Is this dementia or depression ? and why cant they give me a diagnosis ?

[mellymoo]

My beautiful Dad, lost my equally beautiful Mum in August 2010. Initially lost and lonely he struggled on. 5 months later he fell ( 1.1.11) and broke his hip, which had been replaced previously, so was a bit of a problem. He was 80 years old.
After his op he spent a while in hospital, as we were trying to get him 'back on his feet' he was sent to a rehab hospital, but got the inevitable infection and was sent back to hospital.
7 months in they sent him home with a care package, it was struggle, and I noticed he was getting very forgetful and agitated. He didnt want the carers help and could be quite difficult, would eat, wash etc.
I asked his doctor to test him, but she said due to the infection he'd had it could be difficult.
Several more stays in hospital ( due to falls) he was again admitted early November. He was very aggitated, stressed, anxious and scared. He hated it, but after a couple of weeks again transferred to the rehab hospital.
We have decided to transfer him to a care home now, so he can be looked after 24 hours a day. He needs that care, I am happy with that. He calls out all the time in the night and needs reassurance, needs help to tranfer from bed to chair and generally has hugh problems with mobility. From being happily married, working part time, active member of a football team commitee, a car driver and very independent he is reduced to this.
Initially I was told the homes I was being referred to were residential dementia homes, this is due to my Dad needing some specialised handling.
I again asked for a diagnosis......
I went to see some homes, and some have some very troubled souls in them. Im noy happy to put Dad in there as Im sure alot of his problems are depression ( who wouldnt be ?) And I dont want him left in a strange place with people he wont be able to relate to.
Finally found a home with 3 floors, residential, first stage dementia and end stage dementia and it was FAB, felt right, was happy to put my Dad there....... on the residential floor, and if things got worse move up a floor !
Social services were soooo relieved, but then informed me there was only a vacancy on the top floor ( end stage demetia) I explained I was not happy as we didnt have a diagnosis........
A doctors called me to say although Dad wasnt diagnosed he definately had a personality disorder and would get diagnosed in the community !!

They let the home come and assess my Dad today, for the end stage bed available, and the social worker had all but packed my Dads bags, when the home callled and said they wouldn't be happy to take him for that bed as he clearly wasn't at that stage, but would be happy to take him in the residential floor. ALthough they didnt have a space at this time, so he could go on the waiting list.
AT LAST SOMEONE AGREES WITH ME !!

They are so desperate to get him out of hospital, they have sent me details of another home to look at, although my mind is set on the one I chose.

At half four today Im told they have a space, and could I rush along and see this home that is ideal for my Dad.......

Its a residential care home................


How do we go from a end stage dementia space to a care home for the elderly with physical disability place.

Advice much appreciated

 

[Petrina]

A lot of that is similar to Dad. Bereaved, falls, coping less.

The problem with diagnosis is that the combination of depression and anxiety can cause similar symptoms to dementia to the extent that there's a condition called 'pseudodementia'. I expect more experienced members here can tell you more.

I think, though, that you are being very reasonable in not being happy with the inconsistency of approach to dealing with your father's needs.

If you want to get him into the place you've chosen, push hard for it. IMO, where social services and mental health services are concerned, they are all overstretched with regard to staff and finance, so you don't have to just need help, you have to need it more than others, so you have to shout loudest. Again, I'm sure more experienced members here can tell you more about getting your father into the most appropriate place.

 

[Jancis]

Hi Mellymoo,
Just wanted to welcome you to the forum. The title of your thread made me recall a thread I posted a while back with a similar title. I tried, unsuccessfully to persuade Social Services and the NHS that my relative was ill with depression rather more than dementia after his wife died and everything went wrong for him. I didn't want him in a residential dementia nursing home as everyone seemed to be completely 'out of it' and although his mental health state was severe (he was very challenging) his state was non-comparable with those residents I saw and talked to. I may have been in denial looking back on eventualities. My relative was certainly very much in denial himself.

I'm sorry to read your story so far with your dear dad - it's hard to sum up quickly what's been going on but your first post gives an excellent introduction and I'm sure you'll get lots of help and advice here.

My first reaction was to suggest you seriously consider the residential home that has a space, to see if you think this might be suitable for your father - putting aside for a while the formal diagnosis.

I found two lovely residential homes that would take my relative but because of his diagnosis (frontal lobe dementia and psychotic depression) his psychiatrist said they weren't suitable. The homes assessed him and disagreed with this view. SS disagreed with this view. But the psych got his way in the end. So if you have an opportunity to look at a wider field of options I would say go for it. But that's only because of my personal experience and it may not be right for you.

If you like the residential home option then you don't have to agree immediately as there may well be other residential homes that you can consider as well. The most important thing is that the home can cope with elderly folk with depression and have trained staff and credentials that can prove this. The symptoms of depression are very similar to dementia. One home I visited was not registered as an EMI nursing home and yet they had successfully rehabilitated several residents who had tried to commit suicide - when I say rehabilitated I mean, made them stable and contented although they still needed 24hr care.

Sorry for my rather rambly reply and hope it might help. Do keep posting to let us know your further thoughts on this.
Best wishes, Jancis