My Dad's Swift Decline After Respite

Is this a common condition of dementia?

  • Yes

    Votes: 6 50.0%
  • No

    Votes: 2 16.7%
  • Not sure

    Votes: 1 8.3%
  • Can not give an answer

    Votes: 3 25.0%

  • Total voters
    12

marinaporto

Registered User
Mar 29, 2008
3
Hi all,

I am new to your site and I will just say it how it is so here goes:

My dad is 74 and was a heavy smoker all his life he gave up a few months ago, however about 4 years ago he started to have memory loss, and was diagnosed with depression. He would rarely go out of the house and recently started to night walk.

As a break for my mum, dad went into respite for a long weekend about 3 weeks ago, after 3 day of his rest he became quite animated and confused/agitated he was suffering with 2 infections, one on his chest and one on his bladder.

He was sent to the local general hospital and was dehydrated on arrival and extremely confused/agitated, and had been given the wrong medication dosage at respite.

He has been in this general hospital for 2 weeks now and was diagnose with vascular dementia & COPD, and has suffered several mini strokes some time a few months ago. (This was detected on a CT scan he had in Oct 07).

He is getting extremely good care for his conditions in the general hospital, however I have concerns that he will need expert treatment in the future.

My biggest worry is the speed in which his deterioration has come about, he has not eaten for over 2 weeks and rarely sips fluids, around 100 mil a day at most would be accurate, (he is on a glucose drip and medication and has been catheterised). He is often sedated due to his aggressive outbursts and delirious state.

3 weeks ago I could have a relatively normal conversation with him albeit occasionally with a little forgetfulness and occasionally muddling his words.

Can some one please let me know how common is this and his long term options, I know that you are unable to give me any diagnosis of his condition, any support and comments from your own experiences would be appreciated in order to help me and those who care for him; help my father, and have a grater understanding of what has happened and his future options.

Many thanks.

Marina
 
Last edited:

connie

Registered User
Mar 7, 2004
9,519
Frinton-on-Sea
Hi Marina, sorry to read about your dad.

Swift decline: yes with some people this can happen. Others it is a very long drawn out process.

: Not necessarily connected to respite. Sometimes downward treand are picked up more easily when they are away from home.

You ask :
Can some one please let me know how common is this and his long term options
No one can answer you on this.. Members will come along and can tell you how it is for their loved one, but each and every person suffering from dementia illnesses is different.

Am sure however you will find some answers here on TP, and certainly plenty of support.
 

barraf

Registered User
Mar 27, 2004
308
Huddersfield
Hello Marina

I only know one person who suffered a rapid decline similar to your dad and that was at home not in respite.

He was sent to the local general hospital and was dehydrated on arrival and extremely confused/agitated, and had been given the wrong medication dosage at respite.
Peronally I would be looking for another home for any future respite, I always take in a written list of requrements, including medicatiom each time Margaret goes into respite. It may not be foolproof but a bit of prompting doesn't hurt.

Cheers Barraf
 

Skye

Registered User
Aug 29, 2006
17,000
SW Scotland
As a break for my mum, dad went into respite for a long weekend about 3 weeks ago, after 3 day of his rest he became quite animated and confused/agitated he was suffering with 2 infections, one on his chest and one on his bladder.
Hi Marina

Your dad's rapid decline may be due to his infections. I had exactly the same with my husband, and he had to go into care as a result.

Infections can cause severe confusion in people with dementia. In most cases they recover to where they were before, but in other cases, like my husband, the damage is permanent.

I would suggest you make an appointment with the consultant to discuss your dad's condition and likely outcame.

Certainly don't agree to his discharge with out a full review and a care plan form SS.

All the best,
 

Margarita

Registered User
Feb 17, 2006
10,824
london
I would have to say I am not sure .


Even thought when my mother gets back from respite she does seem to decline .


My mother been going to respite for the past 2 years , so I am not sure if the decline would of happen anyway & its just more noticeable because she been away from me for more then a week .


where if she was at home with me all the time I would not notice it, as they do say that a change in environment with someone that has a dementia does effect they mental stability, but would that bring on a mental decline that I have seen in my mother when she come back from respite I am not sure .


As a break for my mum, dad went into respite for a long weekend about 3 weeks ago, after 3 day of his rest he became quite animated and confused/agitated he was suffering with 2 infections, one on his chest and one on his bladder.

I must say that when my mother had her first few respite she was very confused/agitated,ringing me all the time from care home to come to visit her which I did . but it was not due to an infections.

now two years on she fine when she in respite , its only when she gets back home to be that I notice a change in her .


do you think that your father could of had the infection in the bladder anyway & it was only going into respite that brought more attention to it , because they found he was becoming more confused/agitated, meaning brought awareness of it , so he got teated for it ?



because when they find my mother more confused/agitated at day centre they always ask me to test mum for bladder infection which always come back negative. and it always tie in when she gets back from respite .
 
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TinaT

Registered User
Sep 27, 2006
7,095
Bolton
Sorry but I can't read what I'm supposed to be posting about. Can anyone help? I have the yes, no' bit to click onto but not what it is about which I presume would be above this.
xxTinaT
 

hendy

Registered User
Feb 20, 2008
506
West Yorkshire
Hi Marina
Sorry to read about your dad's decline whilst he was in respite. May I ask how you know he was given the wrong medication? Did the respite home say he was dehydrated? Did the respite home send him to hospital? Sorry to ask all these questions. It might be useful to other members if they get an accurate picture and can give you more help. Hazel is right, the infections will cause further confusion and may also have contributed to the dehydration.
Whatever happens though, you should be able to get the advice you need from the consultants, nursing staff etc. Keep a note of any questions you need to ask them.
take care
hendy

ps is there meant to be a 'poll' at the beginning of this thread? It is rather confusing.
 
Last edited:

Margarita

Registered User
Feb 17, 2006
10,824
london
you click your views on the poll , then your see the results & then you post what you want to write ( type ) . that how I done it anyway
 

marinaporto

Registered User
Mar 29, 2008
3
Questions

Hi Hendy,

I was informed by the medical team at the general hospital he had been given the wrong dosage of medication whilst in respite.

The general hospital told me he was dehydrated when admited to them from respite.

Yes the respite discharged him to the general hospital A&E due to his decline in condition.

Thank you for your support and help.

The poll was a way of getting some form of general feedback to my dads condition.

Marina.

Hi Marina
Sorry to read about your dad's decline whilst he was in respite. May I ask how you know he was given the wrong medication? Did the respite home say he was dehydrated? Did the respite home send him to hospital? Sorry to ask all these questions. It might be useful to other members if they get an accurate picture and can give you more help. Hazel is right, the infections will cause further confusion and may also have contributed to the dehydration.
Whatever happens though, you should be able to get the advice you need from the consultants, nursing staff etc. Keep a note of any questions you need to ask them.
take care
hendy

ps is there meant to be a 'poll' at the beginning of this thread? It is rather confusing.
 

marinaporto

Registered User
Mar 29, 2008
3
Yes that is correct

Skye,

yes you are correct, I was trying to find out if this sudden decline is common.

Thank you for your contribution.

Marina.,

Tina, I presume it's whether anyone has experienced a sudden decline as a result of respite .
 

Clive

Registered User
Nov 7, 2004
716
Mum never went into respite so possible my experience isn’t relevant.

Mum did have a fall and the A & E doctor kept mum in hospital overnight for observation.

Early next morning (before 9 o’clock), and with no reference to me, mum was transferred to another hospital and placed in an assessment ward under what I believe they called the “Delayed Discharge Act.”

After 11 days I managed to get mum back home after proving she had a minimum of 3 professional care visits a day plus me. (I suppose I was expected to put her in a Home).

There was a big step change in mum’s ability in the 11 days. Before she went in she still knew she was in her own house and could still make tea and biscuits, dust and clean etc.
After she came back from the assessment ward mum could not differentiate between tea bags and biscuits and could no longer recognise that she was in her own house.

Clive
 

Margarita

Registered User
Feb 17, 2006
10,824
london
Read this http://psychservices.psychiatryonline.org/cgi/content/full/54/6/821

Effects of respite care on patients with dementia



Although inpatient respite care provides a break to caregivers and reduces their sense of burden (8), there is some concern that patients with dementia can undergo a further decline after relocation from one environment to another (9). In clinical practice it is not uncommon to observe exacerbated confusion, increased disruptive behavior, and accelerated deterioration of self-care abilities among older adults with dementia who are in an unfamiliar environment. When patients return home, a similar decline during a period of readjustment may impose a greater burden on caregivers than before patients were admitted for respite care.

Two studies showed that inpatient respite care for patients with advanced dementia might cause a temporary decline in both functional and behavioral status after the patients' return home (10,11). These studies also found that patients with the most severe impairment tended to deteriorate the least, whereas patients who were less impaired deteriorated the most. Homer and Gilleard (11), in their study of a mixed population of patients with and without dementia, found a notable association between the absence of dementia and a lower level of social disturbance created by patients during the respite stay.

The greatest improvement in functioning was observed among patients without dementia who were being cared for by highly stressed relatives. The patients who did have dementia did not improve in functioning as much as the patients who did not have dementia.