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cxmoody Asked July 2022

Today’s fall. Any ideas?

My mother, with severe dementia, fainted once again.


She gets woozy, slides to the floor, and loses consciousness. It’s become routine for her.


Most times, her MC facility just handles things, but today, they called me in case I wanted to come over.


Today, though, she lost control of her bowels, which is new. She needed a shower/cleanup, which they handled.


My question is about another new symptom. After Mom regained consciousness, her eyes were stuck in a rapid side to side motion for a minute or so.


As she is on palliative care only, her hospice nurse didn’t order any testing, which is fine by me. Of course, I know that you all are not her doctor. But, I’m wondering if anyone has had experience with this new symptom? What could cause that rapid side to side eye motion, and how is it related to her loss of consciousness?


Thanks in advance.

97yroldmom Jul 2022
So perhaps it was the fall that caused the eye movement?

https://www.flintrehab.com/nystagmus-after-head-injury/

Nystagmus can also be from a fall or damage to the portion of the brain that knows which position the eyes belong in.
Interestingly the vision is not affected if I understood what I read in the link above.

This link says that many with Alzheimer’s can’t read due to affected eye movement.

https://pubmed.ncbi.nlm.nih.gov/21149116/

Hoping your mom is not in any pain.

EmotionallyNumb Jul 2022
Has her heart been checked recently?
cxmoody Jul 2022
I haven’t had her heart checked, as she is on Palliative Care/Hospice. She has severe dementia, and I don’t want her on any life-extending medications. She has a MISERABLE life, and I don’t want to extend it further. 😢

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lealonnie1 Jul 2022
Just ask the MC to help mom out of bed every morning. If she has a bed alarm, they will know the moment she tries to get off the bed. Of course, it could be too late for the CG to get to her BEFORE she's fallen or fainted, but it's worth a try. Mom fell constantly by trying to get out of bed on her own. Also, hospice put a bolster pillow type thing on mom's bed to prevent her falling out/getting up alone. Does your mom have one of them on her bed? If not, I highly suggest it. It kind of 'cups' her in the bed with soft sides; hard to explain. It's like this:

https://www.amazon.com/Prevention-Bolster-Mattress-Defined-Perimeter/dp/B07X5F5P54/ref=sr_1_47?crid=2VFLUUBYYO7U7&keywords=alzheimers+bed+bolster&qid=1656807492&sprefix=alzheimers+bed+bolster%2Caps%2C146&sr=8-47&ufe=app_do%3Aamzn1.fos.08f69ac3-fd3d-4b88-bca2-8997e41410bb

Hospice put one on mom's bed and it stopped her getting up alone.
cxmoody Jul 2022
I’ll put this on the list to speak with her docs and the MC about. 🙂
graygrammie Jul 2022
Did you see your mom today? I'm wondering how she is today compared to yesterday. Is it possible she is getting our of bed too quickly? She should sit on the side of the bed for a few minutes before rising. I know, hard to expect her to remember that.
cxmoody Jul 2022
I know that that’s exactly what she does. 😩

She gets out of bed, and flies, then staggers across the room.

And, you’re right. Mom can’t remember a minute ago, and even less, a direction like that. ☹️
Sendhelp Jul 2022
Symptoms
Serotonin syndrome symptoms usually occur within several hours of taking a new drug or increasing the dose of a drug you're already taking.
Signs and symptoms include:
Agitation or restlessness
Insomnia
Confusion
Rapid heart rate and high blood pressure
Dilated pupils
Loss of muscle coordination or twitching muscles
High blood pressure
Muscle rigidity
Heavy sweating
Diarrhea
Headache
Shivering
Goose bumps
Severe serotonin syndrome can be life-threatening. Signs include:
High fever
Tremor
Seizures
Irregular heartbeat
Unconsciousness
When to see a doctor
If you suspect you might have serotonin syndrome after starting a new drug or increasing the dose of a drug you're already taking, call your health care provider right away or go to the emergency room. If you have severe or rapidly worsening symptoms, seek emergency treatment immediately.

Hospice can be cancelled (and later reinstated) if a patient needs treatment.
This "treatment" would be for a medication no longer being able to be absorbed by the elderly patient, and possibly doing more harm than good.
The very medications prescribed to help her (behaviors) could be making the end of life a torture for her. Not an easy way to go. Same with "Palliative care", she may need emergency treatment. So sorry to be sounding the alarm, and sorry this is happening to your Mom.

One cannot just discontinue these medications abruptly without medical supervision. Let the professional intervene.

Have her re-tested for a UTI? And treated.
Isthisrealyreal Jul 2022
Serotonin Syndrome is nothing to mess around with.

Our youngest daughter died from this. It was caused from a drug interaction, both of which were prescribed by her doctor.
cwillie Jul 2022
Any chance this could be related to an inner ear problem? Is she experiencing vertigo?

https://www.verywellhealth.com/nystagmus-4783788
cxmoody Jul 2022
Could be!

Mom gets dizzy when she gets up from laying down. 🤔
Sendhelp Jul 2022
One psych medicine used off-label was for seizures.
It is called Gabapentin. If it works, it assists in moods and pain management.

When there are many psych medicines, a serotonin toxicity can develop. Forget what those meds are/any SSRI's? SSRI's are Serotonin Reuptake Inhibitors-but I forget the details.
Get this checked out. (Serotonin toxicity). aka Serotonin Syndrome.

A review maybe?
cxmoody Jul 2022
Good idea! Such a tight rope to walk, between crippling anxiety and possible toxicity!
Sendhelp Jul 2022
Yes, sounds like seizures. ( I also had to look this up).

Try a medication review with her Geriatric Psychiatrist, if that is allowed to do while on hospice. You want her comfortable, and this is not it.

In hospice, many medications can be discontinued-that may cause seizures.

And, ask if the hospice is medicating her with a drug to cause seizures.

Strength to you, CX.
cxmoody Jul 2022
Thanks, Send.

She’s on a bunch of psych meds to handle her anxiety and combativeness. Without them, she can’t have any peace, and is a danger to others.
I wonder if any of them are adding to this new issue. Hmmmmm.
cxmoody Jul 2022
Of course, after a few minutes, my mother completely forgets what’s happened.

I sure wish that she was able to explain how she feels prior to these episodes. But, dementia! Ugh!
Sendhelp Jul 2022
Did your Mom have seizures in her life prior to these incidents?
AlvaDeer Jul 2022
Seizure specifics:

"Lasts for longer than 1 minute
Loss of bladder or bowel control
Tongue biting
Convulsions
Involuntary movements
Lip smacking
Drooling
Random eye movements
staring into space

VERSUS
Fainting specifics:

Lasts for less than 1 minute
Jerking movements
Loss of consciousness
Tunnel or blurred vision
Nausea
Cold sweats
Skin pallor
Dizziness
Dilated pupils"
__________________________________________
I copied the above from the internet, CX. If you "google " "the difference between syncope (fainting) and seizure" The one thing they mention over and over for seizure activity is the rapid eye movement.
I think Mom may be having seizures.
While she is on palliative care only she can still be treated and seen (unlike hospice) and I think as her POA you should discuss this finding with her MD and decide whether or not he might consider a medication for seizures. The loss of bladder and bowel control more common with seizures as well.
Just guessing here from what you describe, purely guessing from what I am reading on google. What Lea found on eye movement for syncopal episodes negates what I find, so go figure. I sure wonder myself.
Wishing you good luck in this mystery.
cxmoody Jul 2022
Thanks, Alva!

Thus is so very interesting! I will have a discussion with her regular hospice nurse after the holiday weekend.
Today, the Fri/Sat/Sun hospice nurse was on duty.
lealonnie1 Jul 2022
Nystagmus eye movements IS related to fainting!! And nystagmus is also related to vertigo which my mother was The Queen of. She would get VERY dizzy with the vertigo, then nauseous which would lead to vomiting. The dizziness would often threaten to make her pass out as well! The nystagmus back & forth eye movements were seen in the ENT office when they'd administer the Epley maneuver to get the vertigo under control.

Here's a medical article about the eye movements of syncope/fainting:

https://pubmed.ncbi.nlm.nih.gov/8780096/

Since fainting was induced in almost half of these volunteers while on a tilt table, I wonder if your mom is passing out when in a tilted kind of position?? Does the MC know when it happens or what seems to provoke it?

Also, I've had several seizures in my life which to me, felt like simple fainting. In reality, it was a seizure each time that my ex husband witnessed and told me about, that I was shaking/jerking, etc. A loss of bowel function can happen during a seizure. I wonder if your mom is having seizures?? According to Google,  nystagmus can indeed be caused by seizure activity. Or even a stroke can cause nystagmus. I believe my mother was having small strokes shortly before she passed away in February, causing her to lean over to the right side DRAMATICALLY in her wheelchair.

I think that whatever is going on, your mother is on the last leg of her journey now. I pray that God takes her soon, sparing her anymore pain & suffering along the way. Sending you a big hug and a lot of prayers for peace.
cxmoody Jul 2022
Mom seems to have this after she gets out of bed, and is beginning to walk out of her room.

Very interesting with your Mom’s experiences!

Thanks!!
cxmoody Jul 2022
Itrr, I pray every day for the Lord to just take her. I know that she’s been ready to go for a long time. 😔

BarbBrooklyn Jul 2022
https://my.clevelandclinic.org/health/diseases/22064-nystagmus
cxmoody Jul 2022
Thanks, Barb. I did look this same term up, but I wonder how it relates to the fainting. 🤷🏻‍♀️
Isthisrealyreal Jul 2022
Cxmoody, when I saw a neurologist they asked me if this was happening, so I would assume it is something happening with her brain. It sounds like things are starting to misfire.

I am so sorry she is declining with falls. It's kinda nerve wracking to me when people fall and become unconscious. I pray she doesn't suffer.

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