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Dementia Symptom or Something Else?
Every test Dad has taken over the last 6 months (Cognitive tests at neurologist, OT tests etc). indicated that he is in about stage 5 what the neurologist termed as "mild" dementia. BUT for months now he has been refusing to get out of bed or to eat much of anything. He isn't able to tell me why though, I just get answers like "I am comfortable". He ended up being hospitalized for dehydration and diarrhea and seemed to get better while in hospital, but now we are right back where we started. The doctors have done a number of tests and can't find anything wrong other then the dementia. I have had them review meds, blood tests, stool samples, CT Scan and Ultrasound. I just don't understand how he is testing so well cognitively, but wont eat or get up. 6 months ago he was able to get up and walk around unassisted and now he is too weak to use his walker. He has lost about 30 lbs this summer. I feel like I have totally failed him and hospice has been suggested.
Has anyone else experienced this??? Suggestions? do I just go ahead and do hospice even though there is nothing physically wrong other then the dementia?
Edited to add that he is on Zoloft and Wellbutrine (sp?) for depression and seeing a psychiatrist.
Diana, you didn't say how old he is and that may change my answer, but
test Dad has taken over the last 6 months (Cognitive tests at
neurologist, OT tests etc). indicated that he is in about stage 5 what
the neurologist termed as "mild" dementia."
My mom is stage 5 and there is nothing mild about it. It is actually, I believe, far more moderate and causes lots of behavioral symptoms. Figuring out which are real and/or concerning is very difficult. Without a lot of background, it sounds like you dad is kinda giving in or giving up. Again, without knowing his age, I may think differently. 75 is very different then 85 or 95.
Diana, 76 is a big difference. It almost sounds like he is depressed big time. He may be on the wrong anti-depressants. Since the physical tests aren't showing anything, I would be totally on top of the neuro and psych. Perhaps the dementia is causing more distress then you think. Does he take Aricept? Does he know he has a memory problem?
Men tend to show symptoms different then women and by telling you he is comfortable maybe he doesn't want you to worry. Does he live with you? Who's watching him?
Is your Dad on any new meds for the dementia?
Something similar happened with my Dad. He is 87 and earlier this year diagnosed with ALZ (although I knew he had it for quite a few years). He was put on 5mg of Donepezil. He seemed to tolerate it well so they increased the dosage to 10mg. Very soon after he seemed weak, often spent the entire day in bed, had no appetite. He would seem hungry but eat 1 or 2 bites and push the plate away saying "I'm just not hungry". This was every day, every meal. he lost a lot of weight, often his BP was too low. The nurse that monitors his daily vitals was concerned (As was I , obviously). I talked to the pharmacist at the VA & his nurse. Even though he claimed his stomach felt fine and said he didn't have diarrhea I felt the meds were upsetting his tummy and that's why he wouldn't eat. They cut back a few of his meds - reduced the Donepezil back to 5mg, cut his glipizide from 10mg in the AM & 5mg at noon to just 5mg in the AM and cut out one of the B12 pills. Almost immediately he improved. He eats well now. He's gained weight. He just seems healthier overall. Hasn't spent the day in bed since.
Definitely have the Drs review his meds. If he's started anything new see if they can cut it down or cut it out all together.
It is important to know the side effects of everything including OTC as well as interactions between the drugs, drugs.com is one site for this.
Our pharmacist told me about this when my husband had a paradoxical reaction to Ativan.
Folks are saying; here she goes again.
I strongly suggest you get, from your library, any book by Naomi Feil with the word Validation in the title. Do read it. It's not easy, but the results may be well worth the time you spend. Absolutely nothing in the method can cause harm.
I did not look up the side effects of zoloft/welbutrine but drugs.com says there is a major interaction;
Applies to: Wellbutrin (bupropion), Zoloft (sertraline)
Talk to your doctor before using buPROPion together with sertraline. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of sertraline, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Aren't they both antidepressents?
When my mom first was diagnozed with mixed demention and lost memory, she didn't want to get out of bed because she didn't know what do to with herself. Her short term memory is like minutes. She as well didn't want to get out and do anything. It was almost a phase she had to go through. It was sleeping aLOT. Finally I just said get up we are going for a walk with the dog (she lives with us as well). And I wouldn't take no for an answer. My mom also had depression, but I figured at least some freash air and looking at trees etc couldn't hurt and it was at least I was trying. After a few times, she was like okay, DOG WALK!! Its amazing what a simple walk and fresh air can do. I know its hard. One thing I learned is to give plenty of time to "get ready" Have a fave snack or coffee, have clothes ready, make sure they are hydrated. If they can go a block do it. Sometimes it takes us an hour to do a mile. But heck, we are out!!
For me it is the balance of repsecting my mom as an adult but knowing she needs MY care...and if it means acting like her mom for a bit, well in the long run, its okay!!
Also I am not dismissing the seriousness of depression, believe me, but I also know that moving the body breathing and fresh air and animals all can help while the rest of the meds etc are figured out
One of the things that also helped with my mom was that she needed to see me more and talk to me more. It was rough, but it seemed that after awhile, she began to FEEL as if I had her back and was making sure she was okay.
This is a tough call because unfortunately they cannot tell you what is going on at all. It's almost like having a new baby and you have to read their cues. We did add an anti-depressant to my mom's meds because I was being pressured from the community to give her something and that seemed like the most benign thing. Interestingly, mom now laughs more. She laughs at her own jokes (which are funny), so maybe that was part of it too.