Dementia?

[VFL]

As a previous posted mentioned - definitely get her checked for a UTI. My MIL had significant rapid mental decline last December. It turned out to be a UTI which causes dementia type symptoms in older people. We had no idea this was a possibility until We started researching. We dealt with dementia with my FIL and it is difficult to say the least. Thoughts and prayers for your family during this difficult time.

 

[goofyernmost]

It really is important to get a medical evaluation first. It could be dementia or ot could be something like normal pressure hydrocephalus. There are medical conditions unfortunately that can mimic dementia, which is why it's important to get medical evaluation.

Or it might even be normal decline due to aging. I know I am unable to remember names at an increasing rate. I always had some problems with that but it seems to be worse now, but I don't have any major problems. It's outside peoples and places names not my family.

 

[disykat]

As a previous posted mentioned - definitely get her checked for a UTI. My MIL had significant rapid mental decline last December. It turned out to be a UTI which causes dementia type symptoms in older people. We had no idea this was a possibility until We started researching. We dealt with dementia with my FIL and it is difficult to say the least. Thoughts and prayers for your family during this difficult time.

We have had several UTI incidents with mom. It's amazing how quickly behavior changes and then how quickly it changes again with treatment. When mom still lived further away she would start calling me over and over again with weird paranoid stuff. After it happened the first time whenever I suspected I'd call the office and have them test her, and she'd get treated. Afterwards she'd say "how did they know to test me?"

 

[lisaviolet]

As a previous posted mentioned - definitely get her checked for a UTI. My MIL had significant rapid mental decline last December. It turned out to be a UTI which causes dementia type symptoms in older people. We had no idea this was a possibility until We started researching. We dealt with dementia with my FIL and it is difficult to say the least. Thoughts and prayers for your family during this difficult time.

This.

Plus please make sure her b12 levels are checked. Pernicious Anemia/b12 deficiency can cause many of the same symptoms, including delusions, apathy, irrational thought process, increased agitation, anxiety, slurring words, word-finding & memory loss. Believe it or not doctors are not even educated enough in this area. Scary.

Also check for TIA (mini-strokes) - can cause similar issues.

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As for your father - love & patience. Of course with pushing to enact as much help - legal & medical as you can.

My mother had dementia for nearly twenty years. I talked to her directly even in the early years, had to for many reasons (only when necessary - as little as I could not to depress or scare her, always trying to have as much compassion as possible). I got crap back from her of course, but of course survived it. My father was in denial and not a ton of help in the beginning. Was at times a roadblock. When he faced it, it was as though he always knew. Because he probably did. Then he cared for her for many years.

The love & compassion -
As hard as this is on you & your sister (love sent), for a man to fear his beloved slowly changing in front of him is beyond devastating. So it is easy to understand the initial denial and fear.

I found it helped to put things like this -

Let's just check this out to simply cross it off. That's all. (Making it more casual)

Or let's just get this in order, just in case. No big deal, then it is done.

Or it just might simply be this or that, let's just see.

Which it might - never let a doctor diagnose a thing without crossing off many other possibilities like a UTI, b12 deficiency, TIA & other possibilities. Every single one of them.

And some doctors are open to conversations, some are not.
But always worth the try. Because it opens the channels of what they see themselves. Mom's would do nothing without me writing a letter or it coming directly from her. And then someone read her the letter, along the way. Insert big fat sigh on that.

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For others reading -

Other possible symptoms because it is beyond memory -

Gait changes, shuffling, falls without protecting one's face, not swinging/moving arms when walking, poor word use & sudden limited vocabulary, word finding issues, hygiene/makeup changes, apathy, changes in eating - awkward use of utensils & amount of food, pronunciation, a very social person staying home more, changes with driving, irrational thought process (huge flag), paranoia, distrust, delusions & personality changes. Also some positive ones - loosening of boundaries when a loved one was a more rigid personality.

All the best to you. Hoping that it is an underlying condition that is causing the changes.

 

[Lilsia]

I guess the elephant in the room is that the relative in need has to trust the person they are giving permission to. And they have to be comfortable with facing they are mortal.
With my mom, the house I could not touch in her lifetime because it was in a trust, but her car and all her bank accounts I could access any time. She had to trust I would not rip her off.

I would think that that would go without saying. It sounded as if the OP has a good relationship with their parents and are not out to rip them off. And that also exactly why I wanted to make sure that I was the one on the accounts. My brother would have ripped my grandma off.

 

[NotUrsula]

It is true that doctors cannot talk to you about your parents' care unless your parents have specifically given the doctor's office permission to do so, but remember that there is nothing stopping YOU from communicating your concerns to the doctor. It's a one-way communication, but it's still important.

One of the better options is to keep a log of incidents you've observed, and then enclose a copy of that in a letter to the physician's office to be included in Mom or Dad's file. Getting the information in writing is useful so that physicians can quickly read it and flag issues, and also because it's easier for them if they don't have to meet you in person and fend off questions they are not allowed to answer.

 

[lisaviolet]

It is true that doctors cannot talk to you about your parents' care unless your parents have specifically given the doctor's office permission to do so, but remember that there is nothing stopping YOU from communicating your concerns to the doctor. It's a one-way communication, but it's still important.

So true. Simply highlighting this great advice.

 

[barkley]

My parents are very open and organized about "where" all of the important paperwork, plans, etc. are at if they pass,

PLEASE for your own sake-look to see what your parents have deemed as 'important paperwork and plans'. i say this b/c we went through a nightmare when mil passed. she repeatedly (in both totally fine as well as declining mental health) told dh where her 'important paperwork' was located, showed him the drawer it was in. dh never looked beyond seeing the envelope on top that had an attorney's name on it figuring it was her will. when his mom passed and we had to deal with stuff we did find a will BUT as far as any information on where bank accounts were, what debts existed, if there was life insurance, passwords to access canceling auto payments for no longer needed (and unknown to us) services, title to car, any info pertaining to her pension... it was nowhere to be found. mil's idea of 'important paperwork and plans' consisted of her will, fil's (long deceased) will, some long deceased family member's death certificates, her dog's shot records (dog had been re-homed long before she had any mental issues or passed), and car service records (on former but not current car she owned). we were left to put together what we refer to as a 'thousand piece jigsaw puzzle with no picture to guide us'.

 

[C&Jx2]

It really is important to get a medical evaluation first. It could be dementia or ot could be something like normal pressure hydrocephalus. There are medical conditions unfortunately that can mimic dementia, which is why it's important to get medical evaluation.

It can be as simple as a UTI in the elderly... Actually a really common cause of change in cognition.





Start keeping a journal also of the behaviors that you feel are a change so when you do speak to someone you have good examples... YOU know her, they don't. So things that are different to you will have more weight when you can provide specifics and context.

 

[C&Jx2]

As a previous posted mentioned - definitely get her checked for a UTI. My MIL had significant rapid mental decline last December. It turned out to be a UTI which causes dementia type symptoms in older people. We had no idea this was a possibility until We started researching. We dealt with dementia with my FIL and it is difficult to say the least. Thoughts and prayers for your family during this difficult time.

This is elderly care (nursing) 101! I wish it was more well known to the public.

 

[mumto3girls]

Oh OP, I feel for you. My mother had Alzheimer’s. My dad was in such denial about it. Half the battle was convincing him that there was an issue. Eventually it became obvious, but there was definitely a period of time where it seemed like my sisters and I had him “on board” and the next time one of us spoke to him he was back in denial. She had always been moody and somewhat difficult and he would think she was just being hard to get along with. My mom refused to go to the doctor and insisted nothing was wrong. She went undiagnosed and unmedicated for years and finally got to the point where she was threatening my dad and me and my sisters. Eventually she was taken out of the house against her will by the police and transported to the local emergency room where she was ultimately transferred to a geriatric psych unit where she stayed for about a month getting diagnosed and on meds—took a while to get them straightened out. Traumatic for everyone involved. Obviously if you can get your mom to the doctor willingly that is a better route. And as others have pointed out, if you don’t have permission to go along or converse with her doctors, you can make them aware of her issues so they are looking for signs in her next appointment.

Some things I tried with my mom were telling her I was noticing that she was forgetting things and that I thought she should talk to her doctor because maybe it was a medication issue that could easily be fixed. She was somewhat receptive to that, but she took very few meds and was a registered nurse and knew, even at that point, way more about meds than I did. So although she initially agreed, I’m not sure that conversation ever happened. I also tried reminding her that if she did have Alzheimer’s, it ran in families and was more prevalent in woman and as someone with 4 daughters and 6 granddaughters, wouldn’t she want us to know if that was part of our history? She would agree, but there was no follow through.

The other thing I would say is to try to get your dad to start paying attention to what your mom normally takes care of within their relationship. For my parents, my mother was the holder of all the medical info for both of them. My dad’s knowledge of even his own history was shockingly poor and his ability to keep up with his doctor appointments, who he saw for what and how often, when he was due for this or that and why he was taking particular meds was something he struggled with long past the point my mom was capable of doing it. Had he been the one who got sick first it would have been financial stuff with her. That is my dad’s comfortable place and he knows exactly where the money is and how to deal with that. My mom would have been lost.

This was long OP—I hope some of that was helpful. More than that I hope your mom has a UTI.

 

[Princesca]

With seniors, there are many MANY things that can affect cognition that are not necessarily dementia. Any medication that causes dehydration, for example. Lack of sleep/interrupted sleep. UTIs. Vitamin and mineral deficiencies. My mom has occasional issues with this (usually when she's had bad sleep over multiple days), and I am convinced that it is ADHD she's been masking her entire life and now, with more limited cognitive agility, is no longer able to mask as well. She ticks all the boxes for ADHD and how it manifests in women, and honestly always has, if I look back to her in my youth.

There are cognition batteries you can have done that are hours/multiple days, and they go through all the steps of ruling out anything else it could be. I really need to get my mom into one of those, and it sounds like it would be a good idea for yours, too. My mom always passes the memory tests the visiting nurses give her with flying colors (drawing the hands on the clock, etc) but apparently those are not sufficient for diagnosing dementia.

And just right here I also want to put in a plug for reading about 'hospital delusions'. If you have a senior parent you care for, and you haven't heard about this or read about it, do yourself a favor and read about it soon. I had a major freak out over hospital delusions (aka hospital delirium) with my mom that completely resolved themselves but were scary AF when they happened. No one ever told me that was a thing with seniors but it occurs in roughly 30% of them, post-op. Ay ay ay.

 

[nw6675]

Oh OP, I feel for you. My mother had Alzheimer’s. My dad was in such denial about it. Half the battle was convincing him that there was an issue. Eventually it became obvious, but there was definitely a period of time where it seemed like my sisters and I had him “on board” and the next time one of us spoke to him he was back in denial. She had always been moody and somewhat difficult and he would think she was just being hard to get along with. My mom refused to go to the doctor and insisted nothing was wrong. She went undiagnosed and unmedicated for years and finally got to the point where she was threatening my dad and me and my sisters. Eventually she was taken out of the house against her will by the police and transported to the local emergency room where she was ultimately transferred to a geriatric psych unit where she stayed for about a month getting diagnosed and on meds—took a while to get them straightened out. Traumatic for everyone involved. Obviously if you can get your mom to the doctor willingly that is a better route. And as others have pointed out, if you don’t have permission to go along or converse with her doctors, you can make them aware of her issues so they are looking for signs in her next appointment.

Some things I tried with my mom were telling her I was noticing that she was forgetting things and that I thought she should talk to her doctor because maybe it was a medication issue that could easily be fixed. She was somewhat receptive to that, but she took very few meds and was a registered nurse and knew, even at that point, way more about meds than I did. So although she initially agreed, I’m not sure that conversation ever happened. I also tried reminding her that if she did have Alzheimer’s, it ran in families and was more prevalent in woman and as someone with 4 daughters and 6 granddaughters, wouldn’t she want us to know if that was part of our history? She would agree, but there was no follow through.

The other thing I would say is to try to get your dad to start paying attention to what your mom normally takes care of within their relationship. For my parents, my mother was the holder of all the medical info for both of them. My dad’s knowledge of even his own history was shockingly poor and his ability to keep up with his doctor appointments, who he saw for what and how often, when he was due for this or that and why he was taking particular meds was something he struggled with long past the point my mom was capable of doing it. Had he been the one who got sick first it would have been financial stuff with her. That is my dad’s comfortable place and he knows exactly where the money is and how to deal with that. My mom would have been lost.

This was long OP—I hope some of that was helpful. More than that I hope your mom has a UTI.

My mom is also an RN so I appreciate your comments about your mom! Your approach about the daughters/grandkids is also well received. Thank you for your post!

Thanks to all of you! It is very much appreciated and lots to consider.

 

[Boopuff]

I had a tough time with my parents. It didn't help that my SIL refused to accept what was going on. By the time I convinced my brother, it was almost too late. Look at all your options, take any help and make sure you take care of yourself!

 

[DisneyHardin]

When my Grandma started to show signs of mental deterioration, my mom found a Geriatric specialist doctor instead of just going to her regular family doctor. The Geriatric Specialist ran lots of tests and gave her the diagnosis of dementia. She saw this doctor regularly up until the time she had to go into a Memory Care unit - Mom was very pleased with the Specialist.

 

[Pea-n-Me]

With seniors, there are many MANY things that can affect cognition that are not necessarily dementia. Any medication that causes dehydration, for example. Lack of sleep/interrupted sleep. UTIs. Vitamin and mineral deficiencies. My mom has occasional issues with this (usually when she's had bad sleep over multiple days), and I am convinced that it is ADHD she's been masking her entire life and now, with more limited cognitive agility, is no longer able to mask as well. She ticks all the boxes for ADHD and how it manifests in women, and honestly always has, if I look back to her in my youth.

There are cognition batteries you can have done that are hours/multiple days, and they go through all the steps of ruling out anything else it could be. I really need to get my mom into one of those, and it sounds like it would be a good idea for yours, too. My mom always passes the memory tests the visiting nurses give her with flying colors (drawing the hands on the clock, etc) but apparently those are not sufficient for diagnosing dementia.

And just right here I also want to put in a plug for reading about 'hospital delusions'. If you have a senior parent you care for, and you haven't heard about this or read about it, do yourself a favor and read about it soon. I had a major freak out over hospital delusions with my mom that completely resolved themselves but were scary AF when they happened. No one ever told me that was a thing with seniors but it occurs in roughly 30% of them, post-op. Ay ay ay.

Delerium

 

[Princesca]

Delerium

Thanks, I have also heard it called that so I amended my post, should people choose to research it. By whatever name, it's shockingly common and is very scary for both the patient and their loved ones.

 

[Pea-n-Me]

My mom is also an RN so I appreciate your comments about your mom! Your approach about the daughters/grandkids is also well received. Thank you for your post!

Thanks to all of you! It is very much appreciated and lots to consider.

We nurses can be tough patients.

Just wanted to say (I briefly touched on it in my first post) there are some medications that can help with cognition but it requires a medical eval and having other causes ruled out. With my aunt they also did a head CT to rule out other neurological causes. The sooner they can get on that, the better.

Also want to say that Stage 1 of Alzheimer’s can be VERY SUBTLE. Married couples often mask this for eachother pretty well so it can go unnoticed for a while. Things start getting more prevalent when they get to the middle stages of Alzheimer’s, and that one is a long one, with early and late middle stages. So when people start noticing big changes, the person affected can more often than not be at the beginning of the middle stages, so there’s not a lot of time to waste. Very common to hear “We didn’t know”. It was true in our family, as well. It was actually at my baby shower that a group of my nurse friends noticed that my aunt was definitely in the throes of dementia. We took it from there.

Also wanted to say it’s not ‘unethical” for caregivers to talk to caring families about concerns with their loved ones, but there are HIPAA rules that have to be adhered to. Here in MA we have what’s called a Health Care Proxy law, which is a simple form filled out that allows caregivers to talk to the person or people named, without any issues. Whatever law you have in your state, it behooves you to get that taken care of asap.

Good luck with this, it is a difficult road to go down.

 

[Pea-n-Me]

Thanks, I have also heard it called that so I amended my post, should people choose to research it. By whatever name, it's shockingly common and is very scary for both the patient and their loved ones.

Yes, delirium is the medical name for it. Delusions can be a symptom of delerium. I can speak to it pretty well because as a hospital nurse I deal with it all the time, and also had to deal with it in my own mother when she was a patient. It is a result of a lot of chemicals in the body becoming out of whack, usually as a result of an illness, surgery, medications, low oxygen levels, hospitalization itself (with days and nights mixed up), infection, electrolyte disturbances, etc. It usually comes on quicker and can resolve. It can get worse at night. (Sundowning.)

https://www.mayoclinic.org/diseases-conditions/delirium/symptoms-causes/syc-20371386

Whereas with Alzheimer’s Disease there are actual changes in the brain, often profound. In the past it was diagnosed on autopsy looking at these changes. Today they can see them on imaging, and there are some features that are more common with Alzheimer’s (such as it being progressive) so they can pretty much say what it is once other causes have been ruled out.



https://www.slideshare.net/Lazoithe...ms-risk-factor-causes-treatment-and-diagnosis

 

[punkin]

I wish you luck. It took me forever to convince my DH and his brother that there was something wrong with their father. They just refused to see it. It's very hard.