Mom's behavior is off

[Anonymous]

Anyone with some advice on this situation: My mother lives on the other side of the country. She's almost 80. She has very few friends and spends the day knitting. In the last year, she has had some erratic behaviors. Nothing dangerous or unsafe but clearly lacking judgment or very socially inappropriate. One example- she called my childhood best friend who she has not spoken to in 25 years (at my wedding) and left her a voicemail saying there was a sale on frozen dinners at the grocery store ($5 off!). There are dozens of other similar examples that are just things that are very erratic. My dad is not much help (and a nasty human). I don't know her doctors but she goes to Kaiser. I suspect it is some type of cognitive decline but her memory is generally fine. Any resources you can recommend? Thanks.

[Anonymous]

How compliant is your mom? Does she have self-awareness? If she will go along with it set up a full evaluation. More can be done to slow things when caught early.

I will tell you these dementia screeners at the general doctor's office are garbage IMO and don't seem to pick it up until they are far along, but if you can't convince her to get a full evaluation, you can request the doctor do a screen. We saw quite a bit of decline before mom get red flagged, but at least you get the ball rolling for all future visits.

You can hire a geriatric social worker to check in on them periodically and increase visits when needed. If they refuse anything and it gets worse and she refuses any help, you can have Adult Protective Services check on her.

[Anonymous]

Have her checked for a uti. They’re common in this age group, asymptomatic, but can cause personality changes when left untreated.

[Anonymous]

Does she have access to bank accounts? I'd worry about scammers.

[Anonymous]

Anonymous wrote:Have her checked for a uti. They’re common in this age group, asymptomatic, but can cause personality changes when left untreated.

This is a very good point. I saw it with my elderly uncle. Often the elderly don’t drink enough fluids and the dehydration can lead to chronic uti’s.

I will say for a neighbor of mine, odd conversations like that were the start of progressive dementia.

[Anonymous]

Can you go out there and accompany her on an appointment and talk to her doctor?

[Anonymous]

She needs to have a MoCA test to evaluate whether and how far she might have declined cognitively (Montreal Cognitive Assessment). She needs to ask her PCP. The Kaiser website has a feature where you can access her online account (with test results, prescriptions, and messaging features to all her doctors!) if she signs off on it. You could then communicate with doctors on her behalf. Please persuade her to do that before she gets any worse.

About UTIs: yes, they can lead to temporary mental confusion in the elderly, but no, these symptoms are likely not the results of UTIs. It's either a temporary and accidental overdose of medication with psychotropic effects, or a form of dementia.

[Anonymous]

Anonymous wrote:Can you go out there and accompany her on an appointment and talk to her doctor?

I agree, can you go visit for her next doctor’s appointment or do you have a sibling that could go? Spend a few days to observe her.

[Anonymous]

Kaiser has a memory clinic. Make an appt.

[Anonymous]

You will need to know where they can live - the next step. You will need to know their finances, what they can afford. Someone will need to be able to step-in and manage their money.

[Anonymous]

MoCA doesn't work very well if you have an anxiety disorder. I would have failed it at age 18. Just download the SAGE test from the University of Ohio and score that way. It's not memory based so being anxious about testing doesn't come into play.

[Anonymous]

If this happened all of the sudden, then UTI is a likely cause. This is common and one of my parents had this issue several times. Every time they began to act strange, we'd get the UTI test done. They'd get on antibiotics and voila!

[Anonymous]

Thanks everyone for your replies. She has zero self-awareness and would likely refuse to go to an appointment that determined her mental fitness. As this has been going on for awhile, I don't think it's a UTI but the thought has crossed my mind. She would in all likelihood not grant me access to her Kaiser portal but I guess I will see if perhaps my dad and message someone in the portal since he has Kaiser as well... thanks again.

[Anonymous]

Anonymous wrote:
Anyone with some advice on this situation: My mother lives on the other side of the country. She's almost 80. She has very few friends and spends the day knitting. In the last year, she has had some erratic behaviors. Nothing dangerous or unsafe but clearly lacking judgment or very socially inappropriate. One example- she called my childhood best friend who she has not spoken to in 25 years (at my wedding) and left her a voicemail saying there was a sale on frozen dinners at the grocery store ($5 off!). There are dozens of other similar examples that are just things that are very erratic. My dad is not much help (and a nasty human). I don't know her doctors but she goes to Kaiser. I suspect it is some type of cognitive decline but her memory is generally fine. Any resources you can recommend? Thanks.

Perhaps she is very lonely and just reached out to your friend?

[Anonymous]

Anonymous wrote:Have her checked for a uti. They’re common in this age group, asymptomatic, but can cause personality changes when left untreated.

I was just going to say the same thing. For us it was even more pronounced though.

I had a conversation with my father in the morning. All was normal. Politics, a computer bug, his schedule. He was going to call back in the evening, but he didn't.

I called him at 10pm and he was totally off. Saying he had a meeting with his long-dead brother, asking how my job was at XYZ (where I left 20 years ago). Unable to answer "who is the president right now?" I called emergency services in his town and they sent an ambulance. He got to the hospital and it was a combination of a UTI and some dehydration (dad mowed the lawn in the heat, went inside to sleep and in the warmer weather napped longer than normal).

This was an extremely pronounced thing, like one day, so we were able to jump on it, but I thought I should mention that delirium is a common symptom of a UTI in older people.