With the exception of these recent stories that have to be dreams she is very very sharp -- 92 but lives alone, takes cabs to her doctors, pays her bills, cooks for herself (and us), finds errors in her taxes that the accountants don't see, reminds us of what we need to do, etc. She is on heart meds, cholesterol meds, mild diabetes and gout meds. I noticed that this situation seems to have started after a gout flare-up then calmed down/went away and then started up again after another gout bout. She was taking colchicine (SP?) for the flare-up and takes ongoing allopurinol (sp?) every day. Are an inability to distinguish vivid dreams from reality known side effects? We argue the stories through and she defends them/tries to find ways to make sense out of them and then realizes it was a dream but then seems to pull back belief in pieces of it. Not sure if this is a medicine reaction or the start of dementia? On a few occasions in the same time period she has been convinced that something has happened before or that she has been someplace before. For example, when something happens -- little things like I stub my toe while doing a particular task, she will say OH you did that last time you did that task too! And I know I didn't. Re the dreams, an example is that after I went to a wedding and had told her about it, she took a nap and then later claimed that a woman she knows had helped plan the wedding i had attended and was distantly related to the groom's parents. Or that friends we had taken her to visit on our vacation had impossible connections to people in her every day life. Weird stuff like that. There has been a lot of family stress (a death as well as estrangement from a close family member). She is handling the stress almost too well.Very philosophical about it, accepting of the situation, not obsessing like the rest of us. Could this dream/reality confusion be a way of focusing on something else, having something else to talk about by creating dreams that bring new scenarios and activity into her life? I realize that at 92 I'm so fortunate that she is here and so active and independent but since longevity runs in the family - my grandmother was 100% sharp until her death at 91, I'm very concerned. This is a first sign and i really don't know what to do. I don't want to "label her" or embarrass her by proving all her facts are wrong by confronting the people involved so at this point, we are arguing it through I'm at a loss. I believe we should discuss it with her doctor but she says she needs to study it and log it and see what patterns she can identify.She is a caretaker at heart and prides herself on being sharp as a tack and I don't want to shake her confidence yet I don't want to let her slip away by not challenging or addressing these obvious "blips". Ideally I want to nip them in the bud if possible. Any ideas?
This is not an either/or. I'm 70 and I always want to log my odd symptoms and look for patterns and do some homework of my own before approaching a doctor, and at least learn the right vocabulary. This saves a lot of confusion at the doctor's, saves being labeled by the doctor or brushed off by him taking a wrong guess because he wasn't expecting an unusual problem. (Once I consulted a GP for tests for possible causes of memory loss, and he said "Depression can cause memory loss, so instead of using tests [which Medicare does not like to pay for] I always try some psyc medicines, giving each medicine a trial for two or three months. If any of them help, then we know it's depression and we don't have to look any further"! )
By researching the names of the symptoms and some likely causes, you can get familiar with the questions the doctor is likely to ask, and can reassure him "It's not X because I don't have symptoms A, B, and C."
As for when she talks or asks about puzzling memories, since she's really trying to figure all this out and is sharp in other ways -- if someone is being dishonest or refusing to discuss it, that could be very hurtful and discouraging to her.
But, OMGosh, the last sentence "begin a massage to CLE approach to ruling out"
was supposed to be "begin a methodical approach to ruling out" ... yeesh.
At her age, medication interaction, blood sugar fluctuations (the diabetes), inflammatory reactions (gout), circulatory changes (heart, blood flow to the brain, arterial clogging), immune system challenges (her body suppressing an oncoming flu, has she had a flu shot recently - you don't want her to get the flu, however flu shots can bring on the like symptoms when the body works to activate the immune response) - these and many other things can be suspect as physical triggers of a parent mental problems. It's kind of like Humpty Dumpty: everything looks okay winter up there on the wall, but if there isn't balance, and there is teetering, the break (cracking the eggshell) comes from the fall. The tendency in our medical society is to look at and try to treat the symptom (the fall) rather than the cause (lack of or inability to balance).
Your mom may seem perfectly reasonable when she's trying to workout and understand her situation. But it seems as if she has become faulty in her reasoning, which we will hope for now is temporary, and is in a form of denial that she may be ill in some way other than mental, but since she can't understand that, she doesn't want to see it.
Two causes of her type of symptoms - that are physical but bring on mental confusion - that come to the forefront always in my mind first are urinary tract infection (UTI) and nutritional deficiencies (such as vitamin B-12, thiamine - "B-1", vitamin D). UTIs can become quite common in the elderly, especially women, can be completely asymptomatic and can cause most of the problems your mother is experiencing. Nutritional deficiencies also become more commonplace in the elderly. Even if they eat well - and sometimes they think they do when in fact they don't - digestion and assimilation of nutrients becomes more and more difficult as we age. Folks often self medicate with baking soda, Tums or other OTC anti-acids without ever complaining of indigestion or "heartburn" 2 family or the doctors. People can even buy an OTC form of Prilosec, a proton pump inhibitor (PPI) that reduces or eliminates the flow of acid into the stomach, although that very thing inhibits adequate digestion, a problem the elderly already have on their own.
With all the TV commercials portraying the need for antiacids as normal, and when you can buy these products over the counter to "fix it", many don't think to tell the doctor they have a digestive problem. Even if they do, they will usually walk out with a prescription for Tagamet, Prilosec (omeprazole), Protonix or Nexium rather than a recommendation to take digestive enzymes and probiotics. BTW, anything longer than short term use of PPIs has been linked to thinning of the bone (osteopenia, osteoporosis), especially at the neck of the femur - that's where the leg meets the hip. Broken hip, anyone?
The GOOD news, "worried" is that UTI's and nutritional deficiencies can be discovered pretty quickly buy a trip to the doctor and some lab tests. Should it turned out to be something of this nature, her confusion can be reversible.
But confusion is insidious. Physiological confusion can lead to withdrawal and anti-socialability. There are many links in the chain in between but it can ultimately lead to mental or neurological withdrawal.
Your "job" right now as I see it is to help her understand that there may be hidden physical causes that, once discovered, can "put her right" but "we" have to get to the doctor right away to find out about it. "Mom, if we wait too long, they may not be able to fix it".
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Science aside, my metaphysical belief spur me on to say that there ARE folks who are quite elderly, who never get dementia, and who crossover peacefully in there sleep or in there rocking chair watching TV. Sometimes preparatory to willfully (even if subconsciously) "stepping out" and leaving their bodies behind, mini begin to have - and often relate - experiences of visitation or communication with "the other side". Some say that soul or spirit guides, or does already departed, are waiting "over there" to help the newcomer adjust to "coming across".
Depending upon a person's belief system, these visitations can be distressing too some but exciting to others. I have no problem with the thought of non physical beings helping us here in the physical, or helping a physical person to fully real marriage into the non-physical but before we decide that it could be that, let's NOT put science aside, let's make sure there aren't easily correctable physiological causes.
YOU have to also leave room for the possibility that there are some NOT so easily correctable physiological causes, what the best way to approach this is "baby steps". Start with the easiest, gentlest things first, and begin a massage to CLE approach to ruling out what's going on one by one.
Please keep posting.
Loss of the close family member, may be taking a toll on her if that person was part of her daily routine. 92 is a bit old to be "living alone" even if the senior is sharp. I would make sure either a care giver is there part of the day or she has a medical alert button to summon help. They need social interaction on a daily basis after 90. If they live alone, see no one for weeks on end---the mind will probably go not to mention they tend not to eat well if they have to prepare the meal and eat alone--which again might be the cause of the mental confusion since she has some diabetes. The diabetes situation may be worsening. It could be playing a part in the confusion she is experiencing.
Good luck, once the senior is over 85 you are working with the "fragile elderly"--things change quickly and continually. I understand wanting not to label her, too frequently temporary mental confusion is written off as dementia or worse. However after this problem is identified and handled, another problem will arise in a month or so as it is best to expect the unexpected. I have friends who claim their parents are in this age range and nothing is wrong with them which is very seldom the fact--but the adult children are not aware of the changes in their parents health. They phone a parent living in Florida who says all is well --the rosy glasses syndrome---the adult children who have a life up north want to live their lives uninterrupted so they convince themselves all is well. If wishing could make it so :)
Enjoy your mother, I would check out the confusion, don't try to set her straight on her confusion because for now they are real to her.
You are to be commended for picking up on these small changes, they are likely fixable.
I have given into Mother's illusions rather then point out the facts as they are. Her Dementia is taking it's toll, at times it seems quickly. I have challenged her, but that serves no real purpose other then upset her and frustrates the daylights out of me. It pains me to 'go along, to get along' but that's what it has come down to.
Though I don't lie to Mother when asked questions, which some say is 'fine to do,' I just won't do it. Hopefully Mother still, somewhere in there, appreciates that aspect of my rearing .... I believe she does.
Colchicine is a drug used to treat the inflammation in the joint created by the deposit of the uric acid. It basically relieves the pain and inflammation such as Asprin would. Again nothing that would cause the vivid images/dreams.
Your mother seems to be treating it very rationally and you should continue your interest and encourage her to keep her log.
Does she take any blood pressure medications? These often cause very vivid dreams. I have experienced this and they are very real in color often with people I currently know or did previously and in places I know or related to recent events. A talk with moms Dr is of course in order.
It is easy to research any of the medications your mom is taking or ask the pharmacist for the drug information sheets they dispense with her prescriptions.
from what you have told us and the way she is handling this I personally would not be worrying about dementia. Mom sounds like a great inspiration for living life to the fullest and keeping the mind sharp