My mother is 82 and recently diagnosed with vascular dementia.
She began periodically falling in 2012 / 2013 (2 times a year at most) and looking like she was having a seizure. Eyes rolling back, rigid body, gasping for air, then passing out for a few moments, coming around, vomiting. When she got to the hospital everything was normal. They would keep her a few hours, do the routine tests, and send her home. I kept asking each time if it cold be TIA (mini strokes) but was told no and neither was it a seizure. The Dr's attributed it to high blood sugar (she is diabetic for 25 years) and atrial fibrillation (she has had for 15 years).
In Sept 2014 she fell between two hotel beds, her head went sideways against the box spring on one of the beds and she broke her neck (thankfully not a vertebrae). They operated and put a pin in. Although a bit unsteady on her feet and range of motion on her neck is more limited, she is fine.
Then she started having falls again in Jan / Feb 2015 (3 in 1 month). She remained lucid and calm and said she tripped over the walker the first 2 times. Given the location of the walker and her eyesight, it seemed logical. The 3rd time she presented the seizure symptoms and vomiting again. Paramedics saw atrial fibrillation pattern on their monitors, took her to the hospital.
Same thing, everything presented normal when she arrived. They kept her over night,sent her home. A week later, we are back again in the ER for the same thing. This time the Dr.admittedher for almost 2 weeks, got the blood sugar under control, did CT scans, heart monitoring, blood tests, urine tests and were watching for another fall to see what the seizure looks like (which of course won't happen when you are in a hospital and waiting for it to happen). But again, they indicated there was nothing they could pin point but possible high blood sugar. Readjusted her medication a bit and sent her home.
Thankfully the falls have not happened again. Follow up CT scans since she left the hospital in Feb show her brain has become smaller and that she did appear to have had mini strokes. Her Dr. is attributing the vascular dementia to that. (my mother does perfect on any dementia test done in the Dr. office (except the short term memory part). But of course she would pass the test....that is the only focus needed in a very quiet room, not one bit like a home environment)
The dementia started back around early March, after she got out of the hospital. Just very slight confusion of thinking she lived in her childhood city. In May, she was displaying more signs of mild confusion when talking with me specifically. However, the Dr did not seem concerned and did not want to put her on another pill just yet (already on 10 in the morning). Did the UTI - fine.
Since July, she consistently thinks there are 2 of me. One is her daughter and I cannot figure out who the other one is in relation. We both have the same name. She will look right at me and say .. not you.. I want the other Sxxxx (meaning her daughter). She will stand at the top of the stairs and call for her daughter Sxxx to come up stairs when I am standing right next to her. She will make dinner for 3 of us (it is just myself and my mother in the home). Her daughter Sxxx is much younger I have concluded. 90% of the time I am not her daughter, but am the other Sxxx. She thinks my mother visits. She calls her "the other mother". There is no name she can give. But will often ask me if the other mother is coming shopping with us.
Everyone else she remembers perfectly. She talks with her niece on the phone every day. She talks to her brother everyday and knows everything perfectly. Both live in her childhood city.
Since August, she comes to my room and asks me where "Sam" is so she can wake him up, then goes to the spare bedroom to look. I have no idea who Sam may be and she cannot tell me. Sam was my dog that has been gone for over 10 years. Sam was her brother that passed away 20 years ago and had been married for 20 before that, so was not a constant in her life
I have a caretaker every day for 4 hours to help bathe, clean but mostly talk and keep my mother's brain active while I work.
It has gotten progressively worse the past couple weeks. Now 80% of the time she think she lives in her childhood home & city. She wants to invite her brother for dinner or drop something off to him (it is 2 hours away). But she knows where she is when he calls on the phone.
She functions fine in all other aspects of her life
I am at a loss as to why it is just me she is confused with. How do I respond when I am not the right Sxxx? When she asks me to get Sxxx to come in the room? She gets agitated and angry when I try to explain I am her daughter & there is only 1 Sxxx. She says everyone is fooling with her. I am tears most days as she can be quite hurtful with her words. I know it is her world at the time, and I try to go there with her, but it is hard.
What your mom is is experiencing is not unique, and it would be worthwhile to discuss it with the doctor who is following her dementia.
In the other cases I've read about the duplication delusion was limited to one person, just as it is only you your mother thinks of as two people.
Look up capgrass syndrome. I don't think that is exactly what your mother is experiencing, but it is close enough to perhaps suggest some insights for you.
Your mother talks to her niece and your brother. Voices typically stay recognizable for decades. If I hear from a relative I haven't talked to in years I often know immediately who it is, or accept who it is after being told. They are the same voices they've always been. But you are right there with her. Your voice might be the same, but you sure don't look like you did thirty years ago (or whatever period your mother is currently occupying mentally.) So you both are and are not her daughter. Sigh. Terribly confusing, isn't it? And painful for you.
Do talk to her doctor. Meanwhile, accept that she cannot be reasoned with on this subject. Do not try to convince her there is only one of you. Logic isn't the issue here. Say, "The other Sxx is out running errands (at the library, at a friend's house, out of town this week, -- anything plausible). Is there anything I could do for you? Well, then, how about a quick hand of rummy before dinner?"
Is it any comfort to know that other caregivers go through this?
Very hard to deal with, but I have stopped trying to reason with him and just go with it. He also thinks he lives in his childhood town, and wants to go by the visit his old friends and relatives, and we live in Arkansas and they live in California.
So we are not going to do that, so I just say we will try and do it tomorrow,and hope he forgets ,.and most of the time he does. I am trying to cope with this it has been about 8 months now, and it never changes, same thing every day.My husband I believe has Lewy Body due to his symptoms, it is really hard
to deal with this, but I do know he loves me, because he never saids anything bad about his wife, always good things, that helps. He is on Namenda and when I added aricept he gets worse, so now I just give him Namenda.
She also is type II diabetic, has afib/heart issues, high blood pressure, vascular disease and bad circulation and inflammation. She is not where your mom is yet and I'm so sorry because it is very difficult to go through with them.
I do and she does a good job still of watching her blood sugars closely, takes her meds, supplements and walks on the treadmill a few times a week. Her heart doc told us the walking really helped with blood flow and growing new blood vessels to circulate to get blood to the heart and brain.
I assume your mom are on meds? Mine takes Lantus, metformin for diabetes, eliquis and isosorbide for afib and heart and atenolol, amlodipine, benazepril for blood pressure, atorvastatin for cholesterol (which I watch closely for memory) and levothyroxine for thyroid. It's a boatload and she does take supplements as well like coconut oil and omega3s along with others her primary doc monitors.
Check her meds and sugars regularly as this seems to really affect mom when she's goes off. The lack of circulation, hardened arteries and such can rapidly increase what you're experiencing. Hopefully she doesn't smoke or is around it as my mom's vascular doctor said they really can make it worse. Also any surgeries should be given much thought as that too can make her worse and the recovery that much longer or near impossible sometimes.
Will be praying for you, I know to a lesser severity so far what you're going through, but keep these things in mind if you can. My mom likes to read the bible so I post some scriptures in huge font in her room in various places which she enjoys reading too. Please know you're not alone.
What you might do besides redirect when she's confused is leave the room to look for your alter ego, put on a different shirt or sweater, return and pretend you're the one about whom she was asking.
I think there are so many aspects to dementia and the confusion it can cause that it will be years before medicine can adequately identify and explain what's happening, so in the meantime the recommendation seems to be as CWillie suggests.
Sorry to learn you're facing this; it must be so challenging as well as very sad.
I expect she seems to be more confused with you simply because you are there more to witness it, and when others are around she may be able to hide her confusion. I remember visiting my great aunt and having lovely conversations with her about the extended family, but afterwards realizing she hadn't had the foggiest idea who we were!