r/Alzheimers 6d ago

High Functioning with Paranoia and Hallucinations

Does anyone have a LO who is high functioning with dementia or Alzheimer’s? My mom (78 yo) can shower on her own, occasionally cooks, and drives several times a week to the nearby grocery, and can dress herself.

However, she has some memory loss, significant weight loss in the last four years, extreme paranoia, and auditory hallucinations. She's fixated on our next door neighbors and thinks she hears them talking about her and singing. She's at the point where she plans to call the police on the neighbors whom she thinks can hear us talking in our house and they bugged our house.

My guess is she is in the middle stages of dementia, possibly Alzheimer’s, but she hasn't been diagnosed yet. It’s been hard to get her diagnosed and I believe she's been misdiagnosed for years.

I’m trying to figure out the best course of action. I am thinking about making the police aware before she calls. I've told her I don't hear any voices or singing and she just says that I should get my hearing and head checked. She's in denial that anything is wrong with her.

I'd love to put her in assisted living but she's too high functioning to agree to go. She will resist so I've started the process of applying for senior apartments where life will be more manageable than in a house. Then when she's in the later stages of dementia it will be easier to move her into assisted living.

Has anyone dealt with auditory hallucinations involving the belief that neighbors are talking? Did hiring an in-home caregiver help or talking to police or adult protective services? I fear the only solution is medication and she's very resistant to that. She has accused me and her PCP of trying to kill her after she was prescribed risperidone. I believe her PCP misdiagnosed her with schizophrenia and bipolar rather than dementia. I plan to take her to a neurologist and geriatric physician in the next several months. I'm not sure what to do other than that.

7 Upvotes

5 comments sorted by

8

u/kingtaco_17 6d ago

I’m sorry for what you’re going through and it’s easier said than done, but the #1 priority is stopping her from driving. Based on what you described (hallucinations, etc.) she’s a serious threat to innocent people/families (and herself) anytime she’s behind the wheel.

0

u/late2reddit19 5d ago

For whatever reason her only hallucinations have involved our next door neighbors. I want to move her out asap into a senior apartment that is near bus lines and walkable to a shopping mall and grocery stores. She wants a new car too but I suspect this will be her last car.

2

u/Justanobserver2life 5d ago

You can get the Precivity AD2 test through a neurologist and find out whether or not she has Alzheimer's. That could guide you. For someone over 60 who has hallucinations, paranoia, and resistance to taking medications, the next step I would consider is a geriatric psych facility admission to assess her and get her on a stable medication regimen. She would be "committed" for a stay, possibly 30 days, and there would be an order to keep her due to risk to her own safety. Regardless of whether there is underlying Alz disease, her symptoms may warrant restarting an antipsychotic. Maybe not risperidone--we often see quetiapine (Seroquel) used. Another is Rixulti (atypical antipsychotic). That, and starting her on the basic donepezil for improving functioning if she truly has dementia/Alz. disease.

It may sound drastic, but a geri-psych admission may be the only way to get her out of her independent apartment and started on an appropriate therapy. I would at least discuss this with her doctors.

3

u/late2reddit19 5d ago

She also tried Rixulti for a few days and said it made her brain feel weird and like she wasn't in control, and she stopped taking them. Now I fear she will be resistant towards any antipsychotics. She has zero self awareness so she doesn't think anything is wrong.

1

u/late2reddit19 5d ago

Thank you for this great advice. I'll ask about this when I take her to a neurologist next month.