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My 93 year old mother was able to live independently with my help until last weekend, when she suddenly started hearing and seeing things and became extremely paranoid. She spent several days in the hospital, and they ruled out any physical issues. Just in those few days, her short term memory and understanding has declined and she's a fall risk. The doctor feels she is psychotic and has dementia, needs 24/7 care, and wants to adjust her medications while she does PT in rehab to strengthen her and then assess if she needs long term care or can move to assisted living.


I took my Mom from the hospital to rehab yesterday. Because of Covid, she is quarantined for two weeks while they follow the doctor's plan. A few hours later she called and begged me to come get her. I calmed her down as best I could, and told her I'd call her today. Then I spoke to her nurse, who said my Mom was fine until she called me. The doctor is to see her this morning and the nursing staff will update me.


The rehab center has an excellent rating, reviews, and is recommended by friends, and I have met several of the staff, who I felt very reassured by. I feel terrible, but also know that she needs 24/7 care in the hopes that she'll improve. The senior social worker told me that the other rehabs in the area have the same basic process. I know she's safe and cared for, but it's very difficult.


What experiences have you had with this situation, and what advice do you have?


Thank you!

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This sounds similar to what happened to my 92 year old mother two years ago. In her case, it was a gallbladder infection that resulted in a 17-day hospital stay, rehab, and then she stayed in the SNF for long term care. Until that point, she'd been living "independently" in a condo 7 minutes from me.

Her cognition increased swiftly and dramatically from the time she entered the hospital. (I think she was able to mask her decline before that because she was able to control her environment.) She descended into paranoia and dementia. She had one pretty lucid day in the following months.

She would call me and beg me to take her home, saying they were trying to fill her, that we could make it work at home, etc.

There was no way I could or was going to do that. Since she had a gallbladder drainage tube, she had to be in a SNF, rather an AL. Before the gallbladder infection occurred, she might have qualified for an AL. People take care of these gallbladder drainage tubes at home, but 24 hr. care would have been necessary (because of her dementia), and that wasn't practical.

So expect your mother to continue to beg you to take her home. Be very clear about what you can and cannot/will and will not do if that were to happen. Strongly consider keeping your mother in a facility of some kind.
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pattiac Nov 2020
CTTN55 - how did you get across to your mother that you were now in charge of her care? My mother is still in rehab under quarantine, and I plan to have her evaluated to go to an assisted living or memory care nearby, which I would set up beforehand. She told me yesterday that if I don't pick her up by next Wednesday, she is calling a lawyer. She wants me to take her "to her apartment and look at places to live," which I know is a ruse to regain control. In just this past week, she has pretended to all to be taken to the ER, yelled at the nurses, refused medication, etc. All of the doctors she has seen agree that she needs 24/7 care due to her delirium, stage of dementia, and being a fall risk. I really appreciate your advice about telling herwhat I will and will not do, and do you have any other advice and/or thoughts? She remains angry at me and I can live with that, but can she get a lawyer when I have medical power of attorney and have been acting on her behalf, even though she doesn't agree with going right to assisted living? Thank you.
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Winston Churchill said it best: "when you're going through H*ll - keep going!"

My advice would be to look ahead to the outcome your mother's doctors and rehab team are hoping for, and encourage your mother to do the same. She feels terrible and perhaps afraid at the moment, but very soon she won't feel so bad. She wants to come home, and if she sticks with the program that's what everybody hopes will happen, very soon.*

It is horrible for those who can only stand and wait. Hugs to you.

*It is possible that the assessment will say otherwise, and in that case there will be a plan that's as close as you can get to what she is happy with; but leave that discussion 'til later. For now, stick to eyes on the prize!
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movingforward19 Nov 2020
What wonderful advice that applies to most of our situations at the moment, focus on the positive outcome you want, then deal with it if it doesn't work out. Thanks!
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Psychosis is not normally an early sign of dementia, especially if it happens out of the blue. Infections or other treatable conditions are more likely. A complete blood workup and urinalysis should be performed.
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Tons of people do just fine in situations like this, but when they talk to relatives do nothing but complain, often to get attention/you to feel sorry for them. Sounds like this is what your Mom is doing.

Stay the course.
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Mysteryshopper Nov 2020
Agreed. Years ago, I worked at a child care center and would observe parents not wanting to leave for the day because their child was crying. We would TRY to tell them they needed to just GO and the child would be fine (99.9% of the time). It could be a gut-wrenching cycle: Kid would likely stop crying if parent could just leave... parent will not leave until child stops crying. I've had the same issue with my elder - on the phone trying to "calm" her down, but finding out from the staff that she WAS calm until she talked to me!
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Thank you, CTTN55, sharing your experience with your mother and your advice. I think I just need to hear it from someone who has gone through what I'm going through. I know in my heart my Mom is where she needs to be, but it's hard to come to terms with it. It's in her best interest for her safety and health. Best wishes to all of us who are doing our best for our loved ones, even when it's very difficult.
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CTTN55 Nov 2020
I'm glad you understood what I posted, because I made some big typos! She experienced a dramatic decline in cognition, not increased cognition as I wrote.

And she would tell me they were trying to Kill her, not fill her.

One thing to be aware of, though -- my mother remained angry at me. She did not see me as doing what was best for her.
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I have had to deal with this twice, once for my mom, and now for one of my “second moms”, and it is easily one of the 5 worst things I’ve ever had to do IN MY LIFE.

It may well be in your mother’s best interests NOT to call her at least for a day or two, until the staff gets a good picture of how she’s reacting and dealing with the new situation. If you make brief calls to her caregivers once or twice a day, it will also help YOUR anxiety, and YOU NEED to be good TO YOURSELF TOO!.
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