I'm sorry to hear about your mom, David. That must be really confusing and scary. It's far more common to have an initial psychotic episode when you're much younger, but I've heard of people having them when they're older.

I agree she needs to be seen by a doctor. A full physical examination would be a good place to start. Btw, does she take any medications?

Since she's resistant, you have more of a challenge. You have my sympathy; I've been in the same spot - only with my son. My advice would be to look for an opening to get her to the emergency room. My son, for example, during his first episode became convinced that he had killed or seriously injured someone over night. He thought that person's friend would come after him. My brother-in-law advised him that he should go to the hospital so he could establish an insanity defense (of course, my son hadn't injured anyone; it was a delusion). And I told him he'd be safe in the hospital if anyone was trying to hurt him. In that way I convinced him to go to the hospital voluntarily.

Another time he was saying the neighbors were spying on him. He said she wanted to kill himself. In the course of the conversation he mentioned he was convinced he had HIV. I told him we could go to the emergency room for an HIV test. Of course, they don't do HIV tests at the emergency room, so when we arrived I took the triage nurse aside and explained the situation.

I guess what I'm saying is that you may have to look for a situation that you can turn to your advantage.

Unfortunately in my experience they don't do much in the way of physical exams under those circumstances. Possibly they'll do a drug test, but they aren't going to look for physical illnesses that might be causing psychosis.