Massive change in my DM :(

[Longdistance]

I wonder if someone has had a similar experience with their elderly parent? DM is going to be 80 next month and she has changed beyond anything I recognise. I'll try to condense it as much as I can.
My db lives with dm and is her carer. He does an amazing job with her, all the care, cooking, cleaning, admin, appointments, even cuts and dyes her hair for her.
About three weeks ago DM was saying strange things, like she could see spiders and spiders webs (not the case as the house is spotless) and that she seen someone pulling up plants in the front garden (again not the case as there are a few plants, but they're all there).
So, cue to last week during half term on the Monday, I get a phone call from my db about DM is acting strange and she's been shouting 'help' out of the window. She then proceeds to call the police (they got and interpreter on the phone as my dm keeps flitting between English and her language) and they turned up. I spoke with them over then phone and as I was going over to take her to the hospital for an appointment in the afternoon anyway, I said I'd come over. I spoke with the police and they were lovely and I showed them some documentation to prove DM didn't own a property she keeps going on about. This house was my uncles but db inherited it. It washy uncles but we all lived there at some point in the 70's. Df bought the family home dm lives in and owns now.

I took her to the hospital appointment that afternoon, she was quite quiet, so we carried on until she got to see the doctor. The doctor asked if she was well in herself and she said she was. I was behind her shaking my head and so the tirade started and she started to talk in her own language getting mixed up. The consultant was concerned as he knows her and her behaviour was erratic. He asked me why she was like that and I said she'd been like it for about 10 days or so.
Tuesday - She declared she was on hunger strike. Then she started attacking my db, pinching his arm, shaking him, punching his back and swearing at him, gelling him she wished she'd aborted him. I told my db to call an ambulance. It came and they and took her to A&E. I followed as she was violent against db so safer I went. I found her in a side room and sat with her. I didn't engage with her and sat looking at my phone. She was quiet, but again went into a tirade with the doctor. I let her do it so the doctor could see what she was like. They admitted her that night. They did a CT scan of her head and an MRI scan of her head too whilst she was in, but nothing has shown up.
We had a call from the psychiatric nurse and she was going to confer with the psychiatric doctor who would also see her.
We had calls from OT and then they were going down the safeguarding route (no concerns on that front). Talking about two houses.
the scans came back with no concerns.
Dm has now been sent home and she is still talking rubbish, moving between English and her language. Getting confused, argumentative and paranoid.
Does anyone have any experience of this? What could it be? If she doesn't have dementia or Alzheimers, what else could it be? She has been given Mirtazapine, but this hasn't calmed her down.
In the mean time I have told db to not engage in conversation with her and to keep things basic, like asking if she wants something to eat and drink.
Thanks for reading if you have got this far x

Check that b12 is one of the blood tests they are doing, as this being low can cause hallucinations too.

My mum was like this, literally like Freddy Kruger on a shit load of speed 😂
She had cancer and very high levels of calcium which was causing the confusion and aggression
I would push for a MRI / Scan and check for calcium levels
They treated the cancer and we got another 3 years with her

Sadly those 3 years she had dementia and Alzheimer’s but could still do a good impression of Freddy Krueger mother 😂

My mum was so bad she thought my sister was her dead cat 😂

Well, a lady from the council has been and suggested a carer come in the mornings. She’d seen dm agitated.
I’m sat here now, she’s flit between aggressive to quiet as a mouse. She’s not a happy soul at the minute and looks very angry.
When she’s been talking rubbish we’ve not engaged with her as she’s clearly ‘right’ in what she’s saying and is convinced she’s right.
The postman delivered a letter, weirdly it was an old pension of mine. She was convinced it was her, I gave it to her to read so she knew it wasn’t for her. She gave it back to me.
Thanks for all the ideas, it’s really appreciated.

Honestly I would ask to get her calcium levels checked for the possibility of cancer
Your mum sounds just like my mum was behaving

My mum's dementia started like this. Erratic behaviour and she kept saying she saw things that weren't there or there were objects there but she saw them as something entirely different. She was eventually diagnosed with mixed dementia - vascular and Alzheimer's

I should add to my post that my dm had episodes, so could have these hallucinations for a period and then be ok, well as ok as you can be with dementia. I wish you and your family all the best and hopefully investigations will give you a clearer picture.

I’d spent the afternoon with her to see how she was. There were some odd conversations. She was talking about the mortgage on her home ( it was paid off 25 years ago), she was getting teary about df. Df passed away in 2017, but dm was talking so much.
My db went out to get a break so I sat with her, and we talked a lot and it felt normal. She was telling me about the handsome doctor she had at the hospital and we were giggling about ‘you can look but can’t touch’. She was smiling and laughing which was lovely, but then descended into a tirade where saying my db was going to put her in an old folks home/ he’s assigned the house to himself ( it’s all a load of rubbish) she’s convinced herself he’s evil, but then as he was going out she gave him a list of shopping to get
We sat and sorted some bills out and she said she was panicking as my dm has hidden all the letters that are red. Not the case as db pays bills etc as well as her as they take turns.
I’ll check to see if she’s had her calcium levels checked. They’ve exhausted the infection route in hospital.

When she’s been talking rubbish we’ve not engaged with her as she’s clearly ‘right’ in what she’s saying and is convinced she’s right. You're right not to try to reason with her, it is just distressing for her, but see if you can engage a bit, eg saying you'll talk to your dm about the red letters and make sure she doesn't hide any in the future (ie don't admit she has been hiding them, don't deny it either, but give her hope that this fantasy she's afraid of will be dealt with).

The same thing use to happen to my auntie when she had a uti, often wouldn't show up on the dipstick test. you say she was dehydrated they often go hand in hand, could you ask for some antibiotics specifically for water infections just to totally rule it out

The hallucinations and erratic behaviour make it sound like Lewy Bodies Dementia. My family member would also see spiders webs, Lilliputian children, rain on the window and was convinced people were trying to steal her purse, handbag or sewing machine.

I’ve mentioned to my db about Lewy dementia, it’s another Avenue to go down.
She was in better spirits today, laughing and joking as she usually is. I took my dds and she was so happy. She seemed much calmer and she had a good feast for lunch.
She’d also slept better, apparently she woke at 8am declared she was still tired and went back to sleep. Although, she’s been wearing her mask in the house and confusing it with the hospital.

My dm has been taken to hospital again as she was call anxious and screaming for help. She attacked my poor db again 😔
He’s going to amble up to the hospital in a bit and sit with her. If things kick off I might need to go up.

I’ve told my db they need to do more tests and give a definitive answer to why she’s behaving this way.

My relative acted like this and was diagnosed with vascular dementia but it was seen on the CT scan. Maybe ask for someone to have another look at the MRI and CT scan. Impressed she managed an MRI scan. Hope it can be sorted easily if it was such a sudden onset.
for you and your family.

@Longdistance

My dm has been taken to hospital again as she was call anxious and screaming for help. She attacked my poor db again 😔 He’s going to amble up to the hospital in a bit and sit with her. If things kick off I might need to go up. I’ve told my db they need to do more tests and give a definitive answer to why she’s behaving this way.

You might find that they have to section her to really find out what is going on. Do not be alarmed if this is the case, it is actually a blessing as she would be in a safe environment surrounded by medics who can observe her and daignose what is causing this behaviour.

I agree that you both should not agree to her being discharged back home at the moment without some kind of diagnosis or medication. There is clearly something wrong here. Wishing you both well.

Thanks @OnthePiste I got the call from the hospital to rehash for the third time the set up in the house. She has the bed downstairs as she can’t manage the stairs. The bathroom is downstairs, there are assist handles in it and has a walk in shower cubicle.
They asked if we’d be happy to have her discharged, I said no as we’ve not been given a formal diagnosis of what’s wrong with her.
Worried about her safety, mainly wandering off and having a fall.

Ask that they get her seen by liaison psychiatry whilst she is in hospital as it would appear no medical cause has been found despite lots of tests done. There's probably limited value in doing a whole lot more tests. She needs a mental health opinion.

Well, I thought I’d come back to update, the hospital set up for dm to have careers come four times a day. Dm has now said it’s too much and only needs them in the morning and evening. She has had her moments when she’s calm and sweetness and light.
Today my db went out as dm wanted a few bits but didn’t want to leave. She rang the police declaring she was locked in the house. She wasn’t at all. They were lovely and they came back later to register her as an elderly person with dementia. We haven’t had a diagnosis. She did have a test via Zoom, but she remembered everything. She was given tablets for delirium, but we’re no closer to a proper diagnosis.

@Longdistance

Well, I thought I’d come back to update, the hospital set up for dm to have careers come four times a day. Dm has now said it’s too much and only needs them in the morning and evening. She has had her moments when she’s calm and sweetness and light. Today my db went out as dm wanted a few bits but didn’t want to leave. She rang the police declaring she was locked in the house. She wasn’t at all. They were lovely and they came back later to register her as an elderly person with dementia. We haven’t had a diagnosis. She did have a test via Zoom, but she remembered everything. She was given tablets for delirium, but we’re no closer to a proper diagnosis.

Have the hospital referred her to the Older people's mental health services? She needs to be if not so that she is in the system and can be assessed by the memory clinic or a psychiatrist.

My mum has done the same in ringing the police to tell them she is locked in. She can also pass the memory tests easily but has a diagnosis of Alzheimer's (which maybe about to change as they are not sure if it might be a different type). It does sound very much like your mum could have a form of dementia.

What do you mean by a proper diagnosis? Delirium is a diagnosis and you say she is being treated for it. You cannot diagnose dementia properly whilst someone is delirious as they may yet recover.

If you mean a cause for the delirium you may not find out. It may have been and gone. Delirium does persist often for many weeks after the cause is resolved. I think you said she was treated for a kidney infection which would certainly be a common cause of delirium

Hard as it is you may need to wait it out to see if it's getting better (delirium) or staying the same or worse in which case maybe dementia. If she's got some medication and a care package then it's hard to know what more could be done. If they didn't find an underlying cause after 2 hospital admissions then probably they are not going to find one I am afraid.

Is she open to a mental health team for support for her and the family ie does she have a CPN?

Well I'm not a medical expert but it sounds like dementia to me. Cast your mind back - had she been behaving a little strangely for a while, now you come to think of it? Can your DB remember any small oddnesses?

I've seen someone with dementia pass one of those stupid tests. Don't rely on them!

Have you got Adult Mental Health involved. You also need a referral by your GP to a psychiatrist.

If I'm going to be honest with you, then I only see this going one way - your DM can no longer be looked after at home. As her behaviour becomes increasingly erratic and she puts herself in harm's way (which she will), she will need to be sectioned. She will go in under Section 2, which lasts for 28 days. After that, if it's clear she has no insight to her condition, they will keep her in under Section 3. After that point, the council have a legal responsibility to house her in suitable accommodation.

Sorry to be so blunt, but she is obviously deteriorating rapidly so you need to be prepared.

Actually, and this is massively important - have you or your DB got a Power of Attorney for her, an LPA?

If not, get one now, before she's diagnosed, if it's possible. This will save you ENORMOUS hassle in the future.

This sounds so hard for you.
Nothing to add except that I hope you manage to gets some answers.

HelloThere I am a medic and that is scaremongering

Very very few people with dementia ever get detained under MHA. OP has not mentioned any risks sufficient to suggest such a course of action. Detention under MHA is a last resort matter.

OP said she deteriorated rapidly which goes against dementia which is a slow deterioration and for delirium which means she may recover and stop behaving oddly soon. She might have an underlying dementia but if this really was a sudden deterioration there is a good chance of recovery.