Update on my mother

[proud2BlibKansan]

The other day I posted a rant about my senile and insane mother. Things have gotten worse since then. Her caregiver quit yesterday after Mom had spent all week hitting her and refusing to cooperate. Last night, I talked to Mom and told her that she is giving us no choice but to put her in a nursing home. This is something she does NOT want; she just spent 6 months in an assisted living facility and hated it. We decided to put her back in her house with a full time caregiver. My sister lives with her. She has now gone through two caregivers since April 1.

So I told her she could not stay in her house with my sister unless she was nice to her caregiver and stopped hitting her. The whole time I was talking to her, she asked me to turn the TV back on, she wanted to watch Keith (she is a lifelong Dem and loves Countdown - so at least she has a few good qualities :) ). I said no, Mom, we need to talk about you hitting your nurse. She said no, she hadn't hit her. Then she looked me right in the eye, called me by my first and middle name and said "I am an almost 80 year old woman and I am going to do what I want when I want to." And she got up and went into her bedroom.

About 10 minutes later, my sister went in her room to talk to her and as soon as she walked in, my mom hit her - hard. I asked Mom why and she said "Because I wanted to".

She has also been delusional. She claims she and her caregiver were going somewhere in the car when the police pulled them over and arrested the caregiver and threw her in jail. Today she told me my sister, who is in Europe now, came over to talk to her this afternoon. And she said the caregiver had gone to the bank to find out if Mom's house is paid for. She has also been saying for about two weeks that her caregiver is very ill and can't take care of her anymore.

So, thanks to the advice I got here on DU the other day, I called her doctor's office today and asked for a psych eval. Her doctor is convinced the chronic urinary tract infections my mom is having (for the past three years) are causing her to be 'difficult'. I told the doctor's nurse that in spite of the cause, we cannot have her hitting anyone. If there is nothing we can do to stop this aggressive behavior, then maybe the doctor can recommend an insane asylum for elderly crazy and violent women.

Tom Cruise would not approve, but I think the best thing we can do now is put her on massive amounts of behavior altering drugs. Either that or wait for her to be charged with assault.

[Frances]

1. Your mom definitely needs to be evaluated

by a psychiatrist with geriatric experience. You are right--whatever the cause, that hitting cannot continue.

[Tallison]

19. Good advice.

See if you can find a geriatric psychiatrist. Unfortunately, finding the source of the problem can take a lot of trial and error med management. Take one away, wait a few weeks, see if there's change, if not replace the original, take away another, repeat... Very frustrating but unfortunately the only way even most good docs can isolate the cause or causes of a problem of this nature. Best of luck.

(Edited for punctuation)

[proud2BlibKansan]

23. Thank you

good advice

[GreenPartyVoter]

2. Wow. I am so sorry *hugs* When my grandfather got to be too much

for my nana we had to put him in the lockdown wing of the VA nursing home.

[proud2BlibKansan]

6. My mom has always been a bit on the insane side

She had a horrid childhood and never had any therapy to deal with her own personal demons. The interesting thing is she has 4 daughters who have never been reluctant to seek counseling as we face life's challenges.

But Mom's insanity is just more obvious now that she is senile. At this point, a lock down facility seems quite possible.

[shugah]

3. if a UTI is the root of the problem

which sounds a little strange - but i'm not a doctor - can't the UTI be treated?

[Tallison]

5. UTI *DEFINITELY* can do this.

If so, it's called delirium, not dementia, though the two can be real hard to distinguish in elderly folks who may have a little of both going on. Delirium is any change in mental status that's metabolically induced and reversible, as opposed to dementia, which results from organic changes in the brain structure itself (as in Alzheimer's, Parkinson's). Trying to reason with someone who's suffering from either is useless until you address the underlying pathophysiology, with antibiotics in the case of a UTI, although if she's had a chronic case for three years, the bacteria causing it are probably resistant to standard varieties, and she may need a newer, atypical kind along with IV administration to really eradicate it. Seen this happen a lot with elderly folks. Feel free to email me with any more specific questions, [e-mail].

[proud2BlibKansan]

8. It's scary

This is what killed the pope. And it is amazing watching what this infection does to my mother.

[Tallison]

11. Some women (like myself) are predisposed to UTIs just based on our

God-given peculiar anatomy. After successfully treating an infection in such cases, some docs will put folks on a daily prophylactic dose to prevent reoccurrences. It's worked for me. Glad to hear she's still ambulatory. Hygiene's real important to chronic UTI management, too, which is something to be sure the caregiver's aware of (most are, but I've been surprised in working w/some in the past!).

[proud2BlibKansan]

15. I used to get them too when I was young

and when I was 21, (30 years ago), I was sent to a urologist who put me on a 6 month regimen of powerful antibiotics. I have NEVER had one since. I also didn't catch a cold or the flu for about ten years after that.

[REP]

18. Maybe in The Elderly

I've had a chronic kidney infection for well over a year (going on two years, really) and while it can make me cranky and cause fevers over 103, it does not cause delirium.

Since the person being discussed is diabetic, it's likely she's having lower-tract infections. Diabetes - especially poorly-controlled diabetes - has been linked to a decline in cognitive function and that, along with age, medicine and other factors may be causing her behaviorial problems. I hate to be the bearer of bad news, but anger and violence is often a symptom of Alzheimer's or dementia.

[Tallison]

25. Particularly in the elderly

I don't know the pathogenicity behind it, but any kind of infection in elderly folks is likely to cause mental status changes, even lower-track UTIs. It's amazing sometimes to see an older person's cognition clear up after a four-day course of antibiotics. Like night and day, in some cases. Now, that's assuming their baseline mental status is all within normal limits, and if someone's in their 80s and been chronically infected for 3 years, it's hard to know what their baseline is any more, and you're right, quite possible there's something comorbid going on.

(Edited for spelling)

[proud2BlibKansan]

26. She has been evaluated for Alzheimer's several times

The doctors also tell us that these UTIs cause crazy behavior in the elderly.

[proud2BlibKansan]

7. It is treated

It just keeps coming back.

[Lilli]

4. I'd also look at drug reactions and interaction

Could easily be related to a medication reaction...even things you might think wouldnt be a problem could cause a shift in personality

[proud2BlibKansan]

10. Thanks

I will remember that.

She has a long history of being extraordinarily healthy. She never even had any childhood diseases. No mumps, measles, chicken pox, etc. She never ran a fever until she was 75 years old. So she has an amazing immune system. She never took any daily meds except vitamins until 3 years ago. Now she is diabetic, has high blood pressure and these chronic UTIs. So she takes several meds daily. And her body is not used to being a chem lab.

[Tallison]

12. Yeah, bacteria LOVE all the excess glucose in the urine of diabetics. n/t

[Lilli]

16. My mother is that way too...never had to take anything and now

shes a walking drug experiment...Shes had BAD reactions to meds no one suspected could cause problems...she calls me to have me check on anything they try to give her now.

Maybe get a list and check them out online...or go see your local pharmacist?

Am hoping you'll find a way through this sooooooon.

[proud2BlibKansan]

22. Thanks

I always thought it was wonderful that she was so healthy. But now it is so weird that she is sick all the time.

[Lilli]

24. Yep....my mom climbed up a tree when she was six months pregnant

saw in hand, because the branches blocked her view...now she just rolls from one health problem to the next...

[MuseRider]

9. Damn

I agree with the poster above who wondered about a UTI being the cause but a drug reaction is more likely.

I am soooo sorry. I was worried when I read that you had caregivers. My problem with them is that they do call in sick or are occasionally unreliable and then there is nothing to do but to take care of them yourself. I could and did do it but I was not working outside my home at that time, my kids were small. That was difficult enough but with your job you just can't call in all the time. (to clarify to all home care givers, I was a nurse so I understand, you do a great, heroic job but some are less reliable than others)

As horrible as the choice might be it might be the only one. I kept my mother at home because she wished it. She was out of her mind and almost burned her house down a couple of times or would yank her trache out in the middle of the night and I would have to go over and put it back in. It is always a mess when the mental faculties start to go. A home may be the only safe place for her at this point. Just be careful to visit often and at different times to check that she is not being mistreated.

:hug: :hug: :hug: :hug:

[proud2BlibKansan]

20. I am lucky - I have 3 sisters

One of them lives with Mom. But she is disabled and can only take so much stress. She was so frantic when she called me yesterday, I was crying out of concern for HER health. Another sister works full time like me and travels a lot. She also has young kids so her time is pretty limited. My third sister is a stay at home mom with three grown kids. So she normally does the lion's share of the work taking care of Mom. But she is in England for the summer. And we vowed not to bother her while she is away enjoying a much needed break. Now I have to call her tomorrow for the second time this week. But we work as a democracy and make all decisions together. She may be a bit irritated with me for calling the doc and asking for the psych eval without consulting my siblings first. But I had to do SOMETHING.

I don't know how only children handle the stress of dealing with elderly parents. I feel very fortunate. We have a rotating schedule and between the 4 of us and our kids, someone spends every evening with Mom. We also take her out to dinner once a week as a family. If nothing else, my sisters and I have grown very close dealing with all of this.

Our dad was a history teacher and a current events junkie and we were all raised to be proud liberals. So we usually talk politics at our family dinners and you know I love that :) I count my blessings all the time that I don't have to deal with obnoxious freeper family members. (There is one BIL, but my sister divorced him:) )

[deadparrot]

13. I don't know if you want or need help/more information,

but here's a link with a little info and a couple of resources for your problem.

http://www.medinfosource.com/expert/exp4091503b.html

[proud2BlibKansan]

27. Looks like a good link

Thanks :)

[deadparrot]

30. No problem.

Hope it helps. :)

[barb162]

14. yeah, Cruise wouldn't approve; maybe send him there and

the current doc and they can talk scientology to her and she can slug both of them a few times. Let's see if the current doc calls her difficult when she slugs him. Seriously, I am so glad you called the doc re the psych evaluation. I bet a good shrink can size her up in a very short time and get her on the proper medication and get her the right help.

[proud2BlibKansan]

28. This is too funny

My mom saved a copy of a newspaper article about Scientology for me. As senile as she is, she can still talk about current events and politics and keeps up with the latest. She knows I detest Tom Cruise and the Scientologists have been sending my son strange junk mail for several years now, so I think they are pretty nutty too.

[barb162]

36. Glad you liked it. You need a break

Caregiving is so difficult in any situation and a lot of people don't understand that until they do it. I lost a lot of weight both times I did it(when I am upset I lose my appetite). Let us know what happens; that doc sees so obstructionist either from ignorance or from lack of caring about the real situation

[faithnotgreed]

17. oh im so sorry.... it really seems youre handling this

as well as anyone possibly could

and im glad you got in touch with a doctor. it really is true that physical problems can greatly impact mood/behavior without realizing that its going on
of course that would be so great if this doctor can help her at all
i have heard of uti being a real issue in the aged

very best wishes and hugs to you and your mother and your sister

[proud2BlibKansan]

29. What a nice post

thanks for the hugs.

[Name removed]

21. Deleted message

Message removed by moderator. Click here to review the message board rules.

[proud2BlibKansan]

31. I honor my mother AND my father every day

by living the life I do as a wife, mother and professional. My parents worked their butts off to send 4 kids to college. Two of my sisters went to Ivy League schools - one shares Hillary Clinton's alma mater. We were raised to be independent women, involved community members and caring individuals. Every single one of us is active in local charities and political causes and give back to our community on a daily basis. Our father was a highly respected educator in our community for 40 years and his legacy is cherished by his daughters. He worked 3 jobs to give us the education and opportunities we had as children. Our mother was the only working mom we knew while we were growing up. She dealt with child care and baby sitters and was determined NOT to make us latch key kids - in a day when she had no peer group since every other mom in the neighborhood and in our extended family stayed home and had no career.

So I honor my parents every day by living a full, complete and satisfying life. That was their dream for all of us.

We were also taught to be assertive and speak up and to fight injustice. But since we were also taught to be respectful, I will refrain from telling you to fuck off.

[Floogeldy]

33. I already figured out that your Mother and Father did those things for you

I was talking about what you are going to do for your mother, now.

I mean, in addition to her being charged with assualt and battery.

[proud2BlibKansan]

35. I have no intention of charging her with assault

but I can't control what her nurses may decide to do.

[blondeatlast]

38. There are no good ways to handle this situation, and it would be

best if you hadn't replied if you have nothing positive to offer.

P2L is making the best of an unwinnable situation. Other's judgments have no place here.

I hope that you are never faced with a similar situation, but if you are, I hope no one disses you on your handling of it.

[carpetbagger]

32. Some stray advice...

Your mom is still your mom, the same person who loved you (I hope) all those years. It's just that her brain no longer works correctly.

Get an evaluation from a geriatric psychiatrist. I'm not giving out advice here, even though I'm a doctor, even as one who is employed in a geriatrics division. Your mom's problems aren't straightforward, and I can't make assumptions about dementia versus other stuff (although a chronic medical condition seems unlikely by itself to cause ALL of this). When you see the psychiatrist, bring in some blood results, including TSH, B12, Folate, maybe RPR (her doctor will know what these are, and may have already ordered them), and copies as well as readings of any CT/MRIs that may have been done in the past.

Medications are often helpful with these types of problems, and your doctors may prescribe antipsychotics or antidepressants, or both (or neither).

If you need to institutionalize her, you'll probably be able to find some type of dementia unit within a nursing home that will work with her behaviors. Occasionally I see people admitted to psych wards for this type of thing. Try to find her a geriatric psych unit if this is recommended: not only for the treatment, but a general psych unit would probably scare her. It's very, very rare for people with her types of problems to end up in any kind of chronic psychiatric hospital.

And remember, your mother is still your mother. She just punches people for reasons she doesn't understand. She loved you when you had your temper tantrums, I assume. Hopefully the upcoming fireworks/indictments over the next few years of Olbermann will distract her a bit.

[proud2BlibKansan]

34. Thanks Carpetbagger

Her doctor seems okay. She does see a geriatric specialist at a teaching hospital. Her practice is in an aging center. The few times she has been hospitalized, they have taken excellent care of her. And the nurse I talked to today at the doctor's office was just wonderful.

[blondeatlast]

37. (Mostly) you've gotten some excellent advice here. I can't add to it.

I can offer support, and you might want to visit DU Chronic Health Conditions forum for some non-judgmental support and advice--plus, if it gets to be too much, we're all ears if you just need to let it out.

It's what we're there for, so drop into our little pub anytime the need rises. :hug:

Link to forum on edit:
http://www.democraticunderground.com/discuss/duboard.php?az=show_topics&forum=317

[ismnotwasm]

39. I was a nurse in long-term care for eleven years

I've read your posts about your Mom, and I wanted to tell you, that there are a lot of folks, (including a prominent republican politician or two--not to be named of course)who would have given up and placed Mom in long term care a long time ago. You are to be commended for looking for help, not giving up, and showing the loving care you have in one of the most stressful situations we face as older adults. A nursing home is not a bad option if you can find a decent facility. I agree with the posters who have suggested to look for physical reasons first. Depression in the elderly remains horribly under-diagnosed and under-treated. And contrary to certain movie stars opinions, I've seen major behavior improvement from antidepressants alone in the elderly, and low doses of the the new generation anti psychotics. A geriatric nurse practitioner or MD is the right idea, like others have said. Have you ever read the poem "Warning" by Jenny Joseph? One of my favorites:

When I am an old woman I shall wear purple
With a red had which doesn't go, and doesn't suit me.
And I shall spend my pension on brandy and summer gloves
And satin sandals, and say we've no money for butter
I shall sit down on the pavement when I'm tired
And gobble up samples in shops and press alarm bells
And run my stick along the public railings
And make up for the sobriety of my youth
I shall go out in my slippers in the rain
And pick the flowers in other people's gardens
And learn to spit

You can wear terrible shirts and grow more fat
And eat three pounds of sausages at a go
Or only bread and pickle for a week
And hoard pens and pencils and beermats and things in boxes

But now we must have clothes that keep us dry
And pay our rent and not swear in the street
And set a good example for the children
We must have friends to dinner and read the papers

But maybe I ought to practice a little now?
So people who know me are not too shocked and surprised
When suddenly I am old, and start to wear purple