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Mom started having hallucinations and showed signs of being paranoid a couple of weeks ago. Her blood pressure has always fluctuated and we watch it very closely, plus she is on bp pills. Last weekend she became very scared at night and saw people in her apartment. I went and got her and brought her to my house. She was good until something switched and she would not take her pills and from 2:00 in the afternoon until 7:00 in the morning she sat in my kitchen and berated my sister and myself, talked non stop the entire night, refused to take her pills, and we tried everything. Finally, we got so worried about her bp and she seemed to be getting worse that we called an ambulance which we did not want to do. She was admitted to the ER first and they gave her something to calm down, and lower her bp. They did a bunch of tests that at first she refused many times such as an EKG, CT scan, MRI, and things came back pretty normal for 91. They think the combo of macular degeneration and high bp is causing the hallucinations which leads to being paranoid. She got moved to the behavioral health wing and she is miserable. Her bp still fluctuates and the drs want it to be consistent, but she is not having hallucinations. We want to get her out of the hospital but the drs day it would be against medical advice and is not a good idea. We can only see Mom two hours a day and she argues and is mean to us for getting her in this situation. We want to take her home, but we are worried about her bp and her reverting back to the hallucinations and then not getting medical care because we went against medical advice. We are going on day 6 of this and she just seems more agitated and my sister and I want her home. We can get her home health care to manage her bp, but the drs want to keep her. What should we do. We feel helpless and terrible for our mom.

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She needs the right combination of medications to deal with her anxiety, paranoia, and hallucinations before she will be ready to take home. Give the medical staff time to fine tune her medication regimen.
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You can discharge her if you agree to take her home. But you have to consider she will need around the clock care and you will have to enter her world because disagreeing makes the agitation worst. Read the 36 hour day. Get her a neurologist who can discuss memory loss and Alzheimer’s. If you get her out, her home will be better because change of environment also causes progression in what she’s going through also. Sorry you guys are dealing with this situation.
signed: your friend who takes care of my alzhiemers mom in my home.
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MiaMoor Jun 15, 2024
I thought that being in hospital, a different and incomprehensible environment, would cause rapid cognitive decline in my mum who has vascular dementia. The opposite happened.

In the 5 weeks that my mum was in hospital, on 3 different wards (including nearly a week in a room on her own due to covid), I had the most normal and lucid conversations with her. It was as if I had got my mum back!
She wasn't like that all the time - when she got tired, she would become withdrawn and forget where she was or why she was there, much like her new normal. But there were flashes of the old Mum and I made the most of those precious moments.

I think it was because she was stimulated in a different way. She's naturally nosy and did a lot of people watching on the ward; she once remarked, after trying to listen in to the nurse and patient opposite, that the ward needed sub-titles, like her telly at home! Also, she had to engage with new people - all the various nurses, doctors, physiotherapists etc.

So, it's not always possible to predict how a person with dementia will react to or cope with a new situation.
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Vascular dementia can cause this.Usually from prolonged high bp.
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So sorry to hear that. Sounds like she's better off in the hospital under 24/7 doctors care until they figure out what the problem is.

My dad had AMD that came on around 2012 and he passed at 90 years old this past January. He dealt with it for 12 years and remained his happy self through it all. He did not have any hallucinations nor did he have any type of dementia. He had a few UTIs as he was on a permanent catheter due to an enlarged prostate, but he was also under the care of a Home Healthcare Doctor who regularly checked on him.

My mother on the other hand experienced hallucinations due to medication, specifically when she was on dilaudid after surgeries. She not only had hallucinations, she also has no memory of anything while on that medication. So it's in her medical records to not give her that medication.
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Charles Bonet syndrome is very real, my mom has had it for years. There is quite a bit on you tube from the British Charles Bonet society. Her retina specialist should have information for both of you. My mom felt much better when she realized she wasn’t losing her mind. Best of luck to both of you.
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Thumbelina: Check out the following - "Charles Bonnet syndrome can make you see things that aren’t there. Scientists think that this happens because the brain may be craving more images than it’s getting. Charles Bonnet syndrome happens in people with low vision." AMD or Age Related Macular Degeneration is sometimes referred to as low vision.
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Have them check your mom for Charles Bonnett Syndrome. With Macular Degeneration the hallucinations come. It’s always misdiagnosed. Take her home where she is comfortable. You can always bring her back to the hospital. My mom is 92 I’ve been dealing with this for 22 months.
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Patients always stay on the Geri Psych floor longer than others. They will evaluate your Mother and start her on medication, but then a lot of medications have to be fine tuned to just the right dose and that takes time.

Please do not take your Mother home early, you’ll be right back where you started. Independent Living may refuse to take her back. And you’ll be back to square one, then what? Start over?? What a waste of time and money that would be.
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Please research Charles Bonnet syndrome. My mom has experienced this. She has had AMD for many years, and has had two or three Charles Bonnet episodes (lasting a few days each?). She had heard of this before so was not completely taken by surprise. If this happened without someone understanding what was happening, it could be very unsettling and disturbing. Obviously there can be other things going on as well, but good to be aware.
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"Yes, age-related macular degeneration (AMD) can cause visual hallucinations called Charles Bonnet syndrome (CBS) in up to half of people who experience it. CBS occurs when the brain adjusts to significant vision loss, and the hallucinations can appear real and come and go without warning. They can last for seconds or days, and CBS itself can last for years."

Do not take Mom outbof the hospital.
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Why on earth would you want mom back home, undiagnosed, in the same condition she was in when you called an ambulance for help???? Geriatric psychiatrists must stabilize her first, and then you can decide what comes next. To take her home AMA is sheer lunacy at this point! Unless you want to be up all night again with her berating you and talking non stop. Mom needs to be evaluated for dementia and mental illness and you gals need to figure out where she's going to live once she's released from the hospital because living alone at 91 will no longer be feasible. Maybe in home caregivers can be an option?

Wishing you the best of luck with a difficult situation.
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I guess I would ask Why do you want to take her home? She is where she needs to be, it is no longer about what your mother wants it is about what she needs.

Sounds like dementia not BP, if so she is at the stage that she will need 24/7 care, are you ready to handle this? Memory Care may be the answer.

As a side note, my mother is 99 and has both as does your mother, she does not have hallucinations, she is in AL and is very happy there, new friends, activities and more.

You and your sister need to have a sit down and really discuss this at length. Dementia is a disease that has no cure and will continue to get worse.

Sorry about all of this.
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You are LUCKY your mom is in hospital care, so please don't interfere with this.
I would have bet on a UTI here given the sudden onset of this, but I would have been wrong it looks like, as the Urinalysis apparently didn't show that.

You are almost certainly looking at dementia here, or mental illness. They are now finding that bipolar disease is, believe it or not, being diagnosed over age 60 in some 25% of bipolar patients. This could be also Lewy's Body Dementia, which can give very real hallucinations.

The only thing now you can do is stay in close contact with the medical team in the psyc eval unit; there is going to have to be scanning and testing and you need a diagnosis, and whatever medication treatments might help.

I am so sorry. I have no answer for you at this time and sounds like the medical team does not either at this point. I sure do hope you update us as this moves along, but you may be looking at placement for your mother in a memory care. Your profile tells us she has been thriving in independent living so far, but unless this "miraculously " goes away, she won't be able to return to IL.

I will be very surprised if all this is due to increasing macular degeneration and/or BP. I suspect the BP is up due to the agitation. But time will tell. Stay in close contact; ask for social worker or care case manager. You need information and testing now.
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It sounds to me as though they saw a 90+ year old and wrote everything off as age related, someone who has lived with vision loss for several years doesn't suddenly experience hallucinations because of it and I can't say I've ever heard of high BP causing them either.
My mom also had a very sudden decline at that age and I never did get a diagnosis (in fact my search for answers is what lead me to AgingCare). My mom did recover for a period of time but it was the beginning of a long, slow decline into what I believe was vascular dementia (which I diagnosed because of her medical history plus evidence of multiple problem areas in her MRI).
Ask to sit with the neurologist to go over exactly what they see on that MRI and the reason they are reluctant to release her - what are they looking for? when will they be satisfied she is stable enough to go home?
Beyond that it's time to make some long term plans because even if she recovers from this crisis there will likely be others in the future. Can she remain at home and who will provide care if she does? If not what/where next?
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Has anyone tested her for a Urinary Tract Infection? These often cause psychiatric symptoms in the elderly.
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I also have a mum with very little vision left from macular degeneration. THe suggestions by the doctors and by others who have replied may well of course be right - I am not a medical person. However you may want to consider CHarles Bonnet syndrome. This is suffered all the time or in episodes by some people with ARMD . It causes hallucinations, patterning in front of the eyes and can cause a lot of distress. For example, my mother saw a horse and carriage in the living room. She also has seen swirling faces of ugly, grinning creatures and vivid patterns. Clearly she can become extremely agitated by this even though she knows it is Charles Bonnet. Most of the time she is fine and does not see anything like this/ PLease look up Charles Bonnet syndrome or Esme's Umbrella, , a charity for sufferers. perhaps talk tothe DR's about this? Some doctors where I live have not come across this syndrome before but others are well clued up/ Just an idea to explore! My love to you and mum/ xx
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I think you and your sister have to get together, and think long and hard about the future, before you bring her home.

Do you want to be a full time caregiver, do you know what this entails, the years of your life it could take from you. The stress, the mental stress, which almost always leads to some physical issues for you.

We have people posting often that they brought their love one home and there are so burnout . It effects every part of your life. And now you may have dementia to add to it.

Also if you read some of others you will learn that once you bring them home you are stuck with them and unable to get them in a facility.

I'm so sorry about your mom, I understand how difficult this is, I'm going through my mom's health failing too. It's so extremely hard.

Best of luck to you
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It sounds more like your mom may be in the throes of dementia, as that can cause hallucinations, especially Lewy Body dementia.
Either that or a bad UTI, but I'm guessing that the ER tested her for that as that is pretty standard.
If it is dementia, your mom will only continue to get worse and it may be best that you just let the hospital place your mom in the appropriate facility where she will receive the 24/7 care she now requires and you and your sister can just be her loving children and advocates, and not her caregivers.
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I am so sorry that your mom is struggling with high blood pressure and hallucinations.

Was your mother checked for a UTI? Urinary tract infections can cause unusual behavior in older people.

Has she always blamed you for her problems? You didn’t cause any of her issues. You did the right thing by making the decision that she needed to be in the ER.

Do you suspect that she may have dementia?

My godmother had macular degeneration and sadly went blind. She also had Alzheimer’s disease. Macular degeneration has been linked to developing dementia.

I would follow the hospital’s recommendation of keeping her in the hospital. You may want to start thinking about placement for your mom in a facility.

Have you spoken with the social worker at the hospital about what might be best for her regarding her future needs?

Best wishes to you and your family.
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