topic Re: Paging Pitdakota in Community Chat

Paging Pitdakota

Lotus — Wed, 15 Oct 2014 00:49:06 GMT

Hiya pit....hope all is well in your little corner of the US of A.

I have a question about dementia and I'm wondering if you have any insight in this area.

(before anyone tells me to check with a doctor....it's been an active ongoing process)

My mom is 85 and she has had worsening short term memory loss over the past 4-5 months. I finally got her to go to the neurologist, but unfortunately I could not go with her. Under other circumstances I would have asked her to change her appointment, but it was a small miracle that she agreed to go and I wasn't about to have her change anything. He did call me during the appointment.

He said there was definite cognitive decline and was a candidate for Aricept. He put her on 5mg and wants to see her back in a month (early Nov) when he will probably raise her to 10mg. He also ordered a brain scan to see if there was anything else going on. He hasn't called me yet (she had it about 10 days ago) but I got a copy of the report. The radiologist's "impression": "Age typical atrophy and white matter degeneration without acute infarct or mass".

I don't understand that if she is age typical why is her short term memory worse than some of her peers?

I also discovered she was not being compliant with her BP meds. I knew this BEFORE she went to the neurologist, but I have not been able to get her to the cardiologist (she refuses) but I HAVE been able to get her to start taking her meds again regularly. (I'm working on getting her to the card) When the neurologist called me during her visit he also mentioned that her BP was high....it was after the neuro visit that I got her to her BP meds.

I read today (magazine article) that high blood pressure can cause "vascular dementia". Could this be part of the reason why she suddenly got much worse over the past 4 months or so (that's about how far back I can figure she stopped taking the BP meds) or is that just a coincidence?

Thanks for "listening" and I hope this made some sense. Hope to hear from you soon.

Re: Paging Pitdakota

dmod nj — Wed, 15 Oct 2014 00:51:46 GMT

Hi Lotus,

Please leave a shout out on my thread for pitty. If she logs in tonight, she is sure to see your request on my thread.

Re: Paging Pitdakota

Lotus — Wed, 15 Oct 2014 00:53:52 GMT

Thanks donna....

Was it a great day today? Or what?

Re: Paging Pitdakota

dmod nj — Wed, 15 Oct 2014 00:55:42 GMT

It was lovely today!! It got less humid this afternoon!!

You are always welcome to join in. Please don't hesitate.

Re: Paging Pitdakota

Lotus — Wed, 15 Oct 2014 01:01:33 GMT

I'd love to donna....hopefully will be there soon.

I have new hours at work since the end of August or so....working days now. I haven't had a "normal" life in 15 years of working nights 2 jobs. I LOVE working days and having my evenings free to do what I please.

There are so many TV shows I never knew existed....I'm catching up on some reading and slowing getting back into my crocheting. And of course dinner's out, Trivia Night and I'm thinking about taking up Ceramics.

I also went to an Elder Law class at our local HS Adult Ed the other night and learned A LOT!

See you soon!!!

Re: Paging Pitdakota

kdgn — Wed, 15 Oct 2014 01:14:09 GMT

Lotus, I am not Pitdakota but perhaps I can help. My mom had vascular dementia and essentially did what your mom did: stopped taking ALL medications, including the BP med. Now she had been experiencing short term memory loss prior to this but it was accelerating. Then I discovered her refusal to take the meds.

She had fallen, split her chin open, waited an hour to call me because I was at work; told the Urgent Care doctor she took no meds (! my jaw hit the floor). After I got her back to her place I did some investigating and my best guess was she had stopped taking all pills a minimum of 4 months prior. I should have been better prepared for that shock because when we got to her place she touched my wedding ring set and said "You're married?"

She went to her volunteer job the next morning and told the ladies there that a nice young lady had taken her to the doctor. Her boss called me that night..... I took her to her doctor the next day. She resumed taking her meds.

Please, please make sure you have power of attorney for health care and for financial matters.

Re: Paging Pitdakota

Lotus — Wed, 15 Oct 2014 01:16:52 GMT

Thanks kdgn.....I'm working on so many things, my head is spinning. My sister is coming up (date to be determined) and we're going to see an attorney. We have a LOT to do.

This is very sad and distressing.

Sorry about your mom too.

Re: Paging Pitdakota

kdgn — Wed, 15 Oct 2014 01:37:09 GMT

The fall happened only a couple of weeks after we had moved to town, Lotus. She had been able to hide a lot of the memory loss from me because I didn't see her all that often and the visits were usually on the short side.

I also discovered she wasn't paying her bills. I found a second notice on the electric bill, found her checkbook and that hadn't been going on for too long. I took over her finances at that point but I'd had POA for health and financial for years.

Her doctor did say the damage was done but she was maintaining until she had a TIA stroke several months later. I had retired, was available, called 911, etc. I followed the ambulance and by the time I got to her in the ER she was signing the paperwork! They kept her overnight in the ER rather than in a room and that was a mistake. I feel very strongly that she had a real stroke during the night. When I got there the next morning she was highly distressed, her BP was almost at stroke level and they were giving her an injection for it. They had neglected to give her her normal meds. When I checked her out she could not sign her name, was very confused. She had aphasia after that and it was downhill from there.

Re: Paging Pitdakota

Lotus — Wed, 15 Oct 2014 01:58:23 GMT

Oh boy....that's terrible.

I live upstairs from mom, which I think made it even harder to see her initial decline. Seeing her everyday made it hard for me to detect it early on. At first she was able to hide it too....then it became very obvious.

She has a lot of good moments...it's amazing to see what short term things she can remember and the things she can't. It's really a horrible thing to witness.

I do her bills....I write the checks and she still signs them. I am working on getting a POA. She still takes good care of herself, cooks and drives. (VERY short trips to the store and back)

Re: Paging Pitdakota

JustJazzmom — Wed, 15 Oct 2014 02:02:30 GMT

And don't forget to get the health care proxy at the same time. You can also do limited POA too.

Re: Paging Pitdakota

Lotus — Wed, 15 Oct 2014 02:15:40 GMT

Thanks Jazz...I'm going to print a Health Care Proxy from the computer...the POA needs to be done by an attorney.

Re: Paging Pitdakota

pitdakota — Wed, 15 Oct 2014 02:36:33 GMT

Hi Lotus. Awww doggone it. I am so sorry you are going through this with your mother.

Glad to see you had some great people here though that chimed in and offered their experiences and advice.

As far as the result of the brain scan....the scans really only pick up the atrophy and can't distinguish any other changes in the brain related to dementia. And as a rule they consider atrophy of the brain in someone is their mid 70s and older a normal part of the aging process.

MRI and CT scans can pick up strokes, major vascular abnormalities such as aneurysms and such, but they are not particularly diagnostic for dementia. The main reason they do them in this case is to rule out a stroke or some other neurological problem that might account for the memory loss, etc.

Great advice here and I also agree to get the health care proxy and POA as soon as possible. Great that you are seeing an elder care attorney.

Big hugs to you (((Lotus))))

Re: Paging Pitdakota

kdgn — Wed, 15 Oct 2014 02:53:11 GMT

Lotus, mom had dementia for a few years before she decided to stop the meds. I didn't know, didn't recognize it. It's only by knowing what I know now and looking back that I can pinpoint the approximate time this started. Truthfully? Many of the signs are related to Alzheimer's but her PCP didn't feel she had that one. I don't think it developed into it either.

She did start to take Aricept about a year after the TIA. I don't know why her PCP didn't get her into a neurologist sooner. At that time a PCP couldn't prescribe the meds. The neuro did and it was a 5 week trial. The first 4 weeks were at the 5 mg, the 5th week was 10 mg. I know things have changed since then-this was almost 9 years ago. At that time she was in assisted living, long story that I won't go into. Anyway, the staff noticed an improvement and so did I. She became more focused, less confused. No, it did not restore her short term memory but it helped in her every day functions. I'd say within 6 months her PCP put her on Namenda in addition to the Aricept.

I couldn't tell you if those two meds helped the last three years of her life or not but I wasn't about to authorize discontinuing them!! They helped her for almost 4 years-

Re: Paging Pitdakota

pitdakota — Wed, 15 Oct 2014 03:00:02 GMT

kdgn, so sad that they didn't admit your Mom so that she would receive her BP meds. Was there any particular reason they kept her in the ER that night? Was it because they were short on hospital beds?

Re: Paging Pitdakota

minkbunny — Wed, 15 Oct 2014 03:01:45 GMT

Lotus, while I cannot offer any practical advice, I would like to give you and your mom a hug. It must be so scary for both of you.

Re: Paging Pitdakota

Lotus — Wed, 15 Oct 2014 03:04:40 GMT

Thank you pity...

kdgn...I've noticed a slight improvement with her. The short term memory is still the same but she doesn't seem to be as "uptight and upset"....she seems more grounded for lack of a better term.

It is very difficult to be working and taking care of things at the same time. My sister is out of state, so it falls on me. I don't mind....she was always there for me and still is in a sense...but it can be overwhelming at times.

Going to bed.....didn't sleep well last night at all.

Sweet dreams ladies.

Re: Paging Pitdakota

kdgn — Wed, 15 Oct 2014 03:06:19 GMT

Yes, Pit, they were short on beds. At the time my BIL was a patient there but had spent about two days in the ER prior to being admitted.

She didn't get her meds at all. When I got to her bed the nurse was giving her an injection in the stomach area. I asked what was going on and was told her BP had soared. She should have had her own meds a couple of hours before and I said so. The nurse told me that the ER doctor found no record of mom's PCP sending a medication list.

I knew that was an outright lie. I had been there when the fax came in, was told it was in. I had also told the paramedics exactly what meds she took and the dosage. I had it all written down in a File of Life on her fridge. I also carried a copy in my purse. The doctor found no record because he hadn't looked. The nurse in question found the medication paperwork immediately after I confronted her.

So she hadn't had her meds the day before or that morning. I wanted her out of that place ASAP.

Re: Paging Pitdakota

Lotus — Wed, 15 Oct 2014 03:10:37 GMT

On 10/14/2014 pitdakota said:
kdgn, so sad that they didn't admit your Mom so that she would receive her BP meds. Was there any particular reason they kept her in the ER that night? Was it because they were short on hospital beds?

Pity...I learned the other night that you can insist that a patient be admitted.

In order for a patient to be eligible for Medicare in a nursing home, they must be admitted in a hospital for at least 3 days and then be transferred to the nursing home.

Many hospitals are now doing what is called "Observation Status", which is not a full admit. I had never heard of this prior to my Elder Care class the other night.

http://newoldage.blogs.nytimes.com/2014/01/10/fighting-observation-status/?_php=true&_type=blogs&_r=0

ETA.....kdgn...that is a travesty what they did to your poor mom. I work in a hospital and if there aren't enough beds and the pt needs to be admitted...they ARE admitted and then stay in the ER till a bed on a floor becomes available. They are treated as if they were on a floor.

Minky....thank you for the hug...I could use it.

Re: Paging Pitdakota

pitdakota — Wed, 15 Oct 2014 03:13:03 GMT

Lotus, no problem at all. Although I don't think that information is all that helpful. Many of us have traveled this road Lotus and we know too well the stress, the responsibility, and the frustration involved. The roles change. Your mother now becomes the child and you become the adult with the responsibility for them.

I am an only child and trying to work full time and take care of Mom. It isn't easy. Hang in there sweetie. Glad to hear though that your Mom seems to be improving with the anxiety.

You know where we are if you need us!!

Get a good night's sleep tonight!!

ETA: Yes, you can insist on admission as Observation. But as you know, they have to have an available bed in the hospital to admit. And one other catch is that Medicare does not have to pay for routine home medications if they are an observation status. So if that ever happens, be sure and ask for the right to bring in her meds from home.

Re: Paging Pitdakota

kdgn — Wed, 15 Oct 2014 03:15:08 GMT

Lotus- My best to you and your mom as you undertake this new journey. "More grounded" is an excellent way to put it!

She knows she's forgetting things and it's frustrating for her. I saw it. Keeping daily events down to a routine really works. The more stable the routine, the better.

I did discover that certain personality traits became more pronounced. I knew my mom was on the stubborn side, but man!! Her tact disappeared and so did her immense self-control. The latter was a bit of a blessing because she finally allowed herself to show emotion. She had always been so reserved but she lost a lot of that. Ready smiles, laughter, hugs, kisses.... In some ways I was able to see a woman that I wished I'd known growing up. I was able to see the younger version of her before tragedy struck the family.

Any questions please feel free to ask. Take a daily dose of patience which was something I sometimes lacked in the early days.