Not sure what is going on or if I am going crazy

[AllTheChaos]

Hi all, first time poster on this particular topic. I am hoping for some guidance on getting tests for an older person who does not think there is anything wrong with them. About to be long winded, but trying to explain where things are at:
My Mum is mid 70s, and until about 6 weeks ago was absolutely fine, totally herself. Then pretty much overnight she experienced a massive personality shift, with about two weeks of dreadful mania and paranoia (ranting, sleeplessness, knew she was manic but no idea why). The worst of the mania then eased, but she is still very much not herself, keeps going on and on about being an enlightened being (!), how she just ‘knows things’ (eg today she is convinced that peace has broken out in Ukraine and doesn’t understand why the papers aren’t reporting on it), spending money wildly, trying to give large amounts (for her) to people she knows a little through her various drama groups etc (no idea if these gifts have been accepted), still sleeping badly, and still suffering from a fair amount of paranoia and anger (lots of shouting and ranting and saying breathtakingly unkind things). Her friends are all worried about her, and several have contacted me to say there is something very wrong. BUT, Mum is convinced she is fine, that she is just an enlightened being now, that this is her ‘true self’, and we all need to accept that. She will not countenance the idea that something is wrong, which means she won’t arrange tests. I’ve contacted her doctor repeatedly to ask that she be tested for UTIs and referred for brain scans, they just send me a triage form, which I complete and return, they call Mum, she tells them she is fine, and nothing more happens. I am at my wits end. I have severe health issues and caring responsibilities for my SEN tweenager, so cannot just go over to where mum lives and try to, I don’t know, physically march her to the doctors? Does anyone have an idea of what I can do? I don’t know if the doctors have any kind of legal responsibility to take my concerns seriously, I am loathe to contact Social Services when they are so overwhelmed with people in serious need (plus poor mum would never forgive me and I don’t want to drive her away, especially not when I think she is very vulnerable), but I just don’t know what to do!
I apologise for such a long a post, I’m just kind of desperate here!

Has she had any medical checks at all? Something as simple as a UTI can cause serious mental changes in more elderly people. You really need to push for some kind of help. This is unlikely to fix itself.

To add, she is getting very confused, getting lost when she is out and about, constantly late and missing things (all of which were alien to her before all this), forgets things moments after they have been said, is fixating on random things (water use is an example, she is hoarding all her water from washing etc. to use to flush the loo as has become fixated on saving water, there’s buckets everywhere in her flat apparently!) She comes here several times a week and is doing the same here. Her memory is now so
poor and erratic that it is sometimes making conversations difficult, though she keeps telling me her memory is perfect,
literally in the same conversation where she’s just forgotten what she said a moment before.

Thank you, @Smartiepants79. I am thinking UTI as it came on so suddenly, but she refuses to even acknowledge the possibility, and I don’t know how to get her doctors to test when mum won’t ask them for a test and they ignore my concerns.

I'm thinking UTI too. My mum got one and she totally changed. Get her to the doctor even if she protests!

Take her out for lunch and stop at doctors on way!

Ooh that’s a thought, @Italiangreyhound, I could ask my doctors if they would agree to doing a test for someone who isn’t a patient, I just assumed they wouldn’t? Honestly I used to be quite a competent person, I’m not any more (brain function is affected by my own health issues), but this is so alien I am just at a loss

How worrying for you. I agree that very sudden onset suggests UTI or brain tumour.

The trouble is, even if you get her there she still has to agree to the test & giving any samples. The assumption is that people have capacity unless you prove otherwise, and proving it is really hard if they don't cooperate.

I'd be inclined to ring adult social services just for advice. And her GP ditto - say you're not asking them to tell you any confidential patient info, but just want to know if there are any referral routes/outreach teams/anything else they can suggest that might help you get her assessed.

If the practice has a specialist in either older people's health or mental health, they may be a better option than her named GP.

That’s my worry, @BinturongsSmellOfPopcorn, there is no way she will agree to a test. I will try her GP again tomorrow, and the Alzheimer’s society. SS depending on what the outcome of those calls is, though that’s a bit of a last resort. I’m praying it’s not dementia or a brain tumor, we went through both with my dad and with my grandmother, and it was horrendous, more than a decade of care and decline in each case. I’m no longer capable of
providing care to someone with either.

It hadn’t occurred to me that her practice might have an older person specialist, they probably do given the demographic of where she lives, good call! Thank you

Dementias almost always come on much more gradually. UTI is by far the most likely option, given how common they are in older women.

Good luck with getting it resolved, but remember you can only do what you can do - within both your own needs/abilities and the limitations of the system. If you don't get anywhere, you've not failed - what matters is that you've tried.

I'd call the mental health team and arrange an assessment at a time you can attend. They are used to working people who do not recognise that they are ill. So are social services, I know you don't want to contact them but I would if you get nowhere with the mental health team.

If you can't get her to agree to go to the gp, when you're with her, call 111 and choose option 2 to get through to the mental health services. Hopefully they'll be able to talk to her over the phone and they can send an ambulance if they can't get her to commit to attend an appointment. It could be a UTI, but whatever it is, she needs treatment

I was going to say, call 111 and speak to them, they may well either tell you to take her to a&e or send an ambulance. We had this with my uncle in his 70s, he thought we were all spying on him, had put cameras in his house and were trying to poison him. Turns out he had a UTI. We ended up calling an ambulance because he wouldn't let us in the house and we were so worried. The paramedics were amazing, they deal with delirium in the elderly all the time and they were able to persuade him to go to a&e and get checked out.

UTIs are the most common thing people think of when an older person suddenly goes a bit deranged, but it can be other things. A stroke could explain the sudden onset of delusions, or an electrolyte imbalance.

My DM had a sudden decline in cognitive ability when her blood sodium levels were out of whack due to a medication she was taking. She wasn't showing symptoms of psychosis like your DM, but her speech was very confused and she was losing touch with reality in other ways. Taking her off the medication led to a rapid improvement.

DF had an episode of delusions of grandeur and paranoia brought on by infections and hospital-induced delirium.

I hope you manage to get her to a doctor somehow.

https://www.mentalhealthcare.org.uk/who-experiences-psychosis/older-people/

Can you get her to GP for 'routine testing' and tell her its normal screening for people of her age? Obvs with gp knowing real reason?
Similar to smear testing at 25 and prostate at 50+ say its a 70+ test or something?

Sorry im not sure what else to suggest. Sadly if she doesnt think anythings wrong then i dont see any other way. Is there something she would be willing to go to gp for that she routinely did?

Aunt 97 was taken into hospital after a fall, had been slightly confused the previous week. She was increasingly aggressive, seeing things, going back to her childhood etc. was a uti. Hospital said delirium which has taken 3 weeks to clear. Now back to normal mentally, although fractured her shoulder while in hospital. Could be very similar with your mum.

This, or if she is very far gone tell her that they are interested in meeting an enlightened being and seeing how it has affected her body’s baseline stats…..