I was thinking about whether to write this or not, and I have decided to do it.
I do not know how much/whether I will be able to write on the blog in the foreseeable future. I would like to but I might not have the strength.
In the last four days, my father’s mind has completely disintegrated. He is babbling incoherent stories over and over again, expressing paranoid fears that somebody, somewhere, somehow is out to get him, rob him or even kill him. It is impossible to reason with him or to have any conversation at all because he is unable to finish one sentence without trailing off to another.
I am not a physician, but this is probably some form of dementia, maybe Alzheimer’s, maybe something else. The trouble is that the very nature of the illness makes it impossible to even start to deal with it. He refuses to acknowledge that something might be wrong with him and refuses to consult a physician. He insists on “important” talks with me where he inevitably trails off to the same string of incoherent and irrelevant stories. He has a deeply held conviction that something is wrong but is completely unable to say what and why. Everything that is even slightly out of the ordinary is proof of some conspiracy against him or against me – the stranger who walked past the house last month, the nurse who was slightly glib with him a year ago, the change in his prescription meds, the unanswered call message on his smartphone – everything and everywhere. After I think we have dealt with one of his imaginary problems, he pulls out another – the same one that I thought we dealt with yesterday. And the day before. And the day before that. We are moving in circles.
He had some signs of mental decline, but at a rate that seemed normal for his age. These last four days it has accelerated extremely and it took me completely by surprise. A week ago he was able to finish a sentence and talk normally, now he is not.
I tried to work, but I can’t concentrate. I tried to explain things to him, but I know that if he has dementia, I can’t do that either. I can’t do anything, except maybe cry. I love my father, but I cannot spend my whole day listening to his incoherent ramblings for hours a day every day. I am exhausted to the point of breaking.
A sudden mental decline, especially if it is associated with a change in meds could be med related. Please talk to his doctor.
Charly, you can’t deal with this alone. Get help. There are probably governmental and non-governmental organisations in your country that know what can be done in your situation, and offer you advice.
Charly, at my age I have been with a good number of family members who succumbed to dementia — and your story does not sound like that! To me it sounds like a stroke, or possibly a fast-growing brain tumor. Either way this is a medical emergency, so you should get him to a hospital right away. He probably will not want to go — this is a situation in which, in the U.S., the police and paramedics work together to do what must be done. I hope you have a similar system. And don’t worry about your loyal readers (but do let us know how it goes when you have time).
Charly, I haven’t posted here before and really haven’t much to say other than to agree with chris61 and Joerg above and offer my own encouragement. I enjoy reading your posts and marvel at how capable, creative and resourceful you show yourself to be so I’m confident you can get through your current troubles and hope for your father’s health to improve.
First, a major change like that should be examined by a doctor. There are a lot of things it could be, some possibly fixable. Second, I once heard advice about how to talk to a person with dementia that worked for me when my father was not making sense. It was to treat conversation like improvisational theater. That took a lot of the tension away for me. Changing their mind, answering their real question or dealing with whatever seems important, probably won’t happen. At some point there’s no there there. Just roll with what they are saying. Its less stress and maybe you can both share a positive experience. I don’t know that will work in your case, but it’s something.
chigau (違う) says
Sudden change sounds like a stroke.
A chill went through me as I read your post. You could have been describing what happened to my mother. I believe your father is having a medical emergency. In my mother’s case, the cause was a combination of medication, cancer, and an infection. Please, I beg of you, get help. I want your outcome to differ from ours.
Same as several others, my mom would go loony when she had a bladder infection. Didn’t always show up in testing immediately, but her mind cleared when her infection was treated. Also, when we got her off as many meds as possible, we rolled the clock back about three years on her declining mental capacity. May you find a path forward.
Sympathy and hopes for the most positive possible outcome from me. It sounds terrible. Get help.
Totally anecdata but a number of my relatives with minor cognitive decline have had episodes that appear like a severe dementia-like downturn that correlated with a UTI and improved significantly on standard treatment..
Oh no, thats terrible. I am reminded of my great aunts stroke, so my advise would be to get him to a doctor asap.
I dearly hope that his condition gets better and that you get help!
My heart goes out to you.
My mother is facing this. You are so right, the person affected usually has no idea and gets combative about medical attention. It’s just so hard… as the others have said try and find a support group. Most of all take care of yourself. If you would like a hug I will offer you one.
Thank you for the support, it helps.
This morning my father was clearly distraught and instead of “good morning” he told me “I’ve lost all our money.” Then he again started babbling incoherently about a plot to kill us. He also complained about headache in one side of the head and trouble seeing. So I have called an ambulance.
The response team has ruled out a stroke or some other acute event and relayed him to an ambulatory examination at a hospital. There they found nothing wrong with his heart or blood and no possible major physical cause. From there he was sent for a psychiatric evaluation. I have spoken shortly with the psychiatrist and she said he does have some minor signs of paranoia, she prescribed him some meds and has recommended him to a geriatrician for further diagnosis. We have just picked him up at the hospital and he is at home now. He seems calmer and has apologized for his behavior -- for which he is not to blame of course and we have said him so. I hope the meds -- even if they are placebo -- will help to keep him calmer and that the geriatrician will be able to help to mitigate the problem.
chigau (違う) says
Thanks for the update, Charly.
Thank you for the upate Charly.
A geriatrician could be extremely helpful, my MiL saw one and he took her off all but one of the pills she’d been on, each had been given to deal with a side effect of the last, and the first had been given for a temporary problem, but no one at the GP practice seems to have had the time or inclination to look at her medicines in the round. Getting rid of all of those medicine did help. Apart from anything else a geratrician will be more likely to know what if anything can be done, as well as how best to handle his future care.
Ice Swimmer says
I’m concurring with Jazzlet about the geriatrician. They know about different forms of dementia (Alzheimer’s , vascular dementia etc.) and other things.
I am happy that he is getting medical attention, and is cognizant that he isn’t behaving in his normal manner. Hopefully the geriatrician can offer some more help. It’s very taxing to watch one’s parents decline. Aged Mum is very cranky, unreasonable, and downright nasty at times due to drug interactions and her oxygen levels. She won’t even remember it the next day, but it’s hard not to feel upset at the tirades and the bizarre things she gets fixated on.
Hugs!! Don’t neglect some self care, even if it’s just a brief walk. We will still be here if you take time for yourself instead of writing blog posts.
If I were able to pick up his meds right away, it might not have happened, but I could not because when we picked him up at the hospital, the apothecaries were closed. I wanted to go for them the first thing in the morning, but I did not get a chance.
At 3:00 a.m. my father barged into my room with a panic attack. He wanted to call Interpol because he was convinced everyone is trying to kill and/or rob him including the ordinary police and ambulance. The radiation therapy last year became an attempted murder. Our GP is apparently trying to kill him. The delivery man who ordered a machete made is trying to rob us. The psychiatrist from yesterday got incorporated into his delusion, he insisted that he never told her the things that are written on the report and that that is proof of some nefarious plot.
I had to call an ambulance again, they picked him up and he goes through the same round as yesterday -- ambulatory evaluation->psychiatric evaluation. This time they found out that he had a spike in blood pressure but I am convinced that that is a symptom of the paranoia and panic attack, not the cause (he is treated for low blood pressure).
I’m so sorry to hear that! Have them check his B12 levels. It’s not uncommon to slowly lose the ability to absorb it as we age, and low levels can cause headaches, weakness, irritability, paranoia, and memory problems.
Mum was sure that a utility worker who was marking buried phone cables was actually planning on robbing the whole neighborhood, and invents very imaginative paranoid delusions about the neighbors. Its very sad to have her yelling about moles coming in her yard to steal her worms. I’m not sure how she thinks the neighbor is training the moles to come steal her worms? The odd belief that everyone is plotting to steal from her is possibly the only way she can account for the missing parts of her memory, but it’s heartbreaking to watch.
Having had similar experiences, I sympathize. My mother slowly became paranoid and mentally unhinged (for lack of a better word) in her fifties. That led to the dissolution of my parents marriage and probably contributed to her early death at 60. Unfortunately she was never properly diagnosed and treated because she didn’t want to; in her opinion there was nothing wrong with her. Several relatives avoided her because her moods were unpredictable. She was functional enough to live independently, so she was not a clear danger to herself or others. At that time that was the legal requirement in our country for having someone treated against their will, so there was not much we could do about it. And logically I accept that this strikes a fair balance between individual freedom and the common good. But still…
I hope you can convince him to accept evaluation and treatment.
The only other thing I can say is “this too shall pass”.
He’s back again, I picked him up at ~6 a.m. at the hospital where they again found nothing physically wrong. I was so tired we nearly had an accident on the way back home. I got enough sleep after that to be able to drive and get his meds but I am still exhausted.
He’s been prescribed antipsychotics. I have now trouble persuading him to take the medication before we can consult further steps with a specialized psychiatrist.
He got a recommendation for a head CT scan.
Thank you for the Updates, my deepest sympathies, this is a very difficult situation. I do hope, the the meds help.
I’m so sorry. My condolences, thoughts and respect for the (very little) they may be worth.
Virtual ((hugs))) if you want them.
I lost my Grandpa before he died to Alzheimers well over a decade ago now.
Since they’ve been unable to find a physical reason for this sudden onset, I still can’t help but wonder if the change in his meds just prior that you mentioned is responsible. It’s not clear whether they somehow ruled this out or never considered it.
Others have suggested it here, and I’ve also known people who had similar adverse reactions to common medicines. One friend was put on the routinely prescribed beta blocker propanolol for hypertension and shortly after became so uncharacteristically violent and paranoid that she tried to assault her neighbor. She was fine once she was switched to a different drug. She was on several other meds at the time, so it might have been a drug interaction, which makes me concerned about piling on more drugs if they haven’t looked carefully at the ones he’s already on.
But I’m not a doctor, I don’t have all the facts, and I don’t know you or your family, so I’ll butt out here. I just hope the doctors/healthcare system in your neck of the world are better than the ones around here, and that you and your father get through this as unscathed as possible.
Tonight he not only woke us at 2:00 a.m, but he also managed to actually call the police whilst I was trying to reach a psychiatrist to consult what to do. I tried to call off the police, but that meant I had to call an ambulance again. Both police and ambulance concluded that since he obviously is in not any danger and is neither aggressive nor suicidal, there is nothing they can do. And all I can do is hope that the antipsychotics start to work in a few days.
He has a deeply held belief that there is something wrong but he cannot find out what is wrong so he constructs narratives trying to explain it. I have cracked the protective glass shield on my phone yesterday so I ordered a new one and I mentioned it to my parents so they know that I will receive a package. This completely innocuous thing got incorporated into his nighttime ramblings about us being in some grave peril.
Right now he said that he has not done anything out of the ordinary this night. When we pointed out that he has called the police, he was confused for a bit and replied “but only the local police came!”. He is unable to process short-term things. He remembers them correctly when they are pointed out to him and fill in some details, but he cannot remember and contextualize them on his own.
Tomorrow I have to leave the house for the whole morning and maybe even a part of the afternoon, the car needs technical evaluation (prescribed by law). I am afraid that he does something daft and my mother won’t be able to stop him. I have barely slept, I have a huge headache and I need to drive tomorrow. I hope the psychiatrist will have an opening very soon. If I do not get a good night’s sleep, I will get into trouble myself. I was always prone to depression and suicidal thoughts. Also, I need to be able to drive a car, without me my parents won’t be able to get even groceries, let alone get to their various doctor appointments.
I hope you manage to get a good night’s sleep tonight Charly, being exhausted is not going to help you cope with everything, as well as of course making driving iffy :-( I wish there was something I could do that would help, apart from more *hugs*
I did get enough sleep tonight to be able to safely drive and get my car to the check-up. There the good news end.
While talking with the psychiatrist’s nurse, she told me that they only have one free window -- tomorrow at 11:00, take it or go somewhere else, we are not obliged to treat you. So I hope I will have the car available (as of now, they are still not done), otherwise, I really do not know what to do. I could get my father there by public transport two hours early and wait, but there is no way to get my father from the clinic to the auto service to pick up the car afterward, he will be tired after having to do two long walks already -- from home to the bus station and from bus station to the psychiatrist. And I cannot let him sit somewhere and wait for me, he must be under constant supervision.
It went today well, all things considered. The walk to the bus station early in the morning was unpleasant because my father did not want to go, and I suspect he dragged his feet just a bit more than was warranted. But later when we were on the bus, I got an SMS that the car is ready. Thus we were able to exit the bus at an earlier stop and do the rest of our traveling during the day easier and my father needed not to walk that much anymore and we were no longer under time stress.
The psychiatrist has ruled out Alzheimer’s, so that’s good news at least. Fathers’ thinking is extremely slow but preliminary tests did not show significant loss of memory. His delusions and ramblings can allegedly be a result of several factors (age, dehydration, medication), but the antipsychotics should help in about two weeks and he might be OK-ish after that. His current medications can play a role, but none can be withdrawn without significant risks to his health and life.
We are scheduled for a more thorough memory testing in September, until then all we can do is to keep an eye on his water intake (we already did, we must do so even more now), see to it that he takes his medication on time, and wait for improvement. I do hope he starts to sleep properly soon, being woken at 3:00 a.m. by his panic attack is not good for either of us. This night at least the panic attack was short and we were able to calm him down and put him to bed almost immediately. I also hope the antipsychotics start to work soon because I see clearly that my father is troubled and depressed.
Well at least today ended up easier than you feared. It is horrible watching those we love being ill, having been on both sides I’m honestly not sure which is worse, and I include both my serious bouts of depression and my serious pain in that.
Can you nap? I wondered if getting a few hours sleep during the day is at all possible. I know your mother is limited in what she can do at the moment, so it’s probably not a good suggestion. Aaaand I’m doing that annoying thing wherre you want to make things better for someone so you suggest all sorts of things they have no doubt thought of and ruled out, sorry.
I hope the anti-psychotics kick in soon and that they help your father, he must be so confused at how he is feeeling.
Ice Swimmer says
Charly @ 29
It’s good to hear that today wasn’t the as bad as it could have been.
Concurring Jazzlet on the anti-psychotics.
The water intake thing seems to be a problem everywhere. I’m hoping that more water will be at least a partially working solution. Of course, further health services will be needed also.
Thanks for keeping us updated!
Not having Alzheimer’s is good news, but that doesn’t help the current problem of his waking up the whole household in the middle of the night because he is having an episode.
I know the B12 suggestion sounds like woo, but IME those symptoms sound very similar to my great aunt Pearl. She would lose touch with reality, become paranoid, and then her spouse took her for B12 treatment at Mayo clinic and ‘poof’ she was back to herself the next day.
Pearl was part of a Mayo Clinic study on Alzheimer’s because of increased genetic risk factors, and did eventually develop the illness.
It’s almost as awful for the caregivers as the person with the disease.
Dr Sarah says
I’m so sorry to hear about this; it sounds incredibly stressful and exhausting and I do hope the medications work quickly. At least you’ve now had him checked out.
I do want to confirm that the B12 suggestion is not woo; it’s one of the routine things we check for when investigating cognitive impairment or other neurological problems. It very likely will have been checked at the hospital, but it’s definitely worth making sure that this was done, as well as other basic bloods including a thyroid check.
I too hope his meds do work and your father gets back to normal. It was very good to read that all the big possibilities were eliminated.
I also do hope that you get enough time for self care!
My father slept well-ish for two nights, and so did we. He is shaking and weak, which can be both a symptom of his failing health and a side-effect of the antipsychotics. Today he did not start rambling yet and did not appear to be frightened and confused, “just” tired and weak. If he sleeps tonight well too, I might be able tomorrow to do some work in the workshop. But I am still tired and weak too and my mood ain’t very good either.
I hope you all get a third night of solid sleep.
Today I found out that my father has not been taking the prescription meds from a urologist for an unknown time. He only had an empty box in his things. He is unable to say how long he was not taking them, our GP cannot prescribe them and we cannot reach the urologist by phone either, we’ve been trying the whole day.
Yesterday I thought he is getting better, today he had a turn for worse again. Again he insisted on important talks with me the whole day, and every time he starts to talk about several disconnected and completely trivial things.
I only know that the various prescriptions that elderly people need can cause very bizarre reactions and behavior.
Maybe the local pharmacist could be of some help, assuming that is who fills the Rx? Mine has been very helpful with keeping track of Mums various medications and alerting Drs when they prescribe meds that interact badly.
Hugs, patience, and fortitude!
Oh Charly, you must be so frustrared! I wonder if him not taking those meds is the cause of all this? I rather hope so as that would be an easy fix.
Yesterday evening and today morning my father was agitated and he did not want to take the antipsychotics. He was paranoid about them and tried to attribute to them his problems. The rest of the day he was relatively calm though and he took his evening meds without complaints. He made some normal small talk and did not start to ramble. His voice is coarse though, he has probably strained his vocal cords.
Two days ago we had a day of extreme heat and today it cooled off a bit. I do wonder if there is some connection or if it is just a coincidence.
Dehydration and extreme heat can certainly cause mental confusion and irritability. I don’t know what urology meds he takes, but if he isn’t taking than, having his kidneys functioning improperly could very well be the root of his erratic behaviors.
Than = them
I can’t do this much longer. I am seriously losing patience with my father’s ramblings. It seemed he got better several times, and he does not wake me up in the middle of the night anymore at least, but he always reverts to incoherent babbling about some unspecified conspiracy at some point in the day.
I have forbidden him from going upstairs and disturbing me. It is bad enough as it is, I do not need him to fall down the stairs to top it all off. They have a bell, so they can ring at me anytime they need me. He promised -- several times -- to not walk upstairs. He also reneges on that promise every-single-fucking day, wobbling on his way back downstairs precariously.
Today he said he found proof that he is right and he is going to show it to me -- a medical report from his cardiologist which contains an illness he does not have. I have asked him how he can recognize a wrongly named illness when he is not a physician. He was unable to say but he insisted he has proof that he is right all along. When I obliged to look at it, he showed me the medical report from last week’s visit to a psychiatrist, and the alleged incriminating line was the paper header containing the name of the company at which the psychiatrist is working. He seems completely unable to grasp any explanation of even the mundanest of mundane things.
According to the medical professionals, his condition is not serious enough for hospitalization, but it certainly is not compatible with normal functioning. Nobody in the whole household can work properly or rest properly. My father is locked in an unpredictable loop of paranoid delusions and my mother and I are constantly on guard to fend him off from doing something dangerous/stupid.
chigau (違う) says
What would it take?
Would it be serious if he set the house on fire?
@chigau, as I understand it, as long as he is not suicidal or homicidal, or otherwise dangerous to himself and/or others, he cannot be hospitalized against his will. And the very nature of his illness precludes him from even recognizing that he has a problem. So even getting him to agree to be at an elderly care facility.
I certainly hope that trying to set the house on fire would count as otherwise dangerous to himself and/or others. I do not think there is a real danger of that, however. He is not dangerous, just persistently annoying and disturbing. I cannot work on a belt-grinder when he could barge in the workshop at any moment insisting on an important talk.
I got used to going on short walks within about 1 km of the house, just to get my 6.000 steps a day for health. Yesterday he got suspicious of these walks, asking me why I am walking on the same piece of the path back and forth. There is literally nothing now that he won’t get paranoid about at some point in the day.
Oh dear, I was hoping you had better medical services than what is typical in the US, where getting help for anything is a series of administrative hurdles and uncaring rules.
He is a danger to himself when he goes wandering, and breaking a hip should not be what it takes to get him into some sort of elder care. Delusional behavior needs medical professionals, you can’t watch him constantly to keep him safe.
Would a baby gate work to keep him from scaling the stairs? Elder-proofing doors with a hook at height? It will at least keep him confined to a safe space, and relieve some worry.
That sounds unbeliveably annoying. my sympathies :(
I hope it gets better or you get professioal help from the social services soon, this can`t go on!