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I live far from my mother. She has been experiencing a rapid mental decline and is now calling me in what I can only describe as a delusional state -- for example, that everyone in her building is leaving for California and she is going to be left alone. She is crying and scared at times but doesn't appear to be at risk of harming anyone or herself.


In the last few months, my sibling, who lives closer, has taken her to the ER in the middle of a less severe episode. They ran every test and found nothing aside from some verbal confusion.


Last week during an episode, I had a police officer do a wellness check. She did not appear to be in danger, so they couldn't do anything.


I was just able to use social services to set up an in-home counseling service, but this doesn't feel like the exact need right now. My sibling may take her back to the ER again Saturday, in hopes of them finding something (last time, she seemed to rally when she talked with them; things are more severe now).


Is this the route or am I missing something?


She has no healthcare or money. The last time I called Adult Protective Services, they put me in touch with Catholic Charities, which provides aging services in the area, and I was unable to complete an intake without her personal info (SS#, etc).

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Has the neurologist suggested Lewey Body Dementia? It manifests in hallucinations and delusions as well as paranoid behavior. A lot of Doctors are unfamiliar with it..........
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Thank you all for your responses. I have some good news: This weekend, after asking many times and receiving a negative response, she revealed she DOES have health insurance (non-Medicaid -- I'm honestly not sure how) and will be able to get her into the doctor.

In terms of traumatic events, she is under a lot of stress as she has been living with my father, her ex, for the past year. They bicker constantly. There is no abuse going on that we can tell, but I think this may have triggered old traumas related to his (previous and current) alcoholism.

To answer some other questions: My feeling had been this was a dementia issue, but now I think it is a mental one related to stress. Her place varies from cluttered to light hoarding by room, but when I was home in December, I found that her bed was unsleepable and her shower unusable (we spent that whole visit cleaning and setting up antennae, DVD players, and senior remotes so they could watch TV). They did find a slight UTI when she was in the emergency room -- I was surprised so many people mentioned this in their responses. I will be researching this when I am home from work.

I should note she is "only" 60 years old and had no interest in addressing these issues in their earlier stages or during the times I have been able to visit with my young children (3-4x/year). She is now very interested in senior living centers...and expects me to arrange this for her.

(Meanwhile, she has lost literally *all* forms of identification (SS card, birth certificate, license, any previous work ID) except for the BCBS card. It's hard to say how much of a barrier this is turning out to be... My sibling, a brother in his 20s, is not much help.)
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Llamalover47 Feb 2019
FATCAT: So since she's only 60, did she get the ACA insurance?
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Becoming Delusional, with psychotic episodes finally made me ask her Neurologist for meds. To help at least a little.
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You probably realize by now that you can't do this long distance.  You and your sister need to work together to make sure that your mother has a safe place to live.  Delusional is not "safe."  No healthcare and no money isn't safe.  Living alone in this condition isn't safe.  Situations like this don't simply resolve themselves and they typically don't end well.

Everyone dreads this time in their lives when they are confronted with this situation because it's unlike anything they've ever faced before and it is like walking into the jaws of hell.  People can tell you what they've done - contacting an elder care attorney, selling the house, applying for Medicare and Medicaid, taking her to the doctor, finding a place for her to live if not with one of you, and the list goes on.  But everyone's experience is very different.  Yours will be too.  And it all depends on your mother and you and your sister.

This is your time.  You're going to have to go and figure out first hand what to do.  This means traveling, taking time off from work, if you work, and making arrangements for your family responsibilities while you're gone.  It may require more than one trip.

There is no easy way to do this.  She desperately needs help, and you need to go help her.  I'm so sorry.
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default24 Feb 2019
100% agree. This certainly is the time to put things into place, especially as it sounds nothing has been done. Action is necessary.
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People who experience these kinds of delusions, scary, but so far not dangerous, do so much better in community living. Given your mom’s finances, that means getting her on Medicaid. Start as soon as possible. Go online. If her assets as uncomplicated as it sounds, you won’t need the help of an attorney. Call your mom’s county’s office of services for the aging. They can help, too.
Good luck.
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Someone should step up and become your mom's POA. Decisions are going to have to be made in care of your mom. You need to contact social services for state and see if Mom qualifies for Medicaid. My mom always had some kind of underlying psychosis but was able to live by herself for years. When her brother died 2 Septembers ago, she started going downhill. He was her best friend and they would talk on the phone all the time. She had breast cancer, broke her shoulder, had multiple UTIs, was in and out of ER, hospital and rehab. Found out she had too much ammonia in blood due to non-alcoholic cirrhosis of the liver, hyperthyroidism, and UTI....any one of which can make her delusional. My mom is 80 and she is now on 8 meds and 4 different eyedrops for glaucoma. Just got her a hearing aid last week. We also sold her house and she moved in with me. Working on spending down her assets to re-qualify for Medicaid. Your mom may have a lot of issues going in and you or your sister or both need to address this now while she can make decisions. Good luck. Taking care of my mother has been the most stressful thing I've ever done
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There are some good suggestions here as to how to go about determining what might be causing your mom's delusions, and what a doctor should look for... could she have a UTI, check her meds, could she be having little strokes, etc.? There is just one small problem... you indicated your mom has no money or health care plan.

Someone suggested selling her house if she has one, and someone else suggested you foot any bills yourself. But suppose neither of these is an option?

I have no answers or suggestions. I'd just like to redirect the community to these issues and ask if anyone else has any. The financial aspect must be considered, as well as the medical aspect. Meanwhile, I hope Catholic Charities is able to assist in some measure, and also possibly put you in touch with some other resources. And rest assured that I will pray for you and your mother as well.
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My mil had same issue. Dr
put her on medication that helped immensely.
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The medications that she may be on are manifesting into hallucinations. I would check and have a full mental evaluation done on her for starters.
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They clearly are not taking adequate time to do a neurological/dementia work up in the ER. Someone needs to set up a visit with a neurologist which will include a list of meds, check her mental status, and for depression, nutrition, UTI (although I don't believe that would cause delusions). She is at risk because being very frightened can cause behavior that will impact her health and well-being, potentially cause a fall. You will have divulge some info in order to get help. She should be able to still get healthcare if she is has Medicare, and/or medicaid. I feel like there is some info missing in this picture because although there may have been no immediate risk, APS saw no need to get involved. It would seem the issue is now in your lap for being unwilling to reveal info. So unless you are willing to take that chance, you will have to make private arrangements and pay for them.
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All good answers here. One more I've not seen - make sure she's not 1) dehydrated, and 2) suffering from a UTI. Both will make them kooky.
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Mom really should be in a Nursing Facility Here, dear, Unless Someone, hun, Would like to Pay for Caregiving services.
It may Come a Time when Mom ends back in the ER that Social Services will Then Intervene in Between in what is Best for Mom Then.
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I understand your delima, my mom went through same thing. What I found out is she was having "non bizarre delusions" meaning she wasnt seeing pink elephants but scenarios that were "possible " if not probable. I too tried APS and all types of medical tests but they were no help as mom would start with another delusion.
Sadly I had no choice but to empathize with her and play into her delusion this kept her calm and reduced the stress on me.
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My late husband frequently had delusions about people being in the house and trying to steal money, but no cause could be found. He also passed out on several occasions and again nothing found in ER. He went through a period of difficulty in judging distances that new glasses didn't help. After his death from a massive stroke, I realized that he had probably been having transient ischemic attacks (TIAs) all along. They come and go without a trace, but are the harbinger of something big coming down the pike one day.
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FATCAT Feb 2019
Yes, this was on my list of worries! My brother took her to the ER in the midst of an early delusion for this very reason, but they didn't find anything.
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Her doctor should be helping with this, there are medications that can help anxiety and delusions. I recommend that she gets a full work up from a gerontologist and perhaps a referral to a geriatric psychiatrist, the people at the ER are only working to treat acute episodes and are not likely to look at the big picture.
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Dear FatCat:
It sounds as though it could still be a health problem. Is she on any medications? Has there be a significant loss in her life? Spouse? Close friend? Siblings? The stress can cause this. Has she recently moved? Examine all the possibilities.
I've not experience this kind of behavior without a cause.
Is she old enough for Medicare? The Department of Human Services can help with the supplemental part. Often times then everything is completely covered.
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Fatcat how old is your mother? How long has this been going on? When your sibling goes to her apartment what is the condition of the apartment? Are you feeling that this is a mental issue or a dementia type issue?
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Do you think she needs to be in Assisted Living or Memory Care? If she lives in a house and she sells it, that money  could be used towards those costs, if she's not eligible for Medicaid. If she is eligible for Medicaid, some Nursing Homes accept that. My mom had delusions, hallucinations and confusion too, due to Alzheimer's. She lived with us, (for 5 years and 3 months). At the beginning, I'd try to convince her that her delusions were just that. After a  while, it was easier just to go along with them, so if she thought someone was coming in  a second story window to steal her coffee, rather than trying to convince her otherwise, (that she had just forgotten that she just drank a cup), I'd just tell her that I'd make her another one, (decaf). Do you have Durable Power of Attorney for healthcare and/or financial? That should help. You might need to contact an elder care lawyer for advice. Best of luck.
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Fatcat how old is your mother? How long has this been going on? When your sibling goes to her apartment what is the condition of the apartment? Are you feeling that this is a mental issue or a dementia type issue?
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FATCAT Feb 2019
She's 60. The apartment is trending downward. One of her rooms is Level 1-2 hoarding, with her bed full of clutter and items in the shower that prevent its use, while the other is just this side of okay. I'm suspecting it's a mental issue caused by the stress of living with her ex-husband, although she had been experiencing some verbal confusion and unusual forgetfulness prior to them cohabitating.
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FatCat, has your Mother had any traumatic event happen lately? I ask because my Mom lost her only other living sibling suddenly and it threw her into early onset dementia with psychosis. The delusions were unreal and downright frightening, as I live 300 miles away and was not there to witness any of this. Someone called DHR on her and they came out and took her to the ER where she was promptly admitted to the geriatric psych ward for 3.5 weeks. Once there she received her diagnosis and was placed on medications until they knew they had the right type/amount of each. Only then was she allowed to return home but with strict instructions not to drive. That didn't fly well and she ran me off. Long story short, 4 months later she was back in again (I was called in once again) and this time couldn't return home. She was then placed in Assisted living. This was almost 4 years ago. UTI really mess up the mind of patients who have dementia related problems; have they tested your Mother for that?? I am so very sorry you are going through this and I wish you and your family the best in finding a solution/resolution to your Mom's fears.
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FATCAT Feb 2019
This sounds so familiar. My mom did not have a large traumatic event, but she is suffering the slow stress of living with my father, her ex (long story), which I think triggered a lot of emotional trauma.

We took her to the ER when she first began with these delusions in November expecting something similar. They "only" found a minor UTI and did not mention this!
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I would check the Office of Aging for your state, there are a lot of services for the elderly. Is she eligible for Medicaid? Does she meet the income requirements for PAAD? My dad was put on and antipsychotic for his delusions. They stopped pretty quickly. It is sad that she has to be fearful, there are medications that can help.
Hope you can find some answers soon.
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