HELP!! What is my next step to deal with bizarre behavior that came on suddenly? - AgingCare.com

HELP!! What is my next step to deal with bizarre behavior that came on suddenly?

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I don't quite know what to do. My 88 year old Mom has been progressing along fairly reasonably with dementia, and I would guess is at mid/late stage. A couple of things happened recently....she lost her balance and fell in the middle of the night about four nights ago, and cut a big gash on her hand. (We still don't how it happened or what she could've cut her hand on, as there is nothing pointed or sharp in her suite of rooms within our home. So that's a bit of a mystery. A trip to Urgent Care resulted in a swath of bandages which she repeatedly removed, exposing the cut, and making it bleed again. It is a huge frustrating ordeal to keep it bandaged, and it appears it's a losing battle. Also several days ago a UA revealed she had a UTI, which was treated w/ a three day dose of antibiotics, just ending two days ago. NOW, the scariest thing, last night I tucked her in to bed at her usual time of 8:30PM. She always sleeps all the way through the night, getting up around 5AM, but is quiet and waits for us to get up. Last night she surprised us by getting up at 10PM talking about a little boy being in her house. We ushered her back to bed assuring her all was well. We went to bed at 11AM. At midnight I was awakened by Mom, calling me, and all agitated about a "couple" being in her bed. She was practically speaking gibberish. I half asleep took her back to her place, and pulled down all the covers in her bed...light on....showing her that no one was there. Even as I showed her, she insisted that there was indeed a couple in her bed, and she would NOT get in the bed with them!! So, she instead went on the couch in her living room, and told me she'd sleep there! Well, she NEVER slept at all, and neither did I, as every half hour she came calling me about groups of people gathering in her place and talking and keeping her awake. She was speaking nonsense. All of her words were scrambled and jumbled. I'd get her back to a comfort level, go back to my bedroom, and then it started all over again. Finally at 6AM I just got up and stayed up, trying to get things back to our usual schedule...opening up all the window coverings, making her pot of tea, toast, and cereal. I thought she would settle down into her normal behavior, but it's not happening. She's wandering around, talking to herself, seeing people that aren't there, and seems very unsettled as though she's looking for someone who needs her, and has escaped. She is exhibiting totally crazy behavior. We have no geriatric psychologist in the town where we live. Her Dr. is a family physician, who does a lot of work with elders but I just wondered if any of you have some suggestions before I see him, so I have a little ammunition or possibilities to bring up to him as I intend to try to get in ASAP. This is really scary to me. And my husband wants to put her in a facility!! That would totally push her over the cliff. Thanks for any help with this!! (We're having an entire houseful of Thanksgiving overnight guests for a week starting this Sat!! HELP!)

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I agree with Countrymouse.
Your mother needs to be seen urgently.
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About time they came up with an MRI scanner that can just do your head, if you ask me. Or a non-metallic pace-maker. One or the other. Infuriating to know the technology is there but you can't use it grrrrrr.

Big hugs, hope you get answers very quickly. x
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It sounds like UTI, it takes 3 days for the culture to come back. We went through 4 UTI'ss in 4 months finally a course of 10 days on levoquin got it cleared up. My mom had the delusions and aggressiveness and etc before the UTI's. That was when we started 12.5 mg of Seroquel about 4pm. That dosage has now increased to 75 mg. The medication helps a lot!
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Supposedly it is not vascular dementia, but I never got a second opinion (it was about 8 years ago when she saw the neurologist). And, unfortunately she couldn't have an MRI, as Vstefans recommended because she has a pacemaker. And it's true, the CT Scans just can't detect as much. Mom has coronary artery disease and has had bypasses, stints, pacemaker, and also as A fib. She's on Coumadin, baby aspirin, digoxin, Atenolol, and Lipitor. I am rather suspicious that it's the UTI and maybe they should do a culture like Bermuda suggested. It seems weird that another stage of dementia would come on so quickly! We'll see what tomorrow brings. Thanks for the info on Haldol, Capt. So far her hallucinations have been fairly unthreatening, (of course the uninvited couple in her bed wasn't her cup of tea...LOL) But I am keeping that Haldol info because it sounded very helpful to your dear Mom, Captain. Thanks again, all, for the feedback. Mom is sleeping peacefully at the moment. Keeping my fingers crossed!!
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I think, if an infection were active enough to be causing this kind of confusion they'd have found it - at this stage of testing they're looking for white blood cells, not for the bacterial culprits, and those would show up.

Can you get her to drink plenty? Water, tea, squash? If she got dehydrated during the previous u.t.i. and hasn't got over it, that won't be helping her brain function either.

Braida, is it vascular dementia your mother's been diagnosed with? Is she already taking meds for it? The common one over here is Clopidogrel for preventing further ischaemic attacks (often called Cloppy Dog for ease of reference and mood-lightening purposes, I assume; I actually find that flippancy slightly grating in the circumstances but it makes the name easier to remember); but in acute crises where they suspect there has been a clot they add in 75mg of enteric-coated aspirin a day for a limited period. I would not dream of suggesting you give aspirin except on medical advice - if she has had a stroke and it's a bleed, not a clot, you could kill her - and Clopidogrel is prescription only, so you'd need to get it from the doctor anyway.

Don't get fobbed off. It may be too late for clot-busting drugs but that's no excuse for her doctors to leave a lady suffering acute confusion untreated, dementia or no dementia. You don't have to turn into the original Dragon Lady, but don't leave the surgery or hospital until you're satisfied that they've paid proper attention and done everything appropriate.

Hideous timing for you. Ideally you'd keep your mother quiet and just soothe her, but as it is you're between a rock and a hard place. Major holidays are a lousy time for anyone to be admitted to any sort of institution because staffing is always a problem and they're busier than ever; but what are you supposed to do with your guests if your mother's ill at home? Well, they will just have to rally round, that's all - delegate for all you're worth. If they're nice enough for you to have invited them, they should also be happy to help out.

And appeal to your husband's humanity: what you need from him right now is sympathy and support, not threats to have your mother taken away. He may have a point in principle, but discussions about going forward can wait until you're all settled down again. Your poor mother - but why oh why can they never pick a quiet patch to have a crisis in?! Best of luck, hope it all turns out well x
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Are they going to do a culture on the sample you brought? It is possible your mother still does have a UTI that would only show up on a culture - if I were you I wouldn't let this one go because the UTI explanation still seems the most likely. The three days of antibiotics could have knocked the infection back enough to not show on a regular UA - persistent deep seated UTI's can require weeks of antibiotics to fully eliminate them. I'm sorry you are dealing with this it sounds really heart-wrenching.
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my mom got to having constant hallucinations in late stage. haldol injections monthly along with oral haldol daily kept her pretty lucid. she even realized the improvement. she was about 60 days from death when the hallucinations got severe. thanks to the haldol her final weeks were pretty pleasant for her. haldol is not recommended for cardiac patients but wth? they are near death anyway, no need to suffer paranoia and agitation.
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So sorry Braida, how upsetting for you to say the very least. I know how frightful it is for you and how powerless you feel, not to mention the loss of sleep and the frantic thoughts. My mother started getting caught up I think in her bed linens, she thrashed around and broke a couple of glass picture frames and a lamp in the process, could she have cut herself on picture frame, I also found under my mother's pillow potatoes and a pair of large scissors, so go figure. I would start to think about your options, it is not easy, never is and it is not easy living like this too.
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CT scans are often not the best way to detect smallish or acute strokes. MRI would make more sense. Granted, it is too late for TPA (clot-busting Rx) but you'd at least know what you were dealing with, maybe have an opportunity for some rehab services (my mom had an extension of an old stroke causing aphasia that partly responded to speech therapy even though she already had significant vascular dementia) or medication changes and preventives for further stroke.
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Thank you very much for the input. I ran a sample down to the Dr. this morning, and by 2PM they called to say it is NOT a UTI, and from what I'd told them this morning, they said to see how today and tonight go, (made sure her face wasn't drooping, or that she couldn't squeeze my hand hard with both left and right hands) and if things aren't any different overnight, possibly do a CT Scan to see about stroke, but it appears to me they're thinking it's the progression of the dementia. Wow. I knew it was coming down the road, but I was thinking slowly, in increments, not just BAM, here it is....a new and ugly phase. How sad it is. She is talking nonsense and seems to be unable to sit still and be restful. I have a feeling we're in store for another sleepless night. And she's got to be close to crashing, because seriously, she hasn't slept a wink since last night's behavior began. No naps today. Me either. The Dr.s nurse said they could possibly prescribe something to help w/ sleeping at night. Any suggestions. I know there was some good stuff just recently about anxiety, etc....Buspar, Sprinkles, and other things but I have to see if I can locate. Any suggestions would be greatly appreciated. Thanks for the above info. I'm feeling a bit depressed to think that this is the new way of life for awhile, but I know that's to be expected. :((
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