My mother has just had a psychotic breakdown. She's 72 not diagnosed with dementia, but shows all signs, she doesn't want to see a Dr.

I found another post from Mommy saying that this, her original post, did not receive enough responses. I see that I did catch this original post, but apparently it sunk down in page numbers quickly that day and didn't get the responses she hoped for.
I answered her question again on the "Why didn't my post get more answers" thread, so won't repeat it here, but am bumping up this question so it will be on page one and perhaps have more responses for our OP.

Call APS and report as senior at risk.
Do not take POA over her. Do not move her in with you.
Immediately order a copy (cheap used on amazon) of Liz Scheier's memoir Never Simple.
Ms Scheier tried to intervene, care for, get help for her mentally challenged mother for decades, and even had the help of the Social Services of the city and state of New York. All to no avail. All to no good result.

If she says she doesn't want any support from you, then believe that.
She knows your contact numbers if she needs you.
Mental illness in this country --the state of things, the inability of any to intervene on a citizen's rights "to be crazy" according to some judges, makes it impossible to intervene, and hopeless.

I am so dreadfully sorry. I cannot imagine standing helpless witness to this, but that essentially is what you are. Please try to get into a support group of some kind. You badly need it.

I will bet she is not taking those meds. You don't live with her so can't be sure she is. Not sure what you can do. I have a cousin who does well with no Meds but he does get manic. Not off the wall but gets depressed and feels sorry for himself. Mom needs a good physical and labs to rule out other things.

For clarity, "psychotic" means one is detached from reality. This doesn't seem to be what you described. She is agitated, paranoid, and forgetful.

She's too young for dementia but not for ALZ. ALZ is usually diagnosed by discounting all other possible medical and health causes for the behaviors.

I agree she may have a UTI, but also consider that maybe she's no longer managing her meds correctly? Over- or under-dosing? Or her BPD has just gotten worse? Or maybe she's moved on to other meds or self-medicating with other drugs...?

You ask, Where do I go from here?

It's difficult to help an uncooperative person, even if you have legal authority for them. I think you go over there and if she winds up, you call 911 and let them know she has a history of BPD and depression and you can tell them you don't know what's going on with her (maybe consider videoing her behavior before EMTs arrive). They may do a social admit for her or a psych hold. If you get access to her residence, look around to see what other signs and clues there may be. Check for empty prescription or meds containers, unopened mail, rotting food in fridge, etc.

If she makes it to a hospital, talk to a social worker there but have tempered expectations that you may not be able to do much, especially if they discharge her back to her home. You can try to tell them she is an unsafe discharge. But if she comes back around to being close to "normal" they will probably discharge her.

In this scenario the most you can do is keep reporting her to APS and talking to the manager of the IL to let them know you're concerned and are trying to get her help. Maybe ask if she's been keeping on top of her payments. Advise them to call 911 or APS if they see any strange behaviors from her.

Whatever you do, do not take her in to live with you. She will burn you out and you will have even less control than you do now. I wish you success in working to get her the help she needs.

I would bet a LOT of money that Mom has a UTI. These can cause bizarre psychiatric symptoms.

Is there someone at the IL she will listen to about getting tested asap for a UTI?