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Hi everyone. I hope you all are going to enjoy some good times yet in this year.
Mom is in the Memory Nursing section of the Independent living community. She has been there for about 3 years now. Dad passed 4 years ago. She has been in her own room (it's a room with a small sofa bed and bedroom furniture but her own place). She has had the level of dementia where she would watch a movie but not remember what it was minutes later. She has been in good spirits through all this but short-term memory has been bad.
About two weeks ago she had an accident in bed. First one. I just learned that since then she now goes most nights and is now having these accidents during the day. They went into her room and she was sitting naked from the waist down. When I talked to her she said she didn't know if she took a shower or not. She says frequently that she has been gone for a year and finally back from hospice. She's very upset that her mother has not come to see her in hospice. The nurse also told me that she is talking about her parents a lot lately.
I mentioned to the nurse that I sense a significant decline in the last week. I just don't know if that is even possible with Dementia. She mentioned that she is not a doctor but she is seeing it as well.


Someone had Covid so now Mom is isolated in her room for two weeks. We can not see her at all. It's heartbreaking.


Can anyone tell me if they experienced these almost "overnight" changes?


Thank you for any input here.


Be and stay well all


Marie

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Yes. My mother has started to wander within her assisted living facility and also has approached a male resident "romantically." This change has all happened in the last month. The isolation has finally driven her over the edge, I think.

Wear a mask. Wash your hands. Avoid large groups. Practice social distancing. We'd all like to see our parents, but here we are----and here THEY are---isolated due to Covid-19 and losing their minds.
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Yes. My father got preoccupied with his parents and got restless a month or two before he passed away. Also contracted UTI.
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Imho, I, too, would suspect a Urinary Tract Infection as others have said. Have her checked for that. Prayers sent.
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I see that you've already taken the UTI advice. Hopefully culture test, not just the dip-stick.

When I joined the forum and read so many comments saying TEST TEST TEST, I was skeptical. When mom had her first UTI (she was notorious for UTIs prior to the move) in MC, she was out of control every afternoon/early evening! Meek, mild, sit-in-a-chair reading paper, magazines, sales flyers mom was fit to be tied, said she had guests coming, had to get out, had to go home, set off every door alarm multiple times! Of course it was Friday night when they called, so we had to wait until Monday morning to see the doc (tried calling, redirected to nurse at hospital, who basically blew me off!) By then we needed antibiotics and mild dose of anti-anxiety until it cleared.

The second UTI showed up as night time bed-wetting. She wasn't incontinent at that time, but often she couldn't get undressed fast enough to make it to the toilet! Her clothes, carpet, etc. I could envision them finding mom naked from the waist down, just for that reason, not incontinence. However, with the second UTI, she'd soak herself and the bed at night. Once treated, all was good again!

NOTE!!
Another person had posted a question and later let me know that HER mother's problem was due to an infection in her mouth, which they did catch. Once treated, mom was back to her normal self! So, it won't necessarily be just a UTI, it could be another infection elsewhere. Blood work might show indication of infection, if the UTI is negative, so consider that too. Definitely ensure everything is checked.

That said, often you do see step-downs in cognition or behavior. We never had the various tests done, there really was no point, as they can't treat dementia (some forms should be identified, as medications can be counter-productive.) Anyway, assumption is mom had vascular dementia. She was on BP meds for as long as I can remember. Even with meds her BP was higher than I cared for, but docs accepted it. Perhaps she had TIAs, we've no way to know.

She was fairly stable and consistent for the first 9 months in MC, then out of the blue she asked about her previous home, not the condo she harped on YB about those 9 months! That home was sold over 25 years ago. At the same time, she became fixated on calling or going to see her mother, who has been gone over 40 years. She also associated her mother with that home. Sometime last year, questions about her younger sister (all are gone, mom was the last man standing, or rather sitting... in a wheelchair) and statements she made clearly put her in that 40 year way back machine!

So, mom made the step down, but remained there for over 3 years, more or less. She was mobile on moving in, and it was 2+ years before she resorted to using a rollator. About a year ago, she refused to stand or walk without help, so she ended up in a wheelchair (mostly her fault for not getting some "exercise", aka WALKING some instead of sitting all the time - staff tried to engage her in activities for this, but she refused! Use it or Lose it!)

It's hard to say if she went back further, as we weren't allowed to visit up close after mid-March. Her hearing and eyesight were not good, so the 2 scheduled visits (one outside, one in a cafe upstairs) were not very good - it isn't clear she knew that I was there, given the 6' spacing and required masks. Discussion with a staff member, when dropping off supplies, indicated she still knew who I was (Oh, her and all those CATS!) and that she was also sad when shown a picture taken of me that I didn't come in to visit. Makes me wish I broke the rules, took the mask off and came closer so she might hear a bit or lip read - I never got the chance to make that close visit. She'd had a stroke early Sept, but was "holding her own", despite it having an impact physically, but given the description from the nurse, it sounds like she had another Dec 15, which was the downfall. Never got a chance to break the rules in time.
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Invisible Dec 2020
Sad for you and everyone else who didn't get the chance to interact with loved ones lost this year. Agreed you need to keeping them walking as long as possible and watch for UTIs. Not much you can do about TIAs. Lost my father also to a stroke in rehab/nursing home. My condolences.
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My husband is in later stages I think. It has been 9 years since first diagnosed. He wants to "go home" which means his childhood home. Recently asked that I call his mother as she needs to know where he is. Also wants to be with his father. Last couple of nights needed to be taken upstairs, which is where his childhood room was. Our house is single story. I also think he may have had a little stroke as his speech is frequently garbled. And he babbles for long period of times. Cannot get him to hush. I have help every morning which keeps me somewhat sane.
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Because of mini-strokes-- which are hard to spot and are caused by years of less than optimal diet and stress-- the plateaus become a quick slide to the next lower level-- we had to learn to live with it-- sometimes I kinda figured it was also due to the level of care and wishful thinking in the facility by the girls( CNAs) who were basically outnumbered by all the patients,, due to the company's slack attitudes toward us who pay out the gazoo (because the facility was not full enough they thought) ! And so my Mother left us all too soon.
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Invisible Dec 2020
My father was the poster child for good health habits most of his life. Liked to exercise and naturally ate the right diet long before popular. Still he had a family history of strokes and he had TIAs. Doctors prescribed aspirin, which worked well for many years until the hospital took it away without telling me after his last fall. Then he had the final stroke. Sometimes I think the medical staff (and CNAs) just follow procedure and wait for the expected outcome.
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Yes mom has dementia since 2010. retired nurse..when has a UTI it gets worse..not drinking enough also. Her declines can been seen weekly..but she is 96. Still walking with walker.
We have cameras in room we can view and communicate daily with her...usually when she not giving them a challenge we know something is wrong... but we all love the old lady...and its her turn for TLC and the home understand we are doing what's best for our Mom. If they had their way if she said no I don't want to get up and eat, shower, or change clothes go to bathroom...they would let it happen. But as we have said she is not dead yet...and til then you will take care of her...neglect is a big thing to watch for with this memory care unit...but we battle with them to just do the job...and they act like its her time to kick the bucket.
Hospice is in charge of that time and we just enjoy the highs and lows of mom days. And I never tire of the stories over and over. Good luck its difficult and different for all loved ones.
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My most recent visit with Mom was heartbreaking. By visit, I mean I was allowed to remove her from Memory Care to take her to a doctor's appointment. Compared to my previous visit, she was much more confused, frightened; had gone from ambulatory with walker to wheelchair confinement. Her memory loss was even worse. Increased isolation because of Covid rules is likely responsible. Poor Mom!
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TrishM Dec 2020
Yes i see that also and in same with mom doctor only thing can get out...lack of contact and one on one visits...she shows decline and its sad they think that it a bubble around unit...I had t o contact the governor office in their lack of cooperation with providing adequate accommodations for as the say end of life...sad 😥
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Hi Marie, I echo the other members who said your Mom may have a UTI. I take care of my almost 95 year old Mom who has alzheimer's / dementia and there have been times where she acted like your Mom.

I would have the nurse check her urine for a UTI. I give my Mom a supplement daily called D-Mannose mixed in juice as it helps prevents UTIs.

Wishing you and your Mom the best,
Jenna
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“Take it day by day” is the best thing you can do when your LO has dementia. One day my mom was basically running laps around me, the next she couldn’t get out of bed. One day she was mocking me for wearing the same leggings two days in a row (she remembered!), the next she couldn’t even form one word. Please be patient with yourself and her during this time. She may seem like she’s severely regressing one day but then give you glimpses of her old coherent self the next day and it can become a nauseating rollercoaster ride. Ultimately it’s a regression but hold on to the moments you two have together (even virtually) in real-time as much as possible.
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Check for UTI.
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I noticed changes in my mom too, who had Alzheimer's. One week, when she was very early on in the disease, she was fine sitting at the eating area at Target, when I did some shopping for a few minutes. The next week, after a particularly frustrating day, ten minutes after I sat her down, (with a snack), I see her looking confused, outside the store. I went to her and said, "Why are you outside? I told you I'd be back in 20 minutes, and I showed you what that looked like on your watch." I continued, "I can't even buy a bra, without having you go outside." Then I turned around and saw that the store had audio and visual surveillance, so I not only told the immediate world (other shoppers) my shopping intentions, but I told the behind the scenes security detail as well. And, out of character for me, I didn't even care. That's what Alzheimer's does: it might strip the patient of memory, but it can strip the caregiver of any sense of propriety and decorum. Before my mom's diagnosis, I would have been mortified re: what everyone heard. Now, I didn't really care.
I even highlighted this episode in a book I wrote called "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale." As the disease progressed, my mom also had the biological issues that you mentioned. The observation that things can change on a dime are right on "Target."
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RedVanAnnie Dec 2020
Love your sense of humor about your an your mother's situation!

Perhaps when you buy your bra, your observers will give you a round of applause.

Your being able to see the humor amidst the difficulties must be a big help in retaining your sanity!!!
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Anytime you notice a sudden decline check for uti it is scary how much they can affect the elderly. Also hospital induced dementia is a real thing and affects pt as young as 60. Although she is not in hospital her Normal routine has changed due to Covid so I am sure she is suffering from that also. God bless her and you as you Travel this journey together.
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Any kind of changes should be ruled out something physical like UTI, stroke, infection, and so on by medical doctor.

Even without UTI, stroke, etc., my mom's Alzheimer's disease did not have anything gradual. She would go on for years at one level then SUDDENLY get a big change. I took her to the Emergency Room and they did EVERY test and it was related to her Alzheimer's disease--because all the tests came back negative. Then that drop becomes the new level for a long time...then another drop in decline.. I also noticed these drops in function happened more frequently as her disease progressed.

Now hospitalization can cause delirium for people with Alzheimer's disease due to the change of routine and excessive stimulation (people, noise, bells, announcements, etc.) They can stay awake for days --- that causes permanent damage. They never do recover from that. Hospitalization of someone with Alzheimer's disease is a risky thing, and their chances of falling are very high. https://www.medpagetoday.org/neurology/alzheimersdisease/33361?vpass=1
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UTI, stroke, other infection, increased stress can all cause sudden declines. This may even be the way that your mom's dementia progresses.
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For my Mom, besides UTI’s, I saw it with stress from a change when I moved in to care for her. Improved when we all got settled.

Then she had a cornea tear and was on an anti-biotic for 6 months to save the eye. The decline was frightening, as soon as they took her off that she started to come right back. Some parts of her brain had changed a bit but she returned for the most part and doing well in early stages again.

Just yesterday she scratched her eye and back to the antibiotics, but now I know and will ask for her to be taken off of them as soon as possible!

so infections and stressful events here in Florida, both improving!
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Please have her urine sample cultured. A UTI (urinary tract infection) can
cause extreme and sudden confusion. In my 98 yo Mom’s case, she’s had
7 UTI’s in the last 10 months. It’s easy to blame it on dementia but if you can identify that it’s a UTI, you can at least treat the infection and not make the dementia worse. The infection effects the brain.

I took Mom out of assisted living and she lives in an apartment down the hall from me with full time care now. I automatically take her urine to the lab when I see a change in behavior.

The assisted living wasn’t good at following up and said they were too busy with covid.....wrong answer.
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Yes. Our Mom has had Dementia for years.... she is 97 years old. The decline actually began over ten years ago after surgery and treatment for breast cancer (it is back). Since the "plandemic" and quarantines, we have noticed a sad, depressing, isolated Mom who is fearful and confused. She refers to the nurses at the home as "they" the "people OVER her"... it is so disturbing! This virus is killing people in more ways than one... the isolation and fear is debilitating to all of us.

As time goes on... they cannot remember you (a daughter), they thank you for calling and enjoy talking to you. I just get off the phone and cry. It is almost as if we would be better if we were freed from this.
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bectwin1 Dec 2020
It is one of the most awful and sad things about this pandemic that our dementia affected people and the people living alone and isolated are suffering so much. Perhaps the good that comes from it will be to point out how much the large number of people living alone, isolated and lonely before the pandemic were actually affected.
Im so sorry about your mother. Is there a special song you could play her, something special between you two?
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My Husband was diagnosed with Alzheimer's. Late, as I learned more I think he also had Vascular dementia as well.
Dementia in general is a decline. Sometimes, like with Alzheimer's, the decline is like walking down a ramp. Slow and steady, a gradual decline. Vascular dementia is like putting a landing then stairs at places on the ramp. You have a steady decline then all of a sudden there is what can be a drastic decline. (I am not familiar with other forms of dementia but most are in general steady declines)
I/my Husband experienced at least 8 or 9 of these drastic changes. One day he could or would do something literally the next day he could not.
The vascular dementia is caused by little mini strokes that will damage a part of the brain. It is possible that your mom is having some of these mini strokes and that is why she is having some of these overnight changes.
Sad to say it is all part of the disease there is nothing that can be done to prevent it.
If this is what is happening there is a possibility that your mom could have a stroke that will take her life rapidly rather than the slow, decline of Alzheimer's.
The only way to verify the mini strokes would be to have a scan done and I don't think it would be worth putting her through that. If it was something that could be changed or cured that would be different.
((hugs))
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Slow decrease in memories and abilities is normal but "sudden changes" should be investigated. Many disease processes can cause this: infections (UTIs especially in women), blood chemistry imbalances, changes in medications, changes in routines (COVID has caused a lot of changes in routines), changes in oxygenation... Almost all of them can be reversed. Please have her evaluated by her doctor soon.
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For some people, their dementia progresses in step-like fashion. For example, they can read a clock one day and cannot remember how to do it the next day. This is particularly true with vascular-type dementia.

Also, sometimes a person has experienced a small stroke - not enough to show up on a brain scan, but enough to impair their thinking or behavior.

Our ability to remain continent of urine and/or feces is dependent on the ability of the brain to send the appropriate "signals" to the bladder or bowel. If the part of the brain that controls these functions is affected, then incontinence can result.
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bectwin1 Dec 2020
Exactly. In fact, vascular dementia IS a series of often teeny tiny strokes presenting with dementia worsening in little steps which is one of the ways of differentiating it from other forms.
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great point!!! Thank you
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Especially since there are both mental and physical changes here there needs to be a urinalysis done right away. I would request they do a culture and sensitivity. It is rare, but for some the bacteria aren't found until these tests are done.
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Murphy18966 Dec 2020
Done. Put in the request . Thank you
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I would be asking for a urinary tract infection test. It could be something as simple as a UTI. Everything that you are describing could be attributed to this.

I pray that it is easily treatable and if it is her time, I pray that she has an easy passing.
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Murphy18966 Dec 2020
Having her checked. It is so sad.
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Yes, changes like this mean your mother has taken a 'step down' with her dementia. They can go along for quite a long time displaying certain behaviors and nothing new. Then, one day, they step down and get a lot worse, with no warning. I've seen it several times with my own mother who also lives in a Memory Care AL and is 94 next month, with moderate dementia.

It could mean that she's had a stroke, or, as is always said here, a UTI. Barring a UTI which is easily checked for, it could be that she had a stroke which happened with my mother but we didn't know it at the time. We found out the following year when she was hospitalized and a CT Scan and MRI were done. Not that there would have been any treatment undertaken for the stroke had we known about it.............but it did happen and it did contribute to her decline in mental cognitive ability.

As far as 'accidents' go, I assume you mean urinary incontinence? One day, my mother was fine, going to the toilet on her own, etc. The next day, we were riding in the elevator at her AL, and she said Oh I Have to Pee. Next thing we knew, she did, all over herself and the carpeted floor of the elevator. From that moment on, she started wearing Depends, day and night. So yeah, it happened overnight the change from being fully continent to being incontinent. She wets the bed (at night) at her ALF now several times a week.

Steps down, or declines, with dementia are to be expected. There are 7 stages of dementia, and here is a link which is helpful:

https://www.dementiacarecentral.com/aboutdementia/facts/stages/

Speaking of deceased loved ones is common too. My mother seems to dream of her mother quite often. At first, I thought maybe it was a sign that she was getting ready to pass away herself (which is sometimes common). But, since this has now been going on for a few years, that's not the case.

It's also common for dementia patients to remove their clothing, or actually defecate on the floor sometimes, thinking it's the toilet. When I worked in a Memory Care AL before the plague hit, I'd often find a resident with his or her pants off wandering the hall. Sometimes they'd leave a pile on the carpet, too, and I'd have to call a care giver. One time an old gal was pooping on the upholstered chair in the hallway, happy as can be, with a big smile on her face!

All bets are off with dementia. It's a sad and unfortunate progression they're on, our mothers, and it's hard for US to witness. I'll vouch for that myself. If your mother is basically happy, though, and in a pretty good mood, that's all that really counts, you know?

Wishing you the best of luck with a most difficult situation, and wishing your mother PEACE as she proceeds on her journey
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Murphy18966 Dec 2020
Your recounting of your mom sounds just like her. I thank you for this. It is so hard to believe this change. Thank you
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Overnite changes can indicate an advancement in the symptoms. Once UTI is ruled out you can assume the change is dementia related. Yes, although dementia symptoms come on quite slowly, a day to day change is not unusual. For instance, she knew who you were yesterday but today you're a stranger. There is no “almost know you” stage. In fact, she may think you are her mother. Her speaking about her parents is also very common. It's good that she's in good spirits. When she talks about her parents go along with her reality don't remind her that they are deceased. You might say “tell me about your mom and dad”. Then you can expand the conversation or redirect her.
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Murphy18966 Dec 2020
Thank you for your insight and how to respond
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I agree with checking her for a urinary tract infection first and foremost.

That said, I've found that my own mother's decline hasn't been all that gradual by instead seems to go in significant steps downward, then she levels out at the new normal before taking another step down. These are usually connected to significant shocks to her system, whether health-related or emotional. She took a big dive (her first) when she had a major health issue back in 2014. She had another hospitalization in 2017 and a subsequent decline, then she went down again when my dad died a year after that. Now she's been fighting an infection in her leg since September, and she's taken a deep dive yet again.

Rule out the UTI first, but she may need to be moved to a higher level of care.
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Murphy18966 Dec 2020
I wish you luck with that infection. Thank you for your response
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Hi Marie, whenever someone says that cognitive/behavioral changes happen very rapidly or overnight, it is suggested that this person be checked for a UTI. Elderly women get the very often and in spite of good hygiene and water consumption practices. Often in the elder, a UTI can have no other symptom except cognitive/mood/behavioral changes. It's easy to diagnose and treat with antibiotics. If she does have a UTI you can pretty much anticipate it won't be her last. If left untreated it can cause sepsis, suffering and even death. Talk to the lead nurse on her floor today to get her checked. Even if it's not a UTI, you'll know it was discounted.
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Murphy18966 Dec 2020
Thank you.
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