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Hello there, my mother is 75, her gait is very unstable, she does not sleep well at night, but when she awakes at night she goes to bathroom herself. She used to take sedatives to sleep better, but now she stopped to use them to avoid addiction, she has a lot of vibrations in her body during night, so she is not refreshed as she says getting up. But the main thing when she gets up she starts making senseless combination of sounds like “pura pura papura” and something similar, humming sometimes. It is very disturbing and I advise her better to sing songs, which she does. When I ask her to stop gibberish, she replies she cannot control it. When she occupied doing something like reading, doing sudoku or watch TV, she stops making noises. I wonder if these are the first signs of dementia or some serious mental disorder. She does not want to go to a psychiatrist as she is afraid of taking antidepressants or some other types of medications. Can somebody give me advice what to do in this situation.

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You need to take her to her PCP and get a referral to a Neurologist. Any changes should be checked out.
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Lora74 Mar 24, 2024
We were at several neurologists with her more than a year and a half ago, they made head MRI and back MRI and several tests for nerve conduction , so they didn’t find anything serious in brain , cerebellum was ok, so no ataxia, no MS or Parkinson disease, no neuropathy, though the feet are numb, so they considered it was functional neurological disorder and at that time her gait was better, but she has osteoarthritis as well , and this wobbly gait does not do any good for her bones, but now her gait became very wobbly and she uses rollator at home.
So neurologist himself is in doubt what condition she has and promised to put her in hospital for making some more tests in addition , but there is a long waiting list for inpatients. She started to make these noises about a year ago and I really wonder why, neurologist could not explain. She used some time ago some antidepressants and her memory became worse, therefore she was afraid to take more antidepressants.
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Why would she be afraid of medications?

I’ve noticed a lot of older people are scared of meds. My grandmother was the most anxious, fearful, and paranoid person I’ve ever known. She was miserable and we begged her to try medication. She never would. Insisted meds would make her “crazy” or addicted. One time she was prescribed antibiotics We noticed she wasn’t improving and that’s when she mentioned she was only taking half of the prescribed dose because she was scared of an overdose. She was in constant pain from a severe car accident and was hollering in pain sometimes, and was still scared to take any pain meds “because I just know I’ll get addicted!”…. Even after doctors and a family member who is a nurse practitioner assured her she would not get addicted. She suffered so much when she didn’t have to.

Used properly, meds aren’t the enemy.
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If your mother was able to control gibberish, why would she not?? And what's the difference between humming and singing songs? Leave mother alone to do what she does naturally w/o trying to manage the sounds she's making.

And "vibrations in the body" while sleeping can be a sign of Parkinson's disease, along with the wobbly gait.

Get her to the doctor for a full medical and cognitive workup, but if she's capable of doing Sudoku puzzles properly, I'd say she's doing well mentally. And if she flat out refuses meds, you can't force her to take them, so try to find acceptance with her, as is, because fighting never accomplishes much of anything. Especially if cognitive decline IS involved. They tend to argue everything. But if PD is involved, there are meds she can take to treat the symptoms. There is a fairly quick test the neurologist took with my mother to rule out Parkinson's right away.

Best of luck to you and mom.
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Clearly your mother is in need of a medical checkup. Given these symptoms I think she needs a neuro-psyc referral and evaluations.

Please make a list of symptoms and make an appointment with her medical doctor right away.

Good luck. I know that you know that a Forum of strangers can do no more than you currently are doing, which is "guesswork". You need expert evaluation. Hope you'll update us when that is done.
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She Needs a Nuerologist - explain what is Happening to the doctor and he can do a pre cog test and a referral to a Neurologist .
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A psychiatrist doesn't automatically mean medication. If she can understand this, you should explain it to her. Her fear is unreasonable. And she can always refuse to take the medications a doctor recommends, people do it all the time (which is too bad, but they do). Also explain that medications have come a long way since that time when she took them and felt they had a bad effect on her.
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Below in a reply you wrote:

"We were at several neurologists with her more than a year and a half ago, they made head MRI and back MRI and several tests for nerve conduction , so they didn’t find anything serious in brain , cerebellum was ok, so no ataxia, no MS or Parkinson disease, no neuropathy, though the feet are numb, so they considered it was functional neurological disorder and at that time her gait was better, but she has osteoarthritis as well , and this wobbly gait does not do any good for her bones, but now her gait became very wobbly and she uses rollator at home. 

So neurologist himself is in doubt what condition she has and promised to put her in hospital for making some more tests in addition , but there is a long waiting list for inpatients. She started to make these noises about a year ago and I really wonder why, neurologist could not explain. She used some time ago some antidepressants and her memory became worse, therefore she was afraid to take more antidepressants."

So I'm assuming the neurologist didn't see any signs of a stroke, either?

"Usually, [speech] tic manifestation in older patients involves cases of drug-induced secondary tourettism due to neuroleptics, levodopa, and sympathomimetic agents, or secondary tourettism related to degenerative neurological disorders, stroke, head trauma, brain tumors, and infections."

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7124874/#:~:text=Usually%2C%20tic%20manifestation%20in%20older,%2C%20and%20infections2%2C8.

To be honest, if her making random noises is the main problem, I wouldn't worry about it too much, although I get it is annoying to listen to. Going to a neurologist is the most you can do. If you eventually find out the cause, please come back with an update so we can all learn.
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My mother had non-diabetic neuropathy in her legs and feet which caused a TON of problems for 20+ years. Nothing "shows up" on tests, really, it's all symptomatically diagnosed. No cure either, except Cymbalta antidepressants which took away moms foot pain and numbness BUT exacerbated her dementia 10 fold. She needed a walker after awhile and wound up taking 50 falls before she went into a wheelchair full time from the neuropathy. When you can't feel your feet, you have no sense of where you are in space. This brought on vertigo BIG time for mom bc she also had loss of hearing and sight.....2 more senses shot. Non diabetic neuropathy is a real issue for many elders and causes buzzing feelings inside the body. I have a bit of it in my feet and hands from cancer treatments, and it worsens at night while lying down. Same for mom, she felt awful at night. The buzzing is like when your foot falls asleep and just starts to wake up....but stays that way.

Penetrex cream on Amazon helped moms feet a lot in the earlier days. Just rub it on her feet a few times a day and it should help the numbness. Mom's neurologist was WORTHLESS with the issue entirely, and would just increase her Gabapentin RX which did nothing.

My father had neuropathy as well, non diabetic, which is highly odd to have 2 family members w/o diabetes suffering the same condition. The doctor felt my parents were exposed to toxins while living together in a home (after I'd grown up) and that is where the nerve damage came from.

Mom was seriously unbalanced too. The walker helped some, but as the doctor in the hospital told me: there comes a time with neuropathy that the elder has to stop walking and go into a wheelchair fulltime. When mom did that, her vertigo immediately disappeared thank God.

Idk if this is the course your mom's neuropathy will take, but I do know it's a frustrating journey to take, for everyone. Especially when the doctors are of no help, there is no cure, and nerve damage is progressive. If things get bad enough, she may be willing to try Cymbalta. But it has its own issues to deal with, but does seem to ease the neuropathy problems significantly. It's always a trade off with these pharmaceuticals, isn't it?
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I had never heard of Functional Neurological Disorder, so I did some quick research online. This webpage focused on functional tics - https://neurosymptoms.org/en/symptoms/fnd-symptoms/functional-tics/

I wonder if this might be what is causing your mom to vocalize involuntarily. According to the webpage, the tic can stop if the brain is distracted away from focus on the body, which might explain why the vocalizing stops when she's engaged in an activity. A neurologist might give you a phone OV to discuss this, if it's hard to get your mom out to doctors now.

So glad she uses a walker!!! Are you aware of the upright walkers? They help to normalize walking, because you don't have to lean forward and down to hold the handles and push the walker forward. Instead of looking down, you can stay upright with a more normal walking gait and look further ahead, like people normally do.

We bought an UPWalker Lite for my mom near the end of her life, once we learned about them. She was thrilled with it and said it was so much easier to walk with; but she had to be able to turn around at the walker and sit down very quickly if she started getting dizzy. Unfortunately, the seat of that particular walker was a lot harder to get settled in than that of the typical walker with a seat, so it didn't work out for her. But if your mom doesn't have a problem like that, the upright walker might help preserve her posture and help her walk more safely. If Mom had gotten hers several years earlier, it would have probably minimized the stooped posture and shuffling gait she had developed due to the low walker restricting natural walking movement. Wish we had known about upright walkers sooner! They aren't a cheap option, and Medicaid wouldn't cover Mom's - but it was so worth the try.

Has your mom been offered physical therapy in hopes of improving her gait and balance? If she can't manage going to a PT location, it might be possible for her doctor to order a few sessions of home PT, if there is any place near you that comes in home. My mom had both PT and OT at our home; the occupational therapist was marvelous, and he was able to teach her how to move across thresholds, out to the deck, etc. with her walker much more safely, in just a couple of sessions.

And several years before, she had severe balance issues that were addressed very well by PT in a rehab facility after a hospitalization. The techniques she was taught to recover from suddenly starting to fall backwards worked amazingly well, and she never had a complete to-the-floor fall (which was happening when rehab staff walked with her, using a gait belt!) the rest of her life, so she had no injuries that could have debilitated her.

FYI - if your mom starts needing assistance with walking in the future, we found that the Cow & Cow gait belt worked much better than the gait belt that is typically provided for the elderly. Hospice had us put under my mom's armpits, rather than below her breasts; my husband could literally hold her up with it, if her legs gave out, and she felt so much safer.

So many odd things can happen to the elderly. It's frustrating when answers aren't found to what's causing a problem, or when nothing is done to deal with the problem. Keep on asking people if they have any suggestions, whenever you get the opportunity; you never know who may have ideas that work! Your mom is so blessed to have your love and caring! Wishing you and her the best.
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https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197

A possibility. Consider meds for depression or anxiety for your Mom -- the right meds in the right combo should not affect her memory. It will take time to adjust and her to acclimate.
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