Mom fixates on things such as "I am so sick and need to go to the hospital" even though they can't fix her dizziness and nausea. Any ideas? - AgingCare.com

Mom fixates on things such as "I am so sick and need to go to the hospital" even though they can't fix her dizziness and nausea. Any ideas?

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Her dizziness and nausea have been assessed multiple times and does not appear to be treatable. She is always asking for tums or to go to the hospital continuously. She is an assisted living facility, but can't seem to find peace. Any ideas?

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Well, I have to agree with Veronica that they may not be paying that much attention to working up the sypmtoms as they would for a younger person without dementia. I'm assuming she wants to go to the hospital because she feels so bad; though just anxiety and fixation could be what's going on, and sure, some people who are anxious don't report feeling anxious, they just complain of the knot in their stomach, but there is a need to rule out other things first. One rule we have is that if the GI tract is not the cause of the nausea - no gastritis, gastroparesis, SMA syndrome (either type) hidden constipation, (e.g. having a bowel movement every day but it is really small and hard, or a little bit leaking around an impaction) etc. you have to think about the head. Migraines, increased pressure due to hydrocephalus or tumor, that sort of thing. And going over her medications - adding something for acid, stopping something that could be making her feel bad - needs to be done very thoroughly and thoughtfully. I have been shocked to find out that quite a few physicians think its OK to leave someone nauseated all the time - but although it may not be life threatening immediate danger, it just isn't!! If there is really no cause that can be treated directly, then intensifying medication and non-medication approached for the symptom is totally appropriate.
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Can you assess your Mom yourself to see if you really think she has the things she complains of. She may be constantly asking for Tumms but is she really nauseous or is it heartburn that can be treated effectively or investigated. Does she still eat well even though she says she feels sick to her stomach. Is she loosing weight? Are her bowels regular. A regular stool softener could be helpful. Does her diet contain enough roughage? Are her teeth in good shape or does she have ill fitting false teeth. Have you eaten a meal with her recently. is she managing cutlery effectively. Can she easily raise a cup to her mouth? Would a straw help, maybe a glass cup with a handle for cold beverages. Although a number of glasses of water are recommended each day that is pretty boring and unappetizing and requires dedication to achieve. Liquid beverages are a better goal and easier to achieve. A carbonated water with a slice of lemon while more expensive might tempt her.
The dizziness is a far more difficult problem. When severe it is hardly possible to raise ones head and the nausea a major problem. Think motion sickness or riding upside down in one of those theme park rides. Has Mom fallen does she hold onto furniture, grab your arm, use a walker or cane. Does she seem reluctant to rise from a sitting position. Is her B/P too low say less than 100/50. do any of her pills have the side effect of dizziness. Can she stand still with her eyes closed. There are many medications available to treat nausea so if may be possible to find something effective. The dizziness is a more difficult problem as there can be many causes even if correctly diagnosed to treat. There are several medications available but like those for nausea can cause sleepiness and like everything else used in the older population can have undesirable side effects.
These may be the realities of physical causes for mom's complaints or there may well be a psychological component which will need careful evaluation. It may be another case where family has to advocate for their loved one if they actually believe there are physical problems. Unfortunately the elderly are frequently brushed aside simply because they are elderly and dementia does not help their case
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If you trust the drs you have taken your mother to and they have no explanation, maybe we're looking at the problem wrong. What I have found with my mother is that she festers on things, constantly thinking about what problems she has and making them bigger than they are. If the drs have reviewed all meds and checked all possible causes maybe the problem isn't as big as she thinks it is. If you can get her to do something that will keep her mind busy she will stop thinking about her problem and it just might go away. With my mother it helped to have her even just sit with the tv on. When she was just sitting alone doing nothing she just kept thinking about her problems and they get bigger and bigger. With something as simple a distraction as the tv, her mind can focus on something that's flashing on the tv. When they are older and don't do anything all day, their minds go to all the little aches and pains they have and they grow bigger and bigger. Having company, talking on the phone, playing cards or just watching tv helps. At least in my home with my mother. The problem doesn't go away, but at least it isn't the main focus of the day.
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Which came first, the chicken or the egg? All kidding aside, all of the suggestions above are very good, yet one can only guess since we don't know all the particulars of your mother's case. If the dizziness came first (prolonged dizziness usually causes nausea), then the first course of action is to check out the dizziness. As stated, it could be an ear infection or an ear plugging up with wax, so an ENT might be visited, unless she's done that already. Next stop would be a neurologist as so many different brain problems can cause dizziness. Many times doctors never do find out what is causing the dizziness. If it comes to that, there are different pills she can take for dizziness - the most common being Meclizine. If the nausea is caused by the dizziness, and a pill can stop the dizziness, then the nausea will stop. If the two are not related, there are also pills for nausea, though they can make you quite sleepy. I work for a home health agency and the physical therapy department has a program called "Balanced for Life". They have found that many times with unexplained dizziness in older people there is an inner ear problem that can be helped with some certain exercises that they have the patient do, though I don't know exactly what those exercises are. They have a little balance test that they do with the patients to be able to tell if they have the kind of dizziness that can be helped by those exercises.
Medicines are also a frequent culprit, but just stopping meds on your own is not a good idea. I would hope her doctor is willing to evaluate all of her meds and maybe hold one med at a time that could be causing it to see if that's the problem. I would exhaust every possible avenue to try to find out the cause because dizziness is a frequent cause of falls in the elderly, resulting in broken hips, and you certainly don't want that. If all else fails and they just can't find a cause, then the medicine for dizziness is at least worth a try.
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Start by looking up the side effects of all medications that Mom is taking. You will find those that can cause nausea and dizziness. DO NOT stop any medication without asking her Dr. You mentions frequent UTIs which I assume are treated with antibiotics. These are well known causes of nausea. It would seem that she feels safer when she is in the hospital and she sees nurses etc every few minutes and knows there is someone at the end of the call button. You said that the AL is a very nice facility but is she afraid to leave her room so is alone most of the time. Perhaps she would feel more comfortable in a NH where she would be more closely supervised. With the elderly it is often not possible to explain the true cause of their actions because they can't or won't explain their true needs. Issue of loss of control, not wanting to burden a relative or embarrassment may all come into play. It's hard to figure all this out if you are not a professional caregiver or have been involved for a long time. You can't be expected to be a mind reader so it may take a little detective work to figure this out. There certainly are medications to treat nausea and dizziness but still may not cure the problem.
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She's been assessed multiple times. Assuming you're confident in the repeated diagnoses, it could be that your mother just can't accept that she can't be 'fixed'. Or, that she gets some positive feelings out of the attention that hospitalization brings.
I'd focus my efforts on helping her cope with however she's feeling rather than supporting a never-ending quest for a treatment that doesn't exist. As, Jaye points out, many people with dementia have very limited coping skills. She could probably use some kind of simple plan for dealing with her dizziness; maybe changing position - like watching TV from her bed or lying on the sofa when she's particularly dizzy.
It does seem that the nausea component could be addressed with drugs, but not if it's largely psychosomatic.
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VERY often what I hear from my Mother is "I just don't feel good, or I have a tummy ache" she has always had a touchy tummy so sometimes I think it is something she ate. WE have had incredible difficulty with UTI's we have tried everything....she has seen a urologist several times... She does NOT drink enough... She has dementia and she does not remember.... She lives in a beautiful independent senior housing complex... I do her medicine get her groceries take her to the DR etc... but she has completely LOST her coping skills... It is a challenge to care for someone with dementia!!!
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I forgot to add that my mother wanted to go to the hospital daily. It was terrible, because she would pack her suitcase and get ready to go check herself in. I took her to so many doctors for her nausea. I finally figured out what the problem was by counting her pills. Do the people at AL manage your mother's medications? Let us know a bit more.
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I was thinking the same thing as Ferris. We don't have any information about your mother. Is she diabetic? Does she have some other diagnosis? My mother suffered from nausea that was caused by her taking too much of her Metformin -- she's diabetic. Another time had nausea that came from laxative abuse. There are so many things that can cause nausea and dizziness that a doctor needs to sort out what she may be doing to cause it. If she isn't doing anything, the problem may be caused by her inner ear or the associated nerves. Let us know a little more and people may have some suggestions.
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The first thing I think of is her meds are causing the dizziness and nausea. Those two symptoms are the most side effects of any med. Coupled with constipation and you have an unhappy patient. Try stopping or cutting out the med that has those side effects listed. Listen to her. She knows her body...
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