My 80-year old mom was cognitively "fine" a year ago. Some forgetfulness, but nothing truly alarming. But recently she has had a series of medical setbacks that seem to have triggered serious cognitive decline: her knee replacement (badly needed-- she is basically crippled and in constant pain) has been canceled 3 times due to high blood pressure, miscommunication about a heart issue, and now a pre-op chest scan that found a (probably benign) large tumor in her lung. She has always been anxious and negative, and she has not handled this well. After each setback, there is a very obvious increase in cognitive decline.
She is now hallucinating. I was playing music in the house the other day. In the morning, she told me there was a man in the house playing rock music and he was "right over there," pointing to her bathroom area. She told her caregiver he waved at her. After her first surgery was canceled in March, she told me she thought my cousin was also in the house taking care of her, but it was only me-- I don't have a female cousin. Yesterday she appeared to talk to her bathrobe, hanging over a door, like it was a person.
She also suddenly is unable to concentrate or read book for more than 5 minutes without falling asleep. She naps much of the day and can't sleep at night. She used to be an avid reader and spend hours with a book! She also exhibits sundowning sometimes in the evening after a nap. She thinks it's morning and wants coffee and it's difficult to convince her otherwise.
She calls me by my dad's name sometimes and refers to me in the third person, addressing me as "she" instead of "you." She gets very simple words confused. She was talking about my brother's funeral, but called it a birthday party. She gets the phone and TV remote confused.
She had tremors in her hands that have become more noticeable. She does walk stiffy and sometimes "locks up" and is scared to move, but I have been attributing that to the knee issue.
Im not sure if this is related, but her motor functions are getting worse. Things like buttoning a shirt and putting in her earrings are a huge chore, and she often spills all over herself when she eats.
LIke I said, this has all happened rapidly. A caregiver who last saw her a month ago, took me aside yesterday and was very concerned with the changes she's seen in just that amount of time. Three or four months ago, she could read a book without any difficulty.
Does thus sound like Lewy Body Dementia? The hallucinations and problems sleeping seem to point to that over Alzheimers. Her symptoms also sound a lot like delirium, triggered by all of these traumatic visits to the doctor and hospital.
She is on the blood pressure meds Benazapril and Corvedilol, as well as Paxil for her anxiety. I read somewhere that Paxil may be bad for people with Lewey Body.
Now I'm especially concerned because I've read that certain types of anesthesia could cause severe adverse effects in people with Lewy Body, and in 2 weeks she will be put under when her pulmonologist takes a biopsy of the lung tumor. I may call him and ask that he switch to another method that doesn't involve anesthesia.
Thank you for your help. I'm trying to figure out what's happening with my mom and her doctor is not helpful. I asked her to please give me a call to discuss this and she messaged me: "Make an appointment."
For those of you who have loved ones with Lewy Body, does what I've described sound familiar to you?
Thank you,
Jaime
I'd be more concerned that with all these changes she will not qualify for anesthesia and you will be playing 'control the fire' with keeping her knee as mobile as possible with shots and PT.
Of course her dr wants to physically see her. It would be almost malpractice to talk on the phone to make a dx of such magnitude w/o seeing the patient.
Know that any surgery, hospitalization, or anesthesia will likely affect her cognition seriously and she won't bounce back well, if at all. Any medical crisis resulted in a big step down for my mother, and she never had anything as major as your mother's facing.
You might want to think long and hard about those surgeries. If she does indeed have lung cancer, what are you prepared to do about it? Is she capable of doing the rehab for a knee replacement successfully, or will she end up in a wheelchair anyway? Perhaps the wheelchair is the way to go now.
These are all things to discuss with her doctor. Just because he's willing to OK these procedures doesn't mean YOU have to.
Start with her primary doctor, yes, you need to make an appointment -- she needs to be seen to be diagnosed. Put everything else on hold until she's been diagnosed properly, including the biopsy. You need to make some big "quality of life" decisions.