Change in behavior. Any advice?

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Msblcb Asked October 2022

Change in behavior. Any advice?

My mom has been in the ALF for about 5 months now. In that time she has allowed herself to be bathed and has taken her meds readily. In the last two weeks she has refused to bath and is spitting her meds out. A complete change in behavior. I have done blood work (all is normal) and checked for a UTI. She came back normal. Any idea why her behavior would changed so dramatically? Is this just part of the general decline? She does seem more confused.

Assisted Living Behavior Change Dementia Behaviors

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score 4 · Answer 1

Just read your update to me yesterday and now ....so glad to hear that bloodwork was done again and low potassium was at the root of mom's mental status change. That's an easy fix, thankfully. You did say in your original post, "I have done blood work (all is normal) and checked for a UTI. She came back normal." It's wise that more bloodwork was done since changes often happen quickly in an elder. You are such a great advocate for your mom! 😊

Helpful Answer (4)

Yes. We do blood work often but apparently potassium can tank pretty quickly when you change diuretic strength, The nurse wanted to check again. That was certainly good advice. Now we just need to get the potassium in her. I will update as we know more, Thank you SO much.

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score 3 · Answer 2

Excellent news!

A change in mental status is a symptom and possibly a medical emergency and should be reported to the patient's doctor immediately.

Everyone, please remember this!!

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score 4 · Answer 3

I have an update. After blood work, it was found that her potassium dropped pretty quickly. Most likely because of the diuretic she is taking. Low potassium can certainly cause anxiety, confusion and weakness. So, we are getting her potassium. She was also on an antibiotic for an open sore on her leg that was treated by the wound care team. They prescribed it to help the sore heal. The antibiotic has a side effect of loss of appetite. So, trying to fix one problem often times creates another.

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score 1 · Answer 4

I am with Geaton here. Thyroid has a lot to do with how the body functions. My SIL had hers removed. After just over 20 yrs of marriage she changed. She was accusing my brother of hitting her and all sorts if other things. My brother is a big teddy bear. It probably all had to do with her meds she now had to take for the rest of her life. It takes a while to get them just right. Problem was the marriage ended in divorce.

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score 2 · Answer 5

If your mom has thyroid issues, when was the last time she was checked to make sure her prescription strength was appropriate for her weight? If she's lost or gained, her prescription may be off and this can cause dementia-like symptoms (had a cousin go through this).

Other causes could be a TIA (mini stroke), dehydration, vitamin deficiency, and other health issues. If she eats decently and takes a multivitamin, then a deficiency is probably not the issue).

Also, please know that most medications, when crush, are incomprehensibly bitter and no type of food will mask the awful taste. And some medications *should not* be crushed if they have a time-release component.

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I did have her thyroid checked. We increased the medication and her thyroid seems stable. She does not eat enough but does take a multivitamin every day. I have her drinking two Ensure Clear drinks per day. That also provides some calories and vitamins. I think you are right on the bitterness when crushed. My next step is to see if any of the medications can be in liquid form. That may be a little more tolerable. I suspect is may be related to a mini stroke. Sunday she was very confused and did not recognize me immediately. That is unusual. She seemed to snap back. These are all wonderful things to check and I appreciate the guidance. These post are life savers for me since this is my first journey with daily caregiving. Most grateful.

(1)

score 2 · Answer 6

When my mother's dementia progressed to the advanced stage, she started refusing her meds too. The doc had to order them crushed in applesauce but even then it was hit or miss. The staff cannot force the issue, either. Mom never refused a shower, but did go thru a fear phase. I figured out she was afraid of slipping in the shower, so water shoes solved that problem. Ask mom why she won't bathe or take her meds.....see what she says. My mother felt certain the meds were "too many" and causing her more issues but that wasn't the case. It was her confused mind playing tricks on her.

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I did ask her today why she was refusing the bath. She talked about being cold. So, I suggested to the aids that they warm the bathroom up before she goes in. In terms of the meds, she does not understand why she needs them. I tried Applesauce today but was not very successful. Tomorrow I may try something sweet, like pudding. She loves sweets. I worry that the hit or miss with the meds will cause more medical issues since she has thyroid, potassium and heart issues. Thank you for your guidance. Very appreciated.

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Change in behavior. Any advice?

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