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Anonymous44076
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Default Mar 19, 2019 at 09:15 PM
 
Hello Ajr1. I am sorry that you and your mother are struggling. She would need to be assessed and it sounds like you have arranged that but she may be living with Alzheimer's disease. There is a lot you can read about it on the internet. What is Alzheimer's | Alzheimer's Association

Respectfully, I do not agree that she's still fully functioning and safe home alone at this point. I believe she is already at the point where she should either have full-time care at home or be residing full-time at a facility with staff support. For her safety. She would of course need to be assessed by a professional which it sounds like is the plan. If that person is highly experienced and sophisticated in their approach to your mother (making it feel like a helpful visit and conversation rather than a formal test...they can tell a lot by asking questions) they may be able to get the info you need without her shutting down. Though you are right, she may grow suspicious and tell them to take a hike.

Are there other people involved here? You didn't mention a father...do you have siblings? You are going to have some major decisions coming up quickly here. Does your mother have a legal healthcare directive or medical power of attorney? Someone, such as yourself or a 3rd party, to legally help her to make decisions...or in the case where she is delusional (this sounds recurrent) that someone has the legal power to make decisions for her.

Other things to check:

medications? You'd be surprised how many geriatrics are taking multiple medications (prescribed by several different MDs unaware of the other Rx) which are actually contraindicated and can cause cognitive changes. It's worth running her med list by a local pharmacist just in case but my hunch is that she is living with alzheimer's. Do you happen to know if there is a history of that in your mother's family?

Other changes....general day to day hour to hour memory (long-term memory remains intact for a long time....you'll notice problems with short-term memory much sooner)? Language skills... forgetting names and places etc. Difficulty planning or solving problems. Difficulty with tasks at home that used to be easy?
Is your mother driving (sounds unsafe at this stage)? You mentioned vision changes...that can be caused by the changes in the brain associated with alzheimers. Your mother mentioned that the lasers are burning her skin. it could well be that she is experiencing sensory changes with the disease and her brain came up with a reason: lasers. That's called confabulation. It is very different from lying. The brain is trying to make sense of confusing stimuli.
Mood swings or changes in personality? Impulsivity or poor judgment?
Any change in physical heath or motor coordination? Sometimes helpful to screen for dehydration, malnutrition, UTI, change in swallow function, or any infection. These can affect cognition in geriatric folks but sometimes if it's a dramatic change (such as delusions) this can highlight a problem like alzheimer's which was running under the surface for a while.
Is she regularly grooming and bathing herself....cleaning and tidying her home...getting groceries...eating and drinking safely and at regular intervals?

Any sudden confusion or anger in the afternoon (see sundowning syndrome)?
Or mixing up day/year, season, month, day versus night etc?

As far as how to help....
join her in her reality as you and the doc have been. There is absolutely no value in negating her delusions. She truly believes what she's telling you about the lasers so if you were to question or negate that she would likely become anxious and fearful/suspicious of you. It is sometimes called "therapeutic truths" to accept the reality of someone living with alzheimer's.

I think between yourself and a good medical team, you will want to start planning for the future provided that they do believe she is living with alzheimer's. I think the doctor should be able to link you with some organizations who can help guide you through the next steps. Financial considerations. Care for your mother. You may even like to consult with a therapist for yourself...for comfort and coping strategies.

If your mother is assessed and found to be needing 24/7 care, there is a very important strategy you can use. It's called the "blame the doctor" strategy. Rather than you suggesting that your mother needs care, and disrupting her relationship with you, you emphasize that this decision is coming from her doctor...a medical decision. That allows her to feel angry toward the doctor (good docs don't mind that and understand) rather than you....you can continue to be the loving child.

If you do not wish for your mother to receive care at a nursing home, people can certainly come to her home to care for her. The problem is that in-home care tends to be much more expensive.

When your mother is fixated on a delusion, you can validate her concern with something like: "That would worry me too, seeing those lasers. I'm sorry you are going through this." Then redirect her with something practical...like a physical activity....something she enjoys. Can be very simple.

Music therapy is very helpful. Fond memories of yesteryear...soothing. Pull out some songs that your mother has always loved. Sing along together.

Photos. Pull out an album. Sit and reminisce with her about the people in the photos and happy memories (as well as comforting her, this will also give you an insight into her cognitive function and memory...if she starts talking like it's 1950 and a deceased person in the photo is still living that is a major indicator of cognitive decline...but again use your therapeutic truths and join her reality).

I hope you and your mother receive the care and support that you need. These situations can be extremely difficult for families...so hard to watch someone you love losing touch with reality. You have my empathy. A support network and strong medical team could be really valuable here. I would encourage you to involve siblings or friends if they are helpful.

Last edited by Anonymous44076; Mar 19, 2019 at 09:51 PM..
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Thanks for this!
Calypso2632