Can an elderly persons cognitive functioning increase and/or decrease from day to day?

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Sometimes my 90 year old father is completely with it (even after his not-seriously-debilitating stroke two months ago) and other times, he is confused. Should I be concerned about this? Or is this just something I should accept as a normal part of aging?

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Chris, I wish you the best, but you say that he has since said and did things that didn't make sense. With his advanced age and saying things that don't make sense, I would hesitate to return him home too early. That's just me. I'm probably too careful about things, but I have seen how people with dementia care for themselves at home and it's not good.

Granted, it sounds like you have a good pan in place and that he will have helpers coming in to bathe and cook for him.

I would have them as well as his family really observe the mental state, because if it is dementia, he may not be that reliable to report how he's doing. He may say he eats when he doesn't, take meds when he doesn't, etc., Does he have someone to administer medication daily?

I support doing anything within reason to make him happy.

I wish you and your dad the best. Let us know how it works out.
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Chris12- I am in USA-Arizona and I've been doing this for 3 years now. It is the hardest 'job' I've ever had! I wanted to honor my parents with their wishes, and they planned well with the trust and the POA set up...BUT...as soon as they needed help, immediately refused all notion that they would ever leave their home, or would ever need any outside help in their home. Dad had to placed into Memory Care by court order, after we had police remove him due to his agitation and acting out against Mom. Mom has been able to be home for two more years, and most of that without caregivers, but getting worse with her Alzheimer's. She is a 'pistol' and much harder to deal with than Dad was, in terms of her own denial and refusal to 'hear' anything anyone says to her...doctors, lawyer, caseworkers, me, granddaughters.... She is being re evaluated, today in fact, with the thought that she will be declared incompetent to remain home alone, so it's reaching a 'head' with her. Very difficult. So I like to share what's worked for me to make it better. I think the goal of keeping parents home as long as possible is a good one, but here in the US, it's not easy to know all the resources that are available in your own town or country...so I just share what I've learned. I love the cameras on the alarm system because I live 5 hours away and my Mom has lots of medical problems along with her Alzheimer's . Having Dad in a facility that is basically good, still convinces me that home with caregivers keeps the elderly with it and happier longer....it may be harder, but worth it. However, I also realize that even though I am a retired RN, I am too old and have my own health care to consider so I could never, at 71, be the 24/7 caregiver as so many on here do either!
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Thank you Joannes. Everything you suggested is what we are working to put in place! I just got off the phone with a private caregiving agency who will come in once a day and prepare his evening meal. We made my dad agree to that if he was going to go back home. (It was nice to have the leverage ;)

We also have a PSW that already visits him in the ALF in the morning and the evening to help him in and out of the shower and to change his clothing (so he is used to that now) and we will just transfer that service to the condo. I spoke with Lifeline from Phillips this morning about the auto alert necklace. Luckily, the ALF insisted on his wearing a similar product in the home, so he is now accustomed to wearing that as well! Did you know that the Lifeline necklace can be worn in the shower or bath? Although he will have help getting in and out of the shower each day from his PSW, if he chooses to shower without help - and then slips - the auto alert will help him. I don't know about where you live, but the PSW (one hour per day) is paid for through our provincial government in Canada (lucky for now!).

I do keep having pangs of second thoughts about our choice to try going back home, but your sensible advice inspires me to stick with the plan. And you are right to remind me to "plan past immediate needs". Great advice. Thanks!
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I think it's good to keep the AL back up plan. And yes, many things cause good and bad days...even as simple as sleeping well the night before. Sometimes dementia shows up after a stroke too...so you must watch for everything now! And if committed to keeping him home and it seems to work out....I would consider a life alert necklace or bracelet and/or a home alarm system with a camera, so that from your homes, on computer, you can see that he is upright and doing OK any time the lights are on. If there are funds, I would also suggest the very smallest amount of caregiver help coming into the home, so you have another set of eyes and ears, and he gets accustomed to some need for help to 'stay home' because should he further decline, it's much easier to extend hours of 'help' coming in than go through the huge argument that comes from the elderly about having anyone come into the home. I sold my Dad, with dementia, on a caregiver by getting an agreement to 'try it for a month and then we'll decide if it helps'. By the time 30 days had gone by he was used to his helper and happy to have her around for 3 hours/day, as a 'friend' to visit with and talk to. It was easy then to keep her, and when he started to need help with other care, like a shower or changing clothes or putting on his TED hose or special cream on his legs, or reminding about his meds, he readily accepted her help. He refused to let Mom help with ANYTHING except finding things and driving him places, because he had always cared for her and HE had always been the MAN in charge!! At age 90, the realization is that he will need more help of SOME kind to remain at home....as time goes by now....so plan past the immediate needs.
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Thank you Sunnygirl and windyridge. As a matter of fact, Dad has been in an ALF retirement home since the mild stroke and has made great progress since the beginning. Three weeks ago he exhibited a lot of confusion about time of day and wanting to eat dinner at 3 a.m.; that sort of thing. The nursing staff noticed before we even knew just how bad he was and had already collected a urine sample and sent it away for testing. It came back negative so I took him to the doctor and by that time, his confusion had been gone for several days! Probably a minor virus that manifested in confusion. Since then he has been great, but depressed and expressing desire to go back to his condo where he lives alone with daily help from my local brother and me two times a week (I am out of town). We had a talk with him a couple of days ago about returning home once we get supports in place and have an occupational therapist evaluate the home. Of course, as these things go, he has started to say and do some things that don't quite make sense. It is reassuring to know that it is "normal" for his cognition to increase or decrease on a daily basis and that I needn't freak out about our decision to help him go home. BTW, yes, we have a Continuing Power of Attorney (had a lawyer prepare so it would be considered more "iron-clad" than one pulled off the internet). We are keeping his room at the ALF for one more month as a backup, just in case our experiment fails...
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Correction to above. If his functioning decreases.
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I think it certainly varies. If he had recent strokes, he could have more. Does he have a plan for his health care?

Some conditions like UTI can cause a change in mental status. Is he in the home with you or elsewhere. Normally, the staff at an assisted living or nursing home keep aware of this and will order a test to see if they have an infection.

You say that he is completely with it on some days. I would ensure his affairs are in order so that if the functioning increases, you have the ability to act on his behalf. Make sure you know what he wants regarding his future medical care.
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It sounds like typical mild dementia. People gradually get worse but there can be good days and bad. My Dad, 85, sometimes can't rember that he ate 10 minutes ago but then manage to drive to Krogers and get everthing on Moms list. And typically the short term memory goes first and eventually the long term memories fade away. There's loads of info on this site about dementia.
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