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OldArkie Asked February 24, 2024

How do others communicate with dementia patients when it comes to health concerns?

When the patient has problems expressing feelings of aches and pains. My wife has tooth problems from dry mouth disease with severely deteriorated teeth. She says one is sharp and cuts her tongue and day of appointment, she has no problem with it! Cancel appt and next week it is on opposite side. Dentist has already diagnosed the problem and the repairs would be overwhelming. Problem 2: itching and burning as in yeast infection. I gave her Vagisil and Hydrocort for itching and showed her how to use... when I ask, she says she is fine and has no itch or burning. Likely later she will have problem again. When her back hurts, or legs hurt I never know how bad... She has hammertoe in great toe and complains of pain. I ask if it is toenail ingrown or pain in joint or nerves and she never knows...


Personal hygiene is constant concern. She hates bathing (too cold, can't stand the water or whatever). I never know if she brushes teeth (I doubt it) even though she says she does. She is up and down at night every 15 minutes or more to pee, get a drink or just has to move!


I realize this is just part of caregiving, but I wonder if there is a source for us poor ignorant spousal caregiver husbands to diagnose our female patients' problems and treat them. The inability to express their feelings makes it very hard to help them and keep from doing something that will hurt them. My AD wife has no expressive reactions at all, happy, funny or mad. She does cry when a sad thought occurs to her such as the fact she can't remember a damn thing!

Dawn88 Mar 8, 2024
Let me say you are an absolute gem of a husband. Many women here would agree. I'm very impressed with your gentle and loving concern.
PS: I've had 2 husbands myself, so I know one when I see one.
OldArkie Mar 8, 2024
You are too kind. thank you so much!😊
Dupedwife Mar 6, 2024
OldArkie: It’s time for a GYN exam for your wife as her symptoms of itching and burning need to be treated by a gynecologist instead of her using OTC medications. Also, your wife needs to be checked to make sure she does not have diabetes as women who are diabetics tend to have recurrent yeast infections. Your wife also needs to be checked by a neurologist to see how advanced her dementia is.

Since your wife has the tendency of canceling her doctors’ appointments, you now have to take the initiative to make sure she keeps her appointments by taking her yourself to these appointments.

I wish you well in this dementia journey with your wife as the road ahead will be a trying one.

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97yroldmom Mar 6, 2024
Take her to the podiatrist and get her toenails cut. Call a home health agency and ask if they can recommend one that makes house calls. You can also call a SNF social worker and ask her if she can refer you to one.
My DH aunt has terrible fungus in her great toes and they have to be sanded down (might not be correct term) or they really bother her. She has a podiatrist that comes to the SNF now. At home she had a service recommended by her home health. Medicare pays for it.
I could always tell it made her feel better to have her nails cut.

Sugar makes the yeast worse, too much starch in her diet.
Keeping her clean and dry helps. Nystatin powder or cream is good to heal places, Gold Bond Powder might work. These are for yeast infection. Different from itching. Hydration helps.
OldArkie Mar 8, 2024
97yom,
Thanks for your good advice. I am making all decisions for her... she has mid-stage AD and a year ago had a stroke (CVA) which effectively wiped out her memory. But she has presence of mind to know what is happening at the minute, (she forgets immediately) and I am keeping her at home where she at least knows her chair and her bed and close family that live next door. Son and his family live several miles away and don't come often and, she is gradually losing memory of them. One problem is the lack of Senior facilities that can help her in our little town. We have Area Agency on Aging but the local administrators are pretty unconcerned with my problems and only advise me to get a lawyer.
I have resolved her yeast infection but now she has acquired a severe UTI (blood in stool) and I took her to doctor for big shot of antibiotics along with 4/500mg ampicillin per day. After 3 days of treatment, it is getting better, and bleeding has nearly stopped. She is likely just one more episode from a nursing home... but I am keeping her home as long as we both can manage.
Thanks for your input. It helps me cope by talking with others about my problems.
Geaton777 Feb 24, 2024
Everything you described is normal. Everything about dementia is hard. There is no "right" answer in these scenarios, just what the LO, the doctor and your budget permits. Primarily, if the LO resists, there's nothing you can really do.

My Mom complained of intense tooth pain. I took her to our dentist and there needs to be an extraction. The next day my Mom refused to do it, saying it was a "conspiracy" with the dentist to "make money off of her". I waited several days without talking about it or making any further appointments. She has not complained about the pain since and has not asked about the extraction appointment, therefore, I will let it drop until she has pain again. I think having pain meds available to address their immediate issues is as much as you can do. My Mom is ok using Anbesol for her tooth pain (her choice).
OldArkie Mar 8, 2024
Geaton,
That is exactly what I did. Her teeth are all in terrible shape from dry mouth disease from overuse of Hydrocodone years ago... and most of her caps have come off and several teeth are broken off. I had dentist grind a sharp place smooth once and couple days later, she had same complaint on other side so, as you suggest, I just wait and see, and offer pain medicine if she wants it. If it gets really bad, I will take her to dentist, although, by the time the appointment comes, usually 8 to 10 days... she has forgotten it and I have to cancel appointment!
funkygrandma59 Feb 24, 2024
OldArkie, you just need to take the bull by the horns now and quit trying to rely on your wife to tell you what's going on or not going on.
Her brain is permanently broken and she can no longer do or express what you think she should be able to.
So when she complains of any ailments, you must be her brain for her and make an executive decision on whether or not the issue needs to be addressed. And if you make an appointment for her and the day of she says she's now fine, you just keep the appointment to be sure that all is fine.
And instead of guessing whether or not she's brushing her teeth(because I can pretty much guarantee that she's not)just bring her in the bathroom and brush them for her.
Your wife is getting much worse and I hope and pray that you either have some full-time help coming in to assist you or that you are now in the process of looking into a memory care facility to place her in where you can get back to just being her loving husband and advocate and not her caregiver.
lealonnie1 Feb 24, 2024
Amen

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