Mom 92, sharp as tack is recently telling stories that must be dreams, mixing unrelated people together. Meds or dementia? -

Mom 92, sharp as tack is recently telling stories that must be dreams, mixing unrelated people together. Meds or dementia?


With the exception of these recent stories that have to be dreams she is very very sharp -- 92 but lives alone, takes cabs to her doctors, pays her bills, cooks for herself (and us), finds errors in her taxes that the accountants don't see, reminds us of what we need to do, etc. She is on heart meds, cholesterol meds, mild diabetes and gout meds. I noticed that this situation seems to have started after a gout flare-up then calmed down/went away and then started up again after another gout bout. She was taking colchicine (SP?) for the flare-up and takes ongoing allopurinol (sp?) every day. Are an inability to distinguish vivid dreams from reality known side effects? We argue the stories through and she defends them/tries to find ways to make sense out of them and then realizes it was a dream but then seems to pull back belief in pieces of it. Not sure if this is a medicine reaction or the start of dementia? On a few occasions in the same time period she has been convinced that something has happened before or that she has been someplace before. For example, when something happens -- little things like I stub my toe while doing a particular task, she will say OH you did that last time you did that task too! And I know I didn't. Re the dreams, an example is that after I went to a wedding and had told her about it, she took a nap and then later claimed that a woman she knows had helped plan the wedding i had attended and was distantly related to the groom's parents. Or that friends we had taken her to visit on our vacation had impossible connections to people in her every day life. Weird stuff like that. There has been a lot of family stress (a death as well as estrangement from a close family member). She is handling the stress almost too well.Very philosophical about it, accepting of the situation, not obsessing like the rest of us. Could this dream/reality confusion be a way of focusing on something else, having something else to talk about by creating dreams that bring new scenarios and activity into her life? I realize that at 92 I'm so fortunate that she is here and so active and independent but since longevity runs in the family - my grandmother was 100% sharp until her death at 91, I'm very concerned. This is a first sign and i really don't know what to do. I don't want to "label her" or embarrass her by proving all her facts are wrong by confronting the people involved so at this point, we are arguing it through I'm at a loss. I believe we should discuss it with her doctor but she says she needs to study it and log it and see what patterns she can identify.She is a caretaker at heart and prides herself on being sharp as a tack and I don't want to shake her confidence yet I don't want to let her slip away by not challenging or addressing these obvious "blips". Ideally I want to nip them in the bud if possible. Any ideas?

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Thank you all for your amazing answers to my question about my 92 year old mom and her dreams. I can't thank all of you enough for your information, suggestions and advice. I have never been on one of these forums before and I am overwhelmed by the incredible insight, kindness and willingness to share your experiences and knowledge. Every post was helpful in its own way, whether providing information, a viewpoint that I feel comfortable with or one that I knew that I'm not yet ready to embrace but that gave me a reality check. From the gut reactions I was getting as I read and re-read all your posts I can see that I'm not yet ready (or capable) of letting her slide into dementia without putting up a fight and seeing whether there is something treatable. She is still so active and vibrant with the exception of these weird blips that I just have to try to help her fight it if it is possible. (I will TRY to be more tactful than I've been!!) She just lost her 89 year old sister who was just starting to get a bit forgetful last month and she called her every day and night to remind her to take her meds and eat and keep her talking and try to be a caretaker and try to convince her to be more active and take the initiative to take better care of herself even though they lived in different states. I know losing her sister has left a big void but knowing how she advocated for her sister and when necessary, tried to nudge/annoy/nag her into action I feel like I owe it to my mom to help her fight this in as dignified way as possible. I thank all of you for your suggestions about possible interactions and infections and flu shot reaction and vitamin defficiencies as those and things like blood test results are something she would find interesting. I will try that angle first as I think those are things that she can look into without impacting her pride. And for those who pointed out that the decline may be inevitable and suggested that I accept and go along with it, I thank you for the heads up and the warning that there may not be a choice and I may have to grow up and accept things I can't change. In the meantime, for those who were concerned about her living alone, she does have a medic alert and lives only a few doors away. I wish I could help her with more chores and things but we do talk several times a day from work and she, my husband and I go away together every weekend (that is one reason I am so attuned to these sudden periodic lapses. So again I thank you all. This weekend we will have friends over and start celebrating her "birthday month". And I will be sure to take lots of pictures of my mom who was never a clothes horse or a glamor puss in her youth, who now, in the 12 years since her 80th birthday has made it a point to get her hair done every week and always wear matching jewelry because she says "when you're old you have to make an effort to look good" and "you always feel better when your hair is done." And I will be thankful that most of the time, she still has more of her marbles and more energy than I do and is able remind us of things and be what my husband calls "our second brain" . I give all of you credit for the jobs you are doing in your own families. Clearly you all have a lot of experience with this and I admire you for your strength and compassion in walking this road. I hope that if I have to walk that road that I will find the grace and strength that all of you have clearly earned by walking a very difficult path. Thank you!!!!
Helpful Answer (3)

"I believe we should discuss it with her doctor but she says she needs to study it and log it and see what patterns she can identify."

This is not an either/or. I'm 70 and I always want to log my odd symptoms and look for patterns and do some homework of my own before approaching a doctor, and at least learn the right vocabulary. This saves a lot of confusion at the doctor's, saves being labeled by the doctor or brushed off by him taking a wrong guess because he wasn't expecting an unusual problem. (Once I consulted a GP for tests for possible causes of memory loss, and he said "Depression can cause memory loss, so instead of using tests [which Medicare does not like to pay for] I always try some psyc medicines, giving each medicine a trial for two or three months. If any of them help, then we know it's depression and we don't have to look any further"! )

By researching the names of the symptoms and some likely causes, you can get familiar with the questions the doctor is likely to ask, and can reassure him "It's not X because I don't have symptoms A, B, and C."

As for when she talks or asks about puzzling memories, since she's really trying to figure all this out and is sharp in other ways -- if someone is being dishonest or refusing to discuss it, that could be very hurtful and discouraging to her.
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My Mom does this a lot...One time she thought she saw the police searching for her on TV and told everyone that she was never wearing the outfit she had on that day again for fear she would be arrested....She used to watch a lot of Law and Order and I think that got mixed in with her sewing and such...but I just told her, you know, I am certain they had you mixed up with someone else and they are not even looking for you ...I am here and will protect you....that seemed to work. I agree, don't try to prove them wrong, other than to comfort them. Mama can come up with some of the most fascinating stories and sometimes I wonder if it is her mind going back over her life and combining things in strange and fascinating isn't hurting anyone I finally decided so I just let her talk, it may be one of those self comfort things...and kind of her way of time travel .. :) God bless you is always good to have any health concerns checked out or reactions to meds...but without those concerns, just part of the process....
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I'm sorry, there are so many mistakes in my voice recognition, most of them little, misspellings, their/there, mini for many, etc, drives me nuts. I just have to hope readers can get it in context rather than going back and making micro changes.

But, OMGosh, the last sentence "begin a massage to CLE approach to ruling out"
was supposed to be "begin a methodical approach to ruling out" ... yeesh.
Helpful Answer (2)

Your mom may not have dementia but she definitely has some dementia-like symptoms. Delusions, fantasizing, confabulation (where a person feels in their memory gaps with stories that seems logical to them but can sometimes sound bizarre to a listener or is known not to be true by a knowledgeable family member.

At her age, medication interaction, blood sugar fluctuations (the diabetes), inflammatory reactions (gout), circulatory changes (heart, blood flow to the brain, arterial clogging), immune system challenges (her body suppressing an oncoming flu, has she had a flu shot recently - you don't want her to get the flu, however flu shots can bring on the like symptoms when the body works to activate the immune response) - these and many other things can be suspect as physical triggers of a parent mental problems. It's kind of like Humpty Dumpty: everything looks okay winter up there on the wall, but if there isn't balance, and there is teetering, the break (cracking the eggshell) comes from the fall. The tendency in our medical society is to look at and try to treat the symptom (the fall) rather than the cause (lack of or inability to balance).

Your mom may seem perfectly reasonable when she's trying to workout and understand her situation. But it seems as if she has become faulty in her reasoning, which we will hope for now is temporary, and is in a form of denial that she may be ill in some way other than mental, but since she can't understand that, she doesn't want to see it.

Two causes of her type of symptoms - that are physical but bring on mental confusion - that come to the forefront always in my mind first are urinary tract infection (UTI) and nutritional deficiencies (such as vitamin B-12, thiamine - "B-1", vitamin D). UTIs can become quite common in the elderly, especially women, can be completely asymptomatic and can cause most of the problems your mother is experiencing. Nutritional deficiencies also become more commonplace in the elderly. Even if they eat well - and sometimes they think they do when in fact they don't - digestion and assimilation of nutrients becomes more and more difficult as we age. Folks often self medicate with baking soda, Tums or other OTC anti-acids without ever complaining of indigestion or "heartburn" 2 family or the doctors. People can even buy an OTC form of Prilosec, a proton pump inhibitor (PPI) that reduces or eliminates the flow of acid into the stomach, although that very thing inhibits adequate digestion, a problem the elderly already have on their own.

With all the TV commercials portraying the need for antiacids as normal, and when you can buy these products over the counter to "fix it", many don't think to tell the doctor they have a digestive problem. Even if they do, they will usually walk out with a prescription for Tagamet, Prilosec (omeprazole), Protonix or Nexium rather than a recommendation to take digestive enzymes and probiotics. BTW, anything longer than short term use of PPIs has been linked to thinning of the bone (osteopenia, osteoporosis), especially at the neck of the femur - that's where the leg meets the hip. Broken hip, anyone?

The GOOD news, "worried" is that UTI's and nutritional deficiencies can be discovered pretty quickly buy a trip to the doctor and some lab tests. Should it turned out to be something of this nature, her confusion can be reversible.

But confusion is insidious. Physiological confusion can lead to withdrawal and anti-socialability. There are many links in the chain in between but it can ultimately lead to mental or neurological withdrawal.

Your "job" right now as I see it is to help her understand that there may be hidden physical causes that, once discovered, can "put her right" but "we" have to get to the doctor right away to find out about it. "Mom, if we wait too long, they may not be able to fix it".

Science aside, my metaphysical belief spur me on to say that there ARE folks who are quite elderly, who never get dementia, and who crossover peacefully in there sleep or in there rocking chair watching TV. Sometimes preparatory to willfully (even if subconsciously) "stepping out" and leaving their bodies behind, mini begin to have - and often relate - experiences of visitation or communication with "the other side". Some say that soul or spirit guides, or does already departed, are waiting "over there" to help the newcomer adjust to "coming across".

Depending upon a person's belief system, these visitations can be distressing too some but exciting to others. I have no problem with the thought of non physical beings helping us here in the physical, or helping a physical person to fully real marriage into the non-physical but before we decide that it could be that, let's NOT put science aside, let's make sure there aren't easily correctable physiological causes.

YOU have to also leave room for the possibility that there are some NOT so easily correctable physiological causes, what the best way to approach this is "baby steps". Start with the easiest, gentlest things first, and begin a massage to CLE approach to ruling out what's going on one by one.

Please keep posting.
Helpful Answer (2)

My mom is 68 years old and has Parkinson. My mom has moments of forgetting things but her mind is really good. I just spent about 2 months of going through a similar situation. It started with her getting UTI really bad. It's amazing how it affects older people's mind. We started dealing with the UTI's around the end of July and finally by October I took her to the ER because she didn't know who I was and told my sister I was trying to poison her. She was up all night walking, wouldn't stay in bed, talking about the school and not being able to get out of the bathroom, and the list goes on! So here are the things we found out that caused her to be doing this. Of course the UTI's was a problem, her magnesium was .6 but should be 1.6 at least, and the medicine's was causing problems. I have to make sure she takes magnesium and potassium daily. These two get low fast and really make her sick. I learned that if one is low, the other will not get to the level it should be. So have magnesium and potassium checked regularly!!!! I had been trying to get UAMS Doctors to review her medicines but they did not, so I blame them for this happening. So find a good Doctor that will listen to you and not just tell you that "your mom is old". The Doctor's at UAMS in Little Rock Arkansas upped her blood pressure medicine which caused her to start falling, took her off her diabetic medication(because her blood work showed she didn't need it), and still would not evaluate her medicine to see if that was a problem. You are with your mother and know her better than a doctor. So make a list and fight for her!
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I would get her checked out by her primary doctor. She is on several medications and they may be fine individually but perhaps she is have an interaction with a couple of them. Gout or other infections (UTI etc) can cause mental confusion by the elderly.

Loss of the close family member, may be taking a toll on her if that person was part of her daily routine. 92 is a bit old to be "living alone" even if the senior is sharp. I would make sure either a care giver is there part of the day or she has a medical alert button to summon help. They need social interaction on a daily basis after 90. If they live alone, see no one for weeks on end---the mind will probably go not to mention they tend not to eat well if they have to prepare the meal and eat alone--which again might be the cause of the mental confusion since she has some diabetes. The diabetes situation may be worsening. It could be playing a part in the confusion she is experiencing.

Good luck, once the senior is over 85 you are working with the "fragile elderly"--things change quickly and continually. I understand wanting not to label her, too frequently temporary mental confusion is written off as dementia or worse. However after this problem is identified and handled, another problem will arise in a month or so as it is best to expect the unexpected. I have friends who claim their parents are in this age range and nothing is wrong with them which is very seldom the fact--but the adult children are not aware of the changes in their parents health. They phone a parent living in Florida who says all is well --the rosy glasses syndrome---the adult children who have a life up north want to live their lives uninterrupted so they convince themselves all is well. If wishing could make it so :)
Enjoy your mother, I would check out the confusion, don't try to set her straight on her confusion because for now they are real to her.
You are to be commended for picking up on these small changes, they are likely fixable.
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Have you read the 'possible side affects' warnings that should be given with all her medications? Though it's a CYA from the manufacturers, you know what I mean, there may be some that actually apply to Mother's case.

I have given into Mother's illusions rather then point out the facts as they are. Her Dementia is taking it's toll, at times it seems quickly. I have challenged her, but that serves no real purpose other then upset her and frustrates the daylights out of me. It pains me to 'go along, to get along' but that's what it has come down to.

Though I don't lie to Mother when asked questions, which some say is 'fine to do,' I just won't do it. Hopefully Mother still, somewhere in there, appreciates that aspect of my rearing .... I believe she does.
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mom asked me once where ike ( the trike ) was cause the bike shed was burning. i told her ike is safe in the front yard so everything is fine. man thats how crazy you have to become to keep a dementia patient calm.
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Allopurinol is a drug used to block the formation of a substance in the body that creates uric acid the cause of gout attacks. I could not find any side effects that matched your mother's vivid images. There were the usual common ones such as digestive upsets and rashes. It was recommended that large amount of water be taken during the day which your mother may not be able or willing to do. This helps protect the kidneys from stone formation. she may have other conditions that make this inadvisable. There seemed to be no drug interactions.
Colchicine is a drug used to treat the inflammation in the joint created by the deposit of the uric acid. It basically relieves the pain and inflammation such as Asprin would. Again nothing that would cause the vivid images/dreams.
Your mother seems to be treating it very rationally and you should continue your interest and encourage her to keep her log.
Does she take any blood pressure medications? These often cause very vivid dreams. I have experienced this and they are very real in color often with people I currently know or did previously and in places I know or related to recent events. A talk with moms Dr is of course in order.
It is easy to research any of the medications your mom is taking or ask the pharmacist for the drug information sheets they dispense with her prescriptions.
from what you have told us and the way she is handling this I personally would not be worrying about dementia. Mom sounds like a great inspiration for living life to the fullest and keeping the mind sharp
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