My mother keeps having sudden delirium-like episodes and we still don’t know why
Hello everyone,
This is the second time I’m writing here (38F). I’m posting again after an event that has left me mentally blocked, and I think I need this as a way to process what is happening.
My mother is 75, has Mild Cognitive Impairment (diagnosed in January 2026), and has a narcissistic personality. Over the past months she has had several very frequent hospital admissions, all of them starting with some kind of confusional episode. In every case, it has been very difficult for doctors to determine the cause, but in the end they have usually concluded it was respiratory:
• 20/11/2025 -> admitted with respiratory infection
• 25/03/2026 -> admitted with bilateral bronchopneumonia
• 20/04/2026 -> admitted with respiratory infection
• 01/05/2026 -> accidental fall at home with split lip (ER visit)
• 12/05/2026 -> yesterday’s episode, which I’ll explain now
During all this time I have noticed a significant decline, and lately it feels much more obvious. Over the last 7 days especially, she seemed even more erratic than usual. She stopped replying to my WhatsApp messages completely, tried to cut my calls short, and when I visited her I noticed inappropriate or incoherent responses appearing very quickly.
One day I noticed she was particularly unwell, so I went to her house with my 4-year-old son and brought a very simple Lego set. I asked her to help me assemble a three-piece figure (head, torso, legs), and she couldn’t do it. She was trying to attach the head to the torso shown in the instructions. That was the moment I thought: this is moving fast.
My father, who lives with her, is 78. In principle he seems mentally fine, although he also has a narcissistic personality, and I’m starting to wonder whether something may also be happening with him cognitively, or whether he is simply so collapsed/self-absorbed that he ignores everything. Every time I ask him how she is, I get random answers. One day he says she is terrible and he can’t cope, the next day he says everything is fine. But he always redirects the conversation back to his own problems, and there is no way to get real clarity, help, or empathy from him—toward my mother, and even less toward his daughters.
The day after the Lego incident, my sister (47 F) stopped by their house before work because she was also worried. She found my mother face down on the floor, the floor covered in feces, and my father trying to clean it up—but he had not called any of us, and he had not called an ambulance. My parents sleep in separate rooms because they have a very bad relationship. My sister called me immediately, we called an ambulance, and the three of us went to the hospital (She, my mum and me).
This pattern—finding her on the floor in the morning—was also how the previous admissions that later ended up being labeled “respiratory infection” had started, so we assumed this would be the same.
At the hospital, she arrived completely drowsy, like she was heavily drunk: she could barely open her eyes, could not hold a conversation, could not keep her gaze fixed without falling asleep, and when she did speak she mumbled very softly and said nonsensical things. Her oxygen was fine, and they did all the tests: chest X-ray, head CT, bloodwork, etc. Nothing conclusive showed up. She only had a very slight temperature of 37°C at the beginning, and then not again. The doctor said they would leave her under observation.
She spent almost the entire day sleeping. Around midday, after spending the whole day without taking any of her usual medication (she takes Tramadol, Pregabalin, and Lorazepam for pain related to a back procedure), she suddenly woke up and became extremely “lucid” but in a completely paranoid, conspiratorial way. She accused us of having locked her up because we didn’t want her at home, said the hospital was actually a prison full of criminals, etc.
I gave her Pregabalin and Tramadol, and she seemed to calm down a little just from taking them. She said she urgently needed to go to the bathroom. She had a bedpan and diaper because she was connected to IV lines and cables and was not really in a condition to get up, but she refused to use them and insisted on standing up and going no matter what.
At that exact moment, the doctor came in. Surprisingly, my mother answered his questions in a semi-coherent way. He asked if she knew where she was, and she answered “in the hospital,” but with a strange half-smile, almost like she was thinking, “that’s what you want me to say.” She lied in response to all his questions. This is extremely typical for her—she lies constantly about everything, including whether she has gone to the bathroom, what medication she takes, and all kinds of daily matters—but of course someone who doesn’t know her would have no way to see that. To the doctor, she appeared coherent enough. She said she wanted the IV removed and wanted to go to the bathroom, and he agreed, partly to see how she functioned. My sister accompanied her.
Then I spoke to the doctor. He told me he did not see anything especially abnormal and wanted to discharge her. I explained the dramatic shift in behavior, the intense paranoid ideas, and the fact that much of what she had told him was false. I also told him that I feel my mother’s cognitive decline is accelerating sharply. He said the CT showed what looked like microinfarcts and findings compatible with the MCI diagnosis, but nothing more. In his opinion, everything that had happened was due to misuse or overuse of the medication she takes, and that even the previous episodes—looking back at the lung images from earlier incidents—could point in the same direction, with a secondary respiratory issue somehow related to not following her medication regimen properly.
He told me I should monitor her medication more closely, but that is simply impossible. She refuses and becomes extremely aggressive if anyone tries. Once I went to her house and threw out a huge stockpile of medications she had accumulated, and it triggered a crisis that lasted for months. After that, she only became more controlling and hostile about her medications.
I explained my personal situation to the doctor: I am 7 months pregnant, I have a 4-year-old son, my father lives with my mother but completely disengages, and my sister also has her own life. His response was basically that he knew it was unfair, but “it is what it is.”
To finish the episode: when my sister came back from the bathroom with my mother, she told me my mother had passed an enormous amount of stool. After that, once we informed her that she was being discharged, she suddenly seemed almost completely normal again—as if nothing had happened. Suddenly lucid, calm, and fine. I was in shock after seeing so many abrupt changes throughout the same day.
This morning, at 5:00 a.m. here in Spain, my sister was planning to stop by the house before work to check on her and see what state she is in.
What we do not know is:
• whether this episode was caused by the medications
• whether it could have been caused (my sister’s theory) by severe constipation / stool retention
• whether it is another step in her cognitive decline
• whether there is, as in previous times, an infection
• or whether infection was not really the cause of the previous episodes either
t the same time, my sister and I both know my mother needs help at home. But when she is relatively “well,” she refuses it completely. My father, despite being in a good financial position, says he does not want to pay for help. They receive a small care/dependency allowance and do not even want to use that. We have already tried several caregivers, and they end up firing all of them. A new person is supposed to start this Friday, and we will see how long she lasts.The situation between my parents is also extremely toxic. My father genuinely seems to want my mother to disappear, and he has absolutely no caregiving attitude toward her. On the contrary, if she appears even minimally well, he expects her to cook for him and do things for him. They constantly insult and disrespect each other, and it often feels as if both of them are just waiting for the other one to die.
I’m sorry this is so long, but I truly feel at the end of my rope. Being 7 months pregnant, I’m not even asking anymore for support or excitement from my family about the pregnancy—for them it is, at best, irrelevant and at worst an inconvenience. What I feel is that I am drowning in this situation. I don’t understand what is really happening, and I don’t know what direction to take.
Without a clear diagnosis, I don’t know whether I should feel grief because my mother is becoming ill, or whether I should respond mainly to the reality that she is also a very selfish and difficult person who does not think about the consequences of her actions.
Thank you for reading, and thank you in advance for any thoughts or feedback