Gradual or sudden decline

[Linbrusco]

From Mums diagnosis in 2013, until she went into care 2016, I would say her decline was gradual.
I did however notice when she had a UTI, there would be the odd random thing that was new, and she had several in the space of 4 mnths.
Mum was free of UTI's in first 8 mnths in care and a gradual decline.

Since March/April shea had 2 UTI's and never been the same since.
Agitated, anxious and angry majority of the time. Staff did a whole raft of different blood tests to rule out all possibilities.
A month ago they started her on 0.5mg of Lorazepam upon waking.
It did help greatly with her mood, but we found after the first week, she was sleepy and often her speech didnt make sense.
Her agitation was less , some days worse than others.

Staff told us that even prior to the Lorazepam, they were helping her now totally with showering and dressing, and she was semi incontinent. Forgetting steps when going to the loo, with wiping and flushing.
Ocassionally they were having to help her eat & drink.

Now with the Lorazepam, which they have increased to 1mg, which is very low still, Mums mood with us at least , is very flat. She is considerably confused, never asks about anyone now, and her speech unless short sentences does not make sense.
They have had a gastro bug at Mums care home, and has reopened today for visitors today after 2 weeks. My sister and I were there for lunch, and were quite shocked at how Mum really didnt know what to do with her knife and fork, wrapped some of her lunch in a serviette and attempted to pour her drink in her food. Mum did recognise us though, and called us by name.

Nursing staff and GP, are saying Lorazepam aside, it may just still be sudden progression of Mums Alzheimers?
If your PWD has a sudden decline what caused it?

 

[Selinacroft]

Hi Linbrsco
Sorry to read of your mum's sudden decline. I have experienced similar with Dad, his rate of decline always increases after UTI. He had 5 months hospitalised for UTIs and infected leg leading to sepsis earlier this year and has never picked up properly since coming home. He's been on anti biotics either by drip, canular or tablets for months on end.
Like your mum , he had anxiety, hallucinations, verbal aggression, shouting and calling all through the night and general cantankerousness. He's been on Mirtazapine now for a couple of weeks, much more subdued but another drop in ability and decline dementia wise.
It seems hard to work out cause and effect in the end. Infection, dementia, behaviour, medication changes , all seem to go round in a constant loop of decline. Sadly the Drs really can't do anything and just trying to tread water lessening the latest symptoms.

 

[Georgina63]

Hi Linbrusco

So sorry to hear about your Mum's decline. It's heartbreaking to watch isn't it? I would say with both Mum and Dad the decline has been gradual though is marked by very significant milestones, losing the ability to do or recognise certain things. In Dad's case talking to the people in a reflection is the latest thing. They both seem 'diminished' and I have been searching back through photos to remind myself how they once were as I feel I'm Finding it hard to remember how they once were In some ways this is a comfort, but also highlights the sense of loss. What has helped, is having a lovely recent photo of each of them, taken on 'good visit days' and I like to hold that picture in my mind. Sorry again, take care, Gx

 

[Linbrusco]

Thanks all.
After talking to the Dr they were going to up Mums Lorazepam from 0.5 to 1 mg in the morning but now increasing her nightly dose of Nortriptyline of 5mg to 10mg. Mum has been on this for 4 yrs as a muscle relaxant/pain for pelvic & bladder spasms which is also an older anti depressant but she has tolerated well.

She has been somewhat less agitated and out of her room more engaging with others which is what you want to see but with us her mood is flat, shes sleepy and as said her speech doesnt make sense unless in very short sentences.
She also seems a bit more disconnected to us, less talkative and I wonder also with her speech if shes aware so not saying much?
My sister says she hates seeing her like this but really what is the alternative. Agitated angry and anxious when were not there ( and sometimes when we are) bordering on being distressed, but a bit more talkative and engaged or calmer but sleepy and confused with her speech.

As the GP said its a fine line trying to find a happy medium and what works with the least side effects?