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My 79 yr old aunt was going out food shopping with my cousin 2 weeks ago and she fell. He took her to urgent care where they detected a fracture is a vertebrae. He then took her to the hospital where she stayed for a week and her early stage dementia worsened dramatically. She is now in a nursing facility and her dementia is getting worse. If she is back at her house with 24/7 care, will her mind go back to where it was 2 weeks ago? She was dressing herself, putting on her makeup, bathing, eating, reading, talking on the phone up until 2 weeks ago when she was taken out of her house. Please advise if taking her home will help her.

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I'll answer your question this way=dementia will not get better.
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My nephew-in-law, who has been having some memory issues, suddenly became worse and wound up in the hospital; they found that he was dehydrated and that set off some other situations. When they got his blood chemistry right, he was able to go home and has been more like his earlier self. However, it happened again and last I heard, he was in the hospital getting straightened out again. It is possible that something set off the fall, and that is a good part of the worsening of her abilities.
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It is very normal for dementia symptoms to become worse in hospitals and care facilities. There is mounds of research to discuss this and why it occurs. Some patients improve when they go home, and some don't. It depends on their base diseases, medicines they are given in facilities, anesthesia, etc., etc., etc. And it's hard to predict. My 96 YO Dad has been hospitalized a lot of times and the docs never believed that he'd improve at home, but he always has. The opposite is true for my husband who has Lewy Body Disease.
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Her dementia may have been accelerated. She might also being experiencing some delirium. They are different conditions and without knowing her symptoms before delirium related behaviors may be diagnosed or seen as dementia. Please look up delirium to see if that may be applicable here. These issues are treated differenrly and delirium is often overlooked.
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Being in a hospital will give a temporary acceleration in dementia. Even when moving them into assisted living it is advised to bring their furniture from home so they will have familiar things. But dementia will continue to worsen. Plenty of ladies in the two assisted living facility/memory care units my relative has been in, will still get all dressed up, put on makeup, and even demand to see their significant others or think they are going to a concert. My aunt constantly wants to go "home" - she believes her parents are still alive and she still lives with them. Balance issues seem to go along with aging, and especially with dementia - so unless someone will be living with her and having help come in, like physical therapists to help her balance issues, and if the house can be "hazard proofed", AND at some point, secured to prevent her getting lost or injured when and if she goes through the "escape" mode (checking every door, trying to open windows, walking down the street or into neighbors houses). There are a lot of hazards and behaviors far more important to worry about then you know, if you are not there seeing it for yourself on a daily basis (and denial is not a safe option for your loved one in dealing with dementia). When my aunt goes to the hospital (falls, pneumonia, UTIs), I can tell when she is "sundowning" and will try to rip out her IVs or catheter, get out of bed, and try to leave. She starts getting agitated, will pull at her sheets, clothing, and keep trying to climb over the anti-fall railings on the bed or slide off the end onto the floor. As soon as I see her start "working" the sheets or her clothing, I have to call the nurse to get her medicated, before she gets so agitated that she will actually punch people who try to keep her in bed (and use some pretty embarrassing language as well). If you are not there, or not aware of the signs, you would think all is well - it's just an anomaly. Most of the nurses and doctors who are not familiar with dementia don't have a clue - so how could you, unless you do a lot of research. Lots of dementia information on reliable sites (forget about the fake news fake cures sites - you cannot afford the luxury of bad information and false hope). It is also important to find a hospital or doctor well versed in dementia so they will already be familiar with all of the suggestions you have seen on here and they know which might or might not be causes that can be explored. NICHE training - committed to care of older adults is one way to find someone trained in gereontology and dementia.
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For a person with early dementia, the incidence of a fall and the pain that is experienced from a vertebral fracture is a major to contributor to delirium. Delirium is a transient change in cognitive functioning with confusion, agitation or even increased sleepiness. It may be worsened by infections, medications such as pain medication, relocation from the home environment and routine etc. It can resolve once the causative factors such as the pain, acute infection, and medication are removed- but in the case of a fracture, pain control is important so the medication is a "double-edged sword". For some patients, delirium worsens the dementia and does not completely resolve. The reason for this unclear and a current focus of research- but as others have stated, the brain is complex. It can take a few weeks - but with support and supervision, the person may regain most of their functioning. It is important to note that once a person has had a case of delirium that they may be at risk for a future incidence of delirium. It is helpful to re-establish the routine and orient the person to the time and place... but don't argue with the person as it only adds to agitation.
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Jkeane,
Maybe, your aunt's POA can discuss some options for care with the Rehab people. They will likely release her only if she has proper care at home and it sounds like she would need 24/7 care, which is very costly.

Whoever is making decisions for her may request tests be made by the doctor, because without an MRI, they may not be able to know if she has had a stroke. There isn't always typical signs like weakness, numbness, etc. My LO's only symptom were poor balance, falls, memory loss and poor judgment. The Neurologist prescribed the MRI and it was then that they found multiple strokes.

I'd also keep in mind that her asking to go home may indicate a desire to go to another place in time and not necessarily her former residence.
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If Aunt has gone down this fast, the doctor needs to run some tests. Not sure but I think its hymaglobin in the blood (spelling is probably wrong) that can cause someone to be really tired. The levels can be brought up.
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My Dad went into a depression for 3yrs. He had been allowing his primary to treat him for heart problems. After a stay in the hospital it was found his potassium was really low, something the primary never tested for. Once my Dad was put on potassium, his depression disappeared. He ate a banana a day. There are all kinds of things that cause Dementia type symtoms and if u have Dementia the same things make it worse. Like diabetes, which also causes neuropothy which will cause falling. Thyroid, u would be surprised what that not working right will cause. UTIs do a number on the elderly. Does ur Aunt use a walker. If I were u, I'd see if you could rent a transporter wheelchair and take her to dinner that way. If she wants to sit in the chair the wheelchair folds up to get it out of the way. Try Red Cross they may have a loan closet. Sometimes firehouses and groups like the Lions Clubs.
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Thank you all for your informative answers. My Aunt has been having balance issues for the past 2 years and went to physical therapy for it last year. That is most likely what caused her fall. As far as I know she has not had a stroke. I don't know what meds she was given in the hospital other than an anti-anxiety medication. She is angry and agitated and wants to go home. She doesn't have much money, so 24/7 care at home is not an option. My cousin is her POA, therefore I don't know how much information the doctor will provide me. Also, I am on the east coast, and they live in Seattle. I am going there on July 13th for a visit, which was scheduled before all this happened. Her 80th birthday is on July 15th, and we were planning on taking her out to dinner. I am hoping the dinner can still happen, but my cousin is doubtful. I'm just saddened by how quickly her dementia advanced by taking her out of her home. It has only been 2 weeks and she is not talking or eating. I thank everyone again!
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Brain chemistry, in a nutshell.

You'll know that people with diabetes can become incredibly aggressive if their sugar gets too low? - it's fortunate this happens, in a way, because it's a signal that they're about to fall into a coma from which they will not wake up unless somebody gets some glucose into them. Similarly, other signs such as drowsiness and disorientation do happen with dementia but do also happen when something's off with your electrolyte balance(s).

Potassium and all the other trace elements (sodium, calcium, that lot) do all sorts of things (highly technical answer!). My totally amateur mental picture of it, so don't quote me, is that because many bodily functions are electrically based (heart, brain, neurons) they all make up part of the correct wiring matrix - which you don't want either blocked or short-circuited. Too much, too little, you get problems.

And with a bit of luck there'll be a chemist or medic on the site who can now give you the proper answer - or there's always dear old Auntie Wikipedia of course :)
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Can someone explain how sugar levels and potassium trigger dementia type symptoms?
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I agree with CM. Your Aunt could have had a stroke. Hopefully, the doctor has checked out all posibilities for her fall. That fracture, even when mended, can still be painful. Her going under could make the Dementia worse. Sugar levels and potassium can cause Dementia type symtoms. As can a UTI. I would not take Aunt homevif she is already in a NH. Its going to be expensive and you are counting on the caregivers being there on time doing their jobs. Aunt is in a better place if she is going downhill. Believe me, a lot less stress.
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Unfortunately, dementia is not that predictable. I would say, from experience, that in most cases it comes gradually. However, I noticed with my mom that she seemed far worse after I took her on a trip to the Bahamas. We hadn't been in several years and she wanted to go one last time to see the friends we made over the years.

After we had finished dinner the first night she kept saying that she had to go home. She was extremely confused and needed help getting dressed. My friend and I were able to convince her that we would take her home in a few days and that she should just enjoy herself. She finally settled down but when we got home she seemed far worse. Sometimes she doesn't know me and her days and nights are all mixed up.

I thought that maybe the trip triggered something in her brain and took her to the doctor because she kept saying that her underwear bothered her and I wanted to rule out a UTI. She didn't and the doctor (after reading all the notes I made) advised me that it's time to place her in a home.

Unfortunately, I doubt that taking your aunt home will help much, but I would definitely discuss this with her doctor.
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Agree with everything CM has said about your aunt and the steps that should be taken. Any kind of injury or illness can cause dementia to advance. Sometimes there is a return to baseline but most often the decline continues to some degree.
Clearly this fall indicates that your aunt should no longer live alone and she may be happier there if help is possible. it is well known that dementia patients do better in familiar surroundings but if she is content where ever she is that will work as well. Unfortunately there is no clear answer to your question. It really depends on finances and your aunts reaction to her circumstances.
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Do you know what condition is causing her dementia? Do you know what caused the fall? For example, does she have Vascular Dementia? Strokes can cause people to fall and it also causes subsequent damage that renders the person unable to function the way they did before. It's often faster than what you might expect with Alzheimers, which is usually gradual decline.

My LO was running her own household, paying bills, shopping, caring for pet, etc, but, she got a fractured wrist (we never figured out how. We suspect she fell.) and suddenly she was unable to manage her household. Bills unpaid, couldn't drive, couldn't work remote, couldn't make a sandwich, etc. She was in her own home. Later, MRI revealed multiple strokes. She never regained anything, but declined rapidly.

I'd discuss it with her doctor. They should be able to tell if she has a UTI, medication reaction, vitamin deficiency or hospital anxiety. I don't think that dementia is reversible, though there are good days and bad days with memory and abilities.

There are various opinions about where a person with dementia can receive the best care. 24/7 in the home is very expensive, but, if funds are available, that is an option. If she's currently in a good place, I'd evaluate it as an option or see where she may be best cared for. An assessment to determine what level of care she needs would be helpful.
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It's not as simple as that - I wish it were.

Things you have to consider include:

1. What caused the fall? It's possible that some change in her condition led to the fall, rather than the fall and injury leading to the change in her condition.

2. What pain relief was given at the hospital and now at the facility? Some can cause side effects, especially in a person with existing health difficulties and/or prescribed medications.

3. What investigations are being done? Your cousin needs to emphasise to your aunt's doctors that this change is very marked and very abrupt. Sadly, it still could be the case that this is a step down in her dementia; but that doesn't mean it isn't worth ruling out reversible causes.

So before you urge your cousin to get your aunt discharged, it's important to get a clear understanding of what the likeliest cause/s of the deterioration are. I do hope you'll get some helpful answers, and that she will make a good recovery; but just taking her home and hoping she'll magically be herself again isn't likely to help her.
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