Delusions ramping up for Mom

andrew250

My mother has vascular dementia (maybe Alzheimer's too, hard to say for sure), and entered MC in Sept. She is 90, and this disease is moving fast for her. She was starting to have delusions over the summer, but they were benign things that were easy to dismiss. 

Since Christmas, she has been mostly in an agitated, delusional state. In particular, she has decided one of my sisters died. Usually I can do the whole "meet me where I am" thing and go along with the delusions, but this one is tough to go along with.  

Every day she has been having a sundown meltdown, with increasing agitation. All the delusions are about needing to get out of the facility. First, she needed to get to the funeral for my sister. Then it switched to needing to get out because her other was waiting in a taxi to take her to get married.  Last night (New Year's Eve) was a bad one where her young children were taken away from her and were going to die. She recognized that her adult children are also her children.

She is on Zyprexa (and Citalopram) and eventually it kicks in. She's EXTREMELY hard to distract. She's very smart, and quickly sees holes in anything we try to say. 

The common thread in the delusions is that she is separated from family, and she needs to get out. The emotion she is feeling is  true and valid, even if the stories are not. Unfortunately, we haven't been able to visit for 3 weeks now after a staff member tested positive for Covid. Hopefully we can visit again soon, and maybe that will help. 

How can we deal with this level of delusions? I can't go along with my sister being dead, so I try to pivot to how sad she must feel about it. Is this what severe dementia looks like? Vascular Dementia is supposed to be noted by the sudden drops in cognitive ability. Maybe this is a new drop? 

M1

Andrew I bet you're on the right track, I wonder if the Covid separation made her think your sister had died (because she hasn't seen her)? So sad, but it sounds like you're handling it as well as you can under the circumstances.

Quilting brings calm

Andrew

Have her tested for UTI with a culture, not just dipstick.  It sounds as if she ramped up suddenly.  

andrew250

I wondered about that, except she had a urine test just over 2 weeks ago. The result showed some bacteria but more indicative of a not-clean catch. She had a round of antibiotics based on the culture results, that ended a few days before this started.  It seems unlikely she would develop a UTI within days of coming off the antibiotics, but maybe?  

I have wondered how often to test for a UTI in general under her circumstances. She was also tested right before Thanksgiving (also a stick and follow up culture) with totally negative results.