Is this a deterioration?

[Reallife]

My Dad was diagnosed with Alzheimer's in November 2010 and while he is getting worse he is not too bad at the moment. He still lives at home with my Mum and knows who we all are. We can have a conversation with him, when he is in the mood, but his short term memory is terrible. While he is still able to walk his mobility is poor and he needs a zimmer frame in the house and a wheelchair if we are going out. He is extremely easy going and there is no aggression.

During the week he had shown some signs of slightly increased confusion and smelly urine, so on Friday I had taken a urine sample to the doctors to be sent for tests. In the mean time the doctor had prescribed antibiotics for a UTI.

On Saturday he had an episode which resulted in him being admitted to hospital. I got a phone call from my Mum saying Dad wasn't talking to her. When I went down he couldn't speak and was just moving his head from side to side. It was as if he could hear but couldn't understand what was said to him. He couldn't walk because he didn't know how to move his feet, if you pushed his legs he would move his feet. He did not know who we were. He was then sick several times, including in the ambulance.

The hospital started him on intravenous antibiotics. They took bloods, listened to his chest and did a chest x-ray and all came back clear. The urine sample from the doctors has also come back clear. He had 3 days of antibiotics and is now back to his normal level. The hospital said he doesn't appear to have had an infection and they think it was just a progression of his Alzheimer's.

Has anyone else experienced this and is it a deterioration? It's just if it is a progression would you expect him to go back to his normal level of confusion after antibiotics?

 

[Amy in the US]

Hello, Reallife, I am sorry to hear about your dad. What a worrying time you have all been having.

It's possible your dad did have a very mild infection, either a UTI or some other sort.

It's possible he had some sort of cold or virus or health problem other than an infection.

I've definitely seen reports here on TP that any sort of illness, not just infections (but especially those) but even something as minor as dehydration, can knock their PWD (person with dementia) for a major loop and cause all sorts of unusual symptoms. It was smart to get him checked out, especially with the unresponsiveness and the vomiting. Just from the vomiting alone, it's clear he had something the matter with him.

Also be aware that the UTIs can recur, and can be hard to clear up. It's possible he did have one, just not at the moment that they tested his urine. I would keep an eye on this, as it's such a common problem in PWD.

I honestly thinks it sounds more like illness, than progression of the dementia, but it's so very hard to know. Is he still in hospital? That alone can cause all sorts of confusion and behavioural issues.

I'm sorry I don't have better advice/suggestions for you. Wishing you all the best.

 

[Reallife]

Thanks Amy, yes Dad is still in hospital but we have been told he will be coming home tomorrow.
That's what I was thinking about it being an illness of some sort. I just don't feel it's a progression, simply because he has improved and is back to normal even taking into account the fact that he is in hospital. He is definitely very confused in hospital , he has told me so. When we are not there they say he asks for my Mum all the time and is very anxious but he asks for her at home when she is out of sight. We visit for 2 - 3 hours every afternoon and when we are there he is only showing the same level of confusion as he was at home.

 

[Linbrusco]

Thanks Amy, yes Dad is still in hospital but we have been told he will be coming home tomorrow.
That's what I was thinking about it being an illness of some sort. I just don't feel it's a progression, simply because he has improved and is back to normal even taking into account the fact that he is in hospital. He is definitely very confused in hospital , he has told me so. When we are not there they say he asks for my Mum all the time and is very anxious but he asks for her at home when she is out of sight. We visit for 2 - 3 hours every afternoon and when we are there he is only showing the same level of confusion as he was at home.

We had an episode a few months back, 2 weeks after Mum had had a UTI and on a 10 day course of anti B's.
Increased confusion, glazed eyes, almost non responsive. Called for an ambulance, spent 4 hrs at hospital, urine tests and blood tests came back fine. her BP was raised though. By the time we got her into teh ambulance she was almost back to her usual self and laughing with the ambulance man
They said it could either still be a result of the infection and previous anti B's, or progression of her Alz.
I have seen one more episode like this, but not as bad to call an ambulance.

 

[Reallife]

Thanks Linbrusco, I know what you mean yesterday and today you would certainly say there was nothing wrong with Dad. Sunday he was still confused and I'm not certain he knew who me and Mum were as he didn't acknowledge us but by Monday he certainly knew who we were and said I'm pleased you are here and that was the first time he mentioned going home. When he has been to hospital in the past he never wants to stay and always wants to come home but this time it was Monday before he mentioned going home and didn't object when I told him he had to stay on Saturday night.

 

[Linbrusco]

Thanks Linbrusco, I know what you mean yesterday and today you would certainly say there was nothing wrong with Dad. Sunday he was still confused and I'm not certain he knew who me and Mum were as he didn't acknowledge us but by Monday he certainly knew who we were and said I'm pleased you are here and that was the first time he mentioned going home. When he has been to hospital in the past he never wants to stay and always wants to come home but this time it was Monday before he mentioned going home and didn't object when I told him he had to stay on Saturday night.

the knowing and not knowing who you are in this in between stage is really difficult.
My Mum has just gone into permanent care, but in the last 2 mnths i was Mums daughter, neighbor, the lady who looks after her. Dad was either her husband Dave or a man called David who lived in her house and she was scared of.
Since being in care, she always knows me and ackknowledges me by name.
Dad she isn't too sure of at times, and doesn't really acknowledge him at all when she sees us.
She goes from " I'm not staying here another minute" to " Do you like my room, I picked it, and the nurses are really nice and talk to me"
At times we can leave her with no fuss at all, and other times she gets agitated, and why isn't she going home with us..... but the other day she asked me where her home was... at this stage I am sure she is thinking of her family home when she first emmigrated here to NZ, and not back in Scotland.

 

[Reallife]

That's something I'm dreading , Dad not knowing who I am. I'm still a Daddy's girl.

 

[lavender1]

Hello real life - my dad has also had Alzheimer's disease since 2010. He had a UTI in 2012, but this was not picked up at hospital - they sent him home even though we knew something was not right. After 4 weeks at home, he was literally on the brink of death and got rushed back into hospital where he was placed on antibiotics. All the health professionals could say was "he did not show the usual signs of a UTI" even though the smell from his urine was horrific and his urine actually bleached his blue underpants white. To cut a long story short, he was in hospital for 4 months after which they said he was no longer able to be looked after at home, and he was admitted into long term care - where he remains. If you still think it is a UTI - insist on another test.

 

[Reallife]

Thanks for that Lavender , I will certainly be keeping my eye on him.
He is doing ok but is showing more signs of confusion but he (and us) have had a lot to deal with since he came home. Despite the hospital says his care package was in place on discharge it wasn't, no carers turned up. When mum rang his original care provider to see where the carers were they said they didn't know he was out of hospital and were not sure that they could provide any carers.
After a frantic afternoon of me ring the duty social worker, ward and hospital social worker it transpired original care agency wouldn't re start his care and another agency had to be found. Dad obviously confused as he was used to the same carers and now has all different ones, he just keeps saying "who are you?" It has really unsettled him and Mum , who has to adjust to new people coming into her house. It's all fun and games at the moment.

 

[Reallife]

Mystery solved. After coming out of hospital ok, Dad has been more confused and then over the last 2 day he has been really sleepy and lethargic. He has been struggling to move his legs when walking. The doctor came out today and he has a chest infection. He is now on antibiotics again so hope they work.