Can Alzheimer's get worse after a fall?

Discussion in 'I care for a person with dementia' started by LittleFeet74, Mar 7, 2015.

  1. LittleFeet74

    LittleFeet74 Registered User

    Aug 30, 2014
    14
    Sorry if this is a silly question but I'm still finding my way with Dad's Alzheimer's. to cut a long story short, a few weeks ago Dad had a very bad fall down the stairs and broke his neck. He is still in a specialist trauma unit and we are awaiting transfer back to his local hospital. He had surgery a week after his fall, it took this long because some of the Dr's did not want him to have the surgery due his his numerous health issues. Anyway, eventually it went ahead. Initially he was doing well, 5 days after surgery he had physio and even managed to stand. Since then however, he has been barely awake and when he is he is incoherent. He didn't have his meds for a week but he is having them now. We were told his Alzheimer's wold be the same as before the fall, but we are not experiencing this. He is extremely confused, is having a lot of visual distortion and is shouting out and having conversations with people who are not there. The Dr's are telling us that we should think about nursing homes as he will need a lot more care that we will not be able to manage at home. It's been very difficult to deal with, I don't feel ready to think of nursing homes but I also need to be realistic. Anyone else had experience of a loved one falling and then the Alzheimer's rapidly changing? Any advice about nursing homes? Would we need to sell his house to fund this? Difficult as my sisters still live there and that would make them homeless. Thanks for reading if you got this far.
     
  2. Raggedrobin

    Raggedrobin Registered User

    Jan 20, 2014
    1,432
    So sorry about your Dad's situation, i must all be v worrying for you. my Mum fell and broke her right hip and yes, after the op her dementia increased big time. But there are several possible things that can be going on. The person may fall because they are having a mini stroke which doesn't necessarily show up, anaesthetics may or may not affect some people with dementia or it could jusg be a short term effect of having an operation.
    My Mum then fell and broke her other hip a year later. I dreaded the operation, I thought she would come out even more incoherent but after about 6 weeks she is back to her normal level of dementia, so it is all rather uncertain.
    I think you need at least 6 weeks before you can establish it is dementia rather than general post op confusion going on. However, it does sound as if he will need more care,which is a difficult step but understandable. I wish my Mum had gone straight from hospital to a home, instead, she came home and it was a nightmare trying to look after her and in the end she still had to go into a home. If she had gone straight into one I could have saved both of us a lot of heartache.
    Re the money, there is plenty of info on here but first you need to contact social services to talk to them about your dad's financial situation. assuming he doesn't have a living wife/partner, the first thing taken into account would be his savings. If your sisters live in the house, the house may be excluded from financial calculations, it depends on the exact circumstances of their living there, their ages etc etc. But I would contact social services first to get a rough sense of what your father's position might be. He may also be eligible for funding in care by the nhs.
     
  3. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,662
    Salford
    Hi LittleFeet
    Sorry I can only say that in my experience any trauma (and your Dad had a big one, a broken neck!) does seem to make it worse as does a hospital stay. Anyone who says someone with AZ gets over any fall and a hospital stay and a week off their meds "wold be the same as before the fall" is talking out of their...let's say bottom.
    The housing situation depends on a few things and needs more details to anwer, if the sisters are over 60, is there any shared ownership of the house, do they have any disabilities and could you ask (shame) the SS into doing a voluntary disregard on the basis of what they've done in caring for him, giving up homes to care for him ect, ect.
    Finally no question on here is ever "silly", if you don't know then ask, none of us know all the answers so we ask too.
    K
     
  4. opaline

    opaline Registered User

    Nov 13, 2014
    182
    Hi, agree with other posters, it's highly likely the confusion and incoherence have been caused by shock/trauma/anaesthetic with a good dose of Alzheimer's thrown in! I'm assuming he has a catheter, chances are he also has a urine infection which can cause complete confusion on its own! It is VERY early days. 're the housing situation I'm in the same boat. If/when Mum has to go into a home and her house be sold, I'll be homeless! Apparently you can apply to the local council for leniency, sorry, can't remember the correct term but the first 12 weeks are ignored, anyway so that gives you a breathing space. Let us know how he goes and stay strong, x
     
  5. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    Hi LittleFeet,

    I agree with previous posters - and I have read this also - Alzheimer's progresses in stages, and any shock to the system, like a fall, a stay in hospital... will make the disease worse.

    My mother fell from a 1st floor balcony 6 weeks ago and was in hospital for 4 weeks, she did not have major surgery (local anaesthetic only) but the whole incident has definitely set her back.

    Before the fall, we could have sensible conversations with her, now not at all, I feel. She is quite simply confused all the time.

    As for care after the fall, I was also told by doctors that we would have to move her into a nursing home, since her needs are far greater than before. I don't know if she will be able to move back into residential care - not for the foreseeable future anyway. We are paying over 50% more for her care than before. Your father should be eligible for FNC - funded nursing care - but I don't know about other funding. The nursing home manager told me that she has people far worse than my mother and they ae not eligible for HNS funding.

    When my mother was in her local hospital, it seemed that most of the patients in the ortho ward were elderly ladies with Alzheimer's - so sad !

    A friend of my mother's, who cares at home for her husband, told me that every time he goes into hospital for something, his Alzheimer's gets worse.

    I hope you find some answers soon,
    Angela
     
  6. Lady in blue

    Lady in blue Registered User

    Mar 6, 2015
    23
    Sheffield
    You say that your Dad didn't have his medications for a week - is he taking Aricept or something similar ?
    My Mum had her Aricept stopped by the hospital after having several fits. They thought the medication had caused the fits as she has AD but also vascular dementia.
    After her return to the care home and without the medication she became a different woman - throwing things around and really agitated. After contacting the memory clinic I was told that this medication should be weaned down and not stopped abruptly and this could be the caused of the massive change in her condition.
    The Aricept was slowly reintroduced and 2-3 weeks later our lovely sweet Mum reappeared.
     
  7. chrisdee

    chrisdee Registered User

    Nov 23, 2014
    171
    Yorkshire
    Good to hear that Lady in Blue has a positive story, which should give you hope.
    My Mum's story was the more common one, ie hospital stay, hip op. and anaesthetic changed her AD for the worse, and by that time she was edging towards late stage anyway. I think many on here would agree that a fall is usually a major event and that one should normally expect change in the aftermath. My Mum realised, at some level that she was now disabled, hated this as she was never one even to sit down much.
     
  8. Ballykeith

    Ballykeith Registered User

    Aug 26, 2013
    24
    Peterborough
    Watershed

    My mum was still managing quite well on her own, post AD diagnosis - I would just come round to cook dinner - until she reported severe pain in her lower back which left her hardly being able to walk. It took a long time to get a correct diagnosis, a fracture of the pelvis, which we were told would heal of its own accord. She had no memory of falling but this is what must have happened. We had to begin hiring wheelchairs before we were eventually issued with one. With perseverence and resort to indoor & outdoor walking frames which I had to source myself without any guidance, my mum was able to walk freely again within a few months and we now walk miles. Mentally however, this trauma was a watershed for her and I realised that she was now wholly dependent on me as she could no longer direct her life. That is now nearly two years ago and I spend around ten hours a day with her. I've recently brought in a carer for an hour in the morning whilst I'm at work and this has really helped.
     
  9. LittleFeet74

    LittleFeet74 Registered User

    Aug 30, 2014
    14
    Thank you all for your support and replies. I don't think I had ever let myself think about whether Dad would ever need hospital care. The fall was so sudden and has just forced the issue of what further care and support he will need.

    Raggedrobin- thanks for sharing your experience. I am thinking about what you said in terms of going from the hospital directly to a nursing home. I need to discuss this with my brother. Financially, Dad has no partner, my Mum died when we were kids and my Dad raised us. My sisters both have different special needs which is why they are living at home. They are functional to a degree but my brother and I have been looking out for them even though we have our own families. I'll have to get in touch with SS. Thanks again.

    Kevin - thanks also for your reply. No my sisters are not over 60 & the house is my Dad's, mortgage is paid off. He has always said he wanted the house paid off so they would always have a roof over their heads. My brother and I oversee maintenance, pay bills etc but at present they are able to manage the house with our help. Thanks for saying no question is silly, I'm new to the site. I'm still learning.

    Opaline - yes, I asked about a urine infection but I was told he doesn't have one. I guess physically he has been through so much that mentally he can't catch up. It's too quick, it feels like Ian few weeks we have gone from manageable AZ to severe. I feel like we're losing him.

    Angela - my goodness, I am so sorry to hear about your Mum's fall. I can only imagine how hard that would have been for you and her. It's the same with us, before Dad's fall we could a conversation, not all the time but most of the time. He had some awareness of things going on with his grandchildren. Now, he is making no sense at all. Most of the time if he is awake he looks vacant which I am struggling with. We still have no idea when Dad will be transferred to his local hospital or how long he will have to be in, but it's clear it's not great for him.

    Lady in blue - yes Dad is on Aricept. It has been reintroduced so I am hoping we will see glimpses of Dad again. This isn't him at the moment. I'm so glad to hear your lovely sweet Mum reappeared.

    Chrisdee - you are right, a fall is a major event. I think in the last few weeks I haven't had the time to process how major this is. I think I was just trying to get through the surgery and know that Dad was going to survive but hadn't thought about the aftermath. Now I guess I have to face it. Sorry to hear what your Mum went through.

    Ballykeith - so sorry to hear what your Mum has been through. Dad's carer was there when he fell and probably saved his life as she kept him still. Had he moved he could have severed his spinal cord. Sounds like you have done a lot for your Mum, it's good to hear the carer is helping.
     
  10. Raggedrobin

    Raggedrobin Registered User

    Jan 20, 2014
    1,432
    Hi, if your sisters both have special needs there would be a good case for them remaining in the home, people with certain disabilities/illnesses can also remain in homes. Worth getting independent advice as well as talking to social services, as the ss don't always get it right.
    I have been allowed to stay in my mum's house due to my own health issues, although the social services told me I would have to take out a deferred payment plan on it, I did my research, much of it on here, and they turned out to be wrong and the council has let me keep the house without taking a charge on it.
     
  11. Lady in blue

    Lady in blue Registered User

    Mar 6, 2015
    23
    Sheffield
    There seems to be a general lack of knowledge about Aricept and drugs similar in the general setting since they should never be stopped suddenly - clearly this is happening all too regularly and causes no end of disruption and distress.
    Maybe the way forward is educate medical and nursing staff about the effects of stopping such vital medication ?
     

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