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My dad is 74 and had the symptoms of early dementia. But, still used a walker, fed himself, had conversations (although he might forget them) and could answer questions and even sometimes could cook a small meal. He also has diabetes, heart issues, and TIAs from a stroke 20 years ago. He had a major TIA 2 weeks ago and fell. He was alert the whole time and refused the hospital when EMTs came. He is a large man (300lbs). He went down rapidly after the hall and in 3 days he had another fall out of bed this time and we insisted on the ER this time. They did a CT to check for stroke (none) but found 2 broken vertebrae in his back. They held him for 4 days and then referred him out to skilled nursing rehab (in a nursing home). Since the day in the ER a week ago, he has declined rapidly. Cannot focus to answer questions or feed himself. Sometimes recognizes us but sometimes night. Sleeps a lot, like deep and unable to rouse. They did discover that he is a Co2 retainer in the hospital and he fights a cpap to blow that off so we aren't sure if we are dealing with dementia or a build up of Co2 in his system. We just didn't realize that dementia could progress so rapidly in just a week's time.

Pain medication to treat his injury can cause a worsening. So can the dramatic change in environment and people.
My mother in law had mild dementia, injured her back, went into the hospital and was given pain meds. She hallucinated and afterwards her dementia rapidly progressed.
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Reply to JanPeck123
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Maloneym2 Oct 24, 2024
Exactly what happened with my husband!
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Even in her 90's my mom was fine and living on her own until she had a minor fall, looking back I think that was just the final straw and she had been very gradually declining without us noticing. Mom did recover somewhat after her initial decline but she never returned to her baseline.
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Reply to cwillie
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You really cannot have any concrete answers here as to exactly why the changes. But do know that an occurance such as this VERY COMMONLY causes a rapid progression. Hospitalization is very difficult for someone with dementia, and hospital induced psychosis is common. Many patients improve when back in their own known living quarters. Many DO NOT improve. TIAs also may damage the brain in ways that do not show up on MRI or CT scanning. The CT scan rules out a bleed ( it is almost worthless in stoke itself that is non-hemorrhagic). But often does little else. TIAs are known as "mini strokes" and do damage the brain over time. Some dementias, in fact, are thought to be primarily driven by vessel disease in the brain.

I am afraid, with dementia, you have entered a no-man's-land of very few answers and a whole lot of questions, and it seems my pounding along on my keyboard every a.m. here amounts to a "who-knows?" more than anything else. Your best answer or your best guess will come from the neurologist seeing Dad at this time.

I wish you good luck.
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Reply to AlvaDeer
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Every time your dad has a TIA that does more damage to his brain so of course his dementia is now worse.
And often it is a fall that will be the demise of a person as well.
Plus if he's hit his head in his falls, that could cause a brain bleed which isn't good either.
I'm sorry that you're going through this with your dad. Just enjoy whatever time you may have left with him.
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The damage from TIA can take a bit to show up.
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Reply to Southernwaver
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Sophie23, welcome to the forum. My Mom (98) had a fall with head injury, where her primary doctor insisted she hire a caregiver to help her. Mom refused saying my Dad could catch her if she were to fall. Mom was in denial of Dad's age and his now abilities. Oh, while Mom was in the hospital, she did experience delirium but that went away once she got back home.


Then later my Mom had another serious fall that included a second head trauma. She was sent to a rehab center where she stayed for a couple of weeks, then she moved into the center's skilled nursing facility. Within weeks of her fall, her mild dementia was now in later stage. She could no longer walk, nor recognize us on a regular basis. She now needed a village to care for her.


I, too, was amazed at how quickly everything transpired. There were times where Mom's brain would loop to understanding some things. She thought she was in a motel in a town where her parents and siblings were living. I had to think of "therapeutic fibs" any time she asked to go visit her parents or siblings. Such as asking to see her parents, I would say "they are visiting the old country" and Mom would smile saying "that's nice".
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JanPeck123 Oct 20, 2024
So sad. I believe that the environmental change was the cause of the rapid decline. My MIL had more cognitive difficulties when we moved in to her home to be her caregivers. It was back in the 1990s and we knew very little about Alzheimers. When she went into skilled nursing her decline progressed even faster.
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HighCO 2 and sleep apnea can contribute to disorientated and difficulty waking. His huge weight contributes to the problem. That might be why he was falling. Many normal people and those with dementia do not tolerate the cpap or bipap (which is less so tolerated if with high pressure settings) He needs to lose a lot of weight and fast.

Does he still have a quality of life? Does it look like he will walk again? It could also be delirium from the hospital stay. The spinal fractures and obesity will be hard to heal.

One thing you can ask about is Wegovy or similar med to bring his weight down. After all he is a diabetic. My friend's sister was 350 lb. She is now in LTC but is using the med to help her move around and take pressure off staff to get her up. Another option is to also ask about a hospice consult.
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Reply to MACinCT
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Yes, I noticed that dementia was worse whenever there was anything going on that prevented total focus on the current activity.

For instance, my Mom could no longer walk and talk. It took all her concentration to walk...she could listen, but forcing her brain to think of the words then voice them, required her to stop, voice her words, then walk again.

I'm glad you are noticing....look past the dementia to figure out what is interfering with brain concentration and try and take care of it. As you alleviate one issue after another, the brain will be less distracted and the dementia will be less noticeable. (and the lack of sleep...yes, that is an issue. However, try to find out why his sleep is interrupted. Is there pain somewhere? Does he think he has to urinate? Is he hungry? Is he thirsty?)
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Reply to ChoppedLiver
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The major TIA could have caused confusion, sleep, and the falls. The blood and oxygen are not getting to parts of his brain. I'm surprised the ER found no sign of a stroke. I'm not familiar with the effects of Co2 buildup.

HIs dementia could have been getting progressively worse, just not noticeably to you, until it was.

In any case, the doctors should be figuring this out. And in his current condition, it sounds like he will be unsafe to return home. He can not stay indefinitely in rehab, but can be transferred to a skilled nursing facility for long term care, if he doesn't improve.
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Reply to CaringWifeAZ
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It can be Co2 poison. Our bodies at 74 don't do well on straight Co2. I would think he is now on concentrator which is more air as apose to just Co2. If he's in rehab medicare is paying. Does he have medi-cal/medicade? If not please apply for it now. Don't let the rehab tell you times up medicare no longer paying. So pay cash or go home. You can tell facility he needs to go long term medicaid. What every you do don't take him home if you can't care for him. (Regardless the reason) it is very difficult to get him back in to a skilled once you take him home. Mostly it's his weight that will be an issue to return. The facility has posters for the Ombudsman please call them for any issues you may have. It's a free service the state pays for.
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