Mom has undiagnosed dementia - NP believes it is vascular dementia, visiting nurse thinks her behavior is more like alzheimers, PCP thinks it could be latent bipolar disease since it happened pretty quickly. In any case, there is some psychosis going on for some reason. We are in the process of getting a psych referral but not sure that Mom will cooperate. Well last night was the worst yet. Mom had a pretty good day. I actually carried on conversations with her most of the day. Then something snapped and she didnt know who I was. This has happened before where she thinks I and my sisters all have imposters. Mom went into the hall in her apartment building and starting banging the walls and screaming to call the police. Two neighbors came out and tried to calm her. I also called a friend and asked her to come over. Mom recognized and responded to all three of them but insisted she had no idea who I was and I was certainly not her daughter. Can anyone shed light on how she can relate/respond to mere acquaintances but doesn't know me? I have been by her side and helping her for the last 10 years. One minute it's what would I do without you and the next she claims I'm not her daughter. We got her settled and into bed last night. This morning she has not uttered a single word and just stares into space it glares at me. I'm at my wits end.
There is a social worker coming Monday to discuss living options for her.
I woke up this morning dreading the fact that I to go over there for the next 2,days.
I feel so guilty for not wanting to be with her but I'm not sure how much more I can take. I also can't even imagine how scared she is and that, too bothers me more than I can say.
According to an article in PubMed, "Capgras syndrome is more commonly associated with neurodegenerative diseases, especially Lewy body disease, where visual hallucinations always coexist. In the absence of a neurodegenerative disease, the onset of Capgras syndrome occurs at a significantly younger age and can be associated with psychiatric disease, cerebrovascular events, and illicit drug use"
I belong to a support group of carers for people with Lewy Body disease, and several of our members have dealt with this.
It would really, really be useful if your mom would have a complete workup. Knowing more about what you are dealing with would be useful. Do look up capgras and at least you'll know that you are not alone. Also ask her geriatrician if her other symptoms seem consistent with Lewy Body.
Has Mom been acting out her dreams -- running in bed, waving her arms, etc?
Has Mom lost her sense of smell?
Is she now unsteady on her feet?
Does she seem to have problems with depth perception -- taking a big step over a door jam, or having trouble getting into bed or a chair?
Does she seem to see things that aren't there?
Keep coming here, keep posting, keep talking this out with your caregiving friends on AC.
I know there is medicine that may allow her to know you for a time, depending on the stage of dementia or alzheimers she is in. Sorry, but I don't know the names of those meds anymore.
Please be brave.
Mom has been diagnosed with CHF and Pulmonary Hypertension. I suppose that's why the NP is presuming that she has vascular dementia. Her PCP is a geriatrician and not convinced. The visiting nurse is there to treat pressure wounds.
As always, appreciate this forum and the input you all offer.
Addressing only the psychosis, (and, I realize there is limited information), this 'case' screams "under-served by the medical community". A NP, visiting nurse,
PCP thinks....all undiagnosed-are they just guessing? How long has this been going on, and how did the patient receive a visiting nurse with no actual diagnosis???
In my opinion, and I am not an expert, not a doctor: Follow the advice to get an expert diagnostician consult. A geriatric psychiatrist, a neuropsychiatrist, an emergency room visit-the fastest route to referral, imo.
I agree that it could be anything, such as a urinary tract infection, or even a side effect of the wrong medication given for the wrong diagnosis.
Start with a diagnosis, have the medications reviewed S.T.A.T.
That means right away-even if it is the 911 call you could have made when Mom was 'upset'. You say that you have been caring for her for ten years. In alzheimers or dementia, this behavior could be a turn for the worse-find out. I don't know, but understand this is way hard on you.
Others will come and give support on how to cope and also how to manage and predict these outbursts. Keep checking back, write more....how is she today?