About 6 months ago my 87 year old mother called an exterminator to her condo to eradicate “invisible mites”. She fully believes that bugs are burrowing in to her body and laying eggs. The exterminator was honest about telling her he never saw any bugs, so she called the BBB to report him. Then she called the maid service to have the maid fired for bringing the bugs in that are constantly biting. She is wreaking havoc.
Upon my own professional investigation, I found there were no bugs.
Unknown to mom, her doctor diagnosed her with delusional parasitosis. (believing there is a biting bug infestation). The doctor gave her a psychotic prescription, but when she read the label, refused to take it.
She spends hours a day showering and lint rolling, microwaving, freezing disinfecting and plastic wrapping clothes but won’t put pants on because all clothing is “infected”. She has barely left her home sitting by herself all winter with no pants on!
I am begging the doctor to give her a mental evaluation but he has not done it. I have told him everything and he says just go along with it.
When I talk to her on the phone, she usually can have a very lucid conversation about most things, but just as easily turn the conversation to delusional thinking. Several years ago she accused me of breaking in to her condo and rifling through drawers to exchange some of my jewelry, cooking pots, camera straps etc. for hers. I couldn’t understand her strange accusations at the time.
I am concerned about her vulnerability for people who are realizing her condition. She is very needy of help but is too stubborn to accept it. I understand I can’t change her thinking. Do I follow the doctor’s advice and allow my mom to suffer?
If she refuses to go, wait till she's having a meltdown about these bugs and call 911 to have her taken to the ER for a mental evaluation. Do you have POA for Mom? Just let the EMTs know privately that she's suffering from dementia and unable to make coherent decisions for herself. That's why YOU are making the decision for her to be taken to the ER. You'll give those docs the heads up about the degree of intensity she's dealing with in regard to these "bugs". If they can stabilize her in the ER with meds, maybe THEN she'll be agreeable to taking them in order to keep these bugs away.
In all fairness to doc 1, he wrote a script he thought would help mom, she's refusing to take it. Thats not his fault. He should agree to further testing bc dementia is not a linear thing. An elder can have times of lucidity as well as huge delusions going on simultaneously. Being coherent and talkative does not mean she isn't suffering from dementia. She just needs new medical eyes to be cast on this situation and diagnosed properly and entirely. Fortunately there are other doctors (hopefully in network to access her medical records more easily) that you can hire.
If this were my mother, I'd load her up into the car and drive her kicking and screaming to the ER or the doctor/neurologists office myself for an evaluation. I'd read her the riot act and tell her that Medicare is CANCELING her insurance entirely if she doesn't have a full 2023 physical by March 30. Don't be afraid to upset her.....be afraid to continue having her live like this! I'm sure she WILL require some type of medication to bring these delusions under control, so you'll have to figure out how it'll be dispensed regularly. Even if that means moving her into a Memory Care Assisted Living facility after she's diagnosed. If you have POA, you can place her without her consent, for safety reasons.
Look into The Baker Act in your state and see what's required to get her committed for evaluation in a facility. You can also seek out the guidance of an Elder Care attorney to give you more ideas, paths to take.
Wishing you the best of luck with a difficult situation.
Can you tell me what exactly you feel a doctor, or anyone else can do about this? Exam has been done. Diagnosis has been done. Medication has been tried.
Not everything can be fixed.
Certainly you can try other doctors, especially those who are familiar with different treatment modalities. But this may in fact not be fixable.
I remember when my Dad was complaining about ants in his senior apartment. He was seeing ants on the walls and in his food. Turned out Dad had an UTI. Once the antibiotics started working, the ants disappears.
Just food for thought.
Consider asking the neurologist to document your Mom is not decisional and should not live alone; ge she will be able to test her for this. Be veey frank telling the neurologist about your Mom not wearing pants, seeing and believing there are bugs everywhere, believes she is being bitten, scratching herself, her rituals to remove the "bugs," her unfounded accusations toward you, the exterminator, the housekeeper, the BBB, her dilusions, not taking meds, etc.; it is important that both the neurologist and new PCP know this.
From what you've described, your Mom should NOT be living alone. By no means am I suggesting you two live together as that will not be mentally healthy for you; however, this will help you as POA when you need to place her into memory care (sooner than later) and assist with her medical decisions, finances, etc.
As far as your Mom not taking meds for her disorder (very common with dementia), in the mean time, try putting the meds in a different prescription bottle and telling her they are for something else like blood pressure, cholesterol, etc.
I wish you all the best.
I had to google this dx as never heard the term before. I have however met one person with similar symtoms. Absolutely convinced mites (or moths?) were burrowing under her skin. Advised everyone to cover their hair to avoid the tiny bugs from landing & laying eggs. But no-one else could see them.
Apparently had consulted many Doctors, more than one Skin Specialist & emergency care too. Had been told it must be "in her head" as no physical evidence of bugs found. She refuted the diagnosis & also refused the medication (anti-psychs I guess).
There were some questions her family had surrounding unknown mental health before the 'bugs', some goodtime party living overseas, possible drug use etc.
While I doubt your Mother has recently been backpacking a hippy trail & this is not a joking matter, according to one thing I read by 'Dr Google' severe or clinical depression can be a possible trigger. I also wonder about side effects of other medications.. as certainly many drugs can cause an itch.
As to the question, to the Doctor's ethics - a Doctor cannot force a patient to take prescribed medicine.
Also, a person is quite able to sit in their home in their underwear if they choose.
Unless Mom decides to trial the medication & improvement is found, I think ensuring the heating is adequate is probably all you can do.
How often do you see your mother?
Maybe the dr. doesn't think it's a concern because he/she figures you are handling it. The medical profession (in my experience) is often willing to ignore things if they think there is a family member who is taking care of an elder.
Should your mother be living alone? She definitely needs some kind of psychiatric evaluation and meds to help her. (BTW, I am NOT suggesting that you move in with her or her with you -- I NEVER suggest that!)
Depending on her residence, your choices are a bit different.
Focusing on insect infestation in an elder care facility usually gets management's attention pretty quickly....even if there are no actual insects, the rumor gets around fast. If a facility is only independent living with maid service, and she fired the maid, she may not be able to keep living there. depends on her lease.
If she is in the independent living section of a building that also has memory care, she seems to qualify to go there. She will need to be on appropriate meds, given to her by med techs as ordered by MD. Using medications to reduce the persistence of this delusion so that she can be distracted from it and focused on other thoughts/activities will reduce her suffering. Delusions may not disappear. Or may be replaced by new ones.
She is not legally competent, in my opinion. (opinion - free advice, may only be worth what you paid to get it.)
Whoever is her medical POA or HCP needs to take the lead on this issue.
If she is at home, hiring 24 hour caregivers from an agency is the best place to start. Interview a few, you need one where they 'get it' about psych issues. This is a short term plan while you get stuff organized for a move to memory care, as that process takes longer than it should, often.
I hope she is not living alone.......that does leave her very vulnerable to people with bad motives, strangers at the door, etc.
Good luck.