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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, 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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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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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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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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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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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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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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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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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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