fairyland927 Asked December 2012
Can mom's Alzheimer's be getting worse?
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Both my parents have Alzheimer's but my dad also has Parkinson. My mom for the past 2 weeks has been alot more forgetful than usual and now for the past 2 days she is sleeping constantly and i mean she does not even want to get up. I gave her a cookie and she was eating it with her eyes closed. The doctor tells me its just her Alzheimer. I don't get it can it be from one day to the next getting worst.
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Yes, dementia can progress suddenly. (Some kinds of dementia are more subject to this than others.) And any kind of virus or physical ailment can make the dementia symptoms much worse.
I wonder if it is time to have a hospice evaluation for your mother?
The most common cause of delirium in a person with dementia or an elderly person is a urinary tract infection (UTI). Delirium is dangerous for a person with dementia as a UTI can be fatal for a person with late stage dementia. People with delirium need to be seen by a physician or in the ER immediately. If your mother was in a community, the nursing staff would immediately request a urine sample and additional lab work to find the source of the infection and begin treatment.
The fact that your mother is on hospice is an indicator that she is in the final stage of her dementia (at least as well as the medical profession can tell that). Sleeping all day can be a sign that the end is near. For some of the symptoms to be getting worse (such as memory problems) is also consistent with an end-of-life scenario. This is something that the hospice nurse can help you evaluate and understand.
Do your best. Try to be at peace with that.
I would say that dementia is a slow progressing disease, except when it is fast progressing. :) From my reading and my observations within my dementia caregivers' support group it seems that in some kinds of dementia and in some people dementia progresses over years; in other kinds and other people it progresses quite rapidly. Some types seem to progress in fits and starts -- very little change and then sudden changes. (Lewy Body Dementia seems to often fit that pattern.)
My husband's dementia was very slow progessing, for which we were grateful. And then at the end it seemed to pick up speed and go fast, for which we were also grateful. His hospice nurse visited on a Wednesday and then was extremely surprised to learn that he died Thursday. He didn't seem that close to death in her experienced observation, but obviously he was.
I look forward to your participation in these forums. Welcome!
It is believed that for many people, the dementia process begins years before symptoms begin to show. For persons with regular onset Alzheimer's for example, symptoms begin to be exhibited in that person's 60s, but the disease has actually been active for 20 years or so.
Dementia in any form kills brain cells and as the cells die, they are removed from the body as waste. As a result, the brain goes from weighing about three pounds to only weighing one pound at death. Over time, there is less and less healthy brain tissue and more and more damage, so the disease really is speeding up in the final stages.
Another thing we notice is the process of "cognitive reserve." In very intelligent or highly educated people, the brain appears to deteriorate very rapidly in the final stages, which are stages five, six and seven. The normal time for these stages is thought to be about five to eight years, but in these folks we see the disease terminate in only about a year or so.
Vascular dementias do appear to advance between periods of stability, but that is due to the causation of the dementia, which is stroke activity. The person has a stroke or strokes, stabilizes, may even recover some abilities, then another stroke occurs. These forms of dementia do appear to start and stop as a result.
An article published in the Journal of Palliative Medicine. ( J. Palliat Med. 2007 June; 10(3): 749–758) titled "Cognitive Functioning Under Stress: Evidence from Informal Caregivers of Palliative Patients" concludes that:
"In addition to the well-documented physical and mental health risks associated with caregiving, this study adds to a small body of literature demonstrating impaired cognitive functioning among family members providing end-of-life care. Secondary findings of both improvement and deterioration of cognition post caregiving provide tentative support for the possibility of reversing certain cognitive deficits by reducing caregiver stress."
Not a very positive picture, perhaps, but one can be on the "improvement" side.
In the past, due to my profession, I read reports of research which investigated the effects of stress on students, and found their school performances were impaired. That was attributed to the known effects of stress hormones on higher brain functions -planning, evaluation, memory etc. My understanding is that, often, it is reversible.
I have read that if severe stress is prolonged in a person's life ( and what that means will differ from individual to individual) for, say, many years -it can permanently affect the brain. I have also read that relaxation can help recovery of impairment from stress. Many of us undergo prolonged stress during life. I know I have, and we recover, or, at least, in terms of daily functioning, we appear to. I have experienced what you are, and, in time, my cognitive abilities returned. After a period of extreme stress in the 1990's I lost the concentration needed for reading for pleasure. I could always read in my field - hard wired, I guess, and short articles, but not books. I had always been an avid reader. It was just returning ten years later, when my youngest son died, and I lost it again. Now, ten years later, once again I am returning to reading, I am thankful. The brain is amazing. Yes, it took time, but other functions returned much sooner, and other factors may have been involved.
The "common wisdom" that one should not make important decisions while under stress is wise, due to the effects of stress on thinking processes.
I believe that you will recover whatever deficits you have now. Grief is very physical, it affects brain cells, blood sugar, hormone levels and so on, but our bodies have an incredible ability to recover a healthy balance. The best thing you can do for yourself is the usual - eat sensibly, stay hydrated, rest/relax get enough sleep, exercise a little, etc. I am confident, in time, you wil find yourself returning to "normal". (((((((((hugs))))))))))))))) Joan
I too am confident that I will get back to "normal," and I am being patient.
catchlab - I am in no way saying it is not stressful to lose a parent, it is, and moreso, if caregiving has been involved. Cognitive impairment can be considered normal, I believe, after any loss. I understand you being worried with Alz in your family. The best thing you can do is as I suggested to jeanne - look after yourself, eat sensibly, get enough rest/sleep etc.
Anyone may find him/herself "seeing" a loved on in a crowd, momentarily disbelieving that they have gone, and similar experiences, and you can think that you are going a little crazy. All of that is normal in grief. It takes a while for our brains to adjust to the loss. I had a strange experience shortly after losing a friend. Walking down the hallways at work, they seemed to "bulge" in and out. I have found that others have weird sensory experiences too, after loss. Again, it is normal.
To anyone grieving, taking a break from grief, when you can, is a good thing. Listen to your favourite music, do something that uplifts you. People can feel guilty about enjoying themselves after they have lost someone, Again that is normal.
There seem to be certain times when the grief really hits us. The first stage is the "numb" stage which can last several months, it varies with individuals, and although you feel the pain, the body protects you to some extent. After that the pain comes on in full force, and needs to be felt, and expressed. I found after losing my son, Gordie, that at three months the pain came on. Six months was bad too, and nine months particularly bad, and I have observed that in others. Then one year and so on. Of course, any special days, birthdays, holidays etc are harder too. It helps to plan something for those days, which include the loved lost one on some way. Things like burnng a special candle, playing special music etc.
Newer research in grief talks about the changed, but continuing relationsship with the lost one. The older model had people "getting over" the loss and moving on. I am more comfortable with the newer model, which includes moving forward, or through the loss, but not expecting those left behind to completely "get over" the loss. Klass et al.’s Continuing Bonds: New Understandings of Grief (1996) talks about "an ongoing inner relationship with the deceased person by the bereaved individual".
(((((((hugs))))) to all who have lost a loved one. Joan
Best of luck