some eyes on her due to the sudden change in mental status. That means, go there, go get her. IMO.  Go now.
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Just a note about UTIs. The pee in the cup is a good start because it pinpoints the fact that a UTI is present. However it does not determine the most effective antibiotic to use. So be sure to demand that the urine be cultured to start the correct antibiotic. The UTI can be treated with a broard spectrum antibiotic straight away as the culture may take several days to come back. The antibiotic can be changed if necessary depending on the culture results.
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The way you wrote about this convinces me that you are very worried about your MIL. And from what you wrote, you have good reason to be. Her living situation is unreliable at best and could be dangerous for her at worst. And, the fact she is still driving is very worrisome. In this age of families spread all over the country, it’s very difficult to uproot elder members of our family and convince them to leave their homes and come live with us in a strange city
It makes a bad situation even worse. And although you say MIL is welcome in your home, are you 100% certain you want to go that route? What about in-home care? Hiring a good aide would be difficult long-distance but doable and better than living with a drug abuser. I would definitely have her tested for a UTI. Those can wreak havoc with the elderly. Unfortunately and sadly, this is not something that goes away or gets better.
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In defense of what I wrote...Lyme disease is known to cause memory loss. And this herb is an adaptogen. It will not hurt to take it. Just FYI. Of course other things can be checked out as well.
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I think there's some validity to the pee in the cup thought in case the UTI is still active...are you SURE she took the meds? She could use the cup at home and someone transport it to wherever it needs to go; for that matter there must be a visiting nurse who could get a blood sample at home as well. Maybe even MD's who make home visits...possibly affiliated with a local med school??
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So, her Primary doctor has the results of her CAT scan and they have referred her to a Neurologist......I'd be thinking more than Lyme's. There must be some basis for referring her to a neurologist. Like, what did the CAT scan reveal? Unless, you are her Healthcare POA, they won't discuss it with you, but, I'd notify the doctor in writing what has happened. Based on that he may notify Adult Protective services, if he has reason to believe that her mental state is putting her at risk.

I'm not sure how leaving a vulnerable women, who has questionable competence, with a known drug abuser, would work. I'd be very concerned. In fact, I'd get a consult with an attorney in her jurisdiction to find out your legal rights as family.

Has anyone, other than the drug abuser, actually been around your MIL to see what other symptoms she may have had? Do you know if she has had other issues with her daily care? Memory?

Unless, you live with the person, you may not have the chance to see if they are doing laundry, cooking meals, taking medication, etc. Are you sure that your MIL actually took the medication that was prescribed for her?
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