Mother's extreme paranoia—is this dementia or psychosis?

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Shari49 Asked March 2022

Mother's extreme paranoia—is this dementia or psychosis?

Mom is 93 and in a nursing home. On a scale of 15 she is a 4. Extreme fear (?) or paranoia of having any of the nurses or aides near her. Not even to scan her temperature. Has anyone else run up against this issue? She will actually start screaming if they come near her. Nothing we say calms her down. Once, the head nurse told me they are tired of fighting her.

They do give her her meds (sprinkles) in her dessert (pudding) as she refuses even a Tylenol from anyone. She would rather suffer with diarrhea than take an Imodium. (She deals with constant diarrhea—always has. She's had every test imaginable and doctors find nothing.)

My sister and I really would like to know if anyone else’s loved one has this crazy fear.

Alzheimer's & Dementia Paranoia Refusing Care Skilled Nursing Facility

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score 0 · Answer 1

This does require a medical professional for evaluation to help your mother's GI and anxiety issues. Does she get any anti-anxiety medication when she is consuming her medications in her food/pudding? They have figured out that route to get her medications into her.

My mother has anti-anxiety issues and was a former nail biter. She was on anti-anxiety medication but was destroying two fingers - literally biting the tips off because she cannot feel them (severe neuropathy). This nail biting was happening at night time when her anxiety attacks happened. The doctor has now tried changing her medication and I've insisted that this hand be covered with a glove or bandages at night.

Talking alone will not change your mother's fear issues - so you need to discuss with the doctor how to address this problem. There may be a medication that will help her.

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They have increased her anti anxiety drugs from twice a day to 3. But this has had no effect on the mere temperature taking. She almost leapt from her wheelchair. Luckily my sister was there at the time and held her down and took the temp for the aide.

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score 1 · Answer 2

Shari, there are meds that can calm Mom down. It may make her be out of it a little but as my RN daughter says it becomes quality of life. Mom screaming all the time is an anxiety. My Mom too did not like to be touched at one point but did not go to this extreme. My Mom started humming and each day it got louder and louder where it was effecting the other residents. She was medicated. She then shut her eyes, then would not get out of bed. A week later she could not swallow, Hospice was called in and she passed 6 days later.

You may want to ask if DON feels that its time for Hospice. Nurses are really not allowed to suggest it. I would also ask about medicating her. Its really not fair to allow her to go on like this.

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score 2 · Answer 3

Alva's advice is "spot on." She summarizes it accurately:

"Only her MD can diagnosis and treat. Anything we say would be pure guesswork. I am uncertain what you mean by on a "scale of 15 she is a 4" because what you are describing is way over a 4."

This is not a question for a forum, but rather for a medical professional.

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score 1 · Answer 4

She would never take them. Never.

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score 2 · Answer 5

Your mother is having the symptoms of a late stage of Alzheimer's. She has little time to live. Nothing will make her better at this time. Medications will kill her sooner.

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Medications will NOT “kill her sooner”.

It’s fine if you think meds are just for doping and death. What is not fine is spreading the opinion as fact when it is not.

If psychiatric meds killed people sooner, we’d have people dropping like flies. Alzheimer’s or no.

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score 8 · Answer 6

Is this a sudden change? Has she been checked for a UTI? She should perhaps be checked for C-Difficile if she has been on antibiotics in the near past.
Only her MD can diagnosis and treat. Anything we say would be pure guesswork. I am uncertain what you mean by on a "scale of 15 she is a 4" because what you are describing is way over a 4.
I wish you luck. Keep touch with the facility and the MDs. Sometimes it takes a while to get a medication that will work without making a patient too sedated. Wishing you luck.

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No this is not sudden. She has been frightened of doctors for years. But has gotten way worse since being in nursing home since September. She went in after a hospitalization for UTI but that cleared up and has been admitted with Medicaid to the home. The scale they use there for measuring her mental dementia status is 15 is normal. 0 I guess is vegetable. She is a 4. She was a “5”3 months ago. But it’s crazy how she starts screaming if they come near her with an aspirin. Or a thermometer. You cannot reason with her.

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score 2 · Answer 7

Probiotics can help with gastro intestinal issues.

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Mother's extreme paranoia—is this dementia or psychosis?

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