After ER last night....more delusions, nurse calls me

John2.0.1

After my topic on the ER trip yesterday, https://www.alzconnected.org/discussion.aspx?g=posts&t=2147556926 and mom' unexplainable injury and delusions, today I called mom in the morning and she was OK. 

But at 5:30pm i got a call from the nurse.

She put mom on the phone.

Mom was insisting I come get her and bring her home. I'm thinking home to her old house? No. She is panicked. She is having a delusion she is at the train station and needs a ride back to her room in the MC. She IS IN HER ROOM at the MC. 

I say "Mom you are in your room. "

Oh...

Apparently she was just about to have dinner in the common area and just snapped into her delusion.

Hearing my voice snapped her out of it but I'm concerned that this can not continue. If it keeps up the MC will say they can't keep her safe.  I am going to try to get an emergency call with her meds person but any suggestions what to ask about? 

The two bolded below are already supposed to help her with her delusions and help her stay calm but it's not working..

She has all kinds of delusions but most common is that she snaps into a delusion that she is not at the MC and in her room and she panics and the only thing to snap her out is my voice of assurance that she is in fact in her room.

These delusions go from 0 to 100mph in a second. And drop away when she hears me.

She has Parkinson's and Parkinson's dementia.

Her current meds are:

Rytary

ROPINIRole

Ursodiol

Donepezil

Pravastatin

Sertraline

Seroquel

and vitamins, aspirin, calcium...

[Deleted User]

The user and all related content has been deleted.

aod326

I agree with Victoria. I know this will feel like yet another thing to take care of, but you may need to consider another MC. From this and other posts, they don't seem well-equipped to deal with dementia patients. Is it an AL with some MC, as opposed to MC exclusively?

You need to talk to the the director and ask what their tailored plan of care is for your mum. Asking to go home is a common behavior for PWDs, whether they are in MC, or still at home. It is not sustainable for the answer to be "call you". 

Medication is one important piece of the picture; dealing with dementia behaviors is what they should be experienced in. (Not to mention what you're paying for.) Having said that, you may not need to add anything - there's a huge range of dosages for those meds.

You are dealing with a great deal right now, and I hope I don't sound unsympathetic. Sometimes we can benefit from others' perspective. Good luck.

John2.0.1

I plan to have a sit down with them and hear their answers on how they plan to deal with her increasing delusions. The place is only 5 minutes away if the traffic lights are with me. I hope they can handle it. My mom is currently paying $10,450 per month.

The other issue is her currrent neurologist is on sabbatical and the appointment with the neurologist temp neurologist isn't until August. We have been working with a very knowledgeable pallative  care NP. I don't know if mom needs a separate geriatric psychiatrist too. 

Would one Dr treat the mobility side of her Parkinson's and another the dementia side? I know that meds on one side can negatively impact the meds on the other. I worry about two DR'S treating the same disease.

Pathfinder52

Dear John --

Sorry you need to be here, but you're in a good place with good company!

I'm wondering if anyone (of her physician team) has ruled out Lewy Body Dementia.  Yes, Parkinson's can come with dementia symptoms but Lewy Body Dementia (a diagnosis that is often over looked) has delusions as a hallmark of the disease.  Treating it as if it was just Parkinson's disease won't help.

Wishing you all the best as you search for answers.

--p

Iris L.

You might want to read A Caregiver's Guide to Lewy Body Dementia by Helen Buell Whitworth and James Whitworth.  It may help guide you to what questions to ask the doctors.

Iris

jfkoc

drugs.com

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

• Rytary (carbidopa / levodopa)
• ropinirole
• sertraline
• Seroquel (quetiapine)