Alzheimer question?

[Cruisin]

Any Alzheimer or dementia experts out there? I could use some opinions.

My dad, who is 73 years old has become over the past few years a little confused and forgetful. I think a lot of it he did at first just to annoy people

Around the beginning of the year we noticed that he was getting worse, more forgetful etc.

About 2 months ago he went on the drug exelon (I think that's how it's spelled) to see if it would help.

Since that time he seems to have gone downhill quite quickly.

He's having some weird episodes that we don't know what to make out of them. My parents always were Sunday drivers, you know, out and about looking at things. Now sometimes he can't figure out where he is but most of the time he can take obscure back roads and be just fine.

Two nights ago, he got up in the night. He went back to bed and told my mother that he got lost He said it was very dark and nothing seemed familiar to him. They have a business attached to their home and he went out there and turned the light on over his desk, put on a sweatshirt he didn't have on when he went to bed etc. He thought he was somewhere else, sleeping over, not at home.

He remembered the episode in the morning and remarked on how strange it was that he got lost during the night.

Last night they were watching television and all of a sudden he says to my mom.......... where do those doors go to? My mom says...... one is to the shop and the other is to the rest of the house. Oh, okay he says.

Then..... Where is the bathroom She explains where it is, just off of the room they are sitting in.

He was sitting looking out the patio door and he mistook the reflection of the family room for another room on the other side of the door. Once my mother shut off the light to show him, he was okay with that?

Some of this seems just like he is high on some sort of drug Just like after his first bypass when he thought he saw snowmen through the hospital window (2 stories up )

Does this sound like Alzheimer symptoms?

Some other background info. He is diabetic, takes pills for that. He has had 2 triple heart bypasses. He has a hearing problem for which he refuses to spend the money on a hearing aid He takes a pile of other drugs of which I'm not sure what all of them are at the moment.

I'm wondering if the exelon is actually making things worse instead of better.

Any opinions. Thanks and sorry for the rambling.

 

[MAKmom]

Sometimes dehydration can cause confusion. He needs to see a Dr ASAP with your Mother in the room with him.

 

[lisajl]

could be, could also be medication. That what my mom's doctor always told us...could be the meds...or she's just getting old. That's what old people do...
My mom is now in a nursing home with dementia. Sounds similiar to what you are going through. She had a machine that would buzz when it was time to take her meds. It went off and she said, "What is that awful thing?" That iswhen my sister and I knew there was no turning back.
She has gone downhill dramatically in the last month. She is not expected to make it through the week.

Oh Geesh! I'm so sorry to ramble on like this. Yes, to me it sounds like dementia. I would go with your mom to the doctor and talk to him/her about what your dad is doing.

My thoughts and prayers are with you.

Lisa

 

[Cruisin]

Thank you both for your input.

He does have an appointment tomorrow but it's with his cardiologist. He was once in a study and they still keep pretty close tabs on him and his general health.

My mother is going with him since it is an hour drive away from home. She has already talked to the doctor's office about these problems, so they are aware and are going to check into the medication part of it.

It's so strange because one day about a month ago, something had to be picked up from a city an hour away. He had gone there literally hundreds of times in the past. He said he most definitely knew how to get there.

He got to the city, in the general vicinity and then couldn't find the road. He could have found his way back home easily enough but just couldn't find the business he needed.

My mother and I drove to "rescue" him. As soon as my mom was in the car with him he knew exactly which road to turn on

While he was waiting for us, he stopped and had some lunch. We wondered if that helped him at the time.

 

[Cruisin]

Lisa, I'm so sorry to hear about your mother.

 

[roseprincess]

It sounds like Dementia to me. For dementia, you lose your short-term memory. Also, there are times where the person may be "with it" for a minute, and the next minute, they are totally "somewhere else".
I have 2 people in my family that have dementia; my FIL and my extended relative, my great aunt.
It can be very scary seeing a loved one going thru dementia.

to you.

 

[Virgo10]

I have to ask. Is your father still driving?

As for the forgetfulness, you mentioned he is seeing a cardiologist. He could be having mini strokes. Be sure the doctor knows about his memory loss.

 

[Abbie]

I'm so sorry for what you're going through. It sounds remarkably similar to what our family has been dealing with for the last few years. It is a very difficult time and if it is Alzheimer's there are a lot of tough decisions to make ahead. In the meantime, definately make an appointment with his general practitioner. He/she can administer a "mini-mental" assessment test that will indicate his short-term memory status. From there, a doppler of his carotids and an MRI will probably be indicated. These will show more definitively what is going on. They can also take a good look at his meds and decide if excelon is exacerbating the problem. There are other drugs to try (namenda for one) that might be a better choice for your dad. Good luck to you and your family!

 

[Cruisin]

Yes, he does still drive but not very often by himself anymore. I asked my mother specifically about his driving skills and she says that he has no problems with the mechanics of driving.

 

[Cruisin]

I'm so sorry for what you're going through. It sounds remarkably similar to what our family has been dealing with for the last few years. It is a very difficult time and if it is Alzheimer's there are a lot of tough decisions to make ahead. In the meantime, definately make an appointment with his general practitioner. He/she can administer a "mini-mental" assessment test that will indicate his short-term memory status. From there, a doppler of his carotids and an MRI will probably be indicated. These will show more definitively what is going on. They can also take a good look at his meds and decide if excelon is exacerbating the problem. There are other drugs to try (namenda for one) that might be a better choice for your dad. Good luck to you and your family!

He has had that mini mental test done and he did actually quite well. I think he got 26 out of 30 (?) don't remember the exact numbers anymore but he didn't do that badly.

That was about 3 months ago.

 

[DISUNC]

Cruisin,

Can I HELP YOU!!!!!!!!!!!!!

Firstoff, Alzeheimas is a disease that cannot be TRULY diagnosed until after death! There are many symptoms of this. Dimentia is one of them.
BOTH come VERY VERY slowly unless some sort of tramatic event took place. Such as a operation involving anesthesia (sp?)!!!!!
So this 3 month thing that your dad is going through is more like a Drug reaction. It is also very common for people on Heart medication to experience this. MUST talk to his doctor...and DONT LET HIM DRIVE!

 

[Dalpal]

Hi Robin,

My Mom takes "Aricept" for her dimentia....You may want to ask about that...
She has been taking it for at least five years, and has done pretty well ...

It does make her antsy...So I have to give it to her in the AM ..or she's up all night...Other then that there has been no real problem with it...and it does seem to have slowed down the effects......Oh she does have to eat first or it makes her nauseous...

I hope that helps....
It does sound like what my mom is like....her is said to be mild dimentia...

 

[rumblytumbly]

RN here with 20 + years of medical nursing and geriatric experience. Please make sure to get to get a complete physical with a complete blood panel including electrolytes, thyroid study, vitamin B, and a CBC etc. etc. Get urine tested for an infection. Make sure all his medications are reviewed for interactions and side effects. That will be a good start and may help determine what other tests are needed. Please make sure there is one good physician looking at all this information together and with someone there who can describe all his memory issues and behavior changes. Delirium and dementia are easy to mix up at first so it is important that memory loss as a result of delirium has been ruled out first. Then you can look at other possible causes for the memory loss. I wish you and your dad the best of luck finding the problem and good treatment for him.

Kari

 

[princess sparkle p]

My DFIL was diagnosed 3 years ago at age 60 w/ frontal temporal dementia. The symptoms you are seeing are a lot like what we saw for several years prior the dx. Several doctors blew us off, which unfortunately delayed the dx and him being on meds to hopeful slow the disease. They did 3 physicals, a hearing test, and an eye exam. All wastes of time. The neurologist was the answer for us. The doctor now tells us that he did not expect him to live more than two years. He has and early onset form that is rather aggressive- at least that is what they tell us. An MRI will clearly show if this is what is wrong. They actually did an MRI on DFIL one year earlier when they did the hearing test b/c the thought he my have a tumor connected to his ear and this was affecting his listening and paying attention to things. The same MRI was used a year later to dx the dementia. How sad is it that no one was able to read what was on the MRI!!!! Anyway, he now requires 24/7 line of sight supervision. This has definitely been a challenged keeping him at home and occupied. Good luck and don’t be afraid to fight for him.

 

[Disney Doll]

I am a nurse, and the primary focus of my nursing unit is geriatric folks.

Usually, when the onset of symptoms is rather quick, it is something more than plain old senile(old age)dementia or Alzheimers. Those usually develop slowly, over time, not within the space of 2-3 months.

If these symptoms started within 2-4 weeks of starting the new medication, Excelon, that could possibly be the culprit.

You also said your Dad has several health issues for which he is taking medications. In the medical world, that is something we call "polypharmacy"...or many medications. many older folks are victims of it...they have one problem, they get a Rx for it, which causes some side effect which means they need another Rx and before you know it, they are taking 10 different meds which can all be interacting with each other. As people age, their body metabolizes drugs differently, so a dose they needed at the age of 50 may not be the dose they need at the age of 73.

He has a history of cardiovascular problems, so he could be spitting little clots off which are causing mini strokes, which over time will affect cerebral circulation. You may be seeing the effects of that.

He could have an infection somewhere which is not causing him a fever or any discomfort, but could be enough to cause some confusion. It's very common in older people.

His diabetes may not be being well-controlled. He could be having upward spikes and downward dips in his blood sugar levels throughout the day, which would affect his mental status.

The fact that he did OK on the mini-mental is another decent indicator that this change in mental status has a cause other than "he's getting old". Plus, 73 isn't all that old these days.

It's a good idea to get him to a doctor. If he were my Dad, I would request a full bloodwork panel, including electrolytes, CBC with diff, liver and kidney function tests, blood sugar level and a hemoglobin A1C, which gives information about what the blood sugar has been doing for the past 3 months. I'd ask them to take a urine specimen to rule out a urine infection, I'd ask for a chest x-ray to rule out a pneumonia. I would have the MD review all his meds and see if there are any that could be changed, decreased in dose, or discontinued all together. Often MDs lose track of exactly what meds their patients are taking, especially if there are specialists involved. His primary doctor should be the one "coordinating" all the specialties and he should be the one who has a handle on your Dad's "big picture". I would have his heart checked for irregular heartbeats, which could be the culprit behind spitting out clots that could be causing cerebral damage. If this acute confusion has occurred since starting the Excelon, I would probably stop it and see if he "clears" at all.

If your Dad is taking a steroid for any reason (Prednisone, Decadron are the 2 most common), they can sometimes cause mental changes.

I would ask for a CT scan of his head to rule out cerebral damage.

The other thing I might recommend to you is a geriatrician. A geriatrician is a doctor who specializes in the care of the elderly, much like a pediatrician specializes in the care of children. The geriatric population, we are slowly discovering, does not respond to medical intervention the same way the "adult" (ages 21-65) population does. Aging causes many changes in the body, and the treatment of the geriatric patient sometimes needs to be different than the treatment of the average adult.

I would urge you to rule out any physical cause before you just say "it's senility". I would also urge you to look at the possibility of depression, which can cause mental status changes.

I wish you well in your quest to find out what's up with your Dad. Feel free to PM if you have any questions which I might be able to help you answer.

 

[Cruisin]

DU, , I'd be glad of any help that we can get at this point. This is very sad to watch, as everyone has stated. Especially such a rapid decline.

rumblytumbly, he had blood work done about a month ago and the doctors office said all was fine. My mom asked for a copy of the results and they didn't want to give them to her, asked what she wanted them for I think we'd have to get my dad to ask for them.

My mom has talked with the pharamcist about the drugs that my dad takes and she checked and couldn't find any reason for interactions between them.

Another thing is that he gets very very tired easily. He takes a nap every afternoon for several hours.

(very cute children rumblytumbly )

Thanks for all the input. I appreciate all of it. I will print this thread out and show it to my mom, so she can read all of your words of wisdom.

 

[Cruisin]

Disney Doll, thanks so much for your post.

Lots of good information and advice in there.

 

[rumblytumbly]

Cruisin,

Disney Doll's advice is excellent advice. I second everything she said wholeheartedly. I was going to type more but I am trying to keep my two "cute" children from killing each other while I type...

Get copies of all the tests you've had done already. That way if you go to get a second opinion or go to see a geriatrician they may not have to repeat some of the tests.

Kari

 

[KimRaye]

Robin! Keep us posted, please.

 

[left210]

I recommend your Mom get a power of attorney now for him so she can access his medical information as needed.