It would appear my mom is in the early stages of dementia.

[Fire_Medic_Dave]

Took her to the neurologist last week. Symptoms are more consistent with dementia than Alzheimer's. She seems to have good days and bad days. Gonna get together with the family and decide how we should proceed. Any personal experiences would help. Please no medical advice, don't want the thread to get locked.

David

[napoleon_in_rags]

1. I've worked with a fair amount of dementia patients in hospice and long term care.

To be honest, outside of medical, I'm not sure what advice to give. I don't know if your a spiritual or secular person, so I won't frame things in those terms...But the best advice I think I can give is that even in severe cases of dementia, a person's humanity still exists. But it can be amazingly frustrating for loved ones, when the effects start to set in. But just as its challenging, I think it can be rewarding. The best path forward is really a lot of patience and a lot of unconditional love.

Good Luck.

[Fire_Medic_Dave]

8. Many thanks.

Really just looking for other peoples experiences and trying to stay within the rules. Thanks again.

David

[sandnsea]

2. Just a hug

A family friend's wife has Alzheimer's. It's just heartbreaking, I've known them all my life. He sits with her every single day, has for years. He finally put her in an Alzheimer's care facility and has felt terrible over it. The last time I saw her I had to tell her my dad had died. I don't know why, but that stayed with her. What didn't, were the various details. You can't not tell them, that would be just mean to ignore the questions. So finally I just skipped anything sad and told her a very whitewashed version so she wouldn't get upset over and over. It's just plain hard, all of it. I hope stem cell research finds some solutions some day.

[Fire_Medic_Dave]

4. Thanks that means a lot.

Especially considering our strident disagreements on other issues. You have always remained a class act though. Thanks for the nice thought.

David

[elleng]

3. It appears to me that dementia and alzheimers are on a spectrum.

I say this based on observations of my mother, who passed on in September after a rather brief illness. The illness caused her to lose the use of her legs, arms and hands, and lose mobility of her neck. As these symptoms progressed, her mental abilities decreased. She had good days and bad days, good hours and bad hours, and I believe the maladies were separate.

Because of her physical illness she required the care that could only be provided in a nursing facility; she needed some medication (not much) but she needed help moving between bed and 'chair.' A major issue concerned 'toileting,' and this typically results in need for constant/regular attention, even for those without physical impairment.

I'll answer any questions you might have, here or via pm.

I posted the following a while ago:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=317x3325

[MADem]

5. That's a good link, and a good approach for a lot of situations. NT

[Fire_Medic_Dave]

6. Thanks.

At first it just seemed to be her memory. Looking back there were other signs that we just overlooked. She was always a fantastic cook. Flavors started being way off, meals wouldn't come together at the right time. Easy enough stuff to overlook, she has a cold her taste buds are off and having cooked at the fire hall for years it's pretty easy to mistime a meal sometimes. She always was fanatical about keeping a clean house. Over the last couple of years stuff just started to stack up. It would be easier if my dads health was better but he is in very bad physical shape. Thanks for the info. I'll keep it in mind.

David

[elleng]

7. Good luck to you all.

E

[tsuki]

9. My Mother had Alzheimer's. I took her to UAB. It was a great

experience, and they helped her, getting her into a research program.

You might consider an appointment at your nearest university hospital. They stay on the cutting edge.

[Fire_Medic_Dave]

12. Thanks for the information.

I'll have to try and pull some strings. I may be able to though I have some connections over there through the fire department. The wait for a neuro appointment was 6 months at last check. I had to take her out of town to a neurologist, I really like him though.

David

[tsuki]

15. I got Mother there by just happening into the "open appointment" month,

or whatever they call it. UAB, which is the closest teaching university to me, accepted new patients during the open month. I think it was May. It is all a blur now.

[no_hypocrisy]

10. You have a sister in solidarity here. Last night, my dad caused a severe fire to our family house.

I mean it. He put a heating pad in the microwave for 20 minutes instead of two (he didn't read the instructions) and the overheated pad fell between the cushions of his easy chair while we ate dinner. Two fire companies and 15 fire trucks later, our house was saved, one room destroyed, and the devastating realization that our 86 yo father can't live by himself any longer.

He's been forgetful, like turning off the oven and stove at inappropriate times (burnt food), he shouldn't be driving, etc. He was evasive and lied to the investigating fire marshall.

My sister, brother-in-law, and I had a horrible epiphany last night that things will no longer be "the same" and we have to alter our lives for the sake of our father. It's sad on so many levels.

We can't get neurological tests for our father as he won't cooperate at all.

Good luck with your mother. I'll be thinking of you as we begin our journey.

[Fire_Medic_Dave]

11. Sorry for your situation. Thanks for the support.

[Heddi]

13. re: neurological tests on your dad

Your father may not cooperate but a good gerontological neurologist (neurologist that specializes in old folks) can do a cognitive evaluation on your dad and your dad won't even know it was done.

If you have the ability, check out local universities or med schools (if there are any in your area), they may be able to reccomend someone who can do an effective cog eval better than a run of the mill GP or someone else who doesn't have specialized training in geriatric and or cog impaired patients

good luck

[Warpy]

19. The first thing I tell people who are going to live with a parent

with dementia is to get a valve for a gas stove and a switch for an electric stove so that they can be turned off when they're not in use.

I've seen too many old folks who went out to get the paper and put it instead of the coffee pot on the stove come in with smoke inhalation and no home left to go back to, the child who was at work coming in, hysterical.

Hell, some days I can almost see myself doing that.

[WillYourVoteBCounted]

25. add getting rid of throw rugs, lock doors that go downstairs

agh, its like childproofing the house.

[Heddi]

14. Gosh, how horrible :( RN's 2 cents here:

1) find out the reason behind the dementia. I know it goes against our initial thoughts, but dementia is NOT a normal part of human aging. Is it because of medication she's taking? Is she getting enough sleep? Is it because of degenerative aging of the brain?

Many folks that we see in the hospital that are Diagnosed with dementia usually always have some underlying reason for the dementia---bad heart, so not pumping enough blood or O2 to the brain, urinary tract infections are the BIGGIE---I see more patients wig out and get Dx'ed with dementia and the cause is an easily treated UTI. Also look into untreated diabetes or chronic hypo/hyperglycemia, as these can have deleritious effects on mental cognition

2) Many people don't know this, but Alzheimers can't be diagnosed definitely until a post-mortem exam is done. So don't necessarily rule out Alzheimers right off the bat. My great-grandmother had definite alzheimers, but in the early stages she was diagnosed with dementia, not otherwise specififed. However, over time, the symptoms progressed to the point of being changed to alzheimers, and that diagnosis was confirmed at the time of her death.

3) If you haven't already, please get a DPOA (durable power of attorney) form for your mom. If she has been declared by the MD unable to make her own decisions, then the DPOA is legally her next of kin--husband, then kids. If husband is unable to make decisions on her behalf, then all the kids have to get together and have a consensus on who will be the DPOA for your mom. This is a legal document and should be filled out and declared earlier rather than later. Nothing worse than having a patient with end of life issues and no DPOA has been designated, causing all kinds of family drama and hand-wringing at the bedside

4) Between your siblings and yourself, figure out what your mom's end of life wishes would be or are. Your mom may or may not be able to make this decision for herself, depending on her mental state. Again, better to get these things figured out earlier rather than when the issue is needing to be decided.

On Edit: Do your best to get involved not just with a Neurologist, but a Neurologist that specializes in care of the geriatric patient. This will be a big help in getting the proper diagnosis and treatment for her dementia, and possibly getting it reversed even! Ask if it is appropriate that she get a carotid doppler study to ensure that she doesn't have a blockage in the carotids that would impede blood flow to the brain, causing confusion from chronic hypoxia.

See if it's appropriate that she get an MRI or CT of the head to rule out TIA's or mini-strokes which can also affect cognition.

Ask the MD to get a BMP (basic metabolic panel) including Mg and PO4, which can show electrolyte embanances which can lead to decline in cognition. Add on a HgbA1C, Glycosolated Hemglobin, which will show the average blood sugar over the life of the red blood cell and can point to whether she had a blood glucose control issue.

Get a UA (urinalysis) to rule out Urinary Tract Infection.

Ask if it is appropriate for a Cardiac ECHO (ultrasound of the heart) to rule out cardiac problems like CHF, or valve problems which can cause regurgitation of blood and pooling of blood, which can lead to the "throwing" of small clots. Also this will show if she has vegetation on the heart valves which can dislodge and be "thrown" like a clot, again, which can lead to stroke-like symptoms or a decline in mental function.

Good luck :(

[Fire_Medic_Dave]

16. Thanks.

We've done pretty much all that. We need to get the DPOA done. I appreciate the input. I'll do the things that you suggested that we haven't already done. Thanks again.

David

[Celebration]

17. Well, I read today that mild dementia

Doesn't necessarily progress.

http://www.reuters.com/article/healthNews/idUSTRE5355CL20090406

"Risk of progression of dementia overestimated"

[Fire_Medic_Dave]

20. That would be very good, she is lucid about 95% of the time now.

Thanks for the information.

David

[Warpy]

18. Major dangers with mild dementia are medical and financial

People with mild impairment screw up their pills and make themselves sicker. The cure for that one is a pill container you can pick up at any drug store, pills can be put into it once a week. If she can't remember if she took her pills that day, she can look in the container. A calendar with a pencil on a string attached to it can help her remember what day it is after she ticks them off before she goes to bed.

The financial stuff is a little tougher. You're going to need her cooperation for that one. Let her pick one person she trusts to be her advocate and to have a revocable power of attorney to be used only if some scammer gets her. That protects her two ways, by offering her a safety valve in case she gets conned and by offering her an out if she thinks that trusted person has been dipping into her funds. It's what I talked my dad into before he started to get forgetful.

If no one lives nearby, then a home health aide or someone else to check on her at least once a week (preferably twice) is essential. A monthly visit from a service to evaluate her mental status would be good.

You're going to be walking a fine line between keeping her safe and taking away her independence. If she becomes unsafe at home, look into assisted living facilities. Some of them are great, although the price is steep.

[Fire_Medic_Dave]

21. Thanks.

Fortunately they bought long term care insurance several years ago. Regardless my wife and I are definitely not hurting financially and my brother is very well off. We already do the pill box. Dad takes care of the financial stuff he still has a great mind.

David

[Fire_Medic_Dave]

22. I talked to a lawyer friend he's going to do the power of attorney for free. Thanks again.

[Bryn]

23. My mother's dementia

My personal experience:

Last December Mom's doctor said that she had dementia after tests were done by two doctors, that she could no longer live alone, cook, drive so Mom moved in with me. Her house is nearby. I have been her caretaker since then seeing that she eats and drinks, etc. I give her patches (ELELON PATCH) to slow down the process. She couldn't take ARICEPT which is supposed to be very good because it was making her sick. Her doctor advised for Mom to have 4oz red wine everyday. My sister comes here to take her to church, shopping, etc. Mom is doing great 95% of time. She forgets how to sew, use TV remote, knit, etc. sometimes. She's only 79, not really old to me. Sometimes I think it was stress that caused it. She lost her son two years ago to vodka and her favorite younger brother whom she was close to passed away unexpectedly a year ago. Widowed 10 years ago. Lost all of her close friends in the village to early death due to cancer. Since she moved in with me she seemed to relax a lot and is doing great. I read over the internet about nicotine helping Alzheimer's/dementia so I am going to ask her doctor if it's okay for her to puff on e-cigarette, low nicotine. ;) She says ... oh, dear I'd have to hide ...drinking and smoking. LOL She used to be a smoker, but stopped 25 years ago. I stopped smoking by switching to e-cigarettes.

So far she's good. It'd been 4 months now since she moved in.

[Fire_Medic_Dave]

27. Thanks for the information.

[WillYourVoteBCounted]

24. my mother has had dementia for years

I've been keeping my mother for 10 years now.
She also has good days and bad days.

I used to take her to a day care during the day while I worked.
She got to where she couldn't do it any more.
The people at the daycare were excellent, but my mother finally reached that point.

She didn't do well with having someone come to the house to take care of her.
Eventually I ended up staying home with her instead of hiring someone.

My neighbor has had good luck with hiring people to watch her mother,
the neighbor is a nurse and has good contacts, plus she can better afford to pay.

Since I began staying home, my mother has been healthier.

My sister recommends sunlight to help stimulate elderly.

Older folks may need more help in washing, some reach a point where they don't want to be
bathed and you have to figure out a way to get them bathed.

With my mother, the changes have been incremental.
Her doctor says that her living with me has extended her life many years.

Its been hard being the sole caregiver, I hope you have family who will pitch in,
but don't count on it.

The local senior services can give you very good advice.

Also, you may want to go to an eldercare lawyer NOW so that you can make sure your mother's
finances don't get screwed up. You have to spend her money a certain way or she can be disqualified for medicaid if or when she runs out of money.

Go to a really good eldercare attorney, one who has people who understand the medicaid rules.

You also need power of attorney, including health care power of attorney. Or someone does.

[Fire_Medic_Dave]

26. Thanks for sharing.