At my wit’s end with Mum’s paranoia & anger.

Beat

Registered User
Sep 11, 2023
16
0
Please forgive this very lengthy post - but I am at my wit’s end & had to get it out there!
My Dad & I are at-home carers for my Mum (diagnosed with Alzheimer’s last year). We knew it would be tough but neither of us were ready for the heartbreak of her regularply asking for her parents (she’s 79 so you won’t be surprised to learn they died many years ago). Akthough the sting has worn off somewhat.
Anyway flash forward to now when she often doesn’t recognise who we are. Or sometimes does, but doesn’t seem to have a handle on what that relationship means. She has intermittant spell of paranoia means she thinks no-one likes her (she has always been much loved & deeply respected). She also rarely derives any comfort from either of us, accuses people (sometimes literally just ‘people’) of moving anything she’s forgotten she’s moved herself. She’ll ask where her parents are, where her husband is (like me, Dad’s at home with her most of the time) and where her daughter (me), her son/the children are (I’m an only child in her 50s). She has spells of anxiety, paranoia & rambling on random subjects lasting 2-3 hours. This used to happen only occasionally, then every few days, as of now we’ve gone at least three weeks with at least one change a day, usually at least 2, sometimes more. Almost always we get a problem at just before 2pm. . If she is out of the house at that time she generally starts up as soon as she gets home. But it can also occur at any time, although first thing in the morning, evenings & last thing at night are most common.
If she’s not satisfied to our answers about her parents she accuses us of either of lying, keeping information from her, or or ’not being very helpful’. Or claims that her parents ignore her, told her to go away, left her behind - when, in fact, they were utterly lovely! She has also recently told each of us that the other one either tried, or threatened, to kill her.
Today has been a nightmare because we’ve had everything thrown at us. The usual 2pm session in which she introduced new imaginary aspects - other family, another husband, a wife (!), a couple that also live here, jobs she never had, etc.
And then there was tonight. At midnight she decided she didn’t know who the strange man in the bed was. Dad decided it was best to get out of bed & sleep on the bedroom couch, but she pursued him and (I can hardly believe I am typing this) smacked him around the head several times. He had to hold back her arm to prevent more blows. I’ve seen her have a couple of swipes at him before, but nothing of this level. While we decided how to proceed - do we call for help? Who do we call? Should I sleep in her room instead etc - she calmed down and even invited him into bed ‘so he could be more comfortable’. So far as I can tell, they are now both in bed (although probably not both asleep.
. I, however, am wide awake and listening out for any little sound from downstairs (my room is the floor above). Is there anyone out there who’s been through this? Or could offer some guidance? Right now I don’t know who to turn to! I’m also worried for my Dad because he’s a similar age & although fairly hale & hearty, it’s weighing him down too.
 

SeaSwallow

Volunteer Moderator
Oct 28, 2019
6,832
0
Hello @Beat and Welcome to Talking Point. I am so sorry to read about what you and your dad are going through.
I would suggest that you get your mum checked out for an infection especially a UTI as these can cause havoc with someone with dementia.
The behaviours that you describe are typical of the later stages of dementia and it might be getting to the point where you and your dad have to consider residential care for your mum, it comes to the stage where it takes a team of people to care for a person with dementia.
The hitting out is a concern, and I would suggest that you discuss it urgently with your GP. If you or your dad ever feel in danger you should get somewhere safe, even if you have to leave the house. Then call the police, they are trained to deal with these issues and will also contact adult social services. The most important thing is to keep your dad safe. Always keep a fully charged mobile with you.
I hope that this helps a little. Please keep posting even if it is just to rant or talk about how you feel.
 

canary

Registered User
Feb 25, 2014
25,456
0
South coast
Hello @Beat

I am sorry to say that all of the things you have mentioned are typical mid-stage and later stage dementia behaviours. The moving things around, forgetting that they have done it and blaming others of doing it (and possibly then accusing them of stealing) is absolutely classic and so common it is almost diagnostic.

The imaginary people and situations that she has created are called confabulations. This a a subconscious response by the brain which is trying to make sense of the fragments of memory which are left and fills in the gaps with false memories. Your mum will have no idea that this is what is happening and the false memories will seem to her to be the real thing, so she will be sure that they are true because she remembers them.

It also sounds like she is time-travelling ie - her mind is going back in time as these memories are so much clearer, but she thinks it is the present. So she thinks her parents are still alive and does not recognise family because she is expecting them to be much younger than they actually are. My mum thought I was her mum, because she was expecting me to a little girl and I was actually the same age her mum was at that time, so I couldnt be her her daughter and must be her mum. This time-travelling comes and goes, so sometimes they know who people are and sometimes they dont and they will often time-travel to different periods in their life. They also lose the concept of what the names of relationships mean, so thy know that people are related to them, but they dont know how.

This all means that your mum is confused, doesnt understand what is happening around her and is frightened. This is what is fuelling the aggressive behaviour - which is a concern. Please get in touch with her GP and tell them what is happening. She would probably benefit from anti-anxiety medication.

Also, dont try and convince her that what she thinks is wrong. She will not believe you and this will make her fear worse. You will not be able to bring her back into reality, so you will have to enter her world in order to calm her. For example, when she asks where her parents are, dont tell her that they have died, say that they are out shopping, or are away for the weekend, or anything else that in her mind, would explain their absence. Your role now is to minimise distress and if this requires Love Lies, or Therapeutic Untruths, so be it.
 

Violet Jane

Registered User
Aug 23, 2021
2,123
0
You need urgently to call your GP and ask about medication / a review of medication as the right medication can make a huge difference. The GP might be able to prescribe something straight away after consulting the Community Mental Health Team. Alternatively s/he might make a referral to that team.
 

Beat

Registered User
Sep 11, 2023
16
0
Thank you all for the very helpful responses. I am going to show them to Dad as soon as his breakfast duties are over. Thankfully, all is quiet on the western front this morning.
 

Beat

Registered User
Sep 11, 2023
16
0
Yes, we will. Because of the worsening situation, last week we'd made contact again with the local dementia services people and we have a rep who is asking the GP to contact us because we, inevitably these days, keep losing out on the 8am lottery for appointments. Assuming nothing further worrying happens today, we are going to see if that comes good today, then begin the 8am calls again tomorrow. If it's okay, I'll let you all know of any developments?
 

Beat

Registered User
Sep 11, 2023
16
0
Hello @Beat

I am sorry to say that all of the things you have mentioned are typical mid-stage and later stage dementia behaviours. The moving things around, forgetting that they have done it and blaming others of doing it (and possibly then accusing them of stealing) is absolutely classic and so common it is almost diagnostic.

The imaginary people and situations that she has created are called confabulations. This a a subconscious response by the brain which is trying to make sense of the fragments of memory which are left and fills in the gaps with false memories. Your mum will have no idea that this is what is happening and the false memories will seem to her to be the real thing, so she will be sure that they are true because she remembers them.

It also sounds like she is time-travelling ie - her mind is going back in time as these memories are so much clearer, but she thinks it is the present. So she thinks her parents are still alive and does not recognise family because she is expecting them to be much younger than they actually are. My mum thought I was her mum, because she was expecting me to a little girl and I was actually the same age her mum was at that time, so I couldnt be her her daughter and must be her mum. This time-travelling comes and goes, so sometimes they know who people are and sometimes they dont and they will often time-travel to different periods in their life. They also lose the concept of what the names of relationships mean, so thy know that people are related to them, but they dont know how.

This all means that your mum is confused, doesnt understand what is happening around her and is frightened. This is what is fuelling the aggressive behaviour - which is a concern. Please get in touch with her GP and tell them what is happening. She would probably benefit from anti-anxiety medication.

Also, dont try and convince her that what she thinks is wrong. She will not believe you and this will make her fear worse. You will not be able to bring her back into reality, so you will have to enter her world in order to calm her. For example, when she asks where her parents are, dont tell her that they have died, say that they are out shopping, or are away for the weekend, or anything else that in her mind, would explain their absence. Your role now is to minimise distress and if this requires Love Lies, or Therapeutic Untruths, so be it.
Since we realised what ailed her, long before her official diagnosis, we have avoided telling her the truth about her parents - you cannot imagine how many trips to the garden centre, darts matches, days out with friends and holidays to Scarborough they have enjoyed! Ironically, she seems to have no memory of her sister. We haven't tried to remind her lately, since they have always had a very troubled relationship.

The time-travelling thing makes sense and I am wondering if it accounts for an aspect that reared its head last night? Mum's often talking about a man and a woman, the other man and his wife, the husband and wife and so on. Last night as she was returning from the bathroom (I was on 'hall duty' at the time because she'd already managed to open every door on that floor and let the cats out), she said that there was a woman already in the bed - on her side of it, actually (it was empty). And I am wondering if part of her might 'see' herself, or a memory of herself, and of Dad in places where she has a flash of a memory, but cannot make sense of it?
 

canary

Registered User
Feb 25, 2014
25,456
0
South coast
And I am wondering if part of her might 'see' herself, or a memory of herself, and of Dad in places where she has a flash of a memory, but cannot make sense of it?
Thats quite possible.
It might also be a memory from her childhood of her parents. Or she might be seeing herself in a mirror and thinking its another woman
 

NickP

Registered User
Feb 23, 2021
123
0
HI @Beat - I'm so sorry to hear about the things you are facing with your mum. As others have said, sadly they seem very common behaviours for people with Alzheimer's. You could have been describing my dad (as he was a year or so ago). When things got like that with him and we couldn't get help, I eventually put in a direct call to Adult Social Care and said that my parents were not safe. The 'safeguarding' issue triggered a response and we fairly quickly had the Integrated Care Team (attached to the GP practice... I know not everywhere has them) involved. This led, amongst other things, to involvement from the mental health team and medication which has really helped. I hope that you get some help soon. Take care.
 

Beat

Registered User
Sep 11, 2023
16
0
Again thank you, everyone. We have taken some action, are awaiting callbacks etc. And have follow-up letters ready for the GP is we appear not to be getting anywhere. For now, all is calm.
It used to be that my main worry was that, Mum's mood might change, as it often does, just prior to an arranged appointment or booking for an activity and we have to cancel. How things change.
 

Beat

Registered User
Sep 11, 2023
16
0
Just to let everyone know, we have been contacted by our GP surgery and Mum (with Dad) has an in-person appointment with one of the GPs on Friday. In the meantime, we have been able to give them a letter detailing all that has been happening, so that the GP can have a full heads-up before the appointment. Will let you know how things go.
 

Beat

Registered User
Sep 11, 2023
16
0
Further to my last message. The face-to-face went well. Some ideas for medication were discussed. Mum has been referred, as an emergency, back to the community mental health team. In the meantime, we are experimenting by having a rest from her Dompezil to see if that helps. Things are currently calmer here, so we are grateful for that, for the progress we seem to be making within the system & for all your help and support. Thank you.
 

Beat

Registered User
Sep 11, 2023
16
0
Hi, I just thought I would update things. The emergency referral was a very long wait ( we’re not complaining because we know the stress the system is under). Eventually we received a visit from a nurse to assess the situation. She recommended Mermantine. Once Mum had been assigned her nurse, who visited a few days ago, we learned that the new drugs had not been organised and that the consultant might first wish to see her in person, and besides that she must have a blood test to check she can tolerate the meds. Because it generally takes a couple of weeks to get a hospital blood test locally, I’ve booked her one in anticipation of us receiving the blood test request form before then. I’ve a feeling I’m going to be rearranging that but, still ... Assuming she’s okay,we’ve been told that it is likely to take 3 months before we see whether/how well it works for Mum. In the meantime we’re left trying to organise some kind of Xmas.
We’ve had a terrible day today (probably payback for my Dad’s birthday being relatively enjoyable the other day), Mum’s been angry a lot of the day, and while there has only been the three of us here, she is adamant that there have been lots of people in the house all day, upstairs, downstairs, telling her to do things, calling her names, being nasty to her etc. Today she’s been saying her parents (died 1974 and 2001) have been ignoring her. Somehow all this seems to be our fault. All this shouting, screaming (sometimes if someone just touches her gently, or brushes past her, she lets out howls of agony. It’s horrible, because I lover her and it’s so bad seeing her like this.
. I am struggling to garner any enthusiasm for preparing the food for Xmas etc. It was always something we did together, but cooking is something she hasn’t been able to do for a long time. We’ve done the only sensible thing and ‘planned’ a quiet Xmas with just the three of us and a lot of buffet-type meals with elements that are either frozen, or will store for several days in the fridge so we can eat when we feel the mood is right.
But I’m not personally feeling the Xmas vibe, Not one bit. .
 

Violet Jane

Registered User
Aug 23, 2021
2,123
0
It's good of you to post an update. I'm shocked that three months later your mother has still not been started on any medication after an emergency referral. Appalling, and appalling disorganisation by your local services. I don't think that you should make any excuses for them.

I think that you're wise to keep Christmas quiet and simple. You don't need the stress of hosting or complicated cooking. You're bound to feel a bit sad when you think back to the Christmases you used to have.
 

Beat

Registered User
Sep 11, 2023
16
0
It's good of you to post an update. I'm shocked that three months later your mother has still not been started on any medication after an emergency referral. Appalling, and appalling disorganisation by your local services. I don't think that you should make any excuses for them.

I think that you're wise to keep Christmas quiet and simple. You don't need the stress of hosting or complicated cooking. You're bound to feel a bit sad when you think back to the Christmases you used to have.
Thanks for your words. We were warned it would take time. If I recall, the GP said it‘s been taking around 10 weeks, but it is a bit of a blur. I’m so grateful there’s the two of us with Mum (Dad and I), because I don’t think either of us could have coped alone! I just don’t know how people manage. You can probably tell by the times I post on here just how well my sleep pattern is going …
We have decided that, if we haven’t received the blood test form straight after New Year, that we’re not letting this one go. We’re both tired, both juggling working from home with caring duties and are dealing with a very stressful and emotionally challenging situation. Our priority, of course, is making sure Mum’s as good as she can be. That’s everything. At the same time, each of us is worried about the welfare of the other.
I’m struggling to get my words out here, so apologies for any typos. I’m going to try to catch a few winks while I still can.