Extremely quick deterioration in my dad.

Discussion in 'Memory concerns and seeking a diagnosis' started by Ozzy71, Nov 23, 2015.

  1. Ozzy71

    Ozzy71 Registered User

    Nov 23, 2015
    26
    Hi
    I've spent a long time reading the forum and all of the excellent advice.
    My lovely dad is 73. Gradually over the past few years he has become forgetful, got lost easily, struggled to find the correct word for something and shown less interest in conversations. He was still keen to walk, spend time with the grandkids, watch t.v and take the car on short journeys but had given up with reading as he couldn't follow the story.

    Last week he went into hospital with pneumonia, the hospital thought that his memory was poor but thought he might have had a mini stroke and put him on a stroke ward for further investigations. ( Dad had pneumonia in Feb and also suffered from a mini stroke at the same time and was disorientated for about a day.) on Wednesday dad had a ct scan and after deciding he hadn't had a stroke, they discharged him.

    Dad was completely disorientated when he got home, he was crawling along the floor, wouldn't speak, was distressed and couldn't remember anything. He didn't seem to know where he was. He was readmitted to the stroke ward. Since then he has been wandering around the ward, fidgeting, feeling very anxious, can't remember anything, just seems to have suddenly lost his short term memory. He can dress himself but can't find find his clothes. He is stealing the belongings of other people on to the ward. If he steps away from his bed he can't find it. He asks the same questions over and over again.

    An OT contacted mum today and asked if she had enough support at home to have him there. Mum asked what kind of support and she said he would need 24 hour care. She talked to mum about a package of care they would provide. I don't understand why they are talking of a package of care but trying to discharge him without a diagnosis.

    We are very confused. He is on a stroke ward but they have said they don't think he has had a stroke. I live far away and won't be able to get to the hospital til the end of the week. My brothers are there everyday with mum but no one offers or seems to be able to provide a diagnosis, possible diagnosis or reason. My brother spoke to the ward sister tonight and she said they will give him an MRI tomorrow.
    Through reading this website I think he is showing the signs of dementia but am not sure how he could have deteriorated so much in a short space. This time last week he was picking up his grandchildren from school! Can anyone tell me if such a sudden deterioration is possible?

    We have no experience to draw on so if anyone can offer us any advice we would really appreciate it.

    Thanks in advance
     
  2. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,739
    Sudden deterioration like this is not very common - have they checked to see if he has a urinary infection - the behaviour you mention is often displayed when someone has an infection. They would normally check this as routine but these days i have less and less confidence so i would definitely ask. Is he drinking enough? Dehydration has a big effect on confusion, but to be honest not as much as you are describing. It isn't typical of any stroke I've ever come across either!

    Earlier someone also mentioned deficiency in Vitamin B causing problems of disorientation - i dont know about this but someone else might

    I think they need to speak to the consultant and tell him/her that this time last week he was picking the grandchildren up from school and only had slight memory problems. This is really key information and they might be just assuming that people are in denial about his previous ability - it would be worth making a list of all the things that he was doing regularly without help just 7 days ago. I would insist that they find out what has caused this massive deterioration before discharge.

    Welcome to TP, keep posting, lots of support on here
     
  3. Ozzy71

    Ozzy71 Registered User

    Nov 23, 2015
    26
    Thanks

    Thanks that is great advice. Will definitely do those things tomorrow :)
     
  4. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,739
    you are welcome, i'm sure others have other ideas too but pls let us know what happens x
     
  5. canary

    canary Registered User

    Feb 25, 2014
    10,531
    Female
    South coast
    Things like a general anesthetic, or an infection of any sort is known to advance the progression of dementia - often quite quickly. I saw this with my mum (after norovirus, not admitted into hospital) and my MIL (after a fall resulting in a fracture needing a general anesthetic). In both these cases the family had not been aware that there was dementia - just thought that they were becoming a bit forgetful. With hindsight I now think that they were both showing symptoms for several years, but people with dementia are often able to "hide" their dementia symptoms for a while if they have visitors, or have to see professionals.

    TBH, the things that you describe about your dad - the getting lost, the not being able to follow the story when reading, the forgetting of words and difficulties with conversations - could be compatible with early/moderate dementia. If this is so, then its probably the pneumonia that has caused the sudden progression.

    This is, however, speculation - it may not be dementia. He needs the proper testing - scans etc and blood tests to rule out vit B deficiency
     
  6. sue38

    sue38 Registered User

    Mar 6, 2007
    10,856
    Wigan, Lancs
    The pneumonia itself is an infection which could have caused the deterioration. Added to that being in an unfamiliar environment will most likely have exacerbated the problem, but it's also worth asking for him to be tested for UTI as Fizzie has suggested.

    Have a look at this factsheet on hospital discharge https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=173
     
  7. Ozzy71

    Ozzy71 Registered User

    Nov 23, 2015
    26
    Thanks

    Thanks Canary and Sue. We thought his prior memory problems could be the start of something. Perhaps the pneumonia has progressed it. I will talk to the hospital today and make sure they know how sudden the change is. I will ask them to rule out a uti and vit b deficiency. The fact sheet is really useful too.
     
  8. Ozzy71

    Ozzy71 Registered User

    Nov 23, 2015
    26
    Update

    We now know that dad has actually had a stroke. I asked about uti and dehydration.
    Although he hasn't got a diagnosis yet, the hospital are saying they suspect he has dementia. It would appear that the stroke/and or pneumonia have accelerated the severity of his confusion and memory loss dramatically.
    Unknown to us, his GP had referred him to a memory clinic a few weeks ago during an appointment about something else but it was never mentioned to my mum???

    The doctor said his memory test score was extremely low but I don't know what it was.

    The sudden change is traumatic. although dad appeares quite cheerful, he spent the whole afternoon and early evening doing the same things over again. Opening his locker, taking out toiletries asking what something was, putting it in a bag, taking it out, asking about it again, putting it somewhere else. Then he goes to another bed if he can and hides the things or takes things from other people but then can't find his own bed. He was also going into little trances and ' shuddering' and also commenting on things we couldn't see such as animals on the wall. We were trying to distract him but he seems to be fixated on this.

    He had the odd moment of apparent clarity, he could tell the time etc but his ability to hold a conversation has gone. He just speaks sentences and phrases that make no sense which we just played along with and agreed with him as this seems the right thing to do but it's just something we have no experience with. He used to walk a lot prior to this so I thought his walking about and fidgeting might be because he isn't getting exercise. My brother has been allowed to take dad for a walk around the ward but they were not keen to let him out of their sight.

    He is doing this through the night too and so the hospital are saying they are not sure if he can ever return home to mum. Mum is physically quite weak and dad is the one who has always looked after her until last week. My understanding is that they have asked us to decide if we think we can take him home but will have to find someone else to be with mum or whoever has him all the time or decide to put him into care. We don't really know the options yet... It's just so sudden.

    Im really sad because I don't know what he is thinking inside. He doesn't appear to know he is confused but I don't know if he is sad or worried. I hope not. He was crying at first but hasn't for a few days. I think I need to keep reading as much as I can on here and elsewhere to help him. He has been such a great dad to us all.

    Sorry for the self indulgence of this giant post - just trying to process it I guess.
     
  9. Ozzy71

    Ozzy71 Registered User

    Nov 23, 2015
    26
    Memory test

    Just found my notes. His memory test score was 4.
     
  10. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,486
    Female
    England
  11. Ozzy71

    Ozzy71 Registered User

    Nov 23, 2015
    26
    Thanks

    Thanks for this. It was really helpful and we are more aware of the procedures from the ward.
     

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