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My mom had a brain injury from a car accident 16 years ago, for which she received treatment at the time. She is now starting to exhibit personality and mood changes. Along with delusions, that seem to get triggered by her being on her own. She is still quite capable of taking care of her daily needs. We have stepped in to help a bit more with bills, expenses etc.. As she seems to get overwhelmed with these tasks. Looking for support as I’m finding it very difficult to accept these changes.

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When my mother scored an 18 on the MoCa exam, she was diagnosed with progressive dementia at that time. When asked to draw a clock, she drew some sort of blob which did NOT resemble a clock at all; that showed a lack of executive brain function which let the testers know she was cognitively impaired. They were right............this was in 2016 and she's gone downhill ever since.

"Showtiming" is also common with dementia, and my mother is STILL the queen of putting on a great act for others when the need arises. The muscle memory stuff is still greatly intact......you know, the small talk? Hi, how are you? Don't you look lovely today! How is your husband and family doing? But when you get into the details, that's when they fall apart. Don't ask them what day it is or what medications they take........that's when the impairment shows up. But the small talk they can win prizes for. It's all part of the show they put on. For you, your mother will have delusions and not know her own name...........the mask falls off BIG time b/c you're safe.

Whether you find it difficult to accept these changes or not, you're faced with them, and so is your mother. Living alone is dangerous now and you'll have to figure out either in home assistance or moving her into Assisted Living/Memory Care soon. You can't believe the mischief and trouble these elders can get into when left to their own devices; it's mind blowing.

Go to Alz.org to read all about dementia and how it presents itself so you'll know what you're facing, what you're mom is facing, and what to expect in the future. My mother is 94 now, incontinent, wheelchair bound, and has fallen 69x so far. She lives in a Memory Care Assisted Living and is in need of Skilled Nursing coming up here in the near future.

Wishing you the best of luck moving forward.
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Nancypr Mar 2021
Thanks for your advice! Yes, my mom was asked to draw the clock. She had a difficult time with this too. It was a circle, but the numbers were all bunched together! I feel like we have been going in circles with Drs.
I like how you called it ‘showtime’ that’s a great way to explain it.
my mother is only 73, but had a brain injury from a car accident about 15 years ago affecting her frontal lobe. But no one is putting the pieces together. Not sure what it’s going to take. I live in Canada and have great supports through the Alzheimer’s society here. I have done some education classes. I’m not a dr, but truly feel my mother is developing dementia and is probably frontaltemperal lobe. Hence the delusions, irrationality, etc..
thanks again for your advice!
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I have to agree with Garden Artist or other medications. Other causes are a urinary tract infection....it is common with elderly people to have delusions, hallucinations with such an infection. Lewy body dementia is another source. I suggest taking her to her dr or the ER for a full work up and examine.
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Nancypr Mar 2021
Thanks for your advice! This has been going on for almost a year. The first thing we did was take her to the ER to rule out UTI or medical delirium. It’s all so hard to deal with. I feel helpless.
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If your mom is responsible for taking any of her own meds, it should be somehow ruled out that she is not accidentally over-medicating herself. Also, are you able to contact her original doctor who most worked with her during her brain injury recovery to see if there are any later-in-life issues associated with her type of brain injury? I wish you much success in helping her.
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Nancypr Mar 2021
Thanks for your response. She is very stubborn about taking her own meds. We did rule out medical delirium awhile back, but should maybe look at her meds again. I am trying to get them organized by the pharmacy, but she refuses this.
I am in the process of trying to figure out where she has her follow up with her brain injury. She was quite young at the time (57ish) she is now 73. There is no doubt in my mind that this brain injury is having an impact now.
thanks for your help!!
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Delusions can be caused by meds.  Ambien was at one time noted for that.   In addition, I was also told that by 3 medical people, 2 nurses and a med tech.  

I myself witnessed one such episode; it was unsettling - there was no way of reassuring the person that the delusion was real, although when she woke up the next day, she stated that this wasn't the first experience with Ambien delusions.

Your mother may be able to handle her daily needs, but does she become frightened being alone at night?
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Nancypr Mar 2021
It’s interesting you say that she may be able to handle her everyday needs...I feel like because she can they are dismissive about things. She has always been very independent as she was a single parent from a young age. I feel like everyone thinks she is functioning with everyday life, but not to the extent she once did. I don’t think she becomes frightened, but I do think her being alone triggers her to get herself into a certain state.
thanks for your response! I’m glad I found this forum!
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With any brain injury the potential for a TBI resulting in Dementia is VERY high.
More likely if the trauma continues, like in people that play sports but all it can take is one time. (friend of mine, her husband was in an accident and it accelerated dementia and made PTSD worse)
An evaluation from a Neurologist or a Neuropsychologist would be in order.
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Nancypr Mar 2021
thanks for your advice! My father in law had a brain injury and eventually ended up with dementia! So I feel that you’re so right when saying that the chances of getting dementia is high.
I live in Canada and here we have geriatrician’s and geriatric psychiatrists that are the ones that do testing etc.. my mom has an appointment coming up, but she has kept us out of her medical appointments at this time. It’s been such a struggle. I feel like she knows things are changing and is probably scared, so she has her guard up.
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It sounds as if your mother may not be safe at night all alone. She may need someone with her at night. It may be time for her to move to more appropriate accommodations. Depending on what part of the brain was injured could account for the now personality, mood changes and delusions. If she is still able to take care of her daily needs, AL might be a good option as someone can check on her at night.

Dad had alzheimer's. Evidently his delusions or more likely dreams were caused by an alzheimer's drug he was given - he had very vivid dreams and had to talk to himself that the dream he had was not real life.

Later on hospice after he was off most all meds, except those for comfort, he would sometimes have delusions. The worst ones according to SNF was when he thought there was a building on fire and tried to get to it to rescue "the children". The nurses had to hold onto him so he would try and stand and fall. Other delusions he had were more mundane, such as calling me for an immediate need for money because he owed it to someone.

Wishing you and your family the best as you face the next chapter in your mother's life.
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Nancypr Mar 2021
Thank you for sharing your story. It is so difficult to watch your loved one go through this. The part of the brain that was injured was her frontal lobe, so the personality and mood changes, irrational thoughts etc. Makes sense! She is digging her heels in and doesn’t think she needs help. How do you help someone that doesn’t think they need it. The journey is not going to be an easy one. I feel helpless and sad for my mom too, because if I’m scared I can’t imagine what she’s feeling!
thanks again!
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If mom won't let you go with her to the doctors appointments, can you write them a letter outlining what you have observed, and heard about the delusions? Like, "please ask her about the time she had tea with the Queen and Snow White?"
I don't know if Canada has the same health privacy laws that we have. US doctors can't discuss your medical issues with anyone unless you give permission. But nothing stops us from being able to tell the doctor additional information about the patient.
You could include the information about the police involvement and the issues with the neighbors so he/she gets a rounded picture of your mom's mental health.

Back in the day, my maternal grandmother "heard on the radio that Pres. Reagan bought the family ranch and discovered some of her paintings in the attic. He was going to bring them to her when he came to his ranch in California". We now know she had Alzheimers, but back then they just called it senility.
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Nancypr Mar 2021
Thanks for sharing and for the advice. With a past dr I have called an ‘filled them in’. I think writing a letter and letting them know what we have observed is a great idea. As we have the same privacy laws here as you do in the US.
thanks again
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GardenArtist:

"It was the lilac bush brushing against the house."

So, did you go shoot it? :-D

If not, at least cut it down to the roots!!! Dang bushes...
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GardenArtist Mar 2021
(Laughing) - no, I didn't shoot the lilac bush!  If I had, the police would be back, this time not to check for prowlers but to arrest me!
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If she is exhibiting new neurological problems and delusions, please have her evaluated by her doctor. There are several different causes for her problems: more neurological insults, blood chemistry imbalances, infection (especially UTI), poor oxygenation, problems with medications... If she exhibits alarming changes in her mental status, take her to the emergency services. She may be having a stroke or strokes. The majority of strokes can be reversed if treated within hours of onset. Her doctor would be able to determine the cause and advise on treatment options.

Until her doctor's appointment, it would be helpful for her to have somebody checking on her throughout the day. If she is threatened with inadvertently hurting herself or safety is a concern, please make sure somebody is with her all the time. Please consider enlisting help of family, friends, members of faith community, and paid help. The goal is to keep her safe and healthy. I suggest creating a journal that all "helpers" write in to let each other know what happened while they were there to "visit."
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Nancypr Mar 2021
Thanks for the advice. We have ruled out UTI and medical delirium.
At this point she isn’t unsafe being alone ( we don’t think), but will have to look at options on the near future of having someone check in on her daily!
thanks for your suggestions
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Dr told me that delusions were a symptom of dementia. Mom would call and tell me she saw a lizard in the corner of her room. She was absolutely sure she was seeing it.
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Nancypr Mar 2021
My mom’s delusions always have a bit of truth to them. For example, in her previous condo, there was a lot of noise coming from upstairs. There were 2 small a children living there. However, my mom had it in her head that there was a 10 year old boy they were hiding. She would confront the neighbours and yell insults to them. She actually called child services to which I had to call and say it was all made up!
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