Sudden onset dementia. Assault? And a WWYD

[Spryte]

Trigger warning.  Possible assault.  Some of this is uncomfortable to write or discuss, and distressing. I’m exhausted, so excuse typos, please.

 

Any ideas or suggestions appreciated.  There are two components here, so it’s confusing, but I’m looking for ideas on what could cause sudden, significant dementia, and thoughts on a possible assault and what to do.

My 78 yr old mother was fine on Thursday night, we had spent the day together.  I didn’t speak to her on Friday, and found her in a strange, disturbing state on Sat am.  

CT and MRI say it’s not a stroke.  Urine is clear.  No recent med changes. Any unusual ideas on causes?  Docs are giving up, say it’s most likely dementia, and telling me to plan for round the clock care, pay out of pocket but she can’t be alone. 

She is still in hospital, and we are awaiting a psych evaluation (she is bipolar but has been on a good cocktail, for her, for a while).

Sat am I found her “sleeping” soundly with her apartment disheveled.  She was mixing up words (cereal for underwear, that sort of thing), would suddenly freeze until I got her moving again, could not dress herself, stuttering, saying nonsense syllables, etc. she had been fine on Thurs, so it was a shock.

I immediately thought stroke or UTI and took her to the ER.  Both are ruled out.  They can’t find a cause.

This morning she had more clear moments and a disturbing focus.  She feels she was assaulted on Friday night - but she has no memory of it. She was also laser focused on a memory of a man in her senior apartment community who followed her down the hall to her room, matching her steps.  He made her uncomfortable.  He’s not a resident. I have confirmed that part of the story with her friend - she had told a friend that this man made her uncomfortable.

Again, my mother is bipolar.  She’s on a lot of meds.  She has minor memory issues normally.  When she was untreated, she had some paranoid thoughts, but nothing like this.

Here’s what I saw, personally, when I opened her apartment door on Sat am:

- her front door was unlocked

- she sits on the couch to do a craft while watching tv, and uses a tray.  That tray was upside down in front of the couch, craft pieces all over the floor.  Her cell phone was on the couch (unusual because she reads her kindle app in bed normally).

- her pants and underwear were strewn on the floor in front of her bedroom, and inside out, twisted together like they came off at the same time.  This is also not her norm.  She takes them off separately because she does everything very slowly, and uses the hamper.

- I found her in her bed, hard to wake.  She was sleeping with her head in the middle of the bed, legs hanging slightly off.  The fitted sheet was removed from the bottom and pushed up to the pillow area, still connected at the top.  She had no pants or underwear  on.

- I feel compelled here to say that my mom is meticulous about sheets.  She sleeps in undies, with a pad on, with a waterproof mattress protector pad, then a sheet.  I have never seen her sleep with no undies or sheet.

All of that, at the time, I attributed to confusion and a possible UTI or stroke.  I picked up the mess a bit and got her to the hospital.

This morning, Sunday,  in her clearer moment, she said, “I think I stood up when someone came in the front door” and that’s how her craft tray fell.

She remembers nothing else.  She was afraid to go home, and asked me to buy a camera so I could watch to make sure he didn’t come back.

I reported this to the doc and her case manager.  I don’t think the case manager believes her.  I don’t know about the doc.

We have to file a police report to get a forensics kit, and she has to transfer hospitals because this hospital doesn’t do them.

In the meantime, they have suggested a psych evaluation, because history of bipolar.  

Here’s the thing:  I am her Med POA.  I have a responsibility to get this checked out, I feel.  What if it happened?  She’s in harm’s way.  On the other hand, it might not have happened.  Regardless, I feel like we must check this out.  

By 3 pm Sunday, my mom was just gone.  She doesn’t know where she is.  She’s in the Philippines, at church, in the choir room, at a fundraiser, playing poker, showing her art, making a price list.  She knows me and my family, but no idea about anything else.  

She can’t  talk to the police in this state.

Her psych evaluation will be in the am. I will try to be there, and I hope I can talk to the psych doc about this, and to a social worker.

So we have two issues immediately:  what’s causing this?   They are leaning to dementia but it feels terribly sudden.  She can’t be alone, so I’ll have to work through her care with a SW, hopefully and find resources.

And - do I put her through a forensics kit?  She can’t remember that she’s in a hospital, even.  It will be traumatic.

Adding to all this is how triggered I am.  How distressed and uncomfortable it is to consider reporting this, even in her behalf.  I feel like a stereotype.

 

 

 

 

[Jaybee]

It sounds like she was drugged. I don't know anything about these things, but it seems like you should go with it as far as you can. Is it too late for a forensic kit? Too late to have her apartment checked out? Because if this man did this, it could be a pattern. And others may not pursue it due to similar situations. If she was drugged, could it have reacted with her regular meds and caused some of the confusion, etc.? 

I'm so sorry you are in this situation. And sorry your mother is, too, whether it really happened or is just in her mind.

[Selkie]

Oh, what an awful situation. I am so sorry. Like a previous poster, I am also wondering whether there are cameras in the hallway.

[lispy]

I am so sorry. This is traumatizing for both of you.   I do think with what you've shared,  I'd file to get the forensics (assuming it's not too late--I don't know how all that works). At least then you'd know.  

I hope they can get your mom (and you!) back to a place of peace soon. 

[mmasc]

I don’t have any words of advice, but after reading your post I just wanted to say how truly sorry I am for what your mom is going through. And for you too, as this must all be very disturbing for you as well. I’m so sorry. 😞 

[ktgrok]

As for sudden onset mental weirdness one thing that can happen and is not often caught is autoimmune encephalitis. It is usually blown off as mental illness. https://aealliance.org/patient-support/symptoms/

But it does sound like she may have been assaulted, which could cause I imagine a mental breakdown, or she may have been drugged and whatever it was interfered with her regular meds?

 

Edited October 7, 2019 by Ktgrok

[Pippen]

I'm so sorry! I had a family member who had rapid onset dementia and it turned out to be Creutzfeldt-Jakob disease.  I will say in my family member's case it wasn't quite overnight, but from the time she had a significant episode to the time she didn't recognize anyone was probably under two weeks. She also had erratic emotions and back pain that couldn't be medically explained in the months leading up to the dementia.

It was shocking to watch the rapid change--I had a completely lucid phone conversation with her one week and two weeks later her mind was nearly all in a totally different world and she was mumbling a great deal. 

It was difficult to diagnose in the local hospital. Once she was transferred up to Mayo Clinic they recognized it right off. 

https://www.mayoclinic.org/diseases-conditions/creutzfeldt-jakob-disease/symptoms-causes/syc-20371226

 

[ktgrok]

Could her sheets be checked for semen, before putting her through the exam?

[Pippen]

4 minutes ago, happysmileylady said:

I am so sorry this is going on.  I agree with everyone else and I do think you should call the police.  

Definitely call the police. Her apartment should be treated like a crime scene.

[caedmyn]

As a former LEO, I'd suggest calling and talking to a law enforcement officer (a detective if possible).  Ask, if there was a sexual assault, how much evidence is likely to remain on her person, what...48 hrs later?  Have her sheets been washed?  Has she showered or bathed since then?  I would think evidence of force could still be present but semen likely not on her person.  Any clothing she wore Saturday should be preserved if possible.

[mumto2]

I am so sorry.  I am going to tell you my mom’s story just because it might give you hope.  

My mother was given too much of a pain med after injuring her foot and went into total la la land for well over a month......she received the Alzheimer’s diagnosis, was placed in a facility, everything.  I noticed that her language skills were making sense in her life context first, than one of her nurses joined in with me.  After one is labeled it is hard to change the label.  Her mind did clear but it took roughly three months for her to really come back.  She went back to living independently for a few years until her death..........

I wonder if your mom was drugged and assaulted.  The spiral down was sudden......my mom lost it in less than half an hour when overmedicated.  Have they done blood work?  I would have the kit done and call the police. Too much is not right........no matter what, if someone did assault her they need to be caught and I think you need to know in your own mind.  Hugs and prayers.

[Junie]

(((Spryte)))  I am so sorry.  Reading this makes me feel sick to my stomach.  I think that I would call the police and ask their advice on how to proceed.  

[gardenmom5]

irrelevant.

Edited October 7, 2019 by gardenmom5

[gardenmom5]

- did anyone do a rape kit?

 

eta: if she's medically/psychologically fragile and someone did enter and assault her, her being off in Lalaland could be dissociation to somewhere she feels "safe".

Edited October 7, 2019 by gardenmom5

[SKL]

I would try to find out if there is any video to show if anyone came to her apartment around that time.

I would try to do the rape kit if it isn't already too late for that.

I hope she was not assaulted, but if she was, whoever did it could come back.  I would be freaked out too.

[SKL]

And I would get a nannycam - sounds like your mom is in favor of this.  But this is not enough IMO if you believe someone might come back and hurt her.

[Chris in VA]

I am so sorry for both of you and hoping the police can help you figure this out. 

[Annie G]

Sadly, it sounds like she was assaulted and the confusion caused either by the trauma or from being drugged. 

I hope the authorities take it seriously- if they investigate and can find no evidence of an assault, good. But it’s worth checking to be sure. 

I’m so sorry- no matter what, you’re both going through a lot. 

[Carol in Cal.]

You’ve gotten good advice so far, but I would strongly suggest not just a camera but one that continuously streams video footage that is time and date stamped, and that is saved into your computer.  Honestly I’m really not sure she should go back there.  In places like that usually the patients can’t really lock themselves in securely, and she is going to be uneasy about the possibility of an attack.  If there was an attack, and unfortunately that seems pretty plausible, the guy is brazen and knows the facility well.  That’s not safe.

[Storygirl]

I'm very, very sorry. My mom has dementia and lives in a nursing home. Although it would be very rough to think of putting my mom through an exam, if we had suspicion that she may have been assaulted, I think we would agree to the rape kit. We would want for the perpetrator to be identified, if at all possible, and prevented from assaulting anyone else. But it is horrifying to consider, and I am sorry that you are having to make these choices. I am so upset and sad for your mom. I hope that her cognitive decline is temporary.

[Pippen]

1 hour ago, Seasider too said:

Keep in mind that hospital delirium can compound the issue. As far as the forensics kit - I am pretty sure I would ask for it. Perhaps she can be sedated for a physical exam - I’m thinking physical evidence is what they’d be collecting at this point? 

If there’s a chance there is a perpetrator, then there’s a chance he’s already considering his next victim. 

But I would not rule out other purely medical possibilities. It sounds like the current care team has gone as far as they are willing to, so a move to a different facility may give you a different, more eager diagnostic team, too. 

In my relative's CJD case, they kept mentioning hospital delirium compounded by steroids, but in reality the just didn't know and they should have transferred her.

[Spryte]

Thank you all.

Right after posting, I decided to call the police and ask for advice. I just couldn’t sit on it, she asked for help and I had to do something.  Even though, right now, she doesn’t remember.

So I spoke to a deputy on duty. I was very clear that she does not remember anything and since 3:00 pm today she doesn’t know where she is.  That I don’t know if something happened but here are all the facts, as I know them. He took the story to his supervisor.  And then, just like that, it was all rolling.  We met at the hospital (despite me wanting to wait till morning because she’s not lucid now).  He spoke to the nurses, got her medical records.  The nurse explained to him that speaking to her now, in her state won’t do any good.  She’s not oriented, doesn’t know her name, birthdate, etc.  So hopefully we can try in the am.

Here’s where we are now:  he’s filing a criminal activity report.  If she is lucid in the am, they will send a detective to her apartment, transfer hospitals so we can do a forensics kit, etc.  But for now, I can take this to her apartment management and try to see if they have cameras, at least.

Hopefully she will be lucid in the am.

I’m disappointed that they can’t just do a kit to rule it out.  I would have liked a better answer.  Then again, maybe that would just be so hard on my mom.... they would have transferred her tonight, I think.

Anyway, it’s not much, but I got it started.  

Hopefully she will be more aware in the morning.

This is horrible.

...and I thought every hospital ER had forensics kits???  Ugh

[Spryte]

He did say that he thinks we should move her to another facility, that we will never be comfortable with her where she is.

Which is true.

Of course, with the state she’s in ... she can’t live there anymore anyway.  I don’t have a clue what we will do about housing and care.

This has been a very hard weekend.  And this part of it has been the worst.  

I’m going to check into the dementia cause ideas, too, thanks for posting them, and I’m so sorry that any of you have had reason to know about them.  

[Melissa in Australia]

HUGE HUGS

how awful. I feel so sad for your whole family  😥

[MercyA]

I'm so sorry, Spryte. I can't really add anything that others haven't already said. I'm glad that the ball is rolling on this, even though it is so very difficult. Hugs.

[Spryte]

5 minutes ago, Medicmom2.0 said:

Forensic kits, truthfully, are of limited value.  There are also laws protecting non-lucid people from just having rape kits done; you may be in a state where they have to get court orders and things.  Also, they don’t tell you whether or not an assault occurred.  The presence of semen could be consensual, or the assailant used a condom or had a vasectomy or any number of things.  I can understand why they aren’t jumping to a forensic kit. 

Psych hospitals don’t generally have them, because the patient is usually treated in a medical ED before being transferred. 

 

 

Thank you for explaining that.  In my head, I hoped that a kit was a magical path to an answer that would give us a “yes, this happened” or “no, it didn’t.” But it’s not.

She’s definitely not lucid now, unfortunately.  I wish I had called the police immediately, but I went through the nurse’s station, notified the case manager, waited on the doc... Hospital stuff takes so much time.  😞  And then around 3, she just ... disappeared.  It’s awful. So I dealt with that till tonight.

Our area has a few hospitals, but this one doesn’t do trauma.  So car accidents, etc, get sent elsewhere.  Mostly stroke and cardiac, and maybe psych.  So that fits, too.

 

 

[Forget-Me-Not]

(((Spryte and mom))).  I have no advice but just wanted to say how sorry I am that you’re in such a hard place right now. 

Edited October 7, 2019 by Forget-Me-Not

[Spryte]

But I also have to say that ... how awful it is to realize how vulnerable people with memory issues are.  No rape kits for non-lucid people... There must be bad people who know this.  Targeting elderly.  I’m horrified.

My mother is terrible about locking her door.  She would be an easy target.  

Though she was lucid until Friday.  We spoke at 4:00 Friday and she was fine.  Now ... she’s not.  

 

ETA: I posted earlier that she and I didn’t talk on Friday.  But I was wrong.  The police officer and I went through my text history, and besides verifying she took her morning meds, we texted at 4:00 when she told me she was going to “do the nap thing.”  ...didn’t mean to be confusing, I just didn’t remember.

Edited October 7, 2019 by Spryte

[Catwoman]

I’m so sorry, Spryte. This is just awful. 

But please don’t second guess your decisions or blame yourself for not immediately calling the police. This was such a huge shock to you, and all you could think of was your mom’s health. You must have been terrified to see her in that state, knowing that she had been perfectly fine on Thursday.

The most important thing is that you are there for your mom and that you are doing everything you can to help her. 

It does sound likely that she was assaulted. Does she have any bruising on her body that would indicate an assault? If she does, be sure to try to get pictures of her injuries. 

I wish I had some words of comfort for you, but I am just so sad and so angry that someone might have hurt your mom that I don’t know what to say. 

 

[gardenmom5]

 if she's in a facility - I would be concerned the facility will try to cover it up, so you may have to really push for a proper investigation.  if it became public knowledge that a patient was assaulted, admin gets paranoid OTHER patients families will remove them and it will hurt their bottom line.  it is in their interests to cover it up.

[Laura Corin]

I don't have anything to add but I'm sorry you and you mum are going through this.

[wintermom]

You are doing an amazing job advocating and caring for your mom. So sorry you are all going through this. 

[Pippen]

5 hours ago, Spryte said:

Thank you all.

Right after posting, I decided to call the police and ask for advice. I just couldn’t sit on it, she asked for help and I had to do something.  Even though, right now, she doesn’t remember.

So I spoke to a deputy on duty. I was very clear that she does not remember anything and since 3:00 pm today she doesn’t know where she is.  That I don’t know if something happened but here are all the facts, as I know them. He took the story to his supervisor.  And then, just like that, it was all rolling.  We met at the hospital (despite me wanting to wait till morning because she’s not lucid now).  He spoke to the nurses, got her medical records.  The nurse explained to him that speaking to her now, in her state won’t do any good.  She’s not oriented, doesn’t know her name, birthdate, etc.  So hopefully we can try in the am.

Here’s where we are now:  he’s filing a criminal activity report.  If she is lucid in the am, they will send a detective to her apartment, transfer hospitals so we can do a forensics kit, etc.  But for now, I can take this to her apartment management and try to see if they have cameras, at least.

Hopefully she will be lucid in the am.

I’m disappointed that they can’t just do a kit to rule it out.  I would have liked a better answer.  Then again, maybe that would just be so hard on my mom.... they would have transferred her tonight, I think.

Anyway, it’s not much, but I got it started.  

Hopefully she will be more aware in the morning.

This is horrible.

...and I thought every hospital ER had forensics kits???  Ugh

I would suggest letting the detective handle obtaining any potential video from her apartment building, instead of you asking. You don't know for sure who (if anyone) was involved. Don't give anyone advance warning of official request for video or even a criminal investigation--let that come from law enforcement.

Edited October 7, 2019 by Pippen

[Innisfree]

Spryte, others have offered better suggestions than I could, but I wanted to say how sorry I am this happened. I hope you get answers and your mother recovers quickly.

[Lanny]

I have not read the replies. My suggestion is that she should be in a Teaching hospital affiliated with a Medical school. That way, lots of doctors can be aware of the case and possibly one of them will get some clues that the others are not getting.   Not being an M.D. I am guessing that Dementia would not come on so suddenly, as described in the OP here.  I am guessing that under "normal" circumstances Dementia would be more of a progressive thing. Sad for the Mother of the OP. 

[J-rap]

I don't have any advice, but I'm so, so sorry this happened to your mother.  My mother suffered an overnight cognitive decline, from being a very sharp 89-year-old woman to being very cognitively impaired the very next day.  She had no physical defects and could speak, but couldn't explain what happened.  However, in her situation, it was clear after her MRI that it was a stroke.

I'm so glad you reported this to the police, and hope they can help you find some answers soon.  

[geodob]

Dementia is progressive, but a rapid onset is more often 'Delirium'.
Here's an article from Mayo on Delirium:
https://www.mayoclinic.org/diseases-conditions/delirium/symptoms-causes/syc-20371386

 

[Ottakee]

So sorry for all that has gone on.  Is there any chance that her urine showed semen or anything abnormal in it from the first test?

I would also ask that they repeat the urinalysis and sent it out to be cultured.  That is a huge cause of confusion in the elderly and maybe for some reason it didn't show up right away.

How are her blood cultures?  Any signs of sepsis?  My older mother was hospitalized with that and was very out of it for days and still today doesn't remember about a week of her time at the hospital.

I would also ask that the sexual assault team handle the criminal case as they are just trained better and have more experience than the run of the mill detectives.

[Harriet Vane]

Spryte, I'm so sorry. I am praying for you and your mom this morning.

[PrincessMommy]

Praying for you and your mom today.  How awful.. no matter what the cause is, it sounds like a terrible place to be. 

[NorthwestMom]

Hugs to you and your mom.  You've gotten excellent advice and support from previous posters. 

[TechWife]

10 hours ago, Spryte said:

But for now, I can take this to her apartment management and try to see if they have cameras, at least.

I am so very sorry about this situation.

I suggest you not approach the management, let the police do that. You don't want to give them a "heads up" and give them an opportunity to erase anything. They may only think about their liability for a sexual assault happening on their property, not what is best for your mother or other women. 

[TechWife]

10 hours ago, Catwoman said:

I Does she have any bruising on her body that would indicate an assault? If she does, be sure to try to get pictures of her injuries.

This needs to be left up to the team that does the sexual assault exam. It is unethical to take intimate pictures of someone without their permission. Preserving the dignity & privacy of the person being examined is paramount.

[Farrar]

Holding you and your mom in the light. This is so upsetting just to read about. I can’t imagine going through it.

[gardenmom5]

10 minutes ago, TechWife said:

This needs to be left up to the team that does the sexual assault exam. It is unethical to take intimate pictures of someone without their permission. Preserving the dignity & privacy of the person being examined is paramount.

bruising and other marks can be all over the body.  arms, wrists, legs, throat.  she could have hit her head, with the only indications being on her scalp- hidden by her hair.

[TechWife]

6 minutes ago, gardenmom5 said:

bruising and other marks can be all over the body.  arms, wrists, legs, throat.  she could have hit her head, with the only indications being on her scalp- hidden by her hair.

And the sexual assault exam team will find it all.

[Catwoman]

1 hour ago, TechWife said:

This needs to be left up to the team that does the sexual assault exam. It is unethical to take intimate pictures of someone without their permission. Preserving the dignity & privacy of the person being examined is paramount.

 

Intimate pictures? Sorry if I wasn’t clear about what I meant. I’m not talking about a vaginal exam here. I mean that her mom is in a hospital gown where pretty much everything is visible every time she gets out of bed. 

I meant to check her for scrapes and bruises — like on her arms and legs and on her hips — that might indicate if someone had grabbed her, hit her, or dragged her on the floor. Also, if Spryte holds her hand, she can check for any signs under her fingernails that she may have scratched an attacker.

 I’m not worried that Spryte would ever do anything to make her mom feel uncomfortable.

Edited October 7, 2019 by Catwoman
Added a sentence because my post sounded a little snarky to TechWife and I didn’t mean it that way!

[Catwoman]

11 minutes ago, gardenmom5 said:

bruising and other marks can be all over the body.  arms, wrists, legs, throat.  she could have hit her head, with the only indications being on her scalp- hidden by her hair.

 

Yes, exactly!

 I’m not sure why Spryte shouldn’t look for things like that. This is her MOM, not some stranger. 

[LucyStoner]

I’m sorry for whatever happened.  How terrifying for her and for you.  I’m glad the police are taking the report seriously.  I’m appalled the case manager didn’t.  

[unsinkable]

I am so sorry, Sprite. Your poor mom. Poor you, you must be beside yourself.

I do think it is important to photograph any visible injuries (on limbs, face, head) before they begin to fade or heal.