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Medical Forum / Diseases and Disorders / Alzheimer's / March 2005Question about sudden decline
My mother has early/mid stage Alzheimer's and has been living indepnedently. The family was just considering having her move to assisted livng. Last week her symptoms seemed to progress so that by friday, I knew she couldn't be left alone. I took her to the ER on Sunday, thinking she might be dehydrated or have a bladder infection because she was so confused and anxious, they didn't find anything. On Wednesday her doctor modified her meds in hopes of improving her condition. Her rapid decline has been shocking and I would like to hear others opinions of whether you think she may make a significant recovery or if the disease is progressing. I know this will all be speculation, but I think it would be comforting to hear others experiences/opinions. There are several factors that have probably contributed to her condition including the following: -She had to have her beloved dog put to sleep early december. Her days was very routine based on the caring for her dog, and now her routine has been disrupted. -She has had chronic diarrhea for several months -Because of the diarrhea, she had to have a colonoscopy two weeks ago to determine the cause. The preparation was very hard on her and she was under anesthesia for quite a while. Although she seemed to be recovering nicely. -She sounded like she caught a cold last week, but there are no longer any syptoms -Her regular companion was gone last week, so she was on her own for long periods -She has lost significant weight in the last 2 months, probably a combination of diarrhea and the colonoscopy prep -She was placed on numenda a month ago, and her aricept was reduced to 5mg. from 10mg (because of the diarrhea). Her physician has now taken her off numenda and I've since learned that in a very small % of the population numenda can cause side effects similar to dementia Thanks for any input. Molly Molly My husband had a definite decline after the colonoscopy. . It was the worst thing I ever allowed and it really accomplished nothing. Personally , I think she is at a stage, where she needs 24/7. I have nothing but praise for Aricept & Namenda. I believe the combo has kept Don continent much longer than I expected...I have to tell him where the toilet is X times a day. He doesn't know my name or who I am, nor his kids, where he is etc. Wouldn't know enough to eat because he doesn't know if he is hungary. Last month the cardiologist suggested a stent...He has a pacemaker & a stent---also done when I didn't know the extent of damage done by anesthesia.. People here have been invaluable helps. PS----I have used lomotil when necessary---& Benedryl for sleep..They are sold over the counter. One Dr says OK--another not sure.. FWIW Florence Yes, the things you mention are probably big factors in her sudden decline. My mother had a marked decline in mental acuity soon after she lost her purse for the first time, and had to have all her insurance cards, Social Security card, etc. replaced. Then Mom went rapidly downhill after Dad was hospitalized and she had to stay elsewhere. A change of environment coupled with additional physical health problems are probably responsible for your Mother's rapid decline. Sarah > My mother has early/mid stage Alzheimer's and has been living > indepnedently. The family was just considering having her move to [quoted text clipped - 31 lines] > > Molly > Yes, the things you mention are probably big factors in her sudden decline. > My mother had a marked decline in mental acuity soon after she lost her > purse for the first time, and had to have all her insurance cards, Social > Security card, etc. replaced. I think you got it backwards. The lost purse was probably a big symptom of her disability. You'd be surprise how good some of them are at masking symptoms, but it takes a hell of a lot of energy, and when they are in private and alone they just fall to pieces and get totally confused. > Then Mom went rapidly downhill after Dad was hospitalized and she had to > stay elsewhere. The ability to learn new things is yet another symptom of the loss of short term memory. Lets see....your poor mom is in middle AD, which is when the illness seems to pick up steam in terms of big impacts what you can see (i.e. having run through all the excess capacity and duplication the nervous system has, every neuron lost seems to translate into the death of some ability). She's got some major stressors emotionally (lost her dog, which changed her routines). She's having a chronic bowel problem which is upsetting and appears to be impacting her nutritionally (i.e. she's losing weight, plus having the "trots" can mean nutritional deficiencies). Her aricept has been cut. And...she had a general anesthesia, which is notorious for totally knocking dementia patients for a major loop from which few recover. Phew! She's got every reason to be declining faster than before. I know its shocking to see - my MIL had a long period of relative stability in the early stages, followed by a sudden drop, and then a steady and more rapid decline, and so on. I know you probably don't want to hear this, but she can't live alone OR be unsupervised any more - ever. You won't ever be sure she'll be safe without someone there. Even if she comes back a bit from this set of challenges, she won't come back all the way, and the rest of the road is relentlessly down hill. I wish I could tell you I thought something different. Mary G. > My mother has early/mid stage Alzheimer's and has been living > indepnedently. The family was just considering having her move to [quoted text clipped - 31 lines] > > Molly Dear Molly, As others have already pointed out, there are several reasons that could have been responsible for the decline, including the illness itself, which is known to sometimes take sudden declines. I can tell you this; when my mother in law was put on a different medication than her Aricept, the decline was astonishing and immediate. When we re-started her back on her original dose of Aricept she regained a lot of her faculties again. That is not to say that all these other factors could not be contributing, but the change in medication could definitely be a big factor. I'd look at that first. Also, the Aricept ceased causing diarrhea when we started giving it to her AFTER her dinner. Before, when she took it without food, it did. It may not solve the problem, but it is at least a place to start.  SignatureRegards, Evelyn (to reply to me personally, remove 'sox") > Also, the Aricept ceased causing diarrhea when we started > giving it to her AFTER her dinner. Before, when she took it without food, > it did. > > It may not solve the problem, but it is at least a place to start. and if she was still dispensing her own meds, she may have been taking too much because she didn't remember that she had already taken it. Dennis: Well DUH!!!! THAT should be obvious. With aldo respect if she is in mid stage she can't remember when where or if she ate and what she ate, I am very surprised to see her living independently. My father 70yrs old is from what i can tell in the mids range, he is not aloud to cook, drive (of course not) and never be alone; well he gets the mail every day becaus its a routine he loves. He is: repetitive, asks "where are we going are we leaving now? Are we suppose to go? No dad we are home ;we are staying home period; unlike my mother who constantly explains we went there already ...Or what are you doing dear ? put your jacket back in the closet and hang your hat up you need to go to bed because yadayada.,., oh geese... My mother doesn't understand that she needs to distract that question and tell him something like " could you help me fold the towels etc.. I always get carried away when I respond on post sorry; A psychologist would read this and say I have issues; Dah LoL;Les |
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