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he's just reasontly been diagnosed while in the hospital but they didn't say what type they also said he has dysphasia, he's refused to go to the follow up with his original doctor, matter of fact he's refused to go to the doctor since November, 2016, he's on high blood pressure medicine, He has COPD, and some heart problems. he has he's lost a large amount of weight in the past 2 years and can not gain it back, he eats good,

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Sandy, there are stages, but they are different for everybody. In some area he may be mistake, some early stage and maybe even some severe stage. Unfortunately there are no standards with dementia.
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it is Dysphasia, I double checked, they didn't say anything about it affecting his speech, they said his throat was shrinking which affects his swallowing and I have to put a product called Thick In his liquids and he has to have soft or pureed foods, but I can't see that he has that problem, I also looked it up and it can also give him stomach problems like acid reflex, so I don't know, I'm getting confused with all that is going on with him and I feel really bad for him, I am going to get some home health coming in to help me with him and I have been wondering if I should get Hospice involved.
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Sandy you certainly have your hands full caring for your Dad.
You mentioned that he has dysphasia which is difficulty swallowing, but at the same time you said he eats well. I think you possibly mean aphasia which is loss of speach.
Loss of weight is very common with both heart failure and COPD because the person can't eat and breath at the same time.
Try contacting your local health department and see if they will send a nurse out to evaluate him. They may be able to provide some in home care at least to get him bathed. I suspect by now it is simply too much effort. He may also be a candidate for hospice if his condition is advanced enough.
Do you have POA and advanced directives in place because if you don't he would now be considered incapable of making those decisions for himself.
At the slightest excuse get him transported to the ER and refuse to take him back because he is too uncooperative for you to manage. He needs to be in some kind of facility where they have the training to get things done. I am sure he is going to refuse and make all kinds of nasty accusations to you but it may be the only way. Please come back and tell us how you are getting on. You are not the first person with this problem
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I will not be able to get him out to see his doctor, he has been doing nothing but staying in the bed for about the last 2 years, it seems like that's when most of these problems started to progress, I know that he had not been to the doctor in at least a year before November, it has been hard to get him out of the bed, he would get out to fix himself something to eat, restroom and when he had company and us kids would visit him, he always said he just didn't have the energy, we couldn't get him to use the oxygen or even get him to take his med's, he had us to run his arrans, my sister started staying with him back in May and it seems like he just got worse faster, she was suppose to be his care giver, but she wouldn't inforce him to do the things he needed to do to keep him going, if she asked if he was hungry he'd tell her no, and she'd just leave him be, so now that he's been in the hospital and been diagnosed we realize it wasn't him just being lazy, you'd have to know our dad to know where I'm coming from, he was always hard to get along with, would always criticized us for what ever we did he was a hard man to deal with.... but any how now we know and we have ton's of guilt. We are just wondering how much longer he's going to be with us. I am concerned that I'm not doing all I can to help him out, he wets the bed. don't want to let me help him get cleaned up, and most of the time he don't want to get up so I can change the bed, and get his self cleaned up and changed, I wonder if he's washing himself off because he won't allow me to do it for him I don't want to force him into doing what we need to do, I don't want to cause him to get upset, all that will do is make it all worse for the both of us, any how, this is the best way I can explain it all, I don't want to be negligent with him, and I don't want the other siblings to thank that I am either, I want them all to know that I'm giving him the best care I know how.....
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With cardiac patients, the most likely cause is vascular dementia. Added to this is his weight loss, which suggests his liver or kidneys are also failing badly. If he has dysphasia (loss of speech) he is in the advanced category. If he does not want to see the MD, your best bet is a Hospice evaluation, because he is failing in more than one area with no road back.
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It might be challenging to get your dad to undergo all the test and doctor visits that it might take to get a definite diagnosis of what is actually causing the dementia. For some people, it's worth it, because they may want to take medication for dementia (there are a couple, but, they have limited if any proven effectiveness) and some conditions don't respond to medications. You would need to know that in advance, but, I'd try to determine if finding the cause is really that helpful. Another reason is that different conditions progress at different rates. You an read about the various conditions and see the descriptions.

My LO's primary doctor diagnosed her with Vascular Dementia in her office based on medical history, mini office exam, symptoms and examination. She was right too, as a follow up with a Neurologist and MRI confirmed. They may also recommend a neuropsychological evaluation, but, it's rather involved and my LO was not up for it. Even after all the testing, they still can't be 100% on what is causing the dementia, such as Alzheimers, Vascular, Lewy Body, Frontal Lobe Dementia, etc.

The kind of things that looked at with my LO was how fast it hit her and her medical conditions like hypertension andType II diabetes. The MRI did show that she had had multiple strokes. Would your dad agree to an MRI?
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To determine the type of dementia would require some testing and most likely a few visits to a specialist. And even then you may not get a definitive diagnosis.

Sometimes by reading descriptions of various kinds of dementia you can get a sense of what might apply to Dad. The Alzheimer Association website contains such descriptions. At this time there is no blood test, urine test, or other such way to determine kind of dementia. It can be accurately determined via autopsy, but that isn't very useful for day-to-day considerations!

Weight loss is fairly common in many types of dementia, as is dysphasia.
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