We are taking care of my mother in law; but it seems that it is moving way too fast. One month ago she was going through the sun downers stage; but now she can hardly walk without assistance and we are having her use depends because she can not control her bladder. She also will not eat and drink as much as she should. Her Neurologist appointment is this Monday. Two months ago she was fine. This seemed like it came out of nowhere. How fast can the progression be with this disease?
The dementia is slow and steady, occasionally, as I said, she will be a bit worse in one area. Like, suddenly she can't remember how to use her phone--- My 3 sibs are all MIA and don't see this. The brother she lives with and I take care of her, so we notice this.
It's sad to watch her "lose it" and repeat herself 5-6 times in an hour. She is obsessed with watching the neighbors, and they know it, and are sweet about her nosiness--something she never would have done "pre dementia". She's also a lot sweeter, so I am personally enjoying THAT.
I have to say that every surgery she has had (A LOT!!!) she would have a long road to shake off the anesthesia. At this point, she is barred from any "elective surgeries" for life. So, unless she falls and must have something repaired, she cannot have surgery. She was kind of a surgery junkie and has had everything replaced or removed. She still has her gallbladder, but doesn't remember that she does, so we NEVER say anything about it, b/c she has faked her way into surgeries before.
She's mostly just really forgetful and that's easily dealt with right now. She doesn't wander, doesn't even walk down a step w/o someone strong by her side. I know she'll get worse, but I'm not looking for trouble. Just taking it one day at a time.
1) She needs blood work that shows if has infection in any part of her body + another UA. I would recommend this done by different doctor than used last. A general practice/family physician or Internal Medicine doctor would be most appropriate for this however, since seeing Neurologist in few days that would probably be fastest appointment.
2) Today, check number of her medications...to see if she could be overdosing on any of her meds, or is taking someone else's meds (family/friends..). Also determine if she is taking alcohol or illegal drugs.
3) If all of the above check out negative: She needs full physical exam, preferably by an Internal Medicine doctor, to check for cancer,...
4) If she does have physical issue, then let them treat that however, if shes to have same symptoms even if somewhat better, then I'd still take her to Psychiatrist for senior population.
5) If all test for physical illness are negative: Take her to Psychiatrist that specializes in elderly population. Seniors can not tolerate the same doses of meds that they could when younger & can easily be overdosed even if taking same meds they did when younger.
IF she refuses to see a Psychiatrist, then have her admitted to a hospital "Senior Care" Psychiatric Unit. There they will have a medical doctor & a psychiatrist reviewing her meds, symptoms, history,.... to problem solve and find the cause of her behavior plus find correct medications for her. (she may agree to go to this due to she will technically just being admitted to a regular hospital & she may never know she was in a "special" unit).
Not all hospitals have these units so may need to ask your doctor, a nursing home/assisted living... These units are NOT for permanent placement. Patients stay until doctors are sure they found the correct meds & doses to help her. This usually takes a stay of 1-5 weeks & Medicare should pay on this. Make sure the unit is for Senior Citizens only.
With a very fast decline like this it is possible that you are dealing with a Vascular Dementia not Alzheimer's or it might possibly be both.
Slow and steady is usually the decline of Alzheimer's. Like walking down a ramp.
Vascular Dementia is a more rapid decline. Like walking down stairs.
I described my Husbands decline like walking down a ramp then going down a few stairs to landing with another ramp.
He was walking one day and literally the next day he could not/would not walk.
He was able to support his weight while I used the Sit to Stand and almost over night he was unable to support himself. Resulting in having to go to a Hoyer.
He was eating and drinking one day and the next day refused all food and water.
Bless you and your MIL
1) An acute illness, such as a uti or other infection. When the illness is cleared up, the person will often return to baseline.
2) A reaction to a medication. Again, when the medication is discontinued, with a few exceptions, the person can return to baseline. (One of the exceptions is Haldol, if given to persons with LBD. It can cause permanent damage.)
3) Progression of the dementia itself. This is permanent. There may continue to be good periods and not-so-good periods. Some forms of dementia decline in a steady, gradual manner, but others "step down" in plateaus, with stable periods between changes that seem very sudden.
So, yes, dementia decline can be sudden. Or it can be caused by illness or medications. You have received some good advice on what kinds of things to check.
I'd like to share one other thought about declines. You may hear, even from medical professionals, that there is no recovery from declines. The decline is the new normal. In my experience that simply isn't true, as katiekay describes. If the decline is the result of illness or medication side effects the person is very likely to return to their previous level of functioning.
After each of his hospitalizations my husband (LBD) had home visits from therapists for a few weeks. Each therapist told me to except the decline to be permanent. They were wrong, but they weren't around long enough to see the recovery, so I'm sure they went about continuing to spread this false message. Hospitalization is NOT GOOD for anyone with dementia, although sometimes it is necessary under the circumstances. In our experience it took maybe a week or two to complete the healing process from whatever sent him to the hospital in the first place, and another few weeks to recover from the hospital experience. Home therapists were long gone at that point.
KathyMarie, please let us know how this works out for your MIL. We learn from each other.
Same with my dad who had an infected gall bladder at one time.
I have read where Alzheimer's symptoms can come very fast but Jjariz makes a good point about UTIs. You can take her to ER or urgent care for a test and meds if positive or you can pick up a self test at the drug store. You would still need to see a dr for an antibiotic if the self test is positive.
If you haven't had experience with UTI in the elderly just know that it can be life threatening and the normal symptoms of burning etcetera will probably not be experienced. Use the search portion on this site and look for threads on UTI. Your MIL should be checked for one anytime you notice drastic change.
Talkey, my DIL father died of PD. He had those moments as well of clarity. Fleeting but treasured.