A very rapid decline...in a few days


Registered User
Sep 21, 2007
Evening all,

This is my first post on here, though in the last few months I have dropped past to read others experiences and get more insight to my father-in-law's condition.

He was diagnosed with Altzheimers approximately 18 months ago now - though I believe he was suffering from it some time before. Both my father and aunt died of progressive dementia - and I became concerned that my father-in-law was displaying many of the early symptoms, forgetfulness - withdrawing and confusion etc.

In the last year he has been prescribed medication from his doctor to help alleviate/slow the illnesses progression - and their has been a marked improvement to the confusion, although in the last month I and my partner have been concerned that he has been withdrawing from people more. Not wanting to leave the confines of his house, and having less interaction with the family.

On tuesday of this week, he was taken to hospital with a suspected heart attack (on a scale of 1-10, the doctor advised his is was a 3-4).

He was initially dazed with the situation, having been moved from home - ambulance - a&e to a ward bed) - but was able to mostly hold a conversation, not in discomfort/anguish and recognised my partner/I and his wife.

On wednesday he was deamed to be making a good recovery and moved from the CCU ward to a heart ward for further lower key monitoring. They are happy with his heart now, and that he is making a good recovery.

However since late wednesday evening he has been in rapid decline. During that night he became very angry and aggressive in wanting to return home - threatening a nurse, attempting to climb out of window, spitting out his tablets etc. To say these actions are out of character is an understatement. Despite all his previous confusions when at home he has 'never' behaved/reacted at all like this.

On thursday when we visited, spending some 6hrs with him - he was very tired after having had such a restless night - could not recognise his surroundings but did recognise us and was able to hold lucid conversations for a few minutes at a time. He was with encouragement eating and drinking and taking medication.

I return last night and sat with his for a couple of hours, and as they evening wore on he became very agitated again. And began talking, but in a gibberish and incomprehensable manner. Spending long periods of time staring in to space, and making lots of involuntary motions/movements and seemed to be hallucinating.

Today he was unrecognisable. Unaware of his visitors, surroundings - impossoble to engage with - and frequently talking to himself in an unintelligible way. He's now refusing to eat/take medication (he spits both across the floor of the ward), and no longer requests assistance to the toilet/seems unaware of when i needs to go etc.

We have spoken with the sister in charge and the doctor who have said this though extreme is quite normal as the stress of the heart attack can enduce a severe bout of dementia, that should regress in a week or two.

I suppose what I was hoping for was some reassurance and insight from others who have been through this scenario or similar?? It all feels very bleak at the moment - and its heart breaking to see how quickly things can go. My partner has no experience of dementia and finding it very hard to deal with as is family.

What I think we all hoping for its for this nightmare to end, and get back the man we all love and care about so much. But if this is how things will stay then its best to know now as false hope I think is worse and harder to cope with.

Sorry this post is soo very long - I've found it difficult to condense it and also I needed to somewhere to talk about this without fear of distressing my partner/his family etc.

Many thanks,



Registered User
Jun 27, 2006
Hi Jane and welcome to Talking Point.

I'm afraid I can't speak from experience about the effect on a dementia sufferer of a heart attack, but hopefully someone will. I do know that hospitalization for any reason can be very stressful for someone with dementia: very few wards can cope with the confused patient, and their efforts to mange the situaion (or more often ignore it ) can make the whole thing worse. However, what I wanted to say is: have they checked him for a UTI (urinary tract infection)? Often the only sign of a UTI in the elderly is an increase in confusion: no fever, no apparant discomfort just this sudden down turn in behaviour. If this sort of thing happened in a geriatrics ward, I think the first thing they would do was check, but I wonder if this will happen on a more general ward.

Best wishes
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Registered User
Jul 2, 2006
Newport, Gwent
Hi Jane

Welcome to TP. I am so sorry to hear that your FIL has had a heart attack, very frightening, and his AD seems worse.

My mum unexpectedly had a heart attack in May, but for the swift action of the NH staff, and the wonderful care on her arrival at A & E would not have survived.

However, it all went down hill after that. I believe in the main due to the Wards staff inability to care for someone with AD, also being in a strange place, with ever changing staff, this added to her confusion, and I believe fear. Mum also spat out her medication, hid it in her locker, etc., etc., she returned to being aggressive and uncooperative. She needed a blood transfusion, and the only way it was going to happen was if my brother and I sat with her for the 12 hours it took for the transfusion to be completed, otherwise she would have pulled out the Venflon. Once she was physically well enough I took her back to the NH where they understand her, and treat her with love and dignity.

She continues to be on ‘medication strike’, but she is content and happy. The staff watch her very carefully for an ‘signs’ that she is having heart problems, and she is checked weekly by the GP. With regard the medication mum says there is nothing wrong with her, so why should she take tablets. She has no insight at all into her AD, also she has no recollection of the heart attack, or being in hospital.

You can only be guided by the doctors on your FIL physical health, and once this is satisfactory enough, then home is the best place for him. Hopefully once back in his own surroundings and being looked after by family who love him, hopefully he will be fine. Right now he is probably more confused and frightened.

Keep posting Jane, and let us know how you all are.

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Registered User
Jul 31, 2007
Hello Janey, I am sorry to hear about your father in law. My husband was diagnoised 4 years ago at the age of 58. Peter had quite a few mild strokes and the symptoms you are describing Peter went through. Once he came out of hospital he settled down to taking medication, eating, more relaxed. The confusion of A.D. plus any additional illness does make them very confused and they do get agitated, they are not able to reason why they are in hospital, change of scenery all adds to problems. Peter was on Aricept and it helped enormously. Being in a routine at home also helped. There were still bad patches whereby he did not want to eat, get washed and dressed. I also found that in talking to him, he could only concentrate for a very short time. No two days ever seem the same. One day they are able to talk and the next day not being able to understnd a word that he is saying. It is very difficult to say the right words to you but there are many on T.P. who will be so supportive. I wish you the very best. Christine


Registered User
Sep 21, 2007

Hi Jennifer and Kate,

Thank you both for your kind words and thoughts.

I will mention the URI thoughts when we visit him tomorrow morning.

I coudlnt agree more, during his short stay he has been faced with an ever changing array of faces and whilst we think the staff are doing there best - they are not specialists in dementia care and so I think this is exacerbating his problems.

At the moment the doctors approach to the confusion has been to terminate his memory tablets as they pose a risk to further heart problem. And this has been replaced with Lorezepram which is a sedative and anxiety relieving medication. I have read up quite a bit about it and common side effects of this can be hallucination and increased confusion...but with the volume of patients of the ward I suppose they have to use it in order to make him more managable in these surroundings.

As he is at the moment its hard to imagine being able to get him home - but hopefully this is realistic as I too think he would be better and more settled in familiar surroundings.

I will attempt to get some rest, as we are due to visit and sit with him again in the morning and my partner and I are trying our best to be as normal and relaxed in him company as possible for fear of causing him more decline and aggitation.

Many thanks,



Registered User
Aug 7, 2007
Rapid Decline

A couple of thoughts:

1. There was a discussion in TP a few weeks ago about any change in routine undermining coping mechanisms and leading to decline in cognitive performance and behaviour

2. It appears that any pain can (and often does) undermine cognitive performance and behaviour. There seem to be two processes going on: a) the brain simply cannot cope with the pain and this undermines other functions; b) the memory that enables pain to be assessed relative to previous experiences has gone and the brain tries to protect itself and shuts down, at least to some extent.
Since J. has had AD, her physical health has been excellent (not even a snuffle). However a couple of months or so ago she had a simple stiff neck. She hallucinated for 36 hours over the weekend until the GP was able to get the pain under control. Fortunately the mental loss was largely reversed, but the drop over that period of time was alarming.

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